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Vascular Surgery Clinical Trials

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https://www.readbyqxmd.com/read/29211969/use-of-platelet-rich-plasma-immediately-after-an-injury-did-not-improve-ligament-healing-and-increasing-platelet-concentrations-was-detrimental-in-an-in-vivo-animal-model
#1
Robert F LaPrade, Laurie R Goodrich, Jennifer Phillips, Grant J Dornan, Travis Lee Turnbull, Michael L Hawes, Kimi D Dahl, Ashley N Coggins, John Kisiday, David Frisbie, Jorge Chahla
BACKGROUND: Limited information in basic science and clinical trials exists to determine if ligament healing may be accelerated with the use of biological adjuvants, such as platelet-rich plasma (PRP). However, there has been widespread acceptance of PRP for use in clinical practice, despite an inadequate understanding of its biological mechanism of action. PURPOSE: To determine whether a single dose of PRP could accelerate ligament healing and correspondingly improve histological characteristics and biomechanical properties when injected immediately postoperatively into the injured medial collateral ligament (MCL) of New Zealand White rabbits...
December 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29209927/hydroxocobalamin-for-the-treatment-of-cardiac-surgery-associated-vasoplegia-a-case-series
#2
Pranav R Shah, Penny S Reynolds, Nirvik Pal, Daniel Tang, Harry McCarthy, Bruce D Spiess
PURPOSE: Vasoplegia is a clinical syndrome marked by severe arteriolar vasodilatation, hypotension, and low systemic vascular resistance refractory to multiple vasopressor treatment. We report our experience with hydroxocobalamin (B12) infusion as a potential rescue adjunct for refractory vasoplegia during cardiopulmonary bypass (CPB). METHODS: We performed a retrospective chart review of 33 patients undergoing cardiac surgery between 1 January 2013 and 31 December 2015, who were given intravenous B12 for refractory hypotension during, or immediately following, CPB...
December 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29183303/link-between-neurodegeneration-and-trabecular-meshwork-injury-in-glaucomatous-patients
#3
Yong Zhang, Qinmei Yang, Feng Guo, Xia Chen, Lin Xie
BACKGROUND: Glaucoma is classified as a neurodegenerative disease. However, the biomarkers of neurodegeneration in the aqueous humour of primary open angle glaucoma (POAG) eyes have not been quantitatively examined yet. In this study, levels of neurodegeneration-related cytokines in the aqueous humour of POAG eyes were measured and compared with those of non-glaucoma (senile cataract) control eyes. METHODS: This cross-sectional study included 24 patients (24 eyes) with POAG and 22 patients (22 eyes) with cataract...
November 28, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/29182953/the-use-of-laser-doppler-flowmetry-to-evaluate-oral-soft-tissue-blood-flow-in-humans-a-review
#4
REVIEW
Ayepa Alain Kouadio, Fabienne Jordana, N'goran Justin Koffi, Pierre Le Bars, Assem Soueidan
The objective of this work is to define the conditions for improving the use of laser Doppler flowmetry (LDF) and to determine the limits for the use of this technique. This article systematically reviews the literature on the evaluation of oral soft tissue blood microcirculation by LDF. We analysed the available literature through October 2016 using the database resources Medline/PubMed, the Cochrane Oral Health Group Specialist Trials Register and the ISI Web of Knowledge. Several points emerged from this literature review The use of LDF involves specific constraints; however, the influence of different factors (temperature, tobacco, pressure etc...
November 22, 2017: Archives of Oral Biology
https://www.readbyqxmd.com/read/29169544/systematic-review-and-meta-analysis-of-duplex-ultrasound-surveillance-for-infrainguinal-vein-bypass-grafts
#5
REVIEW
Abd Moain Abu Dabrh, Khaled Mohammed, Wigdan Farah, Qusay Haydour, R Eugene Zierler, Zhen Wang, Larry J Prokop, M Hassan Murad
OBJECTIVE: Duplex ultrasound (DUS) surveillance of infrainguinal vein bypass grafts is widely practiced, but the evidence of its effectiveness compared with other methods of surveillance remains unclear. METHODS: Following an a priori protocol developed by the guidelines committee from the Society for Vascular Surgery, this systematic review and meta-analysis included randomized and nonrandomized comparative studies that enrolled patients who underwent infrainguinal arterial reconstruction and received DUS surveillance for follow-up compared with any other method of surveillance...
December 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29161549/ultrasound-guided-versus-conventional-injection-for-caudal-block-in-children-a-prospective-randomized-clinical-study
#6
Ali Ahiskalioglu, Ahmet Murat Yayik, Elif Oral Ahiskalioglu, Mursel Ekinci, Birzat Emre Gölboyu, Erkan Cem Celik, Haci Ahmet Alici, Akgun Oral, Saban Oguz Demirdogen
STUDY OBJECTIVE: The aim of this study was to compare the efficacies of ultrasound guided sacral hiatus injection and conventional sacral canal injection performed for caudal block in children. DESIGN: Randomized controlled clinical trial. SETTING: Operating rooms of university hospital of Erzurum, Turkey. PATIENTS: One hundred-thirty four children, American Society of Anesthesiologists I-II, between the ages of 5 and 12, scheduled for elective phimosis and circumcision surgery...
November 18, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29161465/neuromuscular-electrical-stimulation-for-the-prevention-of-venous-thromboembolism
#7
REVIEW
Shahab Hajibandeh, Shahin Hajibandeh, George A Antoniou, James Rh Scurr, Francesco Torella
BACKGROUND: Venous thromboembolism (VTE) is a serious but preventable cause of morbidity and mortality. Neuromuscular electrical stimulation systems (NMES) for the prevention of VTE may be beneficial for patients in whom pharmacological or standard mechanical prophylaxis methods are contraindicated or are regarded as unsafe or impractical. Although findings of experimental studies suggest that NMES reduce venous stasis, the clinical utility and effectiveness of NMES in VTE prevention remain controversial...
November 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29158852/curative-metatarsal-bone-surgery-combined-with-intralesional-administration-of-recombinant-human-epidermal-growth-factor-in-diabetic-neuropathic-ulceration-of-the-forefoot-a-prospective-open-uncontrolled-nonrandomized-observational-study
#8
Aristides L Garcia Herrera, Ridel de Jesús Febles Sanabria, Liliana de Los Ángeles Acosta Cabadilla, Miriam Moliner Cartaya
Background: Curative surgery is performed for a foot with ulcers and loss of protective sensation to heal the wound and prevent amputation. Evidence supports that patients with diabetes have decreased concentrations of growth factors in their tissues, notably epidermal growth factor (EGF). Injecting EGF deep into the bottom of the wound and its contours encourages a more effective response in terms of granulation tissue growth and wound closure. Objective: To assess the effectiveness and safety of curative metatarsal bone surgery combined with intralesional administration of human recombitant EGF in neuropathic diabetic forefoot ulceration...
2017: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/29156557/the-invasive-region-of-glioblastoma-defined-by-5ala-guided-surgery-has-an-altered-cancer-stem-cell-marker-profile-compared-to-central-tumour
#9
Stuart J Smith, Mohammed Diksin, Saachi Chhaya, Shwetha Sairam, Maria A Estevez-Cebrero, Ruman Rahman
Glioblastoma, a WHO grade IV astrocytoma, is a highly aggressive and heterogeneous tumour that infiltrates deeply into surrounding brain parenchyma, making complete surgical resection impossible. Despite chemo-radiotherapy, the residual cell population within brain parenchyma post-surgery causes inevitable recurrence. Previously, the tumour core has been the focus of research and the basis for targeted therapeutic regimes, which have failed to improve survival in clinical trials. Here, we focus on the invasive margin as defined by the region with 5-aminolevulinic acid (5ALA) (GliolanTM) fluorescence at surgery beyond the T1 enhancing region on magnetic resonance imaging (MRI)...
November 18, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29132879/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-coronary-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#10
Stuart J Connolly, John W Eikelboom, Jackie Bosch, Gilles Dagenais, Leanne Dyal, Fernando Lanas, Kaj Metsarinne, Martin O'Donnell, Anthony L Dans, Jong-Won Ha, Alexandr N Parkhomenko, Alvaro A Avezum, Eva Lonn, Liu Lisheng, Christian Torp-Pedersen, Petr Widimsky, Aldo P Maggioni, Camilo Felix, Katalin Keltai, Masatsugu Hori, Khalid Yusoff, Tomasz J Guzik, Deepak L Bhatt, Kelley R H Branch, Nancy Cook Bruns, Scott D Berkowitz, Sonia S Anand, John D Varigos, Keith A A Fox, Salim Yusuf
BACKGROUND: Coronary artery disease is a major cause of morbidity and mortality worldwide, and is a consequence of acute thrombotic events involving activation of platelets and coagulation proteins. Factor Xa inhibitors and aspirin each reduce thrombotic events but have not yet been tested in combination or against each other in patients with stable coronary artery disease. METHODS: In this multicentre, double-blind, randomised, placebo-controlled, outpatient trial, patients with stable coronary artery disease or peripheral artery disease were recruited at 602 hospitals, clinics, or community centres in 33 countries...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29107679/efficacy-and-safety-of-selective-internal-radiotherapy-with-yttrium-90-resin-microspheres-compared-with-sorafenib-in-locally-advanced-and-inoperable-hepatocellular-carcinoma-sarah-an-open-label-randomised-controlled-phase-3-trial
#11
Valérie Vilgrain, Helena Pereira, Eric Assenat, Boris Guiu, Alina Diana Ilonca, Georges-Philippe Pageaux, Annie Sibert, Mohamed Bouattour, Rachida Lebtahi, Wassim Allaham, Hélène Barraud, Valérie Laurent, Elodie Mathias, Jean-Pierre Bronowicki, Jean-Pierre Tasu, Rémy Perdrisot, Christine Silvain, René Gerolami, Olivier Mundler, Jean-Francois Seitz, Vincent Vidal, Christophe Aubé, Frédéric Oberti, Olivier Couturier, Isabelle Brenot-Rossi, Jean-Luc Raoul, Anthony Sarran, Charlotte Costentin, Emmanuel Itti, Alain Luciani, René Adam, Maïté Lewin, Didier Samuel, Maxime Ronot, Aurelia Dinut, Laurent Castera, Gilles Chatellier
BACKGROUND: Sorafenib is the recommended treatment for patients with advanced hepatocellular carcinoma. We aimed to compare the efficacy and safety of sorafenib to that of selective internal radiotherapy (SIRT) with yttrium-90 ((90)Y) resin microspheres in patients with hepatocellular carcinoma. METHODS: SARAH was a multicentre, open-label, randomised, controlled, investigator-initiated, phase 3 trial done at 25 centres specialising in liver diseases in France. Patients were eligible if they were aged at least 18 years with a life expectancy greater than 3 months, had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, Child-Pugh liver function class A or B score of 7 or lower, and locally advanced hepatocellular carcinoma (Barcelona Clinic Liver Cancer [BCLC] stage C), or new hepatocellular carcinoma not eligible for surgical resection, liver transplantation, or thermal ablation after a previously cured hepatocellular carcinoma (cured by surgery or thermoablative therapy), or hepatocellular carcinoma with two unsuccessful rounds of transarterial chemoembolisation...
October 26, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29106320/near-infrared-fluorescence-imaging-for-real-time-intraoperative-guidance-in-anastomotic-colorectal-surgery-a-systematic-review-of-literature
#12
Jacqueline van den Bos, Mahdi Al-Taher, Rutger M Schols, Sander van Kuijk, Nicole D Bouvy, Laurents P S Stassen
PURPOSE: The aims of this review are to determine the feasibility of near-infrared fluorescence (NIRF) angiography in anastomotic colorectal surgery and to determine the effectiveness of the technique in improving imaging and quantification of vascularization, thereby aiding in decision making as to where to establish the anastomosis. METHODS: A systematic literature search of PubMed and EMBASE was conducted. Searching through the reference lists of selected articles identified additional studies...
November 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29080078/blood-flow-changes-using-a-3d-xenogeneic-collagen-matrix-or-a-subepithelial-connective-tissue-graft-for-root-coverage-procedures-a-pilot-study
#13
Nikolaos Tatarakis, Nikolaos Gkranias, Ulpee Darbar, Nikolaos Donos
BACKGROUND: The study investigated the early healing process following the treatment of single Miller class I and II recessions with a 3D xenogeneic collagen matrix (CMX) or connective tissue graft (CTG). METHODS: This pilot investigation was designed as a single-center randomized controlled parallel trial. A total of eight subjects (four per group) were treated with either CMX or CTG in the anterior maxilla. Vascular flow changes were assessed by laser Doppler flowmetry (LDF) before and after surgery and at days 1, 2, 3, 7, 14, and 30 while clinical evaluations took place at baseline and at days 60 and 180...
October 27, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29075781/association-of-cataract-surgery-with-mortality-in-older-women-findings-from-the-women-s-health-initiative
#14
Victoria L Tseng, Rowan T Chlebowski, Fei Yu, Jane A Cauley, Wenjun Li, Fridtjof Thomas, Beth A Virnig, Anne L Coleman
Importance: Previous studies have suggested an association between cataract surgery and decreased risk for all-cause mortality potentially through a mechanism of improved health status and functional independence, but the association between cataract surgery and cause-specific mortality has not been previously studied and is not well understood. Objective: To examine the association between cataract surgery and total and cause-specific mortality in older women with cataract...
October 26, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29055710/remote-ischemic-preconditioning-in-high-risk-cardiovascular-surgery-patients-a-randomized-controlled-trial
#15
Nicole S Coverdale, Andrew Hamilton, Dimitri Petsikas, R Scott McClure, Paul Malik, Brian Milne, Tarit Saha, David Zelt, Peter Brown, Darrin M Payne
Remote ischemic preconditioning (RIPC) may reduce biomarkers of ischemic injury after cardiovascular surgery. However, it is unclear whether RIPC has a positive impact on clinical outcomes. We performed a blinded, randomized controlled trial to determine if RIPC resulted in fewer adverse clinical outcomes after cardiac or vascular surgery. The intervention consisted of 3 cycles of RIPC on the upper limb for 5 minutes alternated with 5 minutes of rest. A sham intervention was performed on the control group. Patients were recruited who were undergoing (1) high-risk cardiac or vascular surgery or (2) cardiac or vascular surgery and were at high risk of ischemic complications...
September 11, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28993845/-new-experimental-strategies-in-cartilage-surgery
#16
REVIEW
L Rackwitz, J C Reichert, O Pullig, U Nöth
BACKGROUND: Cell and growth factor based strategies bear great potential to support the healing processes in cartilage repair and the therapy of osteoarthritic joints. OBJECTIVES: The following review provides an overview of novel experimental strategies for the therapy of focal cartilage defects and osteoarthritis, with emphasis on cell and growth factor based approaches. MATERIALS AND METHODS: The authors summarize their own data regarding the intraarticular injection of stem cells to treat osteoarthritis of the knee and provide a synopsis of the available literature discussing the most significant publications...
November 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28976426/blood-conservation-using-tranexamic-acid-is-not-superior-to-epsilon-aminocaproic-acid-after-total-knee-arthroplasty
#17
RANDOMIZED CONTROLLED TRIAL
Clifford Kent Boese, Leslie Centeno, Ryan W Walters
BACKGROUND: Epsilon-aminocaproic acid (EACA) and tranexamic acid (TXA) are synthetic amino acid derivatives that interfere with fibrinolysis, promoting hemostasis by pharmacological means. Although both drugs have been shown to decrease blood loss with a minimal risk of thromboembolic adverse events following cardiac and vascular surgery, we are aware of only 1 published trial that directly compared the antifibrinolytic effects of EACA with those of TXA after total knee arthroplasty (TKA)...
October 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28943515/bleeding-impacting-mortality-after-noncardiac-surgery-a-protocol-to-establish-diagnostic-criteria-estimate-prognostic-importance-and-develop-and-validate-a-prediction-guide-in-an-international-prospective-cohort-study
#18
Pavel S Roshanov, John W Eikelboom, Mark Crowther, Vikas Tandon, Flavia K Borges, Clive Kearon, Andre Lamy, Richard Whitlock, Bruce M Biccard, Wojciech Szczeklik, Gordon H Guyatt, Mohamed Panju, Jessica Spence, Amit X Garg, Michael McGillion, Tomas VanHelder, Peter A Kavsak, Justin de Beer, Mitchell Winemaker, Daniel I Sessler, Yannick Le Manach, Tej Sheth, Jehonathan H Pinthus, Lehana Thabane, Marko R I Simunovic, Ryszard Mizera, Sebastian Ribas, P J Devereaux
INTRODUCTION: Various definitions of bleeding have been used in perioperative studies without systematic assessment of the diagnostic criteria for their independent association with outcomes important to patients. Our proposed definition of bleeding impacting mortality after noncardiac surgery (BIMS) is bleeding that is independently associated with death during or within 30 days after noncardiac surgery. We describe our analysis plan to sequentially 1) establish the diagnostic criteria for BIMS, 2) estimate the independent contribution of BIMS to 30-day mortality and 3) develop and internally validate a clinical prediction guide to estimate patient-specific risk of BIMS...
August 4, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28943459/descriptive-cadaveric-study-comparing-the-accuracy-of-ultrasound-versus-fluoroscopic-guidance-for-first-sacral-transforaminal-injections-a-comparison-study
#19
Bradley F Thompson, Matthew J Pingree, Wenchun Qu, Naveen S Murthy, Nirusha Lachman, Mark Friedrich Hurdle
BACKGROUND: Ultrasound is rarely used for guiding lumbosacral epidural steroid injections due to its technical limitations. For example, sonographic imaging lacks the ability to confirm epidural spread and identify vascular uptake. The perceived risk that these limitations pose to human subjects has precluded any large scale clinical trials to date. OBJECTIVE: To compare the accuracy of ultrasound versus fluoroscopic guidance for first sacral transforaminal epidural injections DESIGN: Cadaveric comparative study using dichotomous outcomes...
September 21, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28936594/transcatheter-aortic-valve-replacement-outcomes-indications-complications-and-innovations
#20
REVIEW
Michael N Young, Ignacio Inglessis
Transcatheter aortic valve replacement (TAVR) has become the standard of care for the treatment of severe aortic stenosis in individuals who are at prohibitive surgical risk and presents a viable alternative to surgery in selected patients who are at high operative risk. To date, outcomes from the PARTNER (Placement of AoRtic TraNscathetER Valve) and Medtronic CoreValve® US Pivotal trials continue to show the benefits of TAVR in these high-risk subgroups out to 5 and 3 years, respectively (as reported by Mack et al...
September 22, 2017: Current Treatment Options in Cardiovascular Medicine
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