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Microemboli

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https://www.readbyqxmd.com/read/28645797/transcranial-doppler-and-microemboli-detection-relationships-to-symptomatic-status-and-histopathology-findings
#1
Carol C Mitchell, Stephanie M Wilbrand, Bornali Kundu, Catherine N Steffel, Tomy Varghese, Nirvedh H Meshram, Geng Li, Thomas D Cook, M Shahriar Salamat, Robert J Dempsey
The purpose of this study was to determine the relationship between symptomatic status, transcranial Doppler (TCD) microemboli presence and plaque histopathology findings. TCD was performed on 60 patients (37 symptomatic, 23 asymptomatic) before undergoing clinically indicated carotid endarterectomy. The frequency of microemboli signals was not significantly different between symptomatic and asymptomatic subject groups (p = 0.88) and there were no differences observed in the macroscopic or histopathology scoring of these plaques (p-values all > 0...
June 20, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28597590/in-vitro-evaluation-of-pediatric-hollow-fiber-membrane-oxygenators-on-hemodynamic-performance-and-gaseous-microemboli-handling-an-international-multicenter-multidisciplinary-approach
#2
Shigang Wang, Luiz F Caneo, Marcelo B Jatene, Fábio B Jatene, Idagene A Cestari, Allen R Kunselman, Akif Ündar
The objective of this study was to compare the hemodynamic performances and gaseous microemboli (GME) handling ability of two pediatric oxygenators in a simulated pediatric cardiopulmonary bypass (CPB) model and the importance of adding an arterial filter in the circuit. The circuit consisted of a Braile Infant oxygenator or a Maquet Quadrox-I Pediatric oxygenator without integrated arterial filter (parallel arrangement), 1/4 in. ID tubing A-V loop, and a 12-Fr arterial cannula, primed with lactated Ringer's solution and packed red blood cells...
June 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28575478/the-preservation-of-cognition-1-yr-after-carotid-endarterectomy-in-patients-with-prior-cognitive-decline
#3
Robert J Dempsey, Daren C Jackson, Stephanie M Wilbrand, Carol C Mitchell, Sara E Berman, Sterling C Johnson, Nirvedh H Meshram, Tomy Varghese, Bruce P Hermann
BACKGROUND: Vascular cognitive decline is critically important in the course of atherosclerosis and stroke. OBJECTIVE: To explore the hypothesis that carotid endarterectomy (CEA) by removing an unstable plaque may slow the course of vascular cognitive decline in both symptomatic and asymptomatic patients. METHODS: Patients with clinically significant (>60%) carotid stenosis were studied preop and 1 yr post-CEA for clinical symptoms, vascular cognitive decline, instability of carotid plaque-presence of microemboli, brain white matter changes, and medical risk factors...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28560667/strategies-for-isolation-and-molecular-profiling-of-circulating-tumor-cells
#4
Jia-Yang Chen, Ying-Chih Chang
Cancer is the leading cause of death by disease worldwide, and metastasis is responsible for more than 90% of the mortality of cancer patients. Metastasis occurs when tumor cells leave the primary tumor, travel through the blood stream as circulating tumor cells (CTCs), and then colonize secondary tumors at sites distant from the primary tumor. The capture, identification, and analysis of CTCs offer both scientific and clinical benefits. On the scientific side, the analysis of CTCs could help elucidate possible genetic alterations and signaling pathway aberrations during cancer progression, which could then be used to find new methods to stop cancer progression...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28557862/quantification-of-postmembrane-gaseous-microembolization-during-venoarterial-extracorporeal-membrane-oxygenation
#5
York Jiao, Keith E Gipson, Pramod Bonde, Abeel Mangi, Robert Hagberg, David J Rosinski, Jeffrey B Gross, Robert B Schonberger
Prolonged use of venoarterial extracorporeal membrane oxygenation (VA ECMO) may be complicated by end-organ dysfunction. Although gaseous microemboli (GME) are thought to damage end organs during cardiopulmonary bypass, patient exposures to GME have not been well characterized during VA ECMO. We therefore performed an observational study of GME in adult VA ECMO patients, with correlation to clinical events during routine patient care. After institutional review board (IRB) approval, we used two Doppler probes to detect GME noninvasively in extracorporeal membrane oxygenation (ECMO) circuits on four patients for 15 hours total while also recording patient care events...
May 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28514380/-transcatheter-embolization-in-prevention-of-recurrent-bleeding-from-stomach-ulcers
#6
N V Lebedev, G E Belozerov, A E Klimov, P Yu Sokolova, A A Spasskiy, A A Barkhudarov
AIM: To evaluate an efficacy of endovascular hemostasis in patients with gastric ulcerative bleeding and high risk of recurrent bleeding and death. MATERIAL AND METHODS: The work is based on a study of the results in 30 patients with gastric ulcerative bleeding, high risk of recurrent bleeding (rebleeding forecast system (RFS) score over 17) and high risk of death (SAPS II score over 30). We attempted transcatheter embolization of left gastric artery to prevent rebleeding...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28465805/pathogenesis-and-treatment-of-post-operative-cognitive-dysfunction
#7
REVIEW
Maria Pappa, Nikolaos Theodosiadis, Andreas Tsounis, Pavlos Sarafis
Cognitive disorders common in the post-operative period, are the post-operative delirium (POD) and the post-operative cognitive dysfunction (POCD). The Diagnostic and Statistical Manual of Mental Disorders (DSM) does not mention POCD as a separate disease entity, and thus little is known about the pathogenesis of this disorder. The aim of this study was to review, detect and highlight the most important data cited, regarding pathogenesis mechanisms and treatment of the post-operative cognitive dysfunction (POCD)...
February 2017: Electronic Physician
https://www.readbyqxmd.com/read/28456395/quantification-of-lipid-filtration-and-the-effects-on-cerebral-injury-during-cardiopulmonary-bypass
#8
Richard W Issitt, Ian Harvey, Bronagh Walsh, David Voegeli
BACKGROUND: Lipid microemboli (LME) are formed in pericardial suction blood which, when returned to the cardiopulmonary bypass (CPB) circuit, can pass through filter materials and are returned to the arterial cannula. LME have been observed to enter all major organs and have been associated with small capillary arteriolar dilatations in the brains of patients who have died after CPB. However, a causal relationship showing correlation between LME and organ dysfunction has not been demonstrated, or whether removal of LME results in improved organ function...
April 26, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28448959/detection-of-circulating-tumor-cells-and-circulating-tumor-microemboli-in-gastric-cancer
#9
Xiumei Zheng, Li Fan, Pengfei Zhou, Hong Ma, Shaoyi Huang, Dandan Yu, Lei Zhao, Shengli Yang, Jun Liu, Ai Huang, Congli Cai, Xiaomeng Dai, Tao Zhang
PURPOSE: Gastric cancer studies indicated a potential correlation between circulating tumor cells (CTCs) in peripheral blood and tumor relapse/metastasis. The prevalence and significance of circulating tumor microemboli (CTM) in gastric cancer remain unknown. We investigated the prevalence and prognostic value of CTCs and CTM for progression-free survival (PFS) and overall survival (OS) in gastric cancer patients. METHODS: Eighty-one gastric cancer patients consented to provide 5ml of peripheral blood before systematic therapy...
June 2017: Translational Oncology
https://www.readbyqxmd.com/read/28423997/do-lipid-microemboli-induce-acute-kidney-injury-during-cardiopulmonary-bypass
#10
Richard Issitt, Tim James, Bronagh Walsh, David Voegeli
BACKGROUND: Acute kidney injury (AKI) following cardiopulmonary bypass affects 5% of patients, representing significant postoperative morbidity and mortality. Animal models have shown an increased uptake of lipid microemboli (LME) into the renal vasculature, potentially indicating ischaemic causation. This study tested a new lipid filtration system (RemoweLL) against a conventional system with no lipid-depleting capacity to determine the efficacy of the filtration system and its effects on renal function...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28397410/building-a-better-neonatal-extracorporeal-life-support-circuit-comparison-of-hemodynamic-performance-and-gaseous-microemboli-handling-in-different-pump-and-oxygenator-technologies
#11
COMPARATIVE STUDY
Kristen Glass, Payal Trivedi, Shigang Wang, Karl Woitas, Allen R Kunselman, Akif Ündar
Neurologic complications during neonatal extracorporeal life support (ECLS) are associated with significant morbidity and mortality. Gaseous microemboli (GME) in the ECLS circuit may be a possible cause. Advances in neonatal circuitry may improve hemodynamic performance and GME handling leading to reduction in patient complications. This study compared hemodynamic performance and GME handling using two centrifugal pumps (Maquet RotaFlow and Medos Deltastream DP3) and polymethylpentene oxygenators (Maquet Quadrox-iD and Medos Hilite 800LT) in a neonatal ECLS circuit model...
April 2017: Artificial Organs
https://www.readbyqxmd.com/read/28384835/validation-of-the-automated-electronic-microemboli-detection-system-in-patients-undergoing-carotid-endarterectomy
#12
Tesse Leunissen, Daniel van Vriesland, Hester den Ruijter, Frans Moll, Werner Mess, Gert Jan de Borst
Purpose To assess the diagnostic value of automatic embolus detection software (AEDS) in transcranial Doppler (TCD) monitoring for the detection of solid microemboli in patients at risk for perioperative stroke during carotid endarterectomy (CEA). Materials and Methods In 50 patients undergoing CEA, perioperative TCD registration was recorded. All recorded events, identified and saved by the AEDS, were analyzed off-line doubly by two human experts (HEs) within a time frame of > 4 months. The inter- and intraobserver variability was assessed...
April 6, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28352905/site-specific-antibody-modification-and-immobilization-on-a-microfluidic-chip-to-promote-the-capture-of-circulating-tumor-cells-and-microemboli
#13
Chian-Hui Lai, Syer Choon Lim, Liang-Chun Wu, Chien-Fang Wang, Wen-Sy Tsai, Han-Chung Wu, Ying-Chih Chang
We design and synthesize EpCAM antibodies with Fc-domain site-specific linkers that allow preferential alignment when coated on microfluidic devices for capturing circulating tumor cells (CTCs) from colorectal cancer patients. The aligned coating is shown to increase the capture efficiency of CTCs and microemboli by 1.6 and 3.0-fold, respectively (both P < 0.05).
March 29, 2017: Chemical Communications: Chem Comm
https://www.readbyqxmd.com/read/28321147/detection-of-circulating-tumour-cells-in-urothelial-cancers-and-clinical-correlations-comparison-of-two-methods
#14
COMPARATIVE STUDY
Emanuela Fina, Andrea Necchi, Stefano Bottelli, Carolina Reduzzi, Sara Pizzamiglio, Chiara Iacona, Maria Grazia Daidone, Paolo Verderio, Vera Cappelletti
Circulating tumour cells (CTC) are identified exploiting their protein/gene expression patterns or distinct size compared to blood cells. Data on CTC in bladder cancer (BC) are still scarce. We comparatively analyzed CTC enrichment by AdnaTest ProstateCancerSelect (AT) and ScreenCell®Cyto (SC) kits, combined with identification by EPCAM, MUC1, and ERBB2 expression and by cytological criteria, respectively, in 19 nonmetastatic (M0) and 47 metastatic (M+) BC patients, at baseline (T0) and during treatment (T1)...
2017: Disease Markers
https://www.readbyqxmd.com/read/28298048/carotid-atherosclerotic-plaque-instability-and-cognition-determined-by-ultrasound-measured-plaque-strain-in-asymptomatic-patients-with-significant-stenosis
#15
Robert J Dempsey, Tomy Varghese, Daren C Jackson, Xiao Wang, Nirvedh H Meshram, Carol C Mitchell, Bruce P Hermann, Sterling C Johnson, Sara E Berman, Stephanie M Wilbrand
OBJECTIVE This article describes the use of ultrasound measurements of physical strain within carotid atherosclerotic plaques as a measure of instability and the potential for vascular cognitive decline, microemboli, and white matter changes. METHODS Asymptomatic patients with significant (> 60%) carotid artery stenosis were studied for dynamic measures of plaque instability, presence of microemboli, white matter changes, and vascular cognitive decline in comparison with normative controls and premorbid state...
March 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28199523/detection-and-differentiation-of-cerebral-microemboli-in-patients-undergoing-major-orthopaedic-surgery-using-transcranial-doppler-ultrasound
#16
C Kietaibl, A Engel, I Horvat Menih, M Huepfl, G Erdoes, B Kubista, R Ullrich, R Windhager, K Markstaller, K U Klein
Background: Cerebral microemboli (ME) are frequently generated during orthopaedic surgery and may impair cerebral integrity. However, the nature of cerebral ME, being either of solid or gaseous origin, is poorly investigated. Our primary aim was to determine both the frequency and nature of cerebral ME in generally anaesthetised patients undergoing major orthopaedic surgery. Methods: Fifty patients (hip/knee/shoulder prosthesis, spine surgery) were enrolled. Cerebral ME and cerebral blood flow velocity (CBFV) were determined in both middle cerebral arteries for 15 min preoperatively and postoperatively, using transcranial Doppler ultrasound...
March 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28193536/blood-brain-barrier-disruption-after-cardiopulmonary-bypass-diagnosis-and-correlation-to-cognition
#17
Dan Abrahamov, Oren Levran, Sharon Naparstek, Yael Refaeli, Shani Kaptson, Mahmud Abu Salah, Yaron Ishai, Gideon Sahar
BACKGROUND: Cardiopulmonary bypass (CPB) elicits a systemic inflammatory response that may impair blood-brain barrier (BBB) integrity. BBB disruption can currently be detected by dynamic contrast enhancement magnetic resonance imaging (MRI), reflected by an increase in the permeability constant (K(trans)). We aimed to determine (1) whether CPB induces BBB disruption, (2) duration until BBB disruption resolution, and (3) the obtainable correlation between BBB injury (location and intensity) and neurocognitive dysfunction...
February 10, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28121221/the-association-between-circulating-tumor-cells-and-epstein-barr-virus-activation-in-patients-with-nasopharyngeal-carcinoma
#18
Caiyun He, Xinjun Huang, Xuan Su, Tao Tang, Xiao Zhang, Jiangjun Ma, Xiang Guo, Xing Lv
BACKGROUND: Circulating tumor cells (CTCs) and microemboli (CTM) are attracting increasing attention in medical biology and clinical practice. However, the clinical relevance of CTCs in nasopharyngeal carcinoma (NPC) has not yet been ascertained, and no study has focused on the influence of Epstein-Barr virus (EBV) status on CTCs in NPC patients. These issues were therefore examined. METHODS: Peripheral blood samples were prospectively obtained from 33 NPC patients before treatment...
January 25, 2017: Cancer Biology & Therapy
https://www.readbyqxmd.com/read/28097236/lung-vaso-occlusion-in-sickle-cell-disease-mediated-by-arteriolar-neutrophil-platelet-microemboli
#19
Margaret F Bennewitz, Maritza A Jimenez, Ravi Vats, Egemen Tutuncuoglu, Jude Jonassaint, Gregory J Kato, Mark T Gladwin, Prithu Sundd
In patients with sickle cell disease (SCD), the polymerization of intraerythrocytic hemoglobin S promotes downstream vaso-occlusive events in the microvasculature. While vaso-occlusion is known to occur in the lung, often in the context of systemic vaso-occlusive crisis and the acute chest syndrome, the pathophysiological mechanisms that incite lung injury are unknown. We used intravital microscopy of the lung in transgenic humanized SCD mice to monitor acute vaso-occlusive events following an acute dose of systemic lipopolysaccharide sufficient to trigger events in SCD but not control mice...
January 12, 2017: JCI Insight
https://www.readbyqxmd.com/read/28078914/appropriate-patient-selection-for-carotid-revascularization-procedures-is-urgently-needed
#20
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
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