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https://www.readbyqxmd.com/read/28427852/circumferential-pulmonary-vein-isolation-with-second-generation-multipolar-catheter-in-patients-with-paroxysmal-or-persistent-atrial-fibrillation-procedural-and-one-year-follow-up-results
#1
Stefan G Spitzer, Patrick Leitz, Anke Langbein, Laszlo Karolyi, Frank Scharfe, Thomas Weinmann, Carola Rämmler, Christian Pott, Gerold Mönnig, Lars Eckardt
BACKGROUND: There is a lack of procedural and follow-up data on pulmonary vein isolation (PVI) with the second-generation pulmonary vein ablation catheter® (PVAC Gold) in patients with atrial fibrillation (AF). This study provides data on PVI procedures and 1-year follow-up results with PVAC Gold in patients with AF treated in clinical practice. METHODS AND RESULTS: Three hundred and eighty four patients with documented symptomatic paroxysmal (n=198) or persistent (n=186) AF were included in a non-randomized prospectively designed database...
April 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28413930/relationship-of-genetic-variants-with-procedural-pain-anxiety-and-distress-in-children
#2
Anne L Ersig, Debra L Schutte, Jennifer Standley, Elizabeth Leslie, Bridget Zimmerman, Charmaine Kleiber, Kirsten Hanrahan, Jeffrey C Murray, Ann Marie McCarthy
OBJECTIVE: This study used a candidate gene approach to examine genomic variation associated with pain, anxiety, and distress in children undergoing a medical procedure. STUDY DESIGN: Children aged 4-10 years having an IV catheter insertion were recruited from three Midwestern children's hospitals. Self-report measures of pain, anxiety, and distress were obtained as well as an observed measure of distress. Samples were collected from children and biological parents for analysis of genomic variation...
May 2017: Biological Research for Nursing
https://www.readbyqxmd.com/read/28411074/low-dose-sustained-release-deoxycorticosterone-acetate-induced-hypertension-in-bama-miniature-pigs-for-renal-sympathetic-nerve-denervation
#3
Wenzheng Han, Weiyi Fang, Qian Gan, Shaofeng Guan, Yanjie Li, Ming Wang, Kaizheng Gong, Xinkai Qu
Recently, the effectiveness of renal sympathetic nerve denervation for treatment of hypertension has been doubted after SYMPLICITY HTN-3 trial. An ideal animal model is still unavailable for preclinical study about catheter-based renal sympathetic nerve denervation for treatment of hypertension. Traditional high-dose deoxycorticosterone acetate (DOCA)-induced hypertension pig model has some problems due to extensive end-organ damage. Based on the similarity in the anatomic characteristics of renal artery between pigs and humans, this study was undertaken to establish a low-dose sustained-release DOCA-induced hypertension model in pigs...
March 2, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28408649/external-arrhythmia-ablation-using-photon-beams-ablation-of-the-atrioventricular-junction-in-an-intact-animal-model
#4
H Immo Lehmann, Amanda J Deisher, Mitsuru Takami, Jon J Kruse, Limin Song, Sarah E Anderson, Jack T Cusma, Kay D Parker, Susan B Johnson, Samuel J Asirvatham, Robert C Miller, Michael G Herman, Douglas L Packer
BACKGROUND: This study sought to investigate external photon beam radiation for catheter-free ablation of the atrioventricular junction in intact pigs. METHODS AND RESULTS: Ten pigs were randomized to either sham irradiation or irradiation of the atrioventricular junction (55, 50, 40, and 25 Gy). Animals underwent baseline electrophysiological evaluation, cardiac gated multi-row computed tomographic imaging for beam delivery planning, and intensity-modulated radiation therapy...
April 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28406699/early-morphologic-alterations-in-renal-artery-wall-and-renal-nerves-in-response-to-catheter-based-renal-denervation-procedure-in-sheep-difference-between-single-point-and-multiple-point-ablation-catheters
#5
M Táborský, D Richter, Z Tonar, T Kubíková, A Herman, J Peregrin, L Červenková, Z Husková, L Kopkan
Renal sympathetic hyperactivity is critically involved in hypertension pathophysiology; renal denervation (RDN) presents a novel strategy for treatment of resistant hypertension cases. This study assessed effects of two RDN systems to detect acute intravascular, vascular and peri-vascular changes in the renal artery, and renal nerve alterations, in the sheep. The procedures using a single-point or multi-point ablation catheters, Symplicity Flex(TM), Medtronic versus EnligHTN(TM), St. Jude Medical were compared; the intact contralateral kidneys served as controls...
April 12, 2017: Physiological Research
https://www.readbyqxmd.com/read/28405492/a-rare-complication-of-central-venous-catheter-extravasation-in-a-preterm-neonate-hemidiaphragmatic-paralysis
#6
C Hobson, D Dubillot, H Lardy, D Sirinelli, E Saliba, E Lopez
We report a case of a preterm neonate born at 26 weeks' of gestation diagnosed with unilateral diaphragmatic paralysis. This paralysis was a consequence of a phrenic nerve injury due to extravasation of hyperosmolar parenteral nutrition fluid in the upper thorax. Chest X-rays and ultrasonography confirmed the diagnosis. The neonate was treated with prolonged respiratory support and did not require surgical treatment. This report describes a case of hemidiaphragmatic paralysis as a complication of central venous catheter insertion...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28403100/delayed-bilateral-vocal-cord-paresis-after-a-continuous-interscalene-brachial-plexus-block-and-endotracheal-intubation-a-lesson-why-we-should-use-low-concentrated-local-anesthetics-for-continuous-blocks
#7
Hee-Sun Park, Ha-Jung Kim, Young-Jin Ro, Hong-Seuk Yang, Won-Uk Koh
RATIONALE: Recurrent laryngeal nerve block is an uncommon complication that can occur after an interscalene brachial plexus block (ISB), which may lead to vocal cord palsy or paresis. However, if the recurrent laryngeal nerve is blocked in patients with a preexisting contralateral vocal cord palsy following neck surgery, this may lead to devastating acute respiratory failure. Thus, ISB is contraindicated in patients with contralateral vocal cord lesion. To the best of our knowledge, there are no reports of bilateral vocal cord paresis, which occurred after a continuous ISB and endotracheal intubation in a patient with no history of vocal cord injury or surgery of the neck...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28400498/effect-of-thoracic-epidural-anesthesia-on-heart-rate-variability-in-a-porcine-model
#8
Arjun Mahajan, Tatsuo Takamiya, Peyman Benharash, Wei Zhou
Heart rate variability (HRV) is increasingly recognized as a means of evaluating autonomic tone. Thoracic epidural anesthesia (TEA) has been previously demonstrated to suppress the electrical storms in patients. However, the effect of TEA on HRV during sympathoexcitation remains unknown. In this study, we aimed to determine the effects of TEA on HRV response to left stellate ganglion stimulation (LSS) in a porcine model. In 12 anesthetized pigs after insertion of an epidural catheter to T1 level, a median sternotomy was performed to expose the heart and the left stellate ganglion...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28398932/brachial-arterial-pressure-monitoring-during-cardiac-surgery-rarely-causes-complications
#9
Asha Singh, Bobby Bahadorani, Brett J Wakefield, Natalya Makarova, Priya A Kumar, Michael Zhen-Yu Tong, Daniel I Sessler, Andra E Duncan
BACKGROUND: Brachial arterial catheters better estimate aortic pressure than radial arterial catheters but are used infrequently because complications in a major artery without collateral flow are potentially serious. However, the extent to which brachial artery cannulation promotes complications remains unknown. The authors thus evaluated a large cohort of cardiac surgical patients to estimate the incidence of related serious complications. METHODS: The institutional Society of Thoracic Surgeons Adult Cardiac Surgery Database and Perioperative Health Documentation System Registry of the Cleveland Clinic were used to identify patients who had brachial artery cannulation between 2007 and 2015...
April 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28397136/an-experimental-animal-model-for-percutaneous-procedures-used-in-trigeminal-neuralgia
#10
Johannes Herta, Wei-Te Wang, Romana Höftberger, Sabine Breit, Sibylle Kneissl, Helga Bergmeister, Heber Ferraz-Leite
OBJECT: This study describes an experimental rabbit model that allows the reproduction of percutaneous operations that are used in patients with trigeminal neuralgia (TN). Attention was given to an exact anatomical description of the rabbit's middle cranial fossa as well as the establishment of conditions for a successful procedure. METHODS: Morphometric measurements were taken from 20 rabbit skulls and CT scans. The anatomy of the trigeminal nerve, as well as its surrounding structures, was assessed by bilateral dissection of 13 New Zealand white rabbits (NWR)...
April 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28396932/comparison-of-analgaesia-with-lumbar-epidurals-and-lumbar-plexus-nerve-blocks-in-patients-receiving-multimodal-analgaesics-following-primary-total-hip-arthroplasty-a-retrospective-analysis
#11
N Robert Harvey, Bethany J Wolf, Eric D Bolin, Sylvia H Wilson
PURPOSE: Significant post-operative pain occurs after hip arthroplasty. In a prior study, lumbar plexus nerve blocks provided comparable analgaesia to lumbar epidurals; however, multimodal analgaesics were not used consistently. METHODS: This study assessed a randomly selected cohort of 48 patients undergoing primary hip arthroplasty who received a regional anaesthesia technique for post-operative pain. Twenty-four patients with lumbar epidurals and 24 with single-injection lumbar plexus nerve blocks were reviewed using electronic medical records...
April 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28394522/-the-role-of-waterjet-dissection-in-improving-erectile-function-and-continence-after-nerve-sparing-prostatectomy
#12
P V Glybochko, Yu G Alyaev, L M Rapoport, N A Grigorev, E A Bezrukov, D G Tsarichenko, E S Sirota, G A Martirosyan
INTRODUCTION: Erectile dysfunction (ED) and urinary incontinence (UI) following radical prostatectomy (RP) adversely impact patients psycho-emotional status reducing the quality of life and treatment satisfaction. AIM: To investigate the rates of regaining continence and erectile function (EF) after nerve-sparing radical retropubic prostatectomy (NS-RRP) and nerve-sparing laparoscopic radical prostatectomy (NS-LRP) in the early postoperative period. MATERIALS AND METHODS: The study comprised 116 patients who preserved sexual activity and the ability to have sex...
April 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28371877/comprehensive-analysis-of-13-897-consecutive-regional-anesthetics-at-an-ambulatory-surgery-center
#13
Randall J Malchow, Rajnish K Gupta, Yaping Shi, Matthew S Shotwell, Lisa M Jaeger, Clifford Bowens
Objective.:  The authors investigated a wide range of perioperative outcome measures in the context of a robust regional anesthesia practice. Design.:  Comprehensive review of a prospectively collected six-year database. Setting.:  Freestanding, academic ambulatory surgery center. Subjects.:  There were 13,897 consecutive regional anesthetics in 10,338 patients. Methods.:  We investigated patient satisfaction, postoperative nausea and vomiting (PONV), postoperative pain, catheter analgesia, and complications...
March 24, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28348896/effect-of-arm-positioning-on-entrapment-of-infraclavicular-nerve-block-catheter
#14
Eric Kamenetsky, Rahul Reddy, Mark C Kendall, Antoun Nader, Jessica J Weeks
Continuous brachial plexus nerve block catheters are commonly inserted for postoperative analgesia after upper extremity surgery. Modifications of the insertion technique have been described to improve the safety of placing an infraclavicular brachial plexus catheter. Rarely, these catheters may become damaged or entrapped, complicating their removal. We describe a case of infraclavicular brachial plexus catheter entrapment related to differences in arm positioning during catheter placement and removal. Written authorization to obtain, use, and disclose information and images was obtained from the patient...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28346718/modulation-of-the-rat-micturition-reflex-with-transcutaneous-ultrasound
#15
Daniel P Casella, Anne G Dudley, Douglass B Clayton, John C Pope, Stacy T Tanaka, John Thomas, Mark C Adams, John W Brock, Charles F Caskey
INTRODUCTION: Low intensity focused ultrasound has recently been identified as a novel method of stimulating targeted neurons. We hypothesized that ultrasound stimulation of the posterior tibial nerve would inhibit bladder contractions in an established rat model of rhythmic bladder contractions. METHODS: Cyclical detrusor contractions were initiated by placing a transurethral catheter in female rats and infusing saline into the bladder. Transcutaneous ultrasound pulses were then delivered to the lower extremity of a rat (overlying the posterior tibial nerve) using a single element spherically focused 250 kHz transducer...
March 27, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28339449/reversal-of-progressive-conscious-disturbance-with-epidural-blood-patch-for-cerebrospinal-fluid-leakage-at-c2-level
#16
Yi-Chen Lai, Yuan-Yi Chia, Wei-Hung Lien
Intracranial hypotension syndrome (IHS) is generally caused by cerebrospinal fluid (CSF) leakage. Complications include bilateral subdural hygroma or haematoma and herniation of the cerebellar tonsils. Epidural blood patch (EBP) therapy is indicated if conservative treatment is ineffective. We reported the case of a 46-year-old man with a history of postural headache and dizziness. The patient was treated with bed rest and daily hydration with 2000 mL of fluid for 2 weeks. However, dizziness and headache did not resolve, and he became drowsy and disoriented with incomprehensible speech...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28338871/renal-sympathetic-denervation-a-viable-option-for-treating-resistant-hypertension
#17
Markus P Schlaich
Accumulating evidence from mainly uncontrolled clinical studies with various types of ablation catheters have shown that renal denervation (RDN) can be applied safely and is effective in lowering blood pressure (BP) in patients with treatment-resistant hypertension. Sustained BP lowering has been documented up to 3 years. Furthermore, RDN has been associated with regression of target organ damage, such as left ventricular hypertrophy, arterial stiffness, and others. Several studies indicate potential benefit in other common clinical conditions associated with increased sympathetic tone including chronic kidney disease and heart failure...
March 1, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28322213/chronic-monitoring-of-lower-urinary-tract-activity-via-a-sacral-dorsal-root-ganglia-interface
#18
Abeer Khurram, Shani Ross, Zachariah Sperry, Aileen Ouyang, Christopher Stephan, Ahmad Jiman, Tim M Bruns
OBJECTIVE: Our goal is to develop an interface that integrates chronic monitoring of lower urinary tract (LUT) activity with stimulation of peripheral pathways. APPROACH: Penetrating microelectrodes were implanted in sacral dorsal root ganglia (DRG) of adult male felines. Peripheral electrodes were placed on or in the pudendal nerve, bladder neck and near the external urethral sphincter. Supra-pubic bladder catheters were implanted for saline infusion and pressure monitoring...
March 21, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28319550/continuous-transversus-abdominis-plane-nerve-blocks-does-varying-local-anesthetic-delivery-method-automatic-repeated-bolus-versus-continuous-basal-infusion-influence-the-extent-of-sensation-to-cold-a-randomized-triple-masked-crossover-study-in-volunteers
#19
Bahareh Khatibi, Engy T Said, Jacklynn F Sztain, Amanda M Monahan, Rodney A Gabriel, Timothy J Furnish, Johnathan T Tran, Michael C Donohue, Brian M Ilfeld
BACKGROUND: It remains unknown whether continuous or scheduled intermittent bolus local anesthetic administration is preferable for transversus abdominis plane (TAP) catheters. We therefore tested the hypothesis that when using TAP catheters, providing local anesthetic in repeated bolus doses increases the cephalad-caudad cutaneous effects compared with a basal-only infusion. METHODS: Bilateral TAP catheters (posterior approach) were inserted in 24 healthy volunteers followed by ropivacaine 2 mg/mL administration for a total of 6 hours...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28314642/hypotensive-effects-of-renal-denervation-in-spontaneously-hypertensive-rat-based-on-ultrasonic-contrast-imaging
#20
Ke Li, Jinwen Tian, Yuxiao Zhang, Qiao Xue, Caiyi Lu
BACKGROUND: Sympathetic nerves-fire rate is generally enhanced in some types of hypertension models. Renal sympathetic denervation(RSD) by the radiofrequency ablation was used to treat the hypertension has achieved curative effect.HTN-1 and HTN-2 trial reported catheter-based renal denervation may cause substantial and sustained blood-pressure reduction in patients with resistant hypertension. However, recent controlled HTN-3 trial questioned the BP lowering effect of Renal denervation treatment...
February 9, 2017: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
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