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https://www.readbyqxmd.com/read/28822656/phenylephrine-infusion-impact-on-surgical-site-infections-after-lower-extremity-bypass-surgery
#1
Craig Curry, Jens Eldrup-Jorgensen, Janelle Richard, Michele C Siciliano, Wendy Y Craig
OBJECTIVE: Lower extremity bypass (LEB) operations have high rates of surgical site infections (SSI). Phenylephrine is a commonly used vasoconstrictor which may reduce skin blood flow and increase the likelihood of SSI in these patients. We studied the potential effect of phenylephrine infusion during LEB surgery on SSI. METHODS: LEB cases and their demographic data were identified through the Vascular Quality Initiative registry. SSI in this population was identified using the hospital epidemiology surveillance database...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28820359/clinical-outcomes-of-direct-oral-anticoagulants-after-lower-extremity-arterial-procedures
#2
Afsha Aurshina, Pavel Kibrik, Justin Eisenberg, Ahmad Alsheekh, Anil Hingorani, Natalie Marks, Enrico Ascher
Objectives The use of postoperative anticoagulation is not uncommon for patients undergoing lower extremity arterial procedures as adjunctive therapy. Longer postoperative length of stay is necessary to achieve adequate therapeutic international normalized ratio with traditional protocols that call for the use of unfractionated heparin and warfarin therapy. We hypothesized the direct oral anticoagulants are an attractive alternative to provide adequate anticoagulation in patients who undergo lower extremity arterial procedures...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28819879/lower-extremity-bypass-using-bovine-carotid-artery-graft-artegraft-an-analysis-of-124-cases-with-long-term-results
#3
Philip Lindsey, Angela Echeverria, Mathew Cheung, Elias Kfoury, Carlos F Bechara, Peter H Lin
INTRODUCTION: Although biological grafts have been utilized as a vascular conduit in leg bypass for many years, reports of a bovine carotid artery graft (BCAG) in lower extremity revascularization have been scarce. This study analyzed the outcome of lower leg bypass using BCAG. METHODS: A retrospective review of a prospectively collected database of all patients undergoing lower extremity bypass using BCAG from 2002 to 2017 was performed. Clinical outcomes including graft patency and limb salvage were evaluated...
August 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28814831/schiff-base-derived-from-thiosemicarbazone-and-anthracene-showed-high-potential-in-overcoming-multidrug-resistance-in-vitro-with-low-drug-resistance-index
#4
Jie Bai, Rui-Hui Wang, Yan Qiao, Aidong Wang, Chen-Jie Fang
Multidrug resistance (MDR) is a huge obstacle in cancer chemotherapeutics. Overcoming MDR is a great challenge for anticancer drug discovery. Here, DNA binding and cytotoxicity of Schiff base L1 and L2 were explored to assess their efficiency in fighting cancer and overcoming the MDR. L1 and L2 could treat extremely chemoresistant MCF-7/ADR cell as drug-sensitive cell, with drug resistance index (DRI) <2.13, showing high potential in overcoming the MDR. The apoptotic ratio induced by L1 and L2 was low for both MCF-7 and MCF-7/ADR cells...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28795032/extra-anatomic-ascending-aorta-to-abdominal-aorta-bypass-in-takayasu-arteritis-patients-with-mid-aortic-syndrome
#5
Hak Ju Kim, Jae-Woong Choi, Ho Young Hwang, Hyuk Ahn
BACKGROUND: We evaluated the operative outcomes of an extra-anatomic bypass from the ascending aorta to the abdominal aorta in patients with type II or III Takayasu arteritis (TA) with mid-aortic syndrome. METHODS: From 1988 to 2014, 8 patients with type II (n=2) or III (n=6) TA underwent an ascending aorta to abdominal aorta bypass. The mean patient age was 43.5±12.2 years and the mean peak pressure gradient between the upper and lower extremities was 54.8±39...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28790028/staged-retroperitoneal-mesenteric-revascularisation-and-aortobifemoral-bypass-after-endovascular-rescue-for-acute-mesenteric-ischaemia
#6
Shepard Peir Johnson, Melani Lighter, Harry Linne Anderson, Abdulhameed Aziz
Visceral artery revascularisation through a retroperitoneal approach provides an infrequent yet viable, alternative means of managing mesenteric ischaemia in patients with previous abdominal operations. We present a unique case implementing this surgical approach in a 55-year-old man in which we performed a retroperitoneal aortobifemoral bypass with concomitant retrograde jump graft from the aortic prosthesis to the superior mesenteric artery (SMA) for bilateral lower extremity rest pain and chronic mesenteric ischaemia...
August 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28777538/microinjection-for-the-ex-vivo-modification-of-cells-with-artificial-organelles
#7
Peter Tiefenboeck, Jong Ah Kim, Ferdinand Trunk, Tamara Eicher, Erica Russo, Alvaro Teijeira, Cornelia Halin, Jean-Christophe Leroux
Microinjection is extensively used across fields to deliver material intracellularly. Here we address the fundamental aspects of introducing exogenous organelles into cells to endow them with artificial functions. Nanocarriers encapsulating biologically active cargo or extreme intraluminal pH were injected directly into the cytosol of cells, where they bypassed subcellular processing pathways and persisted intact for several days. Nanocarriers' size was found to dictate their intracellular distribution pattern upon injection, with larger vesicles adopting polarized agglomerated distributions and smaller colloids spreading evenly in the cytosol...
August 4, 2017: ACS Nano
https://www.readbyqxmd.com/read/28762298/cardiac-myxoma-clinical-characteristics-surgical-intervention-intra-operative-challenges-and-outcome
#8
Mahmoud Abu Abeeleh, Suhayl Saleh, Emad Alhaddad, Moaath Alsmady, Musa Alshehabat, Zuhair Bani Ismail, Islam Massad, Amjad Bani Hani, Sami Abu Halaweh
OBJECTIVE: The objectives of this retrospective study were to characterize the clinical presentation, diagnostic findings, surgical approaches, intra-operative challenges and complications following the surgical treatment of cardiac myxoma in two of the largest referral hospitals in Jordan. METHODS: Medical records of all patients presented to the cardiology department during the period between 1984 and 2016 were reviewed. Criteria for inclusion in the study were: (1) patients who were presented for cardiac evaluation due to symptoms suggestive of a primary cardiac problem, (2) completed medical records, including results of echocardiography suggestive of intra-cardiac occupying mass, (3) the surgical operation was undertaken and intra-operative data was available, (4) a histological diagnosis of myxoma was available and (5) the discharge status and follow-up data were available for at least 2 years after initial surgery...
July 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28755274/regression-of-left-ventricular-mass-after-bariatric-surgery
#9
REVIEW
Thierry H Le Jemtel, Rohan Samson, Abhishek Jaiswal, Eliza B Lewine, Suzanne Oparil
Notwithstanding the presence of hypertension, obstructive sleep apnea, or both, obesity is associated with increased left ventricular (LV) mass. The effects of bariatric surgery on LV mass have been sparsely investigated by M-mode and two-dimensional (2D) echocardiography. Overall, Roux-en-Y gastric bypass, adjustable gastric banding, and sleeve gastrectomy reduce LV mass. However, the reduction in LV mass is extremely variable. Besides duration and severity of obesity, presence of hypertension, obstructive sleep apnea or both, and type of surgical procedures, the inaccuracy of M-mode and 2D echocardiography for assessment of LV mass contributes to the variable effects of bariatric surgery on LV mass...
September 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28754387/cost-of-cardiac-surgery-in-frail-compared-with-nonfrail-older-adults
#10
Michael Goldfarb, Melissa Bendayan, Lawrence G Rudski, Jean-Francois Morin, Yves Langlois, Felix Ma, Kevin Lachapelle, Renzo Cecere, Benoit DeVarennes, Christo I Tchervenkov, James M Brophy, Jonathan Afilalo
BACKGROUND: Frailty is a risk factor for mortality, morbidity, and prolonged length of stay after cardiac surgery, all of which are major drivers of hospitalization costs. The incremental hospitalization costs incurred in frail patients have yet to be elucidated. METHODS: Patients aged ≥ 60 years were evaluated for frailty before coronary artery bypass grafting or heart valve surgery at 2 academic centres between 2013 and 2015 as part of the McGill Frailty Registry...
August 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28747047/novel-approach-in-using-ultrasound-in-treating-acute-limb-ischemia
#11
Michael H Wholey, Raul G Palacios, Alejandro Mendez-Castillo, Lori C Pounds
BACKGROUND: It is imperative to gain safe access into the occluded targeted vessel and begin treating acute extremity limb ischemia. Often the origin of the targeted native artery or bypass graft will have a flush occlusion making it difficult to cannulate. This paper looks at the novel use of portable ultrasound to evaluate the origin of the artery or bypass graft to help facilitate the start of thrombolysis. METHODS: We reviewed our last 2 years of acute limb ischemia in our patients with high risk factors and co-morbidities...
July 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28740763/lymphaticovenous-bypass-adaptations-and-lessons-learned
#12
Heather L Baltzer, Sebastian Winocour, Christin Harless, Michel Saint-Cyr
Advances in microsurgical instruments and techniques have allowed for introduction of lymphaticovenous anastomosis as a potential surgical treatment for patients with upper and lower extremity lymphedema. This article reviews the approach to lymphaticovenous anastomosis patient selection and technical modifications that improve the ease and efficiency of the procedure.
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28739453/modified-frailty-index-can-be-used-to-predict-adverse-outcomes-and-mortality-after-lower-extremity-bypass-surgery
#13
Tarik Z Ali, Erik B Lehman, Faisal Aziz
BACKGROUND: Frailty has been increasingly used as a prognostic indicator for various surgical operations. Patients with peripheral arterial disease represent a cohort of population with advanced medical comorbidities. The aim of this study is to correlate the postoperative outcomes after lower extremity bypass surgery with preoperative modified frailty index (mFI). METHODS: Using 2010 American College of Surgeons National Surgical Quality Improvement Program database, patients undergoing infrainguinal arterial bypass surgery were identified...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28738956/upper-extremity-pulse-pressure-predicts-amputation-free-survival-after-lower-extremity-bypass
#14
Eric S Wise, Justine E Wergin, Eric H Mace, Justiss A Kallos, Whitney E Muhlestein, Nicholas J Shelburne, Kyle M Hocking, Colleen M Brophy, Raul J Guzman
Increased pulse pressure reflects pathologic arterial stiffening and predicts cardiovascular events and mortality. The effect of pulse pressure on outcomes in lower extremity bypass patients remains unknown. We thus investigated whether preoperative pulse pressure could predict amputation-free survival in patients undergoing lower extremity bypass for atherosclerotic occlusive disease. An institutional database identified 240 included patients undergoing lower extremity bypass from 2005 to 2014. Preoperative demographics, cardiovascular risk factors, operative factors, and systolic and diastolic blood pressures were recorded, and compared between patients with pulse pressures above and below 80 mm Hg...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28735951/presentation-clinical-features-and-results-of-intervention-in-upper-extremity-fibromuscular-dysplasia
#15
MULTICENTER STUDY
Nancy Nguyen, Aditya Sharma, Jonathan K West, Maya Serhal, Ellen Brinza, Heather L Gornik, Esther S H Kim
BACKGROUND: We present a case series of upper extremity fibromuscular dysplasia (UE FMD) consisting of 22 patients from two tertiary referral centers focusing on clinical presentation, diagnostic findings, and interventional outcomes. FMD is a noninflammatory, nonatherosclerotic arteriopathy that has a predisposition for middle-aged women. Involvement of the UE is thought to be rare. Patients with UE FMD can present with claudication or ischemia, or they can be incidentally diagnosed...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28734721/factors-influencing-survival-of-patients-with-pancreatic-adenocarcinoma-and-synchronous-liver-metastases-receiving-palliative-care
#16
Huaqiang Ouyang, Weidong Ma, Fang Liu, Zhensong Yue, Minghui Fang, Manman Quan, Zhanyu Pan
BACKGROUND AND AIMS: Patients with pancreatic ductal adenocarcinoma and synchronous liver metastases (PACLM) have an extremely limited life expectancy. We performed a single-center analysis to explore the clinical results and prognostic factors of patients with PACLM receiving palliative care. METHODS: We retrospectively reviewed 189 patients undergoing palliative care at Tianjin Medical University Cancer Hospital over a 15-year period. Clinical characteristics, survival condition, and factors associated with survival were analyzed...
July 8, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#17
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28712733/long-term-outcomes-after-autogenous-versus-synthetic-lower-extremity-bypass-in-patients-on-hemodialysis
#18
Isibor Arhuidese, Caitlin W Hicks, Satinderjit Locham, Tammam Obeid, Besma Nejim, Mahmoud B Malas
BACKGROUND: Hemodialysis dependence confers unique physiologic conditions. Prior reports of outcomes after infrainguinal open bypass operations in patients on hemodialysis have been based on relatively small sample institutional series. In this study, we evaluate long-term outcomes after open bypass operations in a large contemporary population-based cohort of hemodialysis patients. We studied all hemodialysis patients who underwent infrainguinal open operation using autogenous versus prosthetic conduits in the United States Renal Data System between January 2007 and December 2011...
July 13, 2017: Surgery
https://www.readbyqxmd.com/read/28696492/trocar-site-hernia-after-gastric-bypass
#19
Sandra Ahlqvist, Dennis Björk, Lena Weisby, Leif A Israelsson, Yücel Cengiz
BACKGROUND: The 5.2% rate of trocar site incisional hernia (TSIH) reported appears low in view of the proportion of TSIH repairs being performed. Detecting TSIH by clinical examination may be difficult in the obese. The correlation between clinical examination and a novel radiological examination for the detection of TSIH in obese patients was studied. MATERIALS AND METHODS: Twenty-six patients subjected to laparoscopic gastric bypass in 2010 underwent clinical and radiological examination by three independent assessors for each method, after a mean follow-up time of 33 months...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28689939/variation-in-transfusion-practices-and-the-association-with-perioperative-adverse-events-in-patients-undergoing-open-abdominal-aortic-aneurysm-repair-and-lower-extremity-arterial-bypass-in-the-vascular-quality-initiative
#20
Zachary Osborne, Kristine Hanson, Benjamin S Brooke, Marc Schermerhorn, Peter Henke, Rumi Faizer, Andres Schanzer, Philip Goodney, Thomas Bower, Randall R DeMartino
INTRODUCTION: Blood transfusions are associated with adverse events. We examined perioperative transfusion practices and associated complications following open vascular procedures nationwide in the Vascular Quality Initiative (VQI). METHODS: Adults undergoing open abdominal aortic aneurysm repair (OAR) and lower extremity arterial bypass (Bypass) within VQI (2003-2016) were identified. All emergent cases, patients with pre-operative hemoglobin<7 g/dL, pre-operative hospitalization >1 day, or a return to OR during the index hospitalization were excluded...
July 6, 2017: Annals of Vascular Surgery
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