LIVIVO - Das Suchportal für Lebenswissenschaften

switch to English language
Erweiterte Suche

Suchergebnis

Treffer 1 - 10 von insgesamt 187

Suchoptionen

  1. Artikel ; Online: Etiology, Epidemiology, and Outcomes of Managing Charcot Arthropathy.

    Hester, Thomas / Kavarthapu, Venu

    Foot and ankle clinics

    2022  Band 27, Heft 3, Seite(n) 583–594

    Abstract: Surgical intervention for Charcot arthropathy is becoming more common; this is driven by an increased prevalence, better understanding of the cause, identifying patient risk factors that influence outcomes, and how to best optimize these. This article ... ...

    Abstract Surgical intervention for Charcot arthropathy is becoming more common; this is driven by an increased prevalence, better understanding of the cause, identifying patient risk factors that influence outcomes, and how to best optimize these. This article aims to summarize the cause of Charcot, look at the factors that influence the outcomes, and the financial cost of managing what is a very challenging condition.
    Mesh-Begriff(e) Arthropathy, Neurogenic/diagnosis ; Arthropathy, Neurogenic/epidemiology ; Arthropathy, Neurogenic/etiology ; Humans
    Sprache Englisch
    Erscheinungsdatum 2022-08-10
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2051688-5
    ISSN 1558-1934 ; 1083-7515
    ISSN (online) 1558-1934
    ISSN 1083-7515
    DOI 10.1016/j.fcl.2022.03.002
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

    Volltext online

    Zusatzmaterialien

    Kategorien

    Verfügbar in ZB MED Köln/Königswinter

    Zs.A 5780: Hefte anzeigen Standort:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

  2. Artikel ; Online: Combined Charcot hindfoot and midfoot reconstruction using internal fixation method-surgical technique and single surgeon series.

    Kavarthapu, Venu / Guduri, Venugopal / Hester, Thomas

    Annals of joint

    2023  Band 8, Seite(n) 10

    Abstract: Isolated midfoot and hindfoot Charcot reconstruction using internal fixation is increasingly a common procedure in multidisciplinary diabetic foot units, and the surgical techniques using internal fixation have well been described. However, about a third ...

    Abstract Isolated midfoot and hindfoot Charcot reconstruction using internal fixation is increasingly a common procedure in multidisciplinary diabetic foot units, and the surgical techniques using internal fixation have well been described. However, about a third of Charcot deformities that require surgical limb salvage present with the involvement of midfoot and hindfoot. Surgical reconstruction of a combined hindfoot and midfoot deformity is an evolving technique and technically challenging. We present the surgical technique of deformity correction and stabilisation using internal fixation, developed by the senior author (VK), and present the outcomes. All patients that had undergone combined hindfoot and midfoot reconstruction to address a limb threatening deformity due to Charcot neuroarthropathy, performed by the senior author, with a minimum follow-up of 12 months, have been included in this study. The principles of surgical reconstruction included adequate pre-operative optimisation of the patient, sequential deformity correction and stabilisation of the hindfoot followed by midfoot using the principle of long-segment rigid internal fixation with optimal bone opposition. Standard post-operative regime, including offloading, has been used in all patients. A total of 34 patients (35 feet) had undergone combined midfoot and hindfoot Charcot reconstruction between January 2009 and December 2019. Active ulcers were noted in 13 feet at the time of the procedure. Eleven reconstructions were performed as two-stage procedures due to the presence of active infection. At a mean follow-up of 53 months, 11/13 ulcer healed, and 32 patients (33 feet) were full weightbearing in surgical shoes or a brace at the latest follow-up. Bone fusion was noted in 28 feet in the hindfoot region and 32 feet in the midfoot. Metal work failure was noted in 5 feet requiring removal in 3 feet. Revision procedures were required in 4 patients. Our newly described technique of combined hindfoot and midfoot Charcot has provided functional limb salvage in majority of presentations, with an acceptable level of complications, at a medium-term follow-up of 53 months.
    Sprache Englisch
    Erscheinungsdatum 2023-01-15
    Erscheinungsland China
    Dokumenttyp Journal Article
    ISSN 2415-6809
    ISSN (online) 2415-6809
    DOI 10.21037/aoj-22-23
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

    Zusatzmaterialien

    Kategorien

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

    Fernleihe an ZB MED

    Sie können sich den gewünschten Titel als lokale Nutzerin oder lokaler Nutzer von ZB MED direkt an den Standort Köln schicken lassen.

  3. Artikel: Charcot hindfoot deformity reconstruction using a hindfoot nail- surgical technique.

    Kavarthapu, Venu / Hester, Thomas

    Journal of clinical orthopaedics and trauma

    2021  Band 16, Seite(n) 277–284

    Abstract: Various techniques of reconstruction of deformed Charcot hindfoot using different internal fixation devices have been described in the literature. We present our surgical technique using specific principles that has resulted in improved outcomes to allow ...

    Abstract Various techniques of reconstruction of deformed Charcot hindfoot using different internal fixation devices have been described in the literature. We present our surgical technique using specific principles that has resulted in improved outcomes to allow correction of deformity, obtain stability and allow progression to weightbearing in orthotic shoes. We describe our preoperative evaluation, planning and surgical timing. We also hope to share some technical pearls and details on the finer points to achieve a satisfactory correction and reduce the learning curve.
    Sprache Englisch
    Erscheinungsdatum 2021-02-23
    Erscheinungsland India
    Dokumenttyp Journal Article
    ZDB-ID 2596956-0
    ISSN 2213-3445 ; 0976-5662
    ISSN (online) 2213-3445
    ISSN 0976-5662
    DOI 10.1016/j.jcot.2021.02.007
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

    Volltext online

    Zusatzmaterialien

    Kategorien

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

  4. Artikel: Peristomal intestinal metaplasia with response to serial electrosurgery.

    Poppens, McKayla / Hester, Thomas / Renati, Sruthi / Billi, Allison C / Lowe, Lori / Mervak, Julie E

    JAAD case reports

    2024  Band 45, Seite(n) 38–40

    Sprache Englisch
    Erscheinungsdatum 2024-01-13
    Erscheinungsland United States
    Dokumenttyp Case Reports
    ZDB-ID 2834220-3
    ISSN 2352-5126
    ISSN 2352-5126
    DOI 10.1016/j.jdcr.2024.01.002
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

    Zusatzmaterialien

    Kategorien

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

  5. Artikel: Investigation and management of diabetic foot osteomyelitis: An update for the foot and ankle orthopaedic surgeon.

    Alkhalfan, Yousif / Lewis, Thomas Lorchan / Kavarthapu, Venu / Hester, Thomas

    Journal of clinical orthopaedics and trauma

    2023  Band 48, Seite(n) 102330

    Abstract: Diabetic foot osteomyelitis (DFO) poses a significant challenge in the management of diabetic patients, often leading to severe complications and increased morbidity. Effective management of DFO requires a multidisciplinary approach, involving ... ...

    Abstract Diabetic foot osteomyelitis (DFO) poses a significant challenge in the management of diabetic patients, often leading to severe complications and increased morbidity. Effective management of DFO requires a multidisciplinary approach, involving endocrinologists, infectious disease specialists, vascular surgeons, orthopaedic surgeons, and wound care experts. Early diagnosis is paramount, facilitated by advanced imaging techniques such as magnetic resonance imaging (MRI) and bone scintigraphy. Once diagnosed, the treatment strategy hinges on a combination of medical and surgical interventions. Antibiotic therapy, guided by culture results, plays a central role in managing DFO. Tailored regimens targeting the specific pathogens involved are administered, often for prolonged durations. Surgical intervention becomes necessary when conservative measures fall short. Surgical approaches range from minimally invasive procedures, like percutaneous drainage, to more extensive interventions like debridement and bone resection. Prevention of DFO recurrence is equally vital, emphasising glycemic control, meticulous foot care, patient education, monitoring of at-risk signs, revascularization and early intervention when indicated. The management of diabetic foot osteomyelitis mandates a comprehensive strategy that addresses both the infectious and surgical aspects of the condition. A collaborative, interdisciplinary approach ensures timely diagnosis, tailored treatment, and holistic care. Further research into novel therapeutic modalities and long-term outcomes remains essential in refining the management of this complex and debilitating complication of diabetes.
    Sprache Englisch
    Erscheinungsdatum 2023-12-31
    Erscheinungsland India
    Dokumenttyp Journal Article
    ZDB-ID 2596956-0
    ISSN 2213-3445 ; 0976-5662
    ISSN (online) 2213-3445
    ISSN 0976-5662
    DOI 10.1016/j.jcot.2023.102330
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

    Volltext online

    Zusatzmaterialien

    Kategorien

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

  6. Artikel: Current concepts and challenges in managing ankle fractures in the presence of diabetes: A systematic review of the literature.

    Nash, William J / Hester, Thomas / Ha, Joon

    Journal of clinical orthopaedics and trauma

    2021  Band 17, Seite(n) 44–53

    Abstract: Background: Ankle fractures in diabetic patients are known to have an increased morbidity. This systematic review aims to evaluate the current evidence in terms of risk profile and inform treatment options.: Methods: Following the methodology of the ... ...

    Abstract Background: Ankle fractures in diabetic patients are known to have an increased morbidity. This systematic review aims to evaluate the current evidence in terms of risk profile and inform treatment options.
    Methods: Following the methodology of the Cochrane collaboration, an extensive literature search was conducted. Outcomes included, complications, operative and non-operative management and early weight-bearing.
    Results: A total of 40 studies were included. Complication rates were higher in diabetic patients and more so in poorly controlled diabetes, IDDM, or "complicated" diabetes. Supplementary fixation was associated with lower complication rates. Regarding early weight-bearing, similar results to non-diabetics in the stable fracture pattern were found providing there was no evidence of neuropathy.
    Conclusion: Diabetes, especially complicated diabetes, presents an increased risk of complications. However non operative management of diabetic ankle fractures do poorly, and with the use of 'ORIF plus' techniques there is no increase in complications from early fixation. The use of external fixation for definitive fixation should be minimised as it is associated with high complication rates.
    Sprache Englisch
    Erscheinungsdatum 2021-02-03
    Erscheinungsland India
    Dokumenttyp Journal Article
    ZDB-ID 2596956-0
    ISSN 2213-3445 ; 0976-5662
    ISSN (online) 2213-3445
    ISSN 0976-5662
    DOI 10.1016/j.jcot.2021.01.016
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

    Volltext online

    Zusatzmaterialien

    Kategorien

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

  7. Artikel: Visualising the Future of Orthopaedic Surgery: A Novel Application of Wireless Smart Glasses to Visualise Intraoperative Imaging.

    Park, Se Ri / Park, Jae Yong / Ghani, Rafia / Ha, Joon / Hester, Thomas

    Cureus

    2022  Band 14, Heft 2, Seite(n) e22004

    Abstract: Smart glasses can provide a heads-up display of advanced imaging intraoperatively. In recent years, growing attention has been drawn to the use of smart glasses as an assistive technology to improve both efficiency and ergonomics in a surgical setting. ... ...

    Abstract Smart glasses can provide a heads-up display of advanced imaging intraoperatively. In recent years, growing attention has been drawn to the use of smart glasses as an assistive technology to improve both efficiency and ergonomics in a surgical setting. Previous studies have reported improved surgical accuracy, efficiency, and ergonomics with its usage, but its effectiveness as a form of intraoperative heads-up display remains elusive in the context of orthopaedics. This study provides a novel account of a wireless set-up of the Moverio BT-35E Smart Glasses (Suwa, Japan: Epson Inc.), incorporated in a complex orthopaedic procedure. Hind-foot nailing was performed on a patient with a complex open ankle fracture and multiple co-morbidities. Smart glasses were worn by the primary surgeon throughout the procedure to provide heads-up visualisation of the intraoperative fluoroscopy. In our surgical case, the surgeon experienced improved ergonomics and reduced disruption to focus with the use of smart glasses. The wireless set-up provided excellent signal transmission throughout the duration of the procedure. The wireless set-up of smart glasses is a potential solution for common occupational risks imposed on orthopaedic surgeons. Smart glasses minimise musculoskeletal strain from switching of vision from monitor to patient, whilst the wireless set-up allows for efficient use of space in an operating theatre and may potentially limit radiation exposure. Lastly, ergonomic benefits may increase the efficiency of movement for the surgeon, decreasing operative duration, and in turn minimising the risk of surgical complications for patients.
    Sprache Englisch
    Erscheinungsdatum 2022-02-08
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.22004
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

    Zusatzmaterialien

    Kategorien

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

  8. Artikel ; Online: Predictors of metalwork failure and nonunion after hindfoot Charcot reconstruction.

    Najefi, Ali-Asgar / Zaidi, Razi / Chan, Oliver / Hester, Thomas / Kavarthapu, Venu

    The bone & joint journal

    2022  Band 104-B, Heft 6, Seite(n) 703–708

    Abstract: Aims: Surgical reconstruction of deformed Charcot feet carries a high risk of nonunion, metalwork failure, and deformity recurrence. The primary aim of this study was to identify the factors contributing to these complications following hindfoot Charcot ...

    Abstract Aims: Surgical reconstruction of deformed Charcot feet carries a high risk of nonunion, metalwork failure, and deformity recurrence. The primary aim of this study was to identify the factors contributing to these complications following hindfoot Charcot reconstructions.
    Methods: We retrospectively analyzed patients who underwent hindfoot Charcot reconstruction with an intramedullary nail between January 2007 and December 2019 in our unit. Patient demographic details, comorbidities, weightbearing status, and postoperative complications were noted. Metalwork breakage, nonunion, deformity recurrence, concurrent midfoot reconstruction, and the measurements related to intramedullary nail were also recorded.
    Results: There were 70 patients with mean follow-up of 54 months (SD 26). Overall, 51 patients (72%) and 52 patients (74%) were fully weightbearing at one year postoperatively and at final follow-up, respectively. The overall hindfoot union rate was 83% (58/70 patients). Age, BMI, glycated haemoglobin, and prior revascularization did not affect union. The ratio of nail diameter and isthmus was greater in the united compared to the nonunited group (0.90 (SD 0.06) and 0.86 (SD 0.09), respectively; p = 0.034). In those with a supplementary hindfoot compression screw, there was a 95% union rate (19/20 patients), compared to 78% in those without screws (39/50 patients; p = 0.038). All patients with a miss-a-nail hindfoot compression screw went on to union. Hindfoot metalwork failure was seen in 13 patients (19%). An intact medial malleolus was found more frequently in those with intact metalwork ((77% (44/57 patients) vs 54% (7/13 patients); p = 0.022) and in those with union ((76% (44/58 patients) vs 50% (6/12 patients); p = 0.018). Broken metalwork occurred more frequently in patients with nonunions (69% (9/13 patients) vs 9% (5/57 patients); p < 0.001) and midfoot deformity recurrence (69% (9/13 patients) vs 9% (5/57 patients); p < 0.001).
    Conclusion: Rates of hindfoot union and intact metalwork were noted in over 80% of patients. Union after hindfoot reconstruction occurs more frequently with an isthmic fit of the intramedullary nail and supplementary hindfoot screws. An intact medial malleolus is protective against nonunion and hindfoot metalwork failure. Cite this article:
    Mesh-Begriff(e) Ankle Joint/surgery ; Arthrodesis ; Bone Screws ; Foot/surgery ; Humans ; Retrospective Studies
    Sprache Englisch
    Erscheinungsdatum 2022-05-30
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 2697156-2
    ISSN 2049-4408 ; 2049-4394
    ISSN (online) 2049-4408
    ISSN 2049-4394
    DOI 10.1302/0301-620X.104B6.BJJ-2022-0127
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

    Zusatzmaterialien

    Kategorien

    Verfügbar in ZB MED Köln/Königswinter

    Zs.A 6989: Hefte anzeigen Standort:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

  9. Buch: TEXPLORE: temporal difference reinforcement learning for robots and time-constrained domains

    Hester, Todd

    (Studies in computational intelligence ; 503)

    2013  

    Verfasserangabe Todd Hester
    Serientitel Studies in computational intelligence ; 503
    Sprache Englisch
    Umfang XIII, 165 S., Ill., graph. Darst.
    Verlag Springer
    Erscheinungsort Cham u.a.
    Dokumenttyp Buch
    Anmerkung Main results of the research conducted for Ph.D. thesis at the University of Texas at Austin
    ISBN 9783319011677 ; 9783319011684 ; 3319011677 ; 3319011685
    Datenquelle Katalog der Technische Informationsbibliothek Hannover

    Zusatzmaterialien

    Kategorien

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

    Fernleihe an ZB MED

    Sie können sich den gewünschten Titel als lokale Nutzerin oder lokaler Nutzer von ZB MED direkt an den Standort Köln schicken lassen.

  10. Buch ; Online: TEXPLORE: Temporal Difference Reinforcement Learning for Robots and Time-Constrained Domains

    Hester, Todd

    (Studies in Computational Intelligence ; 503)

    2013  

    Abstract: This book presents and develops new reinforcement learning methods that enable fast and robust learning on robots in real-time. Robots have the potential to solve many problems in society, because of their ability to work in dangerous places doing ... ...

    Verfasserangabe by Todd Hester
    Serientitel Studies in Computational Intelligence ; 503
    Abstract This book presents and develops new reinforcement learning methods that enable fast and robust learning on robots in real-time. Robots have the potential to solve many problems in society, because of their ability to work in dangerous places doing necessary jobs that no one wants or is able to do. One barrier to their widespread deployment is that they are mainly limited to tasks where it is possible to hand-program behaviors for every situation that may be encountered. For robots to meet their potential, they need methods that enable them to learn and adapt to novel situations that they were not programmed for. Reinforcement learning (RL) is a paradigm for learning sequential decision making processes and could solve the problems of learning and adaptation on robots. This book identifies four key challenges that must be addressed for an RL algorithm to be practical for robotic control tasks. These RL for Robotics Challenges are: 1) it must learn in very few samples; 2) it must learn in domains with continuous state features; 3) it must handle sensor and/or actuator delays; and 4) it should continually select actions in real time. This book focuses on addressing all four of these challenges. In particular, this book is focused on time-constrained domains where the first challenge is critically important. In these domains, the agent’s lifetime is not long enough for it to explore the domains thoroughly, and it must learn in very few samples
    Schlagwörter Computer vision ; Engineering
    Sprache Englisch
    Umfang Online-Ressource (XIV, 165 p. 55 illus. in color), digital
    Verlag Springer
    Erscheinungsort Heidelberg
    Dokumenttyp Buch ; Online
    ISBN 9783319011677 ; 9783319011684 ; 3319011677 ; 3319011685
    DOI 10.1007/978-3-319-01168-4
    Datenquelle Ehemaliges Sondersammelgebiet Küsten- und Hochseefischerei

    Zusatzmaterialien

    Kategorien

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

    Fernleihe an ZB MED

    Sie können sich den gewünschten Titel als lokale Nutzerin oder lokaler Nutzer von ZB MED direkt an den Standort Köln schicken lassen.

Zum Seitenanfang