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https://www.readbyqxmd.com/read/28203499/sandwich-fascial-anterolateral-thigh-flap-in-head-and-neck-reconstruction-evolution-or-revolution
#1
Mario Cherubino, Jens Berli, Mario Turri-Zanoni, Paolo Battaglia, Francesca Maggiulli, Martina Corno, Federico Tamborini, Edoardo Montrasio, Paolo Castelnuovo, Luigi Valdatta
INTRODUCTION: The anterolateral thigh perforator flap (ALT) represents the workhorse for most reconstructive efforts in the head and neck regions. The main advantages of this flap are its versatility, the length of the pedicle, and the low morbidity of the donor site. The major drawback is the bulkiness of this flap with the frequent need for secondary revisions. To overcome this, we have developed a novel way to harvest and inset the ALT, called the sandwich fascial ALT flap (SALT). METHODS: All patients undergoing head and neck reconstruction using the SALT flap from January 2013 to March 2016 were included in this retrospective analysis...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28161096/relationship-between-yellow-plaque-grade-and-tissue-protrusion-after-stent-implantation-a-coronary-angioscopy-study
#2
Toru Miyoshi, Hideo Kawakami, Fumiyasu Seike, Akira Oshita, Hiroshi Matsuoka
BACKGROUND: Tissue protrusion detected with optical coherence tomography after percutaneous coronary intervention using stents is one of the risk factors for early stent thrombosis. However, tissue protrusion features have not been described. The aim of this study was to compare tissue morphology at stented sites with or without tissue protrusion by using coronary angioscopy. METHODS: Using optical coherence tomography and coronary angioscopy, we assessed 42 patients [31 men, 11 women; age, 70...
February 1, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28057809/factors-associated-with-long-term-mortality-after-fontan-procedures-a-systematic-review
#3
REVIEW
Tarek Alsaied, Jouke P Bokma, Mark E Engel, Joey M Kuijpers, Samuel P Hanke, Liesl Zuhlke, Bin Zhang, Gruschen R Veldtman
BACKGROUND: Despite an ageing Fontan population, data on late outcomes are still scarce. Reported outcome measures and determinants vary greatly between studies making comprehensive appraisal of mortality hazard challenging. METHODS: We conducted a systematic review to evaluate causes and factors associated with late mortality in patients with Fontan circulation. Late mortality was defined as mortality beyond the first postoperative year. Studies were included if they had ≥90 patients or ≥20 late mortalities and/or transplants...
January 15, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28054326/what-is-the-timing-of-general-health-adverse-events-that-occur-after-total-joint-arthroplasty
#4
Daniel D Bohl, Nathaniel T Ondeck, Bryce A Basques, Brett R Levine, Jonathan N Grauer
BACKGROUND: Despite extensive research regarding risk factors for adverse events after total joint arthroplasty (TJA), there are few publications describing the timing at which such adverse events occur. QUESTIONS/PURPOSES: (1) On which postoperative day do certain adverse events occur? (2) What adverse events occur earlier after TKA than after THA? (3) For each adverse event, what proportion occurred after hospital discharge? METHODS: We screened the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to identify all patients undergoing primary THA and primary TKA between 2005 and 2013, resulting in a study population of 124,657 patients evaluated as part of this retrospective database analysis...
January 4, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28053157/blockade-of-protease-activated-receptor-4-par4-provides-robust-antithrombotic-activity-with-low-bleeding
#5
Pancras C Wong, Dietmar Seiffert, J Eileen Bird, Carol A Watson, Jeffrey S Bostwick, Mary Giancarli, Nick Allegretto, Ji Hua, David Harden, Jocelyne Guay, Mario Callejo, Michael M Miller, R Michael Lawrence, Jacques Banville, Julia Guy, Brad D Maxwell, E Scott Priestley, Anne Marinier, Ruth R Wexler, Michel Bouvier, David A Gordon, William A Schumacher, Jing Yang
Antiplatelet agents are proven efficacious treatments for cardiovascular and cerebrovascular diseases. However, the existing drugs are compromised by unwanted and sometimes life-threatening bleeding that limits drug usage or dosage. There is a substantial unmet medical need for an antiplatelet drug with strong efficacy and low bleeding risk. Thrombin is a potent platelet agonist that directly induces platelet activation via the G protein (heterotrimeric guanine nucleotide-binding protein)-coupled protease-activated receptors PAR1 and PAR4...
January 4, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28051291/biobanking-in-carotid-artery-disease-translation-to-clinical-practice
#6
Ian D VAN Koeverden, Joyce E Vrijenhoek, Gert J DE Borst, Hester M DEN Ruijter, Gerard Pasterkamp
Biobanking of atherosclerotic tissue samples has contributed to our understanding of vascular occlusive disease. The careful examination of atherosclerotic plaques derived during vascular surgery or autopsies helped shape our minds in understanding the underlying substrate of arterial thrombosis. This review will outline concepts of progression of atherosclerotic disease that have been based on descriptions of human plaque pathology. In addition, we will discuss the current shift in clinical presentation and underlying pathology of acute cerebral and coronary events that asks for a careful consideration of the currently widely applied description of the "vulnerable plaque"...
January 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28029187/off-label-uses-for-flow-diversion-in-intracranial-aneurysm-management
#7
Fawaz Al-Mufti, Krishna Amuluru, Gomez Francisco, Vincent Dodson, Mohammad El-Ghanem, Charles J Prestigiacomo, Chirag D Gandhi
Treatment of complex aneurysms using microsurgical and other conventional neuroendovascular techniques remains challenging. As a result, stent- and balloon-assisted coiling are instead performed to treat morphologically complex aneurysms, which include giant, wide-necked, and fusiform aneurysms. While these techniques have had success in treating these complex aneurysms, recanalization rates associated with these techniques are still problematic. In the constant effort to improve the outcome of complex aneurysm treatment, flow-diverting stents (FDSs) have emerged in recent years as the preferred treatment...
December 28, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/27998897/antithrombotic-stewardship-a-multidisciplinary-team-approach-towards-improving-antithrombotic-therapy-outcomes-during-and-after-hospitalisation-a-study-protocol
#8
Albert R Dreijer, Marieke J H A Kruip, Jeroen Diepstraten, Suzanne Polinder, Rolf Brouwer, Frank W G Leebeek, Arnold G Vulto, Patricia M L A van den Bemt
INTRODUCTION: Antithrombotic therapy carries high risks for patient safety. Antithrombotics belong to the top 5 medications involved in potentially preventable hospital admissions related to medication. To provide a standard for antithrombotic therapy and stress the importance of providing optimal care to patients on antithrombotic therapy, the Landelijke Standaard Ketenzorg Antistolling (LSKA; Dutch guideline on integrated antithrombotic care) was drafted. However, the mere publication of this guideline does not guarantee its implementation...
December 20, 2016: BMJ Open
https://www.readbyqxmd.com/read/27994741/discovery-of-phenylglycine-lactams-as-potent-neutral-factor-viia-inhibitors
#9
Nicholas R Wurtz, Brandon L Parkhurst, Wen Jiang, Indawati DeLucca, Xiaojun Zhang, Vladimir Ladziata, Daniel L Cheney, Jeffrey R Bozarth, Alan R Rendina, Anzhi Wei, Joseph M Luettgen, Yiming Wu, Pancras C Wong, Dietmar A Seiffert, Ruth R Wexler, E Scott Priestley
Inhibitors of Factor VIIa (FVIIa), a serine protease in the clotting cascade, have shown strong antithrombotic efficacy in preclinical thrombosis models with minimal bleeding liabilities. Discovery of potent, orally active FVIIa inhibitors has been largely unsuccessful because known chemotypes have required a highly basic group in the S1 binding pocket for high affinity. A recently reported fragment screening effort resulted in the discovery of a neutral heterocycle, 7-chloro-3,4-dihydroisoquinolin-1(2H)-one, that binds in the S1 pocket of FVIIa and can be incorporated into a phenylglycine FVIIa inhibitor...
December 8, 2016: ACS Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/27984252/perioperative-complications-of-spinal-metastases-surgery
#10
Panya Luksanapruksa, Jacob M Buchowski, Lukas P Zebala, Christopher K Kepler, Weerasak Singhatanadgige, David B Bumpass
The incidence of symptomatic spinal metastasis has increased due to treatment improvements and longer patient survival. More patients with spinal tumors are choosing operative treatment with an associated increased rate of perioperative complications. Operative metastatic disease treatment complication rates have also increased with overall rates ranging from 5.3% to 76.20%. The common surgical-related complications are iatrogenic dural injury and wound complications. The most common postoperative medical complications are delirium, pneumonia, and deep vein thrombosis...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27984228/new-innovations-in-circulatory-support-with-ventricular-assist-device-and-extracorporeal-membrane-oxygenation-therapy
#11
Robert N Sladen
The past decade has seen an exponential increase in the application and development of durable long-term as well as nondurable short-term mechanical circulatory support for cardiogenic shock and acute or chronic heart failure. Support has evolved from bridge-to-transplant to destination therapy, bridge to rescue, bridge to decision making, and bridge to a bridge. Notable trends include device miniaturization, minimally invasive and/or percutaneous insertion, and efforts to superimpose pulsatility on continuous flow...
December 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27887648/the-potential-hazard-of-drug-eluting-stent-induced-coronary-vasospasm-causing-subacute-stent-thrombosis-a-case-report
#12
Hiroki Shibutani, Yuzo Akita, Yumie Matsui, Masahiro Yoshinaga, Masahiro Karakawa
BACKGROUND: Drug-eluting stent (DES) -induced coronary vasospasm is a well known phenomenon after stent implantation; however, the extent of this risk is still unknown. We report a case in which DES-induced severe coronary vasospasm was clinically suspected as a cause of subacute stent thrombosis (ST). CASE PRESENTATION: A 67-year-old man came to our hospital due to chest pain with mild exercise. He was diagnosed with effort angina by coronary angiography and underwent DES implantation in the mid-left ascending artery (LAD) after the administration of dual anti-platelet therapy...
November 25, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27860129/the-postthrombotic-syndrome-current-evidence-and-future-challenges
#13
REVIEW
A Rabinovich, S R Kahn
Postthrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT) that develops in 20-50% of patients. PTS manifests as a spectrum of symptoms and signs of chronic venous insufficiency that can impose significant morbidity and have a negative impact on quality of life. Chronic venous hypertension caused by a combination of residual venous obstruction and valvular reflux is believed to play a major role in the pathophysiology of PTS. The Villalta scale is the most widely applied clinical scale used to diagnose and define PTS...
November 18, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27832203/angiotensin-converting-enzyme-inhibitors-angiotensin-receptor-blockers-and-calcium-channel-blockers-are-associated-with-prolonged-vascular-access-patency-in-uremic-patients-undergoing-hemodialysis
#14
Fu-An Chen, Chih-Chiang Chien, Yu-Wei Chen, Yu-Te Wu, Chih-Ching Lin
BACKGROUND: Vascular access failure is a huge burden for patients undergoing hemodialysis. Many efforts have been made to maintain vascular access patency, including pharmacotherapy. Angiotensin converting enzyme inhibitor (ACE-I), angiotensin receptor blocker (ARB), and calcium channel blocker (CCB) are known for their antihypertensive and cardio-protective effects, however, their effects on long-term vascular access patency are still inconclusive. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We retrospectively enrolled patients commencing maintenance hemodialysis between January 1, 2000, and December 31, 2006 by using National Health Insurance Research Database in Taiwan...
2016: PloS One
https://www.readbyqxmd.com/read/27803897/diacylglycerol-kinase-%C3%AE%C2%B5-properties-and-biological-roles
#15
REVIEW
Richard M Epand, Vincent So, William Jennings, Bijendra Khadka, Radhey S Gupta, Mathieu Lemaire
In mammals there are at least 10 isoforms of diacylglycerol kinases (DGK). All catalyze the phosphorylation of diacylglycerol (DAG) to phosphatidic acid (PA). Among DGK isoforms, DGKε has several unique features. It is the only DGK isoform with specificity for a particular species of DAG, i.e., 1-stearoyl-2-arachidonoyl glycerol. The smallest of all known DGK isoforms, DGKε, is also the only DGK devoid of a regulatory domain. DGKε is the only DGK isoform that has a hydrophobic segment that is predicted to form a transmembrane helix...
2016: Frontiers in Cell and Developmental Biology
https://www.readbyqxmd.com/read/27800207/upper-extremity-deep-vein-thromboses-the-bowler-and-the-barista
#16
Seth Stake, Anne L du Breuil, Jeremy Close
Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity...
2016: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/27792650/use-of-chronic-oral-anticoagulation-and-associated-outcomes-among-patients-undergoing-percutaneous-coronary-intervention
#17
Eric A Secemsky, Neel M Butala, Uri Kartoun, Sadiqa Mahmood, Jason H Wasfy, Kevin F Kennedy, Stanley Y Shaw, Robert W Yeh
BACKGROUND: Contemporary rates of oral anticoagulant (OAC) therapy and associated outcomes among patients undergoing percutaneous coronary intervention (PCI) have been poorly described. METHODS AND RESULTS: Using data from an integrated health care system from 2009 to 2014, we identified patients on OACs within 30 days of PCI. Outcomes included in-hospital bleeding and mortality. Of 9566 PCIs, 837 patients (8.8%) were on OACs, and of these, 7.9% used non-vitamin K antagonist agents...
October 17, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27783482/an-asymmetric-runaway-domain-swap-antithrombin-dimer-as-a-key-intermediate-for-polymerization-revealed-by-hydrogen-deuterium-exchange-mass-spectrometry
#18
Morten Beck Trelle, Shona Pedersen, Eva Christina Østerlund, Jeppe Buur Madsen, Søren Risom Kristensen, Thomas J D Jørgensen
Antithrombin deficiency is associated with increased risk of venous thrombosis. In certain families, this condition is caused by pathogenic polymerization of mutated antithrombin in the blood. To facilitate future development of pharmaceuticals against antithrombin polymerization, an improved understanding of the polymerogenic intermediates is crucial. However, X-ray crystallography of these intermediates is severely hampered by the difficulty in obtaining well-diffracting crystals of transient and heterogeneous noncovalent protein assemblies...
December 15, 2016: Analytical Chemistry
https://www.readbyqxmd.com/read/27783010/venous-thromboembolism-a-comparison-of-chronic-spinal-cord-injury-and-general-surgery-patients-in-a-metropolitan-veterans-affairs-hospital
#19
Ryan M Moore, Jonathan Rimler, Brian R Smith, Garrett A Wirth, Keyianoosh Z Paydar
BACKGROUND: Venous thromboembolic events result in significant morbidity, mortality, and costly therapeutic interventions. As medical resource allocation strategies are becoming more pervasive, appropriate risk stratification and prophylactic regimens are essential. Previous studies have shown a decreased incidence of perioperative venous thromboembolism in the chronic spinal cord injury population. The question remains of whether chronic spinal cord injury is protective against venous thromboembolism...
November 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27780149/nanofibrous-bioengineered-heart-valve-application-in-paediatric-medicine
#20
REVIEW
Mehrdad Namdari, Ali Eatemadi
Heart valves are currently under thorough investigation in tissue engineering (TE) research. Mechanical and biological heart valve prostheses which are recently used have several shortcomings. While allogenic and xenogenic biological prostheses are related to graft rejection, degeneration and thrombosis, resulting in a high rate of reoperation. Mechanical prostheses on the other hand are based on metallic, carbon, and polymeric components, and require continuous treatment with anticoagulant, which result in adverse reactions, e...
December 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
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