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Vascular Surgery Clinical Trials

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https://www.readbyqxmd.com/read/28647631/a-prospective-randomized-multicenter-clinical-trial-on-the-safety-and-efficacy-of-a-ready-to-use-fibrin-sealant-as-an-adjunct-to-hemostasis-during-vascular-surgery
#1
Ian Chetter, Gerard Stansby, José Aurelio Sarralde, Vicente Riambau, Antonio Giménez-Gaibar, Kent MacKenzie, Francisco Acín, Jordi Navarro-Puerto
PURPOSE: Anastomotic or "stitch hole" bleeding is common during vascular surgery with synthetic material such as Dacron or polytetrafluoroethylene (PTFE). Hemostatic adjuncts such as fibrin sealant (FS) may reduce blood loss and operating time in such circumstances. We evaluated the safety and the hemostatic effectiveness of a ready-to-use human plasma-derived FS in vascular surgery. METHODS: Patients with mild / moderate suture line bleeding during elective, open, vascular surgery using synthetic grafts or patches were studied...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28629445/effects-of-perioperative-statin-use-on-cardiovascular-complications-in-patients-submitted-to-non-cardiac-surgery-protocol-for-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#2
Erica Aranha Suzumura, Rodrigo Antonini Ribeiro, Leticia Kawano-Dourado, Pedro Gabriel de Barros E Silva, Claudia Oliveira, Mabel Fernandes Figueiró, Alexandre Biasi Cavalcanti, Renato D Lopes, Otavio Berwanger
BACKGROUND: Preliminary evidence suggests statins may reduce major perioperative vascular events. However, evidence is limited to observational studies, underpowered trials, and non-comprehensive systematic reviews. This review aims to assess the effects of perioperative statin use on cardiovascular complications in patients submitted to non-cardiac surgery. METHODS: We will search MEDLINE/PubMed, EMBASE, LILACS, CENTRAL, Web of Science, and CINAHL for randomized controlled trials assessing the effects of perioperative statin use in adults undergoing non-cardiac surgery and reporting cardiovascular complications...
June 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28622175/predictors-prognosis-and-management-of-new-clinically-important-atrial-fibrillation-after-noncardiac-surgery-a-prospective-cohort-study
#3
Pablo Alonso-Coello, Deborah Cook, Shou Chun Xu, Alben Sigamani, Otavio Berwanger, Soori Sivakumaran, Homer Yang, Denis Xavier, Luz Ximena Martinez, Pedro Ibarra, Purnima Rao-Melacini, Janice Pogue, Kelly Zarnke, Pilar Paniagua, Jack Ostrander, Salim Yusuf, P J Devereaux
BACKGROUND: Despite the frequency of new clinically important atrial fibrillation (AF) after noncardiac surgery and its increased association with the risk of stroke at 30 days, there are limited data informing their prediction, association with outcomes, and management. METHODS: We used the data from the PeriOperative ISchemic Evaluation trial to determine, in patients undergoing noncardiac surgery, the association of new clinically important AF with 30-day outcomes, and to assess management of these patients...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28619014/prognostic-impact-of-blood-and-urinary-angiogenic-factor-levels-at-diagnosis-and-during-treatment-in-patients-with-osteosarcoma-a-prospective-study
#4
Marie-Dominique Tabone, Laurence Brugières, Sophie Piperno-Neumann, Marie-Ange Selva, Perrine Marec-Bérard, Hélène Pacquement, Cyril Lervat, Nadège Corradini, Jean-Claude Gentet, Rémy Couderc, Aurélie Chevance, Céline Mahier-Ait Oukhatar, Natacha Entz-Werle, Jean-Yves Blay, Marie-Cecile Le Deley
BACKGROUND: Angiogenesis is essential for the progression and metastatic spread of solid tumours. Expression of vascular endothelial growth factor (VEGF) has been linked to poor survival among osteosarcoma patients but the clinical relevance of monitoring blood and urine angiogenic factors is uncertain. The aim of this study was to determine the prognostic significance of blood VEGF and blood and urinary basic fibroblast growth factor (bFGF) levels in osteosarcoma patients, both at diagnosis and during treatment...
June 15, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28616344/vascular-approaches-for-transcatheter-aortic-valve-implantation
#5
REVIEW
Isaac Pascual, Amelia Carro, Pablo Avanzas, Daniel Hernández-Vaquero, Rocío Díaz, Jose Rozado, Rebeca Lorca, María Martín, Jacobo Silva, César Morís
Transcatheter aortic valve implantation (TAVI) is a rapidly evolving therapeutic modality currently available for patients with severe aortic stenosis (AS) that are unsuitable for surgery because of technical/anatomical issues or high-estimated surgical risk. Transfemoral approach is the preferred TAVI delivery route when possible. Alternative non-transfemoral access options include transaortic, trans-subclavian and transapical access. Other approaches are also feasible (transcarotid, transcaval, and antegrade aortic) but are restricted to operators and hospitals with experience...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28600218/systematic-review-of-patient-specific-surgical-simulation-toward-advancing-medical-education-%C3%A2
#6
Won Hyung A Ryu, Navjit Dharampal, Ahmed E Mostafa, Ehud Sharlin, Gail Kopp, William Bradley Jacobs, Robin John Hurlbert, Sonny Chan, Garnette R Sutherland
OBJECTIVE: Simulation-based education has been shown to be an effective tool to teach foundational technical skills in various surgical specialties. However, most of the current simulations are limited to generic scenarios and do not allow continuation of the learning curve beyond basic technical skills to prepare for more advanced expertise, such as patient-specific surgical planning. The objective of this study was to evaluate the current medical literature with respect to the utilization and educational value of patient-specific simulations for surgical training...
June 6, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28592625/current-clinical-practice-guidelines-for-the-treatment-of-renal-cell-carcinoma-a-systematic-review-and-critical-evaluation
#7
Aristotle Bamias, Bernard Escudier, Cora N Sternberg, Flora Zagouri, Athanasios Dellis, Bob Djavan, Kimon Tzannis, Loukas Kontovinis, Konstantinos Stravodimos, Athanasios Papatsoris, Dionysios Mitropoulos, Charalampos Deliveliotis, Meletios-Athanasios Dimopoulos, Constantine A Constantinides
The landscape of local and systemic therapy of renal cell carcinoma (RCC) is rapidly changing. The increase in the incidental finding of small renal tumors has increased the application of nephron-sparing procedures, while ten novel agents targeting the vascular endothelial growth factor (VEGF) or the mammalian target of rapamycin pathways, or inhibiting the interaction of the programmed death 1 receptor with its ligand, have been approved since 2006 and have dramatically improved the prognosis of metastatic RCC (mRCC)...
June 2017: Oncologist
https://www.readbyqxmd.com/read/28569545/interview-with-alexander-cohen
#8
Alexander Ander Cohen
Ander Cohen speaks to Adam Price-Evans, Commissioning Editor of Future Cardiology: Alexander (Ander) Cohen MBBS (Hons), MSc, MD, FRACP is a vascular physician and epidemiologist at Guy's and St Thomas' Hospital, King's College (London, UK). He graduated with honors in medicine and honors in surgery from the University of Melbourne, Australia, and became a fellow of the Royal Australasian College of Physicians in 1990. He was awarded an MSc in Epidemiology from the London School of Hygiene and Tropical Medicine, University of London in 1991 with a thesis on the metabolic syndrome in South-Asian populations...
June 1, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28565894/contemporary-strategies-to-improve-the-outcome-in-locally-advanced-pancreatic-cancer
#9
Rick Schneider, Christoph Späth, Ulrich Nitsche, Mert Erkan, Jörg Kleeff
Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with an overall 5-year survival rate of less than 7%. After many years of basic and clinical research efforts, pancreatic cancer patients presenting with locally advanced, unresectable tumors remain a therapeutic challenge. Despite the lack of high quality randomized controlled trials, perioperative/ neoadjuvant treatment strategies seem to be beneficial in these patients. At present the FOLFIRINOX regimen, which was established in the palliative setting, is increasingly recognized as the backbone of neoadjuvant therapy for locally advanced PDAC...
May 30, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28554911/navigating-high-risk-surgery-protocol-for-a-multisite-stepped-wedge-cluster-randomised-trial-of-a-question-prompt-list-intervention-to-empower-older-adults-to-ask-questions-that-inform-treatment-decisions
#10
Lauren J Taylor, Paul J Rathouz, Ana Berlin, Karen J Brasel, Anne C Mosenthal, Emily Finlayson, Zara Cooper, Nicole M Steffens, Nora Jacobson, Anne Buffington, Jennifer L Tucholka, Qianqian Zhao, Margaret L Schwarze
INTRODUCTION: Older patients frequently undergo operations that carry high risk for postoperative complications and death. Poor preoperative communication between patients and surgeons can lead to uninformed decisions and result in unexpected outcomes, conflict between surgeons and patients, and treatment inconsistent with patient preferences. This article describes the protocol for a multisite, cluster-randomised trial that uses a stepped wedge design to test a patient-driven question prompt list (QPL) intervention aimed to improve preoperative decision making and inform postoperative expectations...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28553113/methotrexate-carried-in-lipid-core-nanoparticles-reduces-myocardial-infarction-size-and-improves-cardiac-function-in-rats
#11
Raul C Maranhão, Maria C Guido, Aline D de Lima, Elaine R Tavares, Alyne F Marques, Marcelo D Tavares de Melo, Jose C Nicolau, Vera Mc Salemi, Roberto Kalil-Filho
PURPOSE: Acute myocardial infarction (MI) is accompanied by myocardial inflammation, fibrosis, and ventricular remodeling that, when excessive or not properly regulated, may lead to heart failure. Previously, lipid core nanoparticles (LDE) used as carriers of the anti-inflammatory drug methotrexate (MTX) produced an 80-fold increase in the cell uptake of MTX. LDE-MTX treatment reduced vessel inflammation and atheromatous lesions induced in rabbits by cholesterol feeding. The aim of the study was to investigate the effects of LDE-MTX on rats with MI, compared with commercial MTX treatment...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28548204/endovascular-treatment-for-ruptured-abdominal-aortic-aneurysm
#12
REVIEW
Stephen Badger, Rachel Forster, Paul H Blair, Peter Ellis, Frank Kee, Denis W Harkin
BACKGROUND: An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) is a condition that can occur as a person ages. It is most commonly seen in men older than 65 years of age. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, which is fatal unless timely repair can be achieved. Despite improvements in perioperative care, mortality remains high (approximately 50%) after conventional open surgical repair. Endovascular aneurysm repair (EVAR), a minimally invasive technique, has been shown to reduce early morbidity and mortality as compared to conventional open surgery for planned AAA repair...
May 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28540465/technology-induced-errors-associated-with-computerized-provider-order-entry-software-for-older-patients
#13
Manuel Vélez-Díaz-Pallarés, Ana María Álvarez Díaz, Teresa Gramage Caro, Noelia Vicente Oliveros, Eva Delgado-Silveira, María Muñoz García, Alfonso José Cruz-Jentoft, Teresa Bermejo-Vicedo
Background The introduction of new technologies in the prescribing process has seen the emergence of new types of medication errors. Objective To determine the prevalence and consequences of technology-induced prescription errors associated with a computerized provider order entry (CPOE) system in hospitalized older patients. Setting Patients 65 years or older admitted to the Departments of Internal Medicine, General Surgery, and Vascular Surgery of a tertiary hospital. Method Prospective observational 6-month study...
May 24, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28538071/bone-scrapers-versus-piezoelectric-surgery-in-the-lateral-antrostomy-for-sinus-floor-elevation
#14
Claudio Stacchi, Teresa Lombardi, Paolo Cusimano, Federico Berton, Floriana Lauritano, Gabriele Cervino, Roberto Di Lenarda, Marco Cicciù
The purpose of this investigation is to evaluate 2 different methods for reducing cortical wall thickness in sinus floor augmentation surgery. A manual bone scraper was compared in terms of efficacy, speed, and safety to an ultrasonic insert for osteoplasty, in a randomized controlled clinical trial with a split-mouth design. Twenty-five patients with severe posterior maxillary atrophy were treated with bilateral sinus floor elevation with lateral approach. Antrostomies were randomly performed by eroding the cortical wall with a manual bone scraper (test site) or with an ultrasonic insert (control site) until the membrane was visible under a thin layer of bone, before outlining the window with a piezoelectric device...
May 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28537000/advances-in-clinical-cardiology-2016-a-summary-of-the-key-clinical-trials
#15
REVIEW
Alastair Gray, Conor McQuillan, Ian B A Menown
INTRODUCTION: The findings of many new cardiology clinical trials over the last year have been published or presented at major international meetings. This paper aims to describe and place in context a summary of the key clinical trials in cardiology presented between January and December 2016. METHODS: The authors reviewed clinical trials presented at major cardiology conferences during 2016 including the American College of Cardiology (ACC), European Association for Percutaneous Cardiovascular Interventions (EuroPCR), European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD), Transcatheter Cardiovascular Therapeutics (TCT), and the American Heart Association (AHA)...
May 23, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28507839/issues-in-managing-hurthle-cell-carcinoma-of-thyroid-a-case-report
#16
Patricia Tai, Martin Korzeniowski, Evgeny Sadikov, Kurian Joseph, Angus Kirby, Jon Tonita, Aamer Mahmud
A 61-year-old woman noticed a right neck lump in October 2001. Fine needle aspiration showed follicular neoplasm, adenoma versus carcinoma. The ultrasound scan showed a solid mass of maximum dimension of 3.7 cm. She had a right thyroid lobectomy and isthmectomy in January 2002 (first surgery). The tissue specimen showed a 4.5 cm Hurthle cell carcinoma (HCC) with vascular invasion. There were no capsular invasion, extra-thyroidal extension, or margin involvement. A completion left lobectomy (second surgery) was performed two weeks later...
April 14, 2017: Curēus
https://www.readbyqxmd.com/read/28506475/a-novel-perfused-porcine-simulator-for-teaching-aortic-anastomosis-increases-resident-interest-in-vascular-surgery
#17
Peter B Bartline, Jennie O'Shea, James M McGreevy, Michelle T Mueller
OBJECTIVE: This report describes a novel simulator, euthanized pigs on cardiopulmonary bypass, and validates this simulator with a controlled trial in general surgery residents learning aortic anastomosis. We evaluated this novel simulator with the following hypothesis: our porcine perfused simulator is as good as or better than the standard rubber tubing, low-fidelity models used for vascular anastomotic training. METHODS: Euthanized pigs were placed on cardiopulmonary bypass, creating a perfused, ex vivo model on which to perform surgical procedures...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#18
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28494033/intraoperative-complications-during-sinus-floor-elevation-with-lateral-approach-a-systematic-review
#19
Claudio Stacchi, Francesca Andolsek, Federico Berton, Giuseppe Perinetti, Chiara Ottavia Navarra, Roberto Di Lenarda
PURPOSE: To analyze the occurrence of intraoperative complications during sinus floor elevation with a lateral approach and their correlations with the technique adopted by surgeons. MATERIALS AND METHODS: Electronic and manual searches resulted in 4,417 records on sinus floor elevation. Twenty-one randomized clinical trials (RCTs) and 11 prospective controlled clinical trials (CCTs) reporting occurrence of intraoperative complications were included. Risk of bias was assessed according to the Cochrane tool and a modified Downs and Black quality analysis for RCTs and CCTs, respectively...
May 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/28474152/free-vascularized-fibular-grafting-improves-vascularity-compared-with-core-decompression-in-femoral-head-osteonecrosis-a-randomized-clinical-trial
#20
Lu Cao, Changan Guo, Jifei Chen, Zenggan Chen, Zuoqin Yan
BACKGROUND: Management of osteonecrosis of the femoral head remains challenging. Core decompression and free vascularized fibular grafting are commonly used surgical procedures for treatment of osteonecrosis of the femoral head. Few studies, however, have compared these two procedures in a randomized controlled study, in terms of improved vascularity of the femoral head, progression of disease, or hip scores. QUESTION/PURPOSES: (1) What is the effect of core decompression and fibular grafting on vascularity of the femoral head as measured by single-photon emission CT (SPECT)/CT? (2) Does one of these two methods lead to greater progression of Association Research Circulation Osseous (ARCO) stage as determined by serial MRI? (3) What is the relationship between the change in vascularity of the femoral head and hip function as measured by the Harris hip score (HHS) and progression to THA as an endpoint? METHODS: A randomized controlled trial was performed between June 2010 and October 2012 at Zhongshan Hospital, Fudan University...
May 4, 2017: Clinical Orthopaedics and related Research
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