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https://www.readbyqxmd.com/read/28078914/appropriate-patient-selection-for-carotid-revascularization-procedures-is-urgently-needed
#1
Kosmas I Paraskevas, Frank J Veith, Dimitri P Mikhailidis, Christos D Liapis
The identification/selection of appropriate patient subgroups with asymptomatic carotid artery stenosis and the performance of prophylactic carotid endarterectomy (CEA)/carotid artery stenting (CAS) exclusively on these asymptomatic patient subgroups is currently one of the "hottest" topics in vascular surgery. It is now clear that offering CEA/CAS to asymptomatic carotid patients based only on the degree of carotid stenosis is unjustified and scientifically flawed. On the other hand, offering only best medical therapy to every asymptomatic patient, irrespective of certain high-risk criteria (such as the detection of microemboli by transcranial Doppler, intraplaque hemorrhage, silent embolic infarcts on brain computed tomography/magnetic resonance imaging, elevated biomarkers, family history), is equally wrong...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28070749/an-automated-microemboli-detection-and-classification-system-using-backscatter-rf-signals-and-differential-evolution
#2
Karim Ferroudji, Nabil Benoudjit, Ayache Bouakaz
Embolic phenomena, whether air or particulate emboli, can induce immediate damages like heart attack or ischemic stroke. Embolus composition (gaseous or particulate matter) is vital in predicting clinically significant complications. Embolus detection using Doppler methods have shown their limits to differentiate solid and gaseous embolus. Radio-frequency (RF) ultrasound signals backscattered by the emboli contain additional information on the embolus in comparison to the traditionally used Doppler signals...
January 9, 2017: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/28070168/circulating-tumor-microemboli-ctm-and-vimentin-circulating-tumor-cells-ctcs-detected-by-a-size-based-platform-predict-worse-prognosis-in-advanced-colorectal-cancer-patients-during-chemotherapy
#3
Dejun Zhang, Lei Zhao, Pengfei Zhou, Hong Ma, Fang Huang, Min Jin, Xiaomeng Dai, Xiumei Zheng, Shaoyi Huang, Tao Zhang
BACKGROUND: Circulating tumor cells (CTCs) detected in peripheral blood (PB) of cancer patients can be identified as isolated CTCs and circulating tumor microemboli (CTM). This study aimed to evaluate the prognostic value of CTM detection and CTC phenotype in advanced colorectal cancer (CRC) patients during chemotherapy. METHODS: A size-based platform for CTC isolation was applied. PB samples (5 ml) from 98 advanced CRC patients during 2-6 cycles chemotherapy were collected for CTC detection, and CTC count was correlated to patient's clinicopathological characteristics and clinical outcome...
2017: Cancer Cell International
https://www.readbyqxmd.com/read/28060956/technical-insights-into-highly-sensitive-isolation-and-molecular-characterization-of-fixed-and-live-circulating-tumor-cells-for-early-detection-of-tumor-invasion
#4
Sophie Laget, Lucile Broncy, Katia Hormigos, Dalia M Dhingra, Fatima BenMohamed, Thierry Capiod, Magne Osteras, Laurent Farinelli, Stephen Jackson, Patrizia Paterlini-Bréchot
Circulating Tumor Cells (CTC) and Circulating Tumor Microemboli (CTM) are Circulating Rare Cells (CRC) which herald tumor invasion and are expected to provide an opportunity to improve the management of cancer patients. An unsolved technical issue in the CTC field is how to obtain highly sensitive and unbiased collection of these fragile and heterogeneous cells, in both live and fixed form, for their molecular study when they are extremely rare, particularly at the beginning of the invasion process. We report on a new protocol to enrich from blood live CTC using ISET® (Isolation by SizE of Tumor/Trophoblastic Cells), an open system originally developed for marker-independent isolation of fixed tumor cells...
2017: PloS One
https://www.readbyqxmd.com/read/28024850/volume-of-subclinical-embolic-infarct-correlates-to-long-term-cognitive-changes-after-carotid-revascularization
#5
Wei Zhou, Brittanie D Baughman, Salil Soman, Max Wintermark, Laura C Lazzeroni, Elizabeth Hitchner, Jyoti Bhat, Allyson Rosen
OBJECTIVE: Carotid intervention is safe and effective in stroke prevention in appropriately selected patients. Despite minimal neurologic complications, procedure-related subclinical microemboli are common and their cognitive effects are largely unknown. In this prospective longitudinal study, we sought to determine long-term cognitive effects of embolic infarcts. METHODS: The study recruited 119 patients including 46% symptomatic patients who underwent carotid revascularization...
December 23, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27982342/in-vitro-evaluation-of-two-types-of-neonatal-oxygenators-in-handling-gaseous-microemboli-and-maintaining-optimal-hemodynamic-stability-during-cardiopulmonary-bypass
#6
Neelima Marupudi, Shigang Wang, Luiz Fernando Canêo, Fabio Biscegli Jatene, Allen R Kunselman, Akif Undar
Objective: Usually only FDA-approved oxygenators are subject of studies by the international scientific community. The objective of this study is to evaluate two types of neonatal membrane oxygenators in terms of transmembrane pressure gradient, hemodynamic energy transmission and gaseous microemboli capture in simulated cardiopulmonary bypass systems. Methods: We investigated the Braile Infant 1500 (Braile Biomédica, São José do Rio Preto, Brazil), an oxygenator commonly used in Brazilian operating rooms, and compared it to the Dideco Kids D100 (Sorin Group, Arvada, CO, USA), that is an FDA-approved and widely used model in the USA...
September 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27857051/elevation-of-the-acth-cortisol-ratio-in-female-opioid-dependent-patients-a-biomarker-of-aging-and-correlate-of-metabolic-and-immune-activation
#7
Albert Stuart Reece, Gary Kenneth Hulse
BACKGROUND: Whilst the hypothalamic-pituitary-adrenal (HPA) Axis is a major stress axis, and is necessarily perturbed in opioid dependency, and stress is a major contributor to aging mechanisms, the HPA axis has not been studied in opioid dependency in an age-dependent manner. OBJECTIVE: Hypothesis - Differences in age dependent levels of HPA components. DESIGN: Cross-sectional comparison of general medical and opioid dependent patients (ODP, GMP)...
September 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/27818028/high-extent-of-intracranial-carotid-artery-calcification-is-associated-with-downstream-microemboli-in-stroke-patients
#8
Xiao-Hong Wu, Xiang-Yan Chen, Yu-Hua Fan, Thomas Wai-Hong Leung, Ka-Sing Wong
BACKGROUND: Intracranial arterial calcification (ICAC) is frequently detected on head computed tomography and has been found to be associated with ischemic stroke by recent clinical studies. AIMS: Based on a hospital-based study, we aimed to compare the occurrence of cerebral microembolic signals (MES) among stroke patients with different degrees of ICAC, which may indicate the potential mechanisms linking ICAC and ischemic stroke in intracranial atherosclerosis patients...
November 3, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27781040/safety-outcomes-using-a-proximal-protection-device-in-carotid-stenting-of-long-carotid-stenoses
#9
Kunakorn Atchaneeyasakul, Priyank Khandelwal, Sudheer Ambekar, Kevin Ramdas, Luis Guada, Dileep Yavagal
BACKGROUND: Embolic protection devices can prevent atherosclerotic emboli during carotid stenting. Newer proximal protection devices reverse flow in the internal carotid artery (ICA), leading to reduction in perioperative microemboli. The risk of stroke is high for carotid stenting of ICA lesions with a length >10 mm and/or angiographic string sign. OBJECTIVE: We aimed to evaluate the safety outcomes of proximal embolic protection device usage in this high-risk group...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27774971/acute-myocardial-infarction-in-a-patient-with-sickle-cell-trait
#10
Oğuz Akkuş, Mustafa Topuz, Ali Deniz
Presently described is the rare complication of sickle cell trait (HbAS) with acute inferior myocardial infarction in a young adult patient. Angiogram revealed microemboli in the distal thin segment of the circumflex (Cx) artery. Anticoagulant and anti-aggregant therapies were initiated to restore Cx artery flow. HbAS was detected as an underlying pathology. ST segments returned to the isoelectric line and the patient became asymptomatic.
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/27735070/in-vitro-evaluation-of-an-alternative-neonatal-extracorporeal-life-support-circuit-on-hemodynamic-performance-and-bubble-trap
#11
Shannon B Spencer, Shigang Wang, Karl Woitas, Kristen Glass, Allen R Kunselman, Akif Ündar
The objective of this study was to evaluate an alternative neonatal extracorporeal life support (ECLS) circuit with a RotaFlow centrifugal pump and Better-Bladder (BB) for hemodynamic performance and gaseous microemboli (GME) capture in a simulated neonatal ECLS system. The circuit consisted of a Maquet RotaFlow centrifugal pump, a Quadrox-iD Pediatric diffusion membrane oxygenator, 8 Fr arterial cannula, and 10 Fr venous cannula. A "Y" connector was inserted into the venous line to allow for comparison between BB and no BB...
October 13, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27729706/effect-of-normobaric-versus-hypobaric-oxygenation-on-gaseous-microemboli-removal-in-a-diffusion-membrane-oxygenator-an-in-vitro-comparison
#12
Matthew Schuldes, Jeffrey B Riley, Stephen G Francis, Sean Clingan
Gaseous microemboli (GME) are an abnormal physiological occurrence during cardiopulmonary bypass and extracorporeal membrane oxygenation (ECMO). Several studies have correlated negative sequelae with exposure to increased amounts of GME. Hypobaric oxygenation is effective at eliminating GME in hollow-fiber microporous membrane oxygenators. However, hollow-fiber diffusion membrane oxygenators, which are commonly used for ECMO, have yet to be validated. The purpose of this study was to determine if hypobaric oxygenation, compared against normobaric oxygenation, can reduce introduced GME when used on diffusion membrane oxygenators...
September 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27678419/the-cohesive-metastasis-phenotype-in-human-prostate-cancer
#13
REVIEW
William L Harryman, James P Hinton, Cynthia P Rubenstein, Parminder Singh, Raymond B Nagle, Sarah J Parker, Beatrice S Knudsen, Anne E Cress
A critical barrier for the successful prevention and treatment of recurrent prostate cancer is detection and eradication of metastatic and therapy-resistant disease. Despite the fall in diagnoses and mortality, the reported incidence of metastatic disease has increased 72% since 2004. Prostate cancer arises in cohesive groups as intraepithelial neoplasia, migrates through muscle and leaves the gland via perineural invasion for hematogenous dissemination. Current technological advances have shown cohesive-clusters of tumor (also known as microemboli) within the circulation...
December 2016: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27671619/lung-hot-spot-without-corresponding-computed-tomography-abnormality-on-fluorodeoxyglucose-positron-emission-tomography-computed-tomography-artifactual-or-real-iatrogenic-or-pathologic
#14
Yiyan Liu
Focal lung uptake without corresponding lesions or abnormalities on computed tomography (CT) scan poses a dilemma in the interpretation of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). A limited number of case reports have previously suggested an artifactual or iatrogenic nature of the uptake. In the present study, 8 relevant cases were included within a retrospective search of the database. Medical records were reviewed for follow-up radiological and pathologic information...
July 30, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/27641431/infective-endocarditis-after-device-closure-of-atrial-septal-defects-case-report-and-review-of-the-literature
#15
Pascal Amedro, Camille Soulatges, Alain Fraisse
We report a case of late infective endocarditis in an 8-year-old boy 3 years after transcatheter closure of an atrial septal defect with the Amplatzer Atrial Septal Occluder Device. Echocardiography showed a very thick pannus lining the left atrial disc of the prosthesis, with some mobile elements. MRI showed several cerebral microemboli. The patient had dental caries and blood cultures found Staphylococcus aureus. Patient was treated with gentamicin and oxacillin before surgical removal of the prosthesis...
September 19, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27634030/does-coronary-angiography-and-percutaneous-coronary-intervention-affect-cognitive-function
#16
Juliane Jurga, Per Tornvall, Linda Dey, Jan van der Linden, Nondita Sarkar, Mia von Euler
Cerebral microemboli are frequently observed during coronary angiography (CA) and percutaneous coronary intervention (PCI), and their numbers have been related to the vascular access site used. Although cerebral microemboli can cause silent cerebral lesions, their clinical impact is debated. To study this, 93 patients referred for CA or PCI underwent serial cognitive testing using the Montreal Cognitive Assessment (MoCA) test to detect postprocedural cognitive impairment. Patients were randomized to radial or femoral access...
August 24, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27633169/microembolization-is-associated-with-transient-cognitive-decline-in-patients-undergoing-carotid-interventions
#17
Elizabeth Hitchner, Brittanie D Baughman, Salil Soman, Becky Long, Allyson Rosen, Wei Zhou
OBJECTIVE: Carotid interventions are important in helping to reduce the risk of stroke for patients with high-grade carotid artery stenosis; however, subclinical cerebral microemboli can occur during these procedures. Associations have been found between the incidence of microemboli and postoperative decline in memory. We therefore sought to determine whether this decline persisted long-term and to assess changes in other cognitive domains. METHODS: Patients were prospectively recruited under an Institutional Review Board-approved protocol at a single academic center...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27604728/thromboembolic-model-of-cerebral-ischemia-and-reperfusion-in-mice
#18
Ali Alawieh, Wenxue Wang, Aarti Narang, Stephen Tomlinson
Ischemic stroke is the fourth leading cause of death in the USA and a prominent cause of death globally. Besides thrombolytic therapy used in a small subset of patients, no alternative therapeutic strategy has been shown to improve the outcome of stroke patients. Preclinical models of ischemic stroke are an essential tool for investigating pathogenic processes that happen after the ischemic insult, as well as to screen for candidate therapeutic interventions. There are several models of rodent ischemic stroke including mechanical occlusion, thromboembolic stroke, and photothrombotic stroke...
2016: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27528100/sources-of-mortality-on-dialysis-with-an-emphasis-on-microemboli
#19
Bernd G Stegmayr
Patients on chronic hemodialysis have a shortened survival compared to the general population. There are multiple sources of morbidity and mortality unique to the dialysis population that account for this. Reasons include the effects of blood membrane interactions, intradialytic hypotension, myocardial stunning, excessive interdialytic weight gain, high-flow arteriovenous fistulae, and impaired lipid break down by anticoagulation administered during HD. Another risk factor, not well appreciated, is the occurrence of microemboli of air (microbubbles) during HD...
November 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27516417/clinical-evaluation-of-the-air-handling-properties-of-contemporary-oxygenators-with-integrated-arterial-filter
#20
Marco C Stehouwer, Kristina R Legg, Roel de Vroege, Johannes C Kelder, Erik Hofman, Bastian A de Mol, Peter Bruins
Gaseous microemboli (GME) may originate from the extracorporeal circuit and enter the arterial circulation of the patient. GME are thought to contribute to cerebral deficit and to adverse outcome after cardiac surgery. The arterial filter is a specially designed component for removing both gaseous and solid microemboli. Integration of an arterial filter with an oxygenator is a contemporary concept, reducing both prime volume and foreign surface area. This study aims to determine the air-handling properties of four contemporary oxygenator devices with an integrated arterial filter...
August 11, 2016: Perfusion
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