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  • 1
    Publication Date: 2015-12-24
    Description: Background— Transvenous lead removal (TLR) has made significant progress with respect to innovation, efficacy, and safety. However, limited data exist regarding trends in use and adverse outcomes outside the centers of considerable experience for TLR. The aim of our study was to examine use patterns, frequency of adverse events, and influence of hospital volume on complications. Methods and Results— Using the Nationwide Inpatient Sample, we identified 91 890 TLR procedures. We investigated common complications including pericardial complications (hemopericardium, cardiac tamponade, or pericardiocentesis), pneumothorax, stroke, vascular complications (consisting of hemorrhage/hematoma, incidents requiring surgical repair, and accidental arterial puncture), and in-hospital deaths described with TLR, defining them by the validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code. We specifically assessed in-hospital death (2.2%), hemorrhage requiring transfusion (2.6%), vascular complications (2.0%), pericardial complications (1.4%), open heart surgery (0.2%), and postoperative respiratory failure (2.4%). Independent predictors of complications were female sex and device infections. Hospital volume was not independently associated with higher complications. There was a significant rise in overall complication rates over the study period. Conclusions— The overall complication rate in patients undergoing TLR was higher than previously reported. Female sex and device infections are associated with higher complications. Hospital volume was not associated with higher complication rates. The number of adverse events in the literature likely underestimates the actual number of complications associated with TLR.
    Keywords: Arrhythmias, Catheter Ablation and Implantable Cardioverter-Defibrillator, Electrophysiology, Quality and Outcomes
    Electronic ISSN: 1524-4539
    Topics: Medicine
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  • 2
    Publication Date: 2011-12-24
    Description: Arthritis is a leading cause of disability, and when nonoperative methods have failed, a prosthetic implant is a cost-effective and clinically successful treatment. Metal-on-metal replacements are an attractive implant technology, a lower-wear alternative to metal-on-polyethylene devices. Relatively little is known about how sliding occurs in these implants, except that proteins play a critical role and that there is a tribological layer on the metal surface. We report evidence for graphitic material in the tribological layer in metal-on-metal hip replacements retrieved from patients. As graphite is a solid lubricant, its presence helps to explain why these components exhibit low wear and suggests methods of improving their performance; simultaneously, this raises the issue of the physiological effects of graphitic wear debris.〈br /〉〈span class="detail_caption"〉Notes: 〈/span〉Liao, Y -- Pourzal, R -- Wimmer, M A -- Jacobs, J J -- Fischer, A -- Marks, L D -- 1RC2AR058993-01/AR/NIAMS NIH HHS/ -- New York, N.Y. -- Science. 2011 Dec 23;334(6063):1687-90. doi: 10.1126/science.1213902.〈br /〉〈span class="detail_caption"〉Author address: 〈/span〉Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60201, USA.〈br /〉〈span class="detail_caption"〉Record origin:〈/span〉 〈a href="http://www.ncbi.nlm.nih.gov/pubmed/22194573" target="_blank"〉PubMed〈/a〉
    Keywords: Animals ; Arthroplasty, Replacement, Hip ; Biocompatible Materials ; Cattle ; Corrosion ; Friction ; Graphite/*analysis ; *Hip Prosthesis/adverse effects ; Humans ; Metal Nanoparticles ; Prosthesis Design ; Prosthesis Failure ; Serum ; Spectroscopy, Electron Energy-Loss ; Spectrum Analysis, Raman ; Surface Properties ; *Vitallium
    Print ISSN: 0036-8075
    Electronic ISSN: 1095-9203
    Topics: Biology , Chemistry and Pharmacology , Computer Science , Medicine , Natural Sciences in General , Physics
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