Endoscopic Skull Base Surgery in the Pediatric Patient

Pathology along the anterior and posterior skull base has long posed challenges to surgeons due to the difficulty accessing these locations and complexity of the surrounding neurovascular anatomy. Initial surgical management of these disorders included open craniofacial approaches and/or craniotomy and these approaches are still utilized today for selected cases. However, advances in the later half of the 20th century in optics, endoscope design, and high definition digital images allowed the development of microscopic and, more recently, endoscopic approaches to the skull base. This technology was initially developed and used in adults, but has been adapted over time for use in the pediatric patient. In this chapter, the salient points regarding pediatric endoscopic skull base surgery will be reviewed to provide the reader a framework for understanding the indications, pertinent anatomy, preoperative evaluation, and intraoperative management of skull base pathology, highlighting challenges and circumstances unique to the pediatric population

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Fixation of the fully hydroxyapatite-coated Corail stem implanted due to femoral neck fracture: 38 patients followed for 2 years with RSA and DEXA

Background Today, dislocated femoral neck fractures are commonly treated with a cemented hip arthroplasty. However, cementing of the femoral component may lead to adverse effects and even death. Uncemented stems may lower these risks and hydroxyapatite (HA) coating may enhance integration, but prosthetic stability and clinical outcome in patients with osteoporotic bone have not been fully explored. We therefore studied fixation and clinical outcome in patients who had had a femoral neck fracture and who had received a fully HA-coated stem prosthesis. Patients and methods 50 patients with a dislocated femoral neck fracture were operated with the fully HA-coated Corail total or hemiarthroplasty. 38 patients, mean age 81 (70-96) years, were followed for 24 months with conventional radiographs, RSA, DEXA, and for clinical outcome. Results 31 of the 38 implants moved statistically significantly up to 3 months, mainly distally, mean 2.7 mm (max. 20 mm (SD 4.3)), and rotated into retroversion mean 3.3 (-1.8 to 17) (SD 4.3) and then appeared to stabilize. Distal stem migration was more pronounced if the stem was deemed to be too small. There was no correlation between BMD and stem migration. The migration did not result in any clinically adverse effects. Interpretation The fully hydroxyapatite-coated Corail stem migrates during the first 3 months, but clinical outcome appears to be good, without any adverse events

Analysing the impact of rescheduling time in hybrid manufacturing control

Hybrid manufacturing control architectures merge the benefits of hierarchical and heterarchical approaches. Disturbances can be handled at upper or lower decision levels, depending on the type of disturbance, its impact and the time the control system has to react. This paper focuses particularly on a disturbance handling mechanism at upper decision levels using a rescheduling manufacturing method. Such rescheduling is more complex that the offline scheduling since the control system must take into account the current system status, obtain a satisfactory performance under the new conditions, and also come up with a new schedule in a restricted amount of time. Then, this paper proposes a simple and generic rescheduling method which, based on the satisfying principle, analyses the trade-off between the rescheduling time and the performance achieved after a perturbation. The proposed approach is validated on a simulation model of a realistic assembly cell and results demonstrate that adaptation of the rescheduling time might be beneficial in terms of overall performance and reactivity.info:eu-repo/semantics/publishedVersio

Production Scheduling Requirements to Smart Manufacturing

The production scheduling has attracted a lot of researchers for many years, however most of the approaches are not targeted to deal with real manufacturing environments, and those that are, are very particular for the case study. It is crucial to consider important features related with the factories, such as products and machines characteristics and unexpected disturbances, but also information such as when the parts arrive to the factory and when should be delivered. So, the purpose of this paper is to identify some important characteristics that have been considered independently in a lot of studies and that should be considered together to develop a generic scheduling framework to be used in a real manufacturing environment.authorsversionpublishe

Perioperative mortality after hemiarthroplasty related to fixation method: A study based on the Australian Orthopaedic Association National Joint Replacement Registry

Background and purpose: The appropriate fixation method for hemiarthroplasty of the hip as it relates to implant survivorship and patient mortality is a matter of ongoing debate. We examined the influence of fixation method on revision rate and mortality.----- ----- Methods: We analyzed approximately 25,000 hemiarthroplasty cases from the AOA National Joint Replacement Registry. Deaths at 1 day, 1 week, 1 month, and 1 year were compared for all patients and among subgroups based on implant type.----- ----- Results: Patients treated with cemented monoblock hemiarthroplasty had a 1.7-times higher day-1 mortality compared to uncemented monoblock components (p < 0.001). This finding was reversed by 1 week, 1 month, and 1 year after surgery (p < 0.001). Modular hemiarthroplasties did not reveal a difference in mortality between fixation methods at any time point.----- ----- Interpretation: This study shows lower (or similar) overall mortality with cemented hemiarthroplasty of the hip