ObjectivesLittle is known about local access-site complications and upper extremity dysfunction after transradial percutaneous coronary procedures (TR-PCP). This systematic review study aimed to summarise the current knowledge on the incidences of access-site complications and upper extremity dysfunction after TR-PCP.MethodsTwo independent, trained investigators searched MEDLINE, EMBASE and CENTRAL for eligible studies published before 1 January 2015. Also, they hand-searched the conference proceedings of the annual scientific sessions of the American College of Cardiology, the American Heart Association, European Society of Cardiology, and the Trans-catheter Cardiovascular Therapeutics. Inclusion criteria were cohort studies and clinical trials discussing the incidence of access-site complications and upper extremity function after transradial percutaneous coronary intervention (TR-PCI) and/or transradial coronary angiography (TR-CAG) as endpoints.Results176 articles described access-site complications. The incidence is up to 9.6 %. Fourteen articles described upper extremity dysfunction, with an incidence of up to 1.7 %. Upper extremity dysfunction was rarely investigated, hardly ever as primary endpoint, and if investigated not thoroughly enough.ConclusionUpper extremity dysfunction in TR-PCP has never been properly investigated and is therefore underestimated. Further studies are needed to investigate the magnitude, prevention and best treatment of upper extremity dysfunction. Optimising TR-PCP might be achieved by using slender techniques, detection of upper extremity dysfunction and early referral to a hand rehabilitation centre.Electronic supplementary materialThe online version of this article (doi: 10.1007/s12471-015-0747-9) contains supplementary material, which is available to authorized users. This supplementary file contains References 51–202.

Results from this study will elucidate the effect of TR-PCI on upper extremity function. This creates the opportunity to further optimize TR-PCI, to make improvements in functional outcome and to prevent morbidity regarding full upper extremity function. © 2016 Wiley Periodicals, Inc.

ABSTRAO. The ability of erythrocytes from newborn babies and adults to maintain reduced glutathione levels during oxidative stress was studied. In vitro incubation of erythrocytes with H202, with or without inactivation of catalase, caused a rapid depletion of reduced glutathione (CSH) and concomitant accumulation of oxidized glutathione followed by recovery of CSH and fall of oxidized glutathione to initial values in all subjects. In vitro and in vivo studies have shown that the erythrocytes of adult animals can protect other tissues, e.g. lung, against damage induced by reactive oxygen species (1). Erythrocytes can catabolize an H202 load produced by leukocytes (2) and have been shown to protect both cultured pulmonary endothelial cells (3) and the whole lung (4, 5) from oxidative damage. The action of catalase and the glutathione recycling system is believed to be the key factor in this protective mechanism (1).The preterm baby has poorly developed antioxidant enzyme systems in various organs, e.g. lung, and is susceptible to oxygeninduced tissue damage, e.g. bronchopulmonary dysplasia (6, 7). Thus, the ability of the erythrocyte to catabolize H202 may be of particular importance in these patients. The ability of the erythrocyte to handle oxidative stress induced by H202 can be assessed in vitro by serially measuring the initial fall of GSH and the concomitant rise of GSSG and the subsequent recovery of GSH and fall of GSSG to initial values. Glutathione recycling has already been used to assess the antioxidant capacity of erythrocytes of adults (8) and cell cultures (9, 10). We compared glutathione recycling during exposure to H202 in erythrocytes of newborn babies and adults. The erythrocyte activities of enzymes responsible for H202 catabolism, i.e. catalase, glutathione peroxidase, and glutathione reductase, were also measured. MATERIALS AND METHODSThis study was approved by the Scientific Committee of the Department of Pediatrics and the Ethical Committee of the University Hospital of Leiden.Patients. Umbilical cord blood samples were obtained from eight preterm and nine term infants (gestational age [mean (SD)] 32.9 (2.4) and 40.2 (1.5) wk, respectively) within 15 min after delivery of the placenta. The babies were of normal birth weight (10th-90th percentile) and showed no signs of birth asphyxia (Apgar score 1 min r 9, umbilical vein pH r 7.25), respiratory distress, or infection. Their mothers, healthy Caucasian nonsmokers (3), did not receive vitamin or iron supplements. Venous blood samples were taken from 10 healthy Caucasian volunteers (age [mean (SD)] 24.9 (2.4) y), who were nonsmokers.From an additional group of 10 healthy term infants (gestational age [mean (SD) 40.6 (1.4) wk, other characteristics as above) umbilical cord blood samples were obtained to study in vitro the influence of the hematocrit on glutathione recycling.Procedure. Blood was gently withdrawn ( 1.1 -mm diameter needle) into heparinized tubes and immediately centrifuged (750 x g, 10 min). Plasma and buffy coat were discarded ...

Traumatic root avulsions of the brachial plexus constitute a devastating lesion resulting in loss of function of the upper limb and carry a large emotional and socioeconomic impact. In this literature survey, the different factors involved in root avulsion are discussed in combination with various surgical techniques for repair of experimental ventral root avulsion. Until now repair of root avulsions did not generate unequivocal proof of recovery of limb function, particularly of the hand. More experimental studies are needed to assess the efficacy of several repair techniques, the optimal timing for surgery, and the complications associated with spinal cord manipulation.

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