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https://www.readbyqxmd.com/read/28329109/impact-of-early-fontan-completion-on-postoperative-outcomes-in-patients-with-a-functional-single-ventricle%C3%A2
#1
Masamichi Ono, Melchior Burri, Julie Cleuziou, Jelena Pabst von Ohain, Elisabeth Beran, Martina Strbad, Alfred Hager, Jürgen Hörer, Christian Schreiber, Rüdiger Lange
OBJECTIVES: Our aim was to evaluate whether early timing of total cavopulmonary connection (TCPC) affects postoperative outcomes. METHODS: Of 460 consecutive TCPC patients, 51 (11.1%) underwent TCPC ≤ 18 months of age (group A), and 409 patients >18 months of age (group B). We compared the clinical outcomes and exercise capacity between groups. RESULTS: Median age at TCPC was 1.4 (interquartile ranges: 1.3-1.5) years in group A and 2...
February 23, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28299645/new-concepts-in-embolotherapy-of-hcc
#2
REVIEW
F Pesapane, N Nezami, F Patella, J F Geschwind
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related deaths worldwide with rapidly growing incidence rates in the USA and Europe. Despite improving surveillance programs, most patients are diagnosed at intermediate to advanced stages and are no longer amenable to curative therapies, such as ablation, surgical resection and liver transplantation. For such patients, catheter-based image-guided embolotherapies such as transarterial chemoembolization (TACE) represent the standard of care and mainstay therapy, as recommended and endorsed by a variety of national guidelines and staging systems...
April 2017: Medical Oncology
https://www.readbyqxmd.com/read/28262244/risk-adapted-management-of-pulmonary-embolism
#3
Stefano Barco, Stavros V Konstantinides
The presence and severity of right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of pulmonary embolism (PE). Risk-adapted treatment strategies continue to evolve, tailoring initial management to the clinical presentation and the functional status of the RV. Beyond pharmacological and, if necessary, mechanical circulatory support, systemic thrombolysis remains the mainstay of treatment for hemodynamically unstable patients; in contrast, it is not routinely recommended for intermediate-risk PE...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28257640/risk-factors-for-candida-parapsilosis-bloodstream-infection-in-a-neonatal-intensive-care-unit-a-case-control-study
#4
Carmine Garzillo, Maria Bagattini, Lidija Bogdanović, Anna Di Popolo, Vita Dora Iula, Maria Rosaria Catania, Francesco Raimondi, Maria Triassi, Raffaele Zarrilli
BACKGROUND: Candida parapsilosis is increasingly responsible for invasive candidiasis in neonates. This study investigates phenotypic and genotypic features of C. parapsilosis microbial isolates and underlying clinical conditions associated with acquisition of C. parapsilosis in a neonatal intensive care unit (NICU) in Italy. METHODS: Identification of C. parapsilosis was performed by VITEK® 2 and MALDI TOF and confirmed by analysis of internal transcribed spacer ribosomal DNA sequences...
January 19, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28248406/trans-catheter-aortic-valve-implantation-contemporary-practice-and-the-future
#5
Omar Aldalati, Philip MacCarthy, Rafał Dworakowski
With increasing life expectancy, the epidemic of valvular heart disease, especially aortic stenosis (AS), is becoming more prevalent. Transcatheter aortic valve implantation (TAVI) has emerged as an alternative therapy for patients with significant aortic valve disease. It offers a less invasive procedure in comparison to surgical aortic valve replacement (sAVR) and an attractive substitute from the patient's perspective. The evidence for TAVI in inoperable and high risk surgical patients is now established and in the intermediate risk group has been accumulating rapidly and is looking favourable for TAVI...
March 1, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28214484/hybrid-operative-thrombectomy-is-noninferior-to-percutaneous-techniques-for-the-treatment-of-acute-iliofemoral-deep-venous-thrombosis
#6
Limael E Rodríguez, Aihab Aboukheir-Aboukheir, Ricardo Figueroa-Vicente, Hiram Soler-Bernardini, Guillermo Bolanos-Avila, Luis J Torruella-Bartolomei, Anthony J Comerota, Jorge L Martinez-Trabal
OBJECTIVE: Hybrid operative thrombectomy (HOT) is a novel technique for the treatment of acute iliofemoral deep venous thrombosis (IFDVT) and is an alternative to percutaneous techniques (PTs) that use thrombolytics. In this study, we compare perioperative and intermediate outcomes of HOT vs PT as interventions for early thrombus removal. METHODS: From July 2008 to May 2015, there were 71 consecutive patients who were treated with either PT (n = 31) or HOT (n = 40) for acute or subacute single-limb IFDVT...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#7
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28208201/catheter-based-approaches-for-the-treatment-of-acute-pulmonary-embolism
#8
Victor F Tapson, David Jimenez
Except when contraindicated, anticoagulation should be initiated when pulmonary embolism (PE) is strongly suspected and the bleeding risk is perceived to be low, even if the evaluation has not been completed. Low-risk patients with acute PE are simply continued on anticoagulation. Severely ill patients with high-risk (massive) PE require aggressive therapy, and if the bleeding risk is acceptable, systemic thrombolysis should be considered. However, despite clear evidence that parenteral thrombolytic therapy leads to more rapid clot resolution than anticoagulation alone, the risk of major bleeding including intracranial bleeding is significantly higher with thrombolytic therapy...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208199/systemic-thrombolytic-therapy-for-acute-pulmonary-embolism-who-is-a-candidate
#9
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of both acute and long-term morbidity for a large number of patients worldwide, and massive PE is frequently fatal. Right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of PE. Patients with clinically overt RV failure, that is, with cardiogenic shock or persistent hypotension at presentation (acute high-risk PE), are clearly in need of immediate reperfusion treatment with systemic thrombolysis or, alternatively, surgical or catheter-directed techniques...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28129819/-evaluation-of-clinical-evidence-for-dalbavancin
#10
Dolors Rodríguez-Pardo
Gram-positive infections are currently a therapeutic challenge because of the emergence of strains resistant to first-line antibiotics. Consequently, in the last few years, new antibiotics have been developed with activity against multiresistant Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus and strains with intermediate sensitivity to vancomycin. Among the new antibiotics approved for the treatment of these microorganisms, dalbavancin is a semisynthetic lipoglycopeptide derived from teicoplanin, but has a superior efficacy profile to the latter...
January 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28094045/quantification-of-user-and-manufacturer-variabilities-in-urinary-catheter-anchoring-balloon-inflation-and-mitigation-of-variability-by-flow-resistance
#11
Niall F Davis, Eoghan M Cunnane, Rory C Mooney, Rustom P Manecksha, John A Thornhill, Michael T Walsh
OBJECTIVE: To quantify user variability and manufacturer variability in urinary catheter anchoring balloon inflation pressure and to mitigate any significant variance by incorporating flow resistance into the anchoring balloon inflation process. METHODS: Inflation of a urinary catheter anchoring balloon was performed at atmospheric pressure by different users (n = 8) to investigate user variability. A calibrated pressure transducer measured inflation pressures, and a video extensometer measured balloon inflation profiles...
January 13, 2017: Urology
https://www.readbyqxmd.com/read/28047374/su-f-t-55-reproducibility-of-interstitial-hdr-brachytherapy-plans
#12
S Lee, R Ellis, B Traughber, T Podder
PURPOSE: Treating gynecological cancers with interstitial high-dose-rate (HDR) brachytherapy requires precise reconstruction of catheter positions to obtain accurate dosimetric plans. In this study, we investigated the degree of reproducibility of dosimetric plans for Syed HDR brachytherapy. METHODS: We randomly selected five patients having cervix-vaginal cancer who were recently treated in our clinic with interstitial HDR brachytherapy with a prescription dose of 25-30 Gy in five fractions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28039852/pathway-from-delirium-to-death-potential-in-hospital-mediators-of-excess-mortality
#13
Kumar Dharmarajan, Sunil Swami, Ray Y Gou, Richard N Jones, Sharon K Inouye
OBJECTIVES: (1) To determine the relationship of incident delirium during hospitalization with 90-day mortality; (2) to identify potential in-hospital mediators through which delirium increases 90-day mortality. DESIGN: Analysis of data from Project Recovery, a controlled clinical trial of a delirium prevention intervention from 1995 to 1998 with follow-up through 2000. SETTING: Large academic hospital. PARTICIPANTS: Patients ≥70 years old without delirium at hospital admission who were at intermediate-to-high risk of developing delirium and received usual care only...
December 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28031194/azithromycin-ciprofloxacin-impregnated-urinary-catheters-avert-bacterial-colonization-biofilm-formation-and-inflammation-in-a-murine-model-of-foreign-body-associated-urinary-tract-infections-caused-by-pseudomonas-aeruginosa
#14
Hina Saini, Anitha Vadekeetil, Sanjay Chhibber, Kusum Harjai
Pseudomonas aeruginosa is a multifaceted pathogen causing a variety of biofilm-mediated infections, including catheter-associated urinary tract infections (CAUTIs). The high prevalence of CAUTIs in hospitals, their clinical manifestations, such as urethritis, cystitis, pyelonephritis, meningitis, urosepsis, and death, and the associated economic challenges underscore the need for management of these infections. Biomaterial modification of urinary catheters with two drugs seems an interesting approach to combat CAUTIs by inhibiting biofilm...
March 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27991478/hemodialysis-delivery-dialysis-dose-achievement-and-vascular-access-types-in-hemodialysis-patients-from-the-gulf-cooperation-council-countries-enrolled-in-the-dialysis-outcomes-and-practice-patterns-study-phase-5-2012-2015
#15
Anas AlYousef, Sumaya AlGhareeb, Jamal Al Wakeel, Saeed M G Al-Ghamdi, Brian A Bieber, Mohamad Hassan, Yacoub Al Maimani, Naser Alkandari, Haroun Z Ahmed, Ashraf Fawzy, Ronald L Pisoni
The prospective observational Dialysis Outcomes and Practice Patterns Study (DOPPS) was initiated in late 2012 in national samples of hemodialysis (HD) units (n = 41 study sites) in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). For many years, guidelines have recommended single pool Kt/V ≥1.2 as the minimum adequate dose for chronic HD patients. Here, we report initial DOPPS results regarding HD practices related to dialysis dose achievement in the GCC...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27887785/thromboelastography-teg%C3%A2-demonstrates-that-tinzaparin-4500-international-units-has-no-detectable-anticoagulant-activity-after-caesarean-section
#16
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...
February 2017: 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
#17
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
#18
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
#19
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
#20
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
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