25 research outputs found

    Surgery for complications of trans-catheter closure of atrial septal defects: a multi-institutional study from the European Congenital Heart Surgeons Association

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    Objective: This study aims to analyse the collective experience of participating European Congenital Heart Surgeons Association centres in the surgical management of complications resulting from trans-catheter closure of atrial septal defects (ASDs). Methods: The records of all (n=56) patients, aged 3-70 years (median 18 years), who underwent surgery for complications of trans-catheter ASD closure in 19 participating institutions over a 10-year period (1997-2007) were retrospectively reviewed. Risk factors for surgical complications were sought. Surgical outcomes were compared with those reported for primary surgical ASD closure in the European Association of Cardio-thoracic Surgery Congenital Database. Results: A wide range of ASD sizes (5-34mm) and devices of various types and sizes (range 12-60mm) were involved, including 13 devices less than 20mm. Complications leading to surgery included embolisation (n=29), thrombosis/thrombo-embolism/cerebral ischaemia or stroke (n=12), significant residual shunt (n=12), aortic or atrial perforation or erosion (n=9), haemopericardium with tamponade (n=5), aortic or mitral valve injury (n=2) and endocarditis (n=1). Surgery (39 early emergent and 17 late operations) involved device removal, repair of damaged structures and ASD closure. Late operations were needed 12 days to 8 years (median 3 years) after device implantation. There were three hospital deaths (mortality 5.4%). During the same time period, mortality for all 4453 surgical ASD closures reported in the European Association of Cardio-Thoracic Surgery Congenital Database was 0.36% (p=0.001). Conclusions: Trans-catheter device closure of ASDs, even in cases when small devices are used, can lead to significant complications requiring surgical intervention. Once a complication leading to surgery occurs, mortality is significantly greater than that of primary surgical ASD closure. Major complications can occur late after device placement. Therefore, lifelong follow-up of patients in whom ASDs have been closed by devices is mandator

    Max Wertheimer productive thinking

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    Max Wertheimer (1880-1943), a pioneer of 20th-century psychology, had a major influence on the development of cognitive psychology, especially the psychology of perception and of productive thinking. His work “Productive Thinking” (1945), written in New York, is regarded as a milestone in creativity research. Consisting of many examples of creative thought processes - from geometric tasks to socio-psychologically relevant conflict resolutions to the development of Einstein’s theory of relativity - the book leads the reader through a multi-faceted body of thought in the psychology of thinking. Detailed historical commentary by Viktor Sarris. Only a few texts in psychology have remained significant even after a period of three quarters of a century - Max Wertheimer’s Productive Thinking is such an exception. This book, which also presents an exposition of Gestalt psychology, highlights the “productive” (insightful) versus automatic (unreflected) thought processes for many areas of life. In addition to examples from school teaching, the chapter on the emergence of Albert Einstein's theory of relativity is of lasting interest to today's generation of psychologists, pedagogues, brain researchers, neuroinformatics scientists/researchers and philosophers. Wertheimer had the unique opportunity to analyze Einstein’s thinking in direct conversation. An introductory commentary by Viktor Sarris for this new edition of the first publication of Productive Thinking in 1945 offers a detailed account of the genesis and reception of Wertheimer’s work

    Memory and assimilation to context in delayed matching-to-sample

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    This paper reports effects of short-term memory and context stimuli on recognition of visual stimuli. After presentation of a square as the target stimulus, participants had to store the target during a variable delay, until they had to identify the target within a sample of seven squares that differed systematically in size (context variation). Marked context effects (“shifts”) that occurred as responses to the test series were obtained when sets of comparison stimuli were arranged asymmetrically with respect to targets. Participants overestimated the size of the target in a set of larger comparison stimuli by choosing a larger stimulus to match the target, and vice versa (Experiment 1). This assimilation effect increased with longer delays between target offset and the onset of comparison stimuli (Experiment 2). Briefer target exposure also induced stronger assimilation (Experiment 3). The results indicated that visual short-term memory modulates (contextual) stimulus integration in delayed matching to sample. A working model of memory and contextual effects in matching is discussed
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