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https://www.readbyqxmd.com/read/28808190/cholesterol-crystal-embolization-following-plaque-rupture-a-systemic-disease-with-unusual-features
#1
Firas Ghanem, Deepthi Vodnala, Jagadeesh K Kalavakunta, Sridevi Durga, Noah Thormeier, Prem Subramaniyam, Scott Abela, George S Abela
Cholesterol crystal embolic (CCE) syndrome is often a clinically challenging condition that has a poor prognostic implication. It is a result of plaque rupture with release of cholesterol crystals into the circulation that embolize into various tissue organs. Plaque rupture seems to be triggered by an expanding necrotic core during cholesterol crystallization forming sharp tipped crystals that perforate and tear the fibrous cap. Embolizing cholesterol crystals then initiate both local and systemic inflammation that eventually lead to vascular fibrosis and obstruction causing symptoms that can mimic other vasculitic conditions...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28713066/approaches-for-stricture-prevention-after-esophageal-endoscopic-resection
#2
REVIEW
Seiichiro Abe, Prasad G Iyer, Ichiro Oda, Nobuo Kanai, Yutaka Saito
BACKGROUND AND AIMS: Endoscopic resection of extensive esophageal lesions has become more common as endoscopic resection techniques and equipment has developed. However, extensive esophageal endoscopic resections can cause postoperative esophageal strictures, which have a negative impact on the quality of life of patients. We aimed to review current treatments and innovative approaches to prevent esophageal strictures after widespread endoscopic resection of esophageal lesions. METHODS: We performed a comprehensive literature search using predetermined search terms from 2000 to 2016 to identify relevant articles and summarized their results as a narrative review...
July 13, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28662972/utilization-of-sinus-stents-as-a-novel-approach-for-benign-cystic-lesions-of-the-sella
#3
Akina Tamaki, Berje Shammassian, Abhishek Ray, Warren R Selman, Kenneth Rodriguez
Steroid-releasing sinus stents have emerged as a safe and effective tool in endoscopic sinus surgery. In this case report, we present two patients with recurrent cystic sellar masses. Transsphenoidal approach was used to access the sella. Following resection and drainage of the cystic pathology, a Propel (Menlo Park, CA) stent was placed through the corridor of the resection site to stent the cavity open. This is the first report where a steroid-releasing sinus stent was used in the treatment of a sellar lesion...
June 21, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28643106/-new-and-old-aspects-of-retroperitoneal-fibrosis
#4
REVIEW
A S Brandt, N M Dreger, E Müller, S Kukuk, S Roth
Retroperitoneal fibrosis (RPF) is an uncommon chronic inflammatory disease of the rear abdomen and it is commonly associated with the complication of uni- or bilateral hydronephrosis. Despite the rarity of this disease, multiple publications concerning etiology, diagnosis, therapy monitoring and both medical and surgical therapy have been published in recent years. Recent research has focused on asbestos exposure as a possible risk factor, the meaning of IgG4-associated RPF, measuring disease activity using different radiological and nuclear medicine procedures, and new approaches to medical therapy...
July 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28616399/management-of-strictures-after-endoscopic-submucosal-dissection-for-superficial-esophageal-cancer
#5
REVIEW
Koichiro Kawaguchi, Hiroki Kurumi, Yohei Takeda, Kazuo Yashima, Hajime Isomoto
Endoscopic resection of early esophageal cancer has a high therapeutic effect while being minimally invasive. Especially, the establishment of the endoscopic submucosal dissection (ESD) procedure has made it possible to resect large lesions in an en-bloc manner. As a result, accurate pathology evaluation became possible, and the risk of local recurrence was extremely low. On the other hand, esophageal strictures after endoscopic treatment of an extensive circumferential lesion are a potential problem. Previously, for the prevention and treatment of esophageal strictures, patients had to undergo painful endoscopic balloon dilation (EBD) many times...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28611969/anastomotic-strictures-after-esophageal-atresia-repair-incidence-investigations-and-management-including-treatment-of-refractory-and-recurrent-strictures
#6
REVIEW
Renato Tambucci, Giulia Angelino, Paola De Angelis, Filippo Torroni, Tamara Caldaro, Valerio Balassone, Anna Chiara Contini, Erminia Romeo, Francesca Rea, Simona Faraci, Giovanni Federici di Abriola, Luigi Dall'Oglio
Improved surgical techniques, as well as preoperative and postoperative care, have dramatically changed survival of children with esophageal atresia (EA) over the last decades. Nowadays, we are increasingly seeing EA patients experiencing significant short- and long-term gastrointestinal morbidities. Anastomotic stricture (AS) is the most common complication following operative repair. An esophageal stricture is defined as an intrinsic luminal narrowing in a clinically symptomatic patient, but no symptoms are sensitive or specific enough to diagnose an AS...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28588863/hemodynamic-collapse-due-to-the-stenosis-of-four-pulmonary-veins-in-a-patient-with-mediastinal-tumor
#7
Kentaro Yoshida, Fumie Fujisawa, Hiroshi Kojima, Noriyuki Takeyasu
Cardiogenic shock can occur due to compression of the four pulmonary veins and the left atrium by a mediastinal tumor. Steroid infusion can be a temporary alternative therapy before obtaining a definite diagnosis and performing an intervention with stents to dilate the pulmonary veins.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28492612/a-prospective-randomized-clinical-study-comparing-drug-eluting-stent-therapy-and-intranasal-corticoid-steroid-therapy-in-the-treatment-of-patients-with-chronic-rhinosinusitis
#8
R Taulu, A J Bizaki, J Numminen, M Rautiainen
OBJECTIVES: To conduct the first prospective, randomized controlled clinical trial comparing the efficacy of a drug-eluting stent (DES) (the Relieva StratusTM MicroFlow Spacer) and topical intranasal corticosteroid therapy in patients with chronic rhinosinusitis (CRS). METHODS: Sixty-three adult patients with ethmoiditis were randomized into either the DES group (n=34) or nasal spray group (n=29). The main outcome variable was the Sinonasal Outcome Test 22, Visual Analogue Scale, nasal endoscopy, rhinometric measurements were performed at the beginning of the study, after three months and six months of follow-up...
May 10, 2017: Rhinology
https://www.readbyqxmd.com/read/28325633/trends-in-the-use-of-stents-and-drug-eluting-stents-in-sinus-surgery
#9
REVIEW
Leah J Hauser, Justin H Turner, Rakesh K Chandra
Stenting has long been used in the paranasal sinuses with the goals of maintaining a patent sinus cavity during the postoperative healing process and preventing restenosis from inflammation or scarring. More recently, drug-eluting stents have been introduced. Steroid-impregnated dressings and implants appear to be safe, although likely have increased systemic absorption compared with topical nasal steroid sprays and rinses. There is evidence to support the use of steroid-releasing implants in the ethmoid cavity in the postoperative period; however, more study is needed to truly define the role of these implants...
June 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28235953/nickel-associated-delayed-multiple-white-matter-lesions-after-stent-assisted-coil-embolization-of-intracranial-unruptured-aneurysm
#10
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Daisuke Wajima, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions...
February 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28219914/nickel-associated-delayed-multiple-white-matter-lesions-after-stent-assisted-coil-embolization-of-intracranial-unruptured-aneurysm
#11
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Daisuke Wajima, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions...
February 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28207528/idiopathic-retroperitoneal-fibrosis-causing-unilateral-ureteral-and-sigmoid-colon-obstruction-a-case-report
#12
Ting Yan, Yujuan Wang, Zhijun Liu, Xiaolei Zhang, Qian Wu, Mingrong Xi
OBJECTIVE: The present report aimed to present a unique case of idiopathic retroperitoneal fibrosis (RPF) presenting features of unilateral ureteral and sigmoid colon obstruction. RPF is a rare disorder with unclear etiology. CASE REPORT: A 43-year-old female had a 10-day history of lower right abdominal and lumbar pain. Gynecological examination, ultrasound, and computed tomography (CT) were all suggestive of right ovarian tumor. An enhanced CT showed right-sided hydronephrosis...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28128720/surgical-complications-after-pediatric-renal-transplant
#13
Hakan Sözen, Kibriya Fidan, Onur Özen, Oğuz Söylemezoğlu, Aydın Dalgıç
OBJECTIVES: Renal transplant is the most appropriate treatment for both adult and pediatric patients with end-stage renal failure. Here, we analyzed surgical complications after pediatric renal transplant at our center. MATERIALS AND METHODS: We retrospectively analyzed data from patient files and hospital charts of pediatric patients who had renal transplant at our center (Gazi University, Ankara, Turkey). Our immunosuppression protocol, a calcineurin inhibitor-based triple regimen, was applied to all recipients (steroids, mycophenolic acid)...
January 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28109377/antineutrophil-cytoplasmic-antibody-associated-multiple-giant-saccular-aortic-aneurysms
#14
Ryoji Kinoshita, Tomohiro Mizuno, Tsuyoshi Hachimaru, Keiji Oi, Masafumi Yashima, Eiki Nagaoka, Tatsuki Fujiwara, Hidehito Kuroki, Dai Tasaki, Hirokuni Arai
We describe a very rare case of a 67-year-old man with multiple saccular aortic aneurysms throughout the entire aorta due to antineutrophil cytoplasmic antibody-associated vasculitis (AAV). The patient underwent staged aortic surgical procedures, including stent-graft insertion for a left iliac artery aneurysm, thoracic endovascular aortic repair for a descending aortic aneurysm, and total replacement of the ascending aorta and aortic arch with the use of high-dose steroids to control inflammation. The histologic findings demonstrated that the damage to the vasa vasorum of the adventitia resulting from AAV caused ischemia of the media, resulting in the formation of saccular aneurysmal changes...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28092201/evaluation-of-a-steroid-releasing-sinus-implant-for-the-treatment-of-patients-undergoing-frontal-sinus-surgery-for-chronic-rhinosinusitis
#15
Sean Bury, Ameet Singh
Management of the frontal sinus places great demands on the otolaryngologist. Given that the fronto-ethmoidal region is susceptible to recurrent inflammation, scarring, and stenosis, maintaining long-term patency of the frontal sinus is a difficult challenge. Oral and topical anti-inflammatory therapy, post-operative stenting, and 'home-brew' drug elution have been used for the treatment of the frontal sinus with mixed success. Recently an implant has been approved for post-operative placement into the frontal recess...
February 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28089777/bioresorbable-vascular-scaffold-to-treat-malignant-in-stent-restenosis-in-a-patient-with-nickel-allergy
#16
Alfonso Jurado-Román, María T López-Lluva, Ignacio Sánchez-Pérez, Jesús Piqueras-Flores, Ramón Maseda, Fernando Lozano-Ruíz-Poveda
Nickel is the most frequent allergen in patients with allergic contact dermatitis and nickel allergy has been associated with recurrent in-stent restenosis. However, it is often misdiagnosed because of a low suspicion threshold. It should be discarded in patients with recurrent in-stent restenosis, especially if their medical history reveals prior contact dermatitis. It is also noteworthy and rarely specified that even newer generation stents that use novel metal alloys also contain low amounts of nickel. To avoid the implantation of new stents containing this metal, when percutaneous coronary intervention is indicated, drug eluting balloons or bioresorbable vascular scaffolds associated with small doses of steroids could provide good alternatives of treatment...
January 2, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27977475/trabecular-micro-bypass-stent-use-in-necrotizing-scleritis
#17
Simrenjeet Sandhu, Lisa Heckler, Dean Mah, Michael W Dorey
PURPOSE: In this case report, we describe the successful implantation of multiple trabecular micro-bypass iStents in a patient with necrotizing scleritis. DESIGN: The study design is a case report. PARTICIPANTS: The participant was a patient who underwent multiple micro-bypass iStent surgery. METHODS: A 71-year-old man with primary open-angle glaucoma, diagnosed with necrotizing scleritis and treated with steroids consequently resulting in significantly elevated intraocular pressure in the right eye...
February 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/27913724/novel-application-of-steroid-eluting-stents-in-choanal-atresia-repair-a-case-series
#18
John N Bangiyev, Nandini Govil, Anthony Sheyn, Michael Haupert, Prasad John Thottam
PURPOSE: To describe the application of mometasone furoate eluting sinus stent technology in the treatment of choanal atresia (CA) in the hopes of preventing postsurgical stenosis. METHODS: We analyzed 3 consecutive patients aged 4 days to 16 years undergoing repair of CA at a tertiary pediatric hospital. Mometasone furoate eluting sinus stents were placed intraoperatively. Postoperative need for revision surgery as well as routine surveillance endoscopy were used to determine success of surgery...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27888909/topical-therapies-for-refractory-chronic-rhinosinusitis
#19
REVIEW
Akshay Sanan, Mindy Rabinowitz, Marc Rosen, Gurston Nyquist
Topical therapy has become an important tool in the otolaryngologist's armamentarium for refractory chronic rhinosinusitis (CRS). Daily high-volume sinonasal saline irrigation and standard metered-dose topical nasal steroid therapy are supported by the most evidence. Nonstandard topical sinonasal steroid therapies are a potential option for refractory CRS. Current evidence recommends against the use of topical antifungal therapy and topical antibiotic therapy delivered using spray and nebulized techniques in routine cases of CRS...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27853071/a-destabilized-case-of-stable-effort-angina-pectoris-induced-by-low-dose-adenosine-triphosphate
#20
Daisuke Sueta, Sunao Kojima, Yasuhiro Izumiya, Megumi Yamamuro, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa
A 79-year-old man was diagnosed with sudden deafness. He had previously experienced a suspected episode of angina pectoris. At a local hospital, after 500 mg of hydrocortisone and 80 mg adenosine triphosphate (ATP) were administered, he became aware of chest discomfort. An electrocardiogram revealed serious ST-segment depressions. He was diagnosed with a non-ST elevated myocardial infarction (NSTEMI). Emergency coronary angiography revealed triple vessel disease, and the lesion was successfully stented. The mechanisms whereby the stable effort angina pectoris destabilized in this case were thought to include a reduction of the local blood flow because of an ATP product and probable thrombus formation in response to the administered steroids...
2016: Internal Medicine
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