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https://www.readbyqxmd.com/read/27887785/thromboelastography-teg%C3%A2-demonstrates-that-tinzaparin-4500-international-units-has-no-detectable-anticoagulant-activity-after-caesarean-section
#1
S Griffiths, C Woo, V Mansoubi, A Riccoboni, A Sabharwal, S Napier, M Columb, M Laffan, G Stocks
BACKGROUND: Low molecular weight heparin is routinely used for thromboprophylaxis in pregnancy and the puerperium. Consensus guidelines recommend waiting 10-12h after administration of a thromboprophylactic dose of low molecular weight heparin before performing a neuraxial block or removing an epidural catheter. Thromboelastography (TEG®) has been reported to be sensitive to the effects of enoxaparin 4h after administration. The purpose of this study was to use TEG to examine coagulation changes in the first 10h after a thromboprophylactic dose of tinzaparin in an attempt to ratify the current consensus guidelines about timing of neuraxial blockade and epidural catheter removal...
October 8, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27864325/a-technical-consideration-when-using-flow-diversion-for-recurrent-aneurysms-following-stent-assisted-coiling
#2
Justin R Mascitelli, Daniel Wei, Thomas J Oxley, Christopher P Kellner, Hazem Shoirah, Reade A De Leacy, J Mocco, Johanna T Fifi
Flow diversion (FD) is a treatment option for recurrent aneurysms including following stent-assisted coiling (SAC), although this approach is both 'off-label' and unproven. A technical challenge of FD placement may involve the microwire catching on the tines of the previously placed stent or potentially going 'in-out-in' from the central axis of the stent. We report a case and technique that assures the wire has safely remained within the central axis of the stent. The procedure was performed in standard fashion except that the intermediate catheter was passed completely through the previously placed stent after the microwire/microcatheter had crossed...
November 18, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27852655/a-technical-consideration-when-using-flow-diversion-for-recurrent-aneurysms-following-stent-assisted-coiling
#3
Justin R Mascitelli, Daniel Wei, Thomas J Oxley, Christopher P Kellner, Hazem Shoirah, Reade A De Leacy, J Mocco, Johanna T Fifi
Flow diversion (FD) is a treatment option for recurrent aneurysms including following stent-assisted coiling (SAC), although this approach is both 'off-label' and unproven. A technical challenge of FD placement may involve the microwire catching on the tines of the previously placed stent or potentially going 'in-out-in' from the central axis of the stent. We report a case and technique that assures the wire has safely remained within the central axis of the stent. The procedure was performed in standard fashion except that the intermediate catheter was passed completely through the previously placed stent after the microwire/microcatheter had crossed...
November 15, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27830895/thrombolysis-for-acute-deep-vein-thrombosis
#4
REVIEW
Lorna Watson, Cathryn Broderick, Matthew P Armon
BACKGROUND: Standard treatment for deep vein thrombosis aims to reduce immediate complications. Use of thrombolysis or clot dissolving drugs could reduce the long-term complications of post-thrombotic syndrome (PTS) including pain, swelling, skin discolouration, or venous ulceration in the affected leg. This is the third update of a review first published in 2004. OBJECTIVES: To assess the effects of thrombolytic therapy and anticoagulation compared to anticoagulation alone for the management of people with acute deep vein thrombosis (DVT) of the lower limb as determined by the effects on pulmonary embolism, recurrent venous thromboembolism, major bleeding, post-thrombotic complications, venous patency and venous function...
November 10, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27824609/prospective-validation-of-right-ventricular-role-in-primary-graft-dysfunction-after-lung-transplantation
#5
Purificación Pérez-Terán, Oriol Roca, José Rodríguez-Palomares, Juan C Ruiz-Rodríguez, Ana Zapatero, Joaquim Gea, Joaquim Serra, Arturo Evangelista, Joan R Masclans
Primary graft dysfunction is a significant cause of lung transplant morbidity and mortality, but its underlying mechanisms are not completely understood. The aims of the present study were: 1) to confirm that right ventricular function is a risk factor for severe primary graft dysfunction; and 2) to propose a clinical model for predicting the development of severe primary graft dysfunction.A prospective cohort study was performed over 14 months. The primary outcome was development of primary graft dysfunction grade 3...
December 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27823821/prostate-high-dose-rate-brachytherapy-as-monotherapy-for-low-and-intermediate-risk-prostate-cancer-early-toxicity-and-quality-of-life-results-from-a-randomized-phase-ii-clinical-trial-of-one-fraction-of-19gy-or-two-fractions-of-13-5gy
#6
Gerard Morton, Hans T Chung, Merrylee McGuffin, Joelle Helou, Laura D'Alimonte, Ananth Ravi, Patrick Cheung, Ewa Szumacher, Stanley Liu, Motasem Al-Hanaqta, Liying Zhang, Alexandre Mamedov, Andrew Loblaw
BACKGROUND AND PURPOSE: Multi-fraction high dose-rate (HDR) brachytherapy as monotherapy is safe and effective for low and intermediate risk prostate cancer. Two or single fraction regimens have some radiobiological rationale. The purpose is to determine toxicity and effect on health related quality of life (HRQOL) of single fraction 19Gy or 13.5Gy×2. MATERIALS AND METHODS: Eligible patients had low or intermediate risk prostate cancer, prostate volume <60cc, and no androgen deprivation use...
November 4, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/27818999/percutaneous-transluminal-angioplasty-in-patients-with-peripheral-arterial-disease-does-not-affect-circulating-monocyte-subpopulations
#7
Pawel Maga, Tomasz P Mikolajczyk, Lukasz Partyka, Marek Krzanowski, Krzysztof P Malinowski, Rafal Nizankowski
Monocytes are mononuclear cells characterized by distinct morphology and expression of CD14 and CD16 surface receptors. Classical, quiescent monocytes are positive for CD14 (lipopolysaccharide receptor) but do not express Fc gamma receptor III (CD16). Intermediate monocytes coexpress CD16 and CD14. Nonclassical monocytes with low expression of CD14 represent mature macrophage-like monocytes. Monocyte behavior in peripheral arterial disease (PAD) and during vessel wall directed treatment is not well defined...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27815709/stage-directed-therapy-of-pleural-empyema
#8
REVIEW
Martin Reichert, Matthias Hecker, Biruta Witte, Johannes Bodner, Winfried Padberg, Markus A Weigand, Andreas Hecker
PURPOSE: Intensivists and surgeons are often confronted with critically ill patients suffering from pleural empyema. Due to it' s multifactorial pathogenesis and etiology, medicals should be sensitized to recognize the different stages of the disease. Besides a whole bundle of different established classification systems, the progress of pleural effusions can be subdivided into the early exudative, the intermediate fibropurulent and the late organized phase according to the classification of the American Thoracic Society...
November 4, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27789787/initial-experience-with-sofia-as-an-intermediate-catheter-in-mechanical-thrombectomy-for-acute-ischemic-stroke
#9
Johnny H Y Wong, Huy M Do, Nicholas A Telischak, Adrienne M Moraff, Robert L Dodd, Michael P Marks, Shreya M Ingle, Jeremy J Heit
BACKGROUND: The benefits of mechanical thrombectomy for emergent large vessel occlusion (ELVO) have been established. Combined mechanical/aspiration (Solumbra) and a direct aspiration as a first pass technique (ADAPT) are valid procedures requiring an intermediate catheter for clot suction. Recently, SOFIA (Soft torqueable catheter Optimized For Intracranial Access) was developed as a single lumen flexible catheter with coil and braid reinforcement, but its suitability for mechanical thrombectomy had not been evaluated...
October 27, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27769084/pulmonary-embolism-response-teams
#10
Alison S Witkin, Savanah Harshbarger, Christopher Kabrhel
Pulmonary embolism is a common and often life-threatening event. Treatment options include anticoagulation alone, catheter-directed therapies, and surgical thromboembolectomy. While guidelines exist, there is often controversy over which treatment is most appropriate, particularly for intermediate-risk patients. The traditional care model, in which the primary team is responsible for consulting the appropriate specialists, may be inadequate and inefficient for emergent situations, as ensuring coordination and communication between various consulting services can be a time consuming and confusing process...
November 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27754185/hw-02-3-ambulatory-central-blood-pressure-what-is-the-evidence-for-validation
#11
Thomas Weber
Validation of a medical device measuring a biomarker is a complex process, involving technical aspects (What is actually measured by the device, and how is this done ? Is the measurement reproducible ? Is there a gold standard for measurement of the particular biomarker ? If yes, how accurate and how precise are the measurements by the device, compared to the gold standard ?) and clinical aspects (Do the measurements predict outcome ? If yes, is there added value, when standard clinical parameters are considered ? Is there a treatment strategy, based on the mesurements of the novel device ? Is this strategy cost-effective ?)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27741040/citric-acid-cycle-metabolites-predict-the-severity-of-myocardial-stunning-and-mortality-in-newborn-pigs
#12
Janus Adler Hyldebrandt, Nicolaj Brejnholt Støttrup, Christian Alcaraz Frederiksen, Johan Heiberg, Rune Isak Dupont Birkler, Mogens Johannsen, Michael Rahbek Schmidt, Hanne Berg Ravn
OBJECTIVES: Myocardial infarction and chronic heart failure induce specific metabolic changes in the neonatal myocardium that are closely correlated to outcome. The aim of this study was to examine the metabolic responses to noninfarct heart failure and inotropic treatments in the newborn heart, which so far are undetermined. DESIGN: A total of 28 newborn pigs were instrumented with a microdialysis catheter in the right ventricle, and intercellular citric acid cycle intermediates and adenosine metabolite concentrations were determined at 20-minute intervals...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27707526/identifying-and-managing-premature-ventricular-contraction-induced-cardiomyopathy-what-why-and-how
#13
Wael A Alqarawi, F Daniel Ramirez, Pablo B Nery, Calum J Redpath, Mouhannad M Sadek, Martin S Green, David H Birnie, Girish M Nair
Premature ventricular contraction (PVC)-induced cardiomyopathy is increasingly being recognized as a reversible cause of left ventricular (LV) systolic dysfunction (LVSD). The diagnosis of PVC-induced cardiomyopathy is considered in subjects with high PVC burdens (> 10,000 per 24 hours) after excluding other known causes of LVSD. PVC suppression is the mainstay of the management of PVC-induced cardiomyopathy, in addition to proven evidence-based medical therapy recommended for subjects with LVSD. Management strategies for PVC-induced cardiomyopathy include medical therapy and/or catheter ablation, with an increasing role for catheter ablation as a first-line therapy in view of the potential for permanent suppression of PVCs...
July 1, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27702853/left-atrial-model-reconstruction-in-atrial-fibrillation-ablation-reliability-of-new-mapping-and-complex-impedance-systems
#14
Aldo Bonso, Mauro Fantinel, Giovanna Scalchi, Sabrina Ferrara, Stefano Indiani, Federico Calore, Claudia Licciardello
AIMS: The effectiveness of atrial fibrillation (AF) ablation relies on detailed knowledge of the anatomy of the left atrium (LA) and pulmonary veins (PVs). It is common to combine computed tomography/magnetic resonance (CT/MR) with imaging by electroanatomical (EA) mapping systems. The aim of this study was to evaluate the accuracy of LA anatomical reconstruction by 'One Model' and 'VeriSense' tools (Ensite Velocity 3.0, St Jude Medical), compared with CT/MR imaging. METHODS AND RESULTS: Seventy-two patients with AF underwent pre-procedural imaging (97% CT-scan, 3% MR imaging) and transcatheter ablation of PVs...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27695816/dexamethasone-treatment-differentially-alters-viral-shedding-and-the-antibody-and-acute-phase-protein-response-after-multivalent-respiratory-vaccination-in-beef-steers
#15
J T Richeson, J A Carroll, N C Burdick Sanchez, N D May, H D Hughes, S L Roberts, P R Broadway, K P Sharon, M A Ballou
Our objective was to examine immunosuppression induced by dexamethasone (DEX) administration in cattle on immunological responses to a multivalent respiratory vaccine containing replicating and nonreplicating agents. Steers ( = 32; 209 ± 8 kg) seronegative to infectious bovine rhinotracheitis virus (IBRV), bovine viral diarrhea virus (BVDV), bovine respiratory syncytial virus (BRSV), and parainfluenza-3 virus (PI3V) were stratified by BW and randomly assigned to 1 of 3 treatments: 1) acute immunosuppression (ACU; 0...
August 2016: Journal of Animal Science
https://www.readbyqxmd.com/read/27662566/prediction-of-catheter-associated-thrombosis-in-critically-ill-children
#16
Alexandra Marquez, Veronika Shabanova, Edward Vincent S Faustino
OBJECTIVE: We determined whether in critically ill children with an untunneled central venous catheter, the risk of catheter-associated deep venous thrombosis can be predicted within 24 hours after insertion of the catheter. DESIGN: Secondary analysis of two multicenter prospective cohort studies. SETTING: PICUs in Northeastern United States. PATIENTS: A total of 175 children admitted to the PICU within 24 hours after insertion of an untunneled central venous catheter who did not receive anticoagulation were included...
November 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27643142/hw-02-3-ambulatory-central-blood-pressure-what-is-the-evidence-for-validation
#17
Thomas Weber
Validation of a medical device measuring a biomarker is a complex process, involving technical aspects (What is actually measured by the device, and how is this done ? Is the measurement reproducible ? Is there a gold standard for measurement of the particular biomarker ? If yes, how accurate and how precise are the measurements by the device, compared to the gold standard ?) and clinical aspects (Do the measurements predict outcome ? If yes, is there added value, when standard clinical parameters are considered ? Is there a treatment strategy, based on the mesurements of the novel device ? Is this strategy cost-effective ?)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27609936/ultrasound-assisted-catheter-directed-thrombolysis-a-novel-and-promising-endovascular-therapeutic-modality-for-intermediate-risk-pulmonary-embolism
#18
Mohamed Teleb, Mateo Porres-Aguilar, Belinda Rivera-Lebron, Kyari Sumayin Ngamdu, Gehan Botrus, Javier E Anaya-Ayala, Debabrata Mukherjee
Intermediate-risk pulmonary embolism (PE), also known as submassive PE, occurs in a substantial group of patients and carries a significant mortality risk. With adequate risk stratification, catheter-directed techniques could be used as a therapeutic approach in the intermediate-risk PE. Ultrasound-assisted catheter-directed thrombolysis (UCDT) represents a novel endovascular technique with good clinical and safety outcomes. Ultrasound-assisted catheter-directed thrombolysis can achieve reduction in the thrombus burden and improvement of pulmonary hemodynamics and right ventricular (RV) dysfunction and/or dilatation, without major procedure-related complications, major bleeding, or hemorrhagic strokes...
September 7, 2016: Angiology
https://www.readbyqxmd.com/read/27593228/clinical-significance-of-peripheral-endothelial-function-for-left-atrial-blood-stagnation-in-nonvalvular-atrial-fibrillation-patients-with-low-to-intermediate-stroke-risk
#19
Akira Fujii, Katsuji Inoue, Takayuki Nagai, Teruyoshi Uetani, Kazuhisa Nishimura, Jun Suzuki, Jun-Ichi Funada, Takafumi Okura, Jitsuo Higaki, Akiyoshi Ogimoto
BACKGROUND: In patients who have atrial fibrillation (AF) with CHADS2score of 0-1 (categorized as low-to-intermediate risk), there is little information on stratifying the risk of stroke. This study aimed to determine whether impaired endothelial function assessed by reactive hyperemia-peripheral arterial tonometry (RH-PAT) predicted left atrial blood stagnation in these patients. METHODS AND RESULTS: We enrolled 81 consecutive patients with nonvalvular AF. The reactive hyperemia index (RHI) was measured using RH-PAT...
September 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27493743/eliminating-guidewire-retention-during-ultrasound-guided-central-venous-catheter-insertion-via-an-educational-program-a-modified-cvc-set-and-a-drape-with-reminder-stickers
#20
Wee Ming Peh, Wann Jia Loh, Ghee Chee Phua, Chian Min Loo
Guidewire retention is a severe but preventable complication from central venous catheter (CVC) insertion. There were three cases of guidewire retention during CVC insertion in the medical intensive care unit (MICU) in Singapore General Hospital, in the period between December 2011 and February 2012. The primary objective of this quality improvement project was to eliminate future incidences of guidewire retention during CVC insertion in the MICU and medical intermediate care area (MICA) via a structured educational program and a cost effective modified CVC set...
2016: BMJ Quality Improvement Reports
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