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https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#1
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28318147/effects-of-alfapump-system-on-kidney-and-circulatory-function-in-patients-with-cirrhosis-and-refractory-ascites
#2
Elsa Solà, Santiago Sanchez-Cabús, Ezequiel Rodriguez, Chiara Elia, Raquel Cela, Rebeca Moreira, Elisa Pose, Jordi Sánchez-Delgado, Nuria Cañete, Manuel Morales-Ruiz, Francisco Campos, Jaume Balust, Mónica Guevara, Juan Carlos García-Valdecasas, Pere Ginès
The alfapump system has been proposed as a new treatment for the management of refractory ascites. The system removes ascites from the peritoneal cavity to urinary bladder, producing a continuous low-volume paracentesis. AIM: To investigate the effects of treatment with the alfapump system on kidney and circulatory function in patients with cirrhosis and refractory ascites. METHODS: Prospective study including 10 patients with cirrhosis and refractory ascites. Primary outcomes were changes in glomerular filtration rate (GFR), as assessed by isotopic techniques, and changes in circulatory function assessed by arterial pressure, cardiac output and activity of vasoconstrictor systems...
March 20, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28316276/levosimendan-in-patients-with-left-ventricular-dysfunction-undergoing-cardiac-surgery
#3
Rajendra H Mehta, Jeffrey D Leimberger, Sean van Diepen, James Meza, Alice Wang, Rachael Jankowich, Robert W Harrison, Douglas Hay, Stephen Fremes, Andra Duncan, Edward G Soltesz, John Luber, Soon Park, Michael Argenziano, Edward Murphy, Randy Marcel, Dimitri Kalavrouziotis, Dave Nagpal, John Bozinovski, Wolfgang Toller, Matthias Heringlake, Shaun G Goodman, Jerrold H Levy, Robert A Harrington, Kevin J Anstrom, John H Alexander
Background Levosimendan is an inotropic agent that has been shown in small studies to prevent or treat the low cardiac output syndrome after cardiac surgery. Methods In a multicenter, randomized, placebo-controlled, phase 3 trial, we evaluated the efficacy and safety of levosimendan in patients with a left ventricular ejection fraction of 35% or less who were undergoing cardiac surgery with the use of cardiopulmonary bypass. Patients were randomly assigned to receive either intravenous levosimendan (at a dose of 0...
March 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28306515/decentralized-safety-concept-for-closed-loop-controlled-intensive-care
#4
Jan Kühn, Christian Brendle, André Stollenwerk, Martin Schweigler, Stefan Kowalewski, Thorsten Janisch, Rolf Rossaint, Steffen Leonhardt, Marian Walter, Rüdger Kopp
This paper presents a decentralized safety concept for networked intensive care setups, for which a decentralized network of sensors and actuators is realized by embedded microcontroller nodes. It is evaluated for up to eleven medical devices in a setup for automated acute respiratory distress syndrome (ARDS) therapy. In this contribution we highlight a blood pump supervision as exemplary safety measure, which allows a reliable bubble detection in an extracorporeal blood circulation. The approach is validated with data of animal experiments including 35 bubbles with a size between 0...
March 17, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28302228/anaesthetic-management-in-a-child-with-goldenhar-syndrome
#5
Waqas Ahmed Khan, Bushra Salim, Ausaf Ahmed Khan, Shakaib Chughtai
Goldenhar syndrome is a congenital disorder involving deformities of the face. It usually affects one side of the face only and poses significant challenges in the airway management. We herein, report an 8-year boy, known case of Goldenhar syndrome, who presented to our radiology suite for a magnetic resonance imaging (MRI) brain, followed by a computed tomography (CT) scan brain. The boy had various features of Goldenhar syndrome, e.g. cleft palate, absent right eye and ear, right mandibular hypoplasia, micrognathia, and preauricular tags...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28299676/bioresorbable-scaffolds-for-coronary-stenosis-when-and-how-based-upon-current-studies
#6
REVIEW
Alexandre Abizaid, J Ribamar Costa
PURPOSE OF REVIEW: First-generation bioresorbable scaffolds (BRS), largely represented by the poly-l-lactic acid (PLLA) ABSORB (Abbott Vascular, Temecula, Illinois, US), have demonstrated, in low to moderate lesion complexity, similar efficacy to current generation metallic drug-eluting stents. However, a trend toward more device thrombosis has been observed, especially when the scaffolds are used in off-label situations. In this review, we address the most relevant drawbacks of these devices and, based on the available scientific data, we visit the scenarios where there is more uncertainty about their indication, trying to identify the lesions/patients to whom this technology should be voided at its current stage of development...
March 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28295054/microfluidic-device-enabled-quantitative-time-lapse-microscopic-photography-for-phenotyping-vegetative-and-reproductive-phases-in-fusarium-virguliforme-which-is-pathogenic-to-soybean
#7
Jill Marshall, Xuan Qiao, Jordan Baumbach, Jingyu Xie, Liang Dong, Madan K Bhattacharyya
Time-lapse microscopic-photography allows in-depth phenotyping of microorganisms. Here we report development of such a system using a microfluidic device, generated from polydimethylsiloxane and glass slide, placed on a motorized stage of a microscope for conducting time-lapse microphotography of multiple observations in 20 channels simultaneously. We have demonstrated the utility of the device in studying growth, germination and sporulation in Fusarium virguliforme that causes sudden death syndrome in soybean...
March 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28294670/-endovascular-treatment-of-acute-iliofemoral-deep-venous-thrombosis-our-results-with-catheter-directed-thrombolysis-and-angiojet
#8
Anikó Berencsi, Edit Dósa, Balázs Nemes, Kálmán Hüttl, Péter Legeza, Zoltán Oláh, Vera Kristóf, György Acsády, Péter Sótonyi
INTRODUCTION: Most of the patients with iliofemoral thrombosis treated with anticoagulants only are affected with postthrombotic syndrome (PTS) that worsens the patients' quality of life. In the acute phase of proximal deep venous thrombosis (DVT) catheter-directed (CDT) and pharmacomechanical thrombolysis may be a reasonable alternative therapeutic method. Our aim was to summarize our results using these methods. METHODS: Since 2009 twenty-four patients with iliofemoral DVT were treated with these endovascular procedures and with stenting at our Institution...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28294380/oral-appliance-therapy-versus-nasal-continuous-positive-airway-pressure-in-obstructive-sleep-apnea-syndrome-a-randomized-placebo-controlled-trial-on-self-reported-symptoms-of-common-sleep-disorders-and-sleep-related-problems
#9
Maria Nikolopoulou, Anna Byraki, Jari Ahlberg, Martijn W Heymans, H L Hamburger, Jan De Lange, Frank Lobbezoo, Ghizlane Aarab
Obstructive sleep apnea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomized placebo-controlled trial sixty-four OSAS patients (52.0± 9.6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design...
March 10, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28292407/small-bowel-target-devices-and-techniques
#10
REVIEW
Steven A Edmundowicz
The small bowel is a prime target for bariatric and metabolic endoscopic therapies. New insights into the mechanisms of action of surgical therapies have led to new endoscopic therapies for obesity, type 2 diabetes mellitus, and the metabolic syndrome. The development of endoluminal sleeves that bypass the proximal duodenum have replicated some of the effects of surgical bypass procedures. The endoscopic dual-path enteral bypass has created new and treatment options for these conditions. Duodenal mucosal resurfacing offers significant promise for diabetes management...
April 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28291620/pacing-in-congenital-heart-disease-a-four-decade-experience-in-a-single-tertiary-centre
#11
Disha Midha, Zhong Chen, David G Jones, Howell J Williams, Karen Lascelles, Julian Jarman, Jonathan Clague, Janice Till, Konstatinos Dimopoulos, Sonya V Babu-Narayan, Vias Markides, Michael A Gatzoulis, Tom Wong
BACKGROUND: The increased risk of brady- and tachy-arrhythmias in the congenital heart disease (CHD) population means that cardiac rhythm management devices are often required at an early age and expose patients to device-related complications. The present study drew upon four decades of experience at a tertiary adult congenital heart disease ACHD center and aimed to investigate the indication for cardiac implantable electronic devices (CIEDs) and predictors of late device-related complication requiring re-intervention...
March 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28287212/-the-pacemaker-and-implantable-cardioverter-defibrillator-registry-of-the-italian-association-of-arrhythmology-and-cardiac-pacing-annual-report-2015
#12
Alessandro Proclemer, Massimo Zecchin, Antonio D'Onofrio, Giuseppe Boriani, Giovanni Luca Botto, Domenico Facchin, Luca Rebellato, Marco Ghidina, Giulia Bianco, Emanuela Bernardelli, Elsa Pucher, Dario Gregori
BACKGROUND: The pacemaker (PM) and implantable cardioverter-defibrillator (ICD) Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) monitors the main epidemiological data in real-world practice. The survey for the 2015 activity collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the Italian collaborating centers. METHODS: The Registry collects prospectively national PM and ICD implantation activity on the basis of European cards...
January 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28287009/continuous-positive-airway-pressure-therapy-in-obstuctive-sleep-apnea-benefits-and-alternatives
#13
Michelle T Cao, Joshua M Sternbach, C Guilleminault
Obstructive sleep apnea (OSA) is a highly prevalent condition affecting persons of all age with an increasing public health burden. It is implicated in cardiovascular disease, metabolic syndrome, neurocognitive impairment, reductions in quality of life, and increased motor vehicle accidents. The goals of OSA treatment are to improve sleep and daytime symptoms, and minimize cardiovascular risks. Continuous positive airway pressure (CPAP) is considered the gold standard therapy that delivers pressurized air into the upper airway to relieve obstruction during sleep...
March 13, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28281510/-the-prevalence-of-bacterial-overgrowth-syndrome-and-its-associated-factors-in-patients-with-inflammatory-bowel-diseases-according-to-the-data-of-the-novosibirsk-registry
#14
Yu A Kulygina, M F Osipenko, M I Skalinskaya, K D Pal'chunova
AIM: To assess the prevalence of bacterial overgrowth syndrome (BOS) and its risk factors in patients with inflammatory bowel diseases (IBD). SUBJECTS AND METHODS: The patients from the Novosibirsk IBD registry, who had undergone a hydrogen breath test (HBT) using a Gastro+ device, were examined. RESULTS: In 93 IBD patients who had undergone a HBD, the prevalence of BOS was 48% (46.2% for ulcerative colitis and 51.2% for Crohn's disease). There was a strong correlation between abdominal bloating, abdominal rumbling, and positive HBT results in both patient groups...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28280785/cost-effectiveness-analysis-of-quadripolar%C3%A2-versus-bipolar-left-ventricular-leads-for-cardiac-resynchronization-defibrillator-therapy%C3%A2-in%C3%A2-a-large-multicenter-uk%C3%A2-registry
#15
Jonathan M Behar, Hui Men Selina Chin, Steve Fearn, Julian O M Ormerod, James Gamble, Paul W X Foley, Julian Bostock, Simon Claridge, Tom Jackson, Manav Sohal, Antonios P Antoniadis, Reza Razavi, Tim R Betts, Neil Herring, Christopher Aldo Rinaldi
OBJECTIVES: The objective of this study was to evaluate the cost-effectiveness of quadripolar versus bipolar cardiac resynchronization defibrillator therapy systems. BACKGROUND: Quadripolar left ventricular (LV) leads for cardiac resynchronization therapy reduce phrenic nerve stimulation (PNS) and are associated with reduced mortality compared with bipolar leads. METHODS: A total of 606 patients received implants at 3 UK centers (319 Q, 287 B), between 2009 and 2014; mean follow-up was 879 days...
February 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28279721/the-petticoat-technique-for-complicated-acute-stanford-type-b-aortic-dissection-using-as-distal-uncovered-stent-a-tapered-self-expanding-nitinol-device
#16
Michele Antonello, Francesco Squizzato, Chiara Colacchio, Jacopo Taglialavoro, Franco Grego, Michele Piazza
PURPOSE: Provisional ExTension To Induce COmplete Attachment (PETTICOAT) technique has shown good results in the treatment of acute type B aortic dissections (ABAD). Usually uncovered tubular stainless steel stents are used to promote distal true lumen reattachment. We describe the Petticoat technique using a conic self-expanding nitinol device as distal uncovered stent. CASE REPORT: Five cases of complicated ABAD were treated using a single-flared E-XL (Jotec-GmbH) as distal uncovered stent...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28277856/electrical-therapies-for-gastrointestinal-motility-disorders
#17
Jiande D Z Chen, Jieyun Yin, Wei Wei
Gastrointestinal (GI) motility disorders are common in clinical settings, including esophageal motility disorders, gastroesophageal reflux disease, functional dyspepsia, gastroparesis, chronic intestinal pseudo-obstruction, post-operative ileus, irritable bowel syndrome, diarrhea and constipation. While a number of drugs have been developed for treating GI motility disorders, few are currently available. Emerging electrical stimulation methods may provide new treatment options for these GI motility disorders...
March 6, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28275227/halogenated-volatile-anesthetics-in-the-intensive-care-unit-current-knowledge-on-an-upcoming-practice
#18
Pascal L Langlois, Frederick D'Aragon, William Manzanares
The aim of this narrative review was to highlight key points of volatile anesthetics administration in the intensive care unit (ICU), including AnaConDa® and Mirus® devices characteristics and the reported findings on clinical outcomes in critically ill patients. Intravenous sedation in the ICU is associated with issues, such as over- and under-sedation. Halogenated compounds, which can be safely administered by inserting a device in any ICU ventilation circuit, have interesting pharmacodynamic and pharmacokinetic profiles for patients with multi-organ failure...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28273989/healthcare-associated-infections-in-a-resource-limited-setting
#19
Chanaveerappa Bammigatti, Saikumar Doradla, Harish Narasimha Belgode, Harichandra Kumar, Rathinam Palamalai Swaminathan
INTRODUCTION: Health Care associated Infections (HAI) are the most common complications affecting the hospitalized patients. HAI are more common in developing and under developed countries. However, there are no systematic surveillance programs in these countries. AIM: To find out the burden, predisposing factors and multidrug resistant organisms causing HAI in a resource limited setting. MATERIALS AND METHODS: This prospective observational study was done at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28273273/prevalence-of-small-intestine-bacterial-overgrowth-in-patients-with-gastrointestinal-symptoms
#20
Carolina Piedade Martins, Caio Henrique Amorim Chaves, Maurício Gustavo Bravim de Castro, Isabel Cristina Gomes, Maria do Carmo Friche Passos
BACKGROUND: Small intestine bacterial overgrowth is a heterogeneous syndrome characterized by an increase in the number and/or the presence of atypical microbiota in the small intestine. The symptoms of small intestine bacterial overgrowth are unspecific, encompassing abdominal pain/distension, diarrhea and flatulence. Due to the increased cost and complexity for carrying out the jejunal aspirate, the gold standard for diagnosis of the syndrome, routinely the hydrogen (H 2 ) breath test has been used, utilizing glucose or lactulose as substrate, which is able to determine, in the exhaled air, the H 2 concentration produced from the intestinal bacterial metabolism...
February 23, 2017: Arquivos de Gastroenterologia
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