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https://www.readbyqxmd.com/read/29452441/assessing-the-safety-and-efficacy-of-regional-anesthesia-for-lower-extremity-microvascular-reconstruction-enhancing-recovery
#1
Qing Zhao Ruan, Shawn Diamond, Scott Zimmer, Matthew L Iorio
BACKGROUND: Perioperative pain, increased sympathetic tone, and peripheral vasospasm may be safely managed with regional nerve blockade during microvascular reconstruction in the lower extremity. Limited reports exist in this setting; therefore, we evaluated our use of peripheral nerve catheters (PNCs) during microvascular limb salvage to determine safety and efficacy for both patient and flap. METHODS: A single-institution, retrospective review of a prospectively maintained database on all patients with lower extremity free tissue transfers between 2012 and 2017 was completed...
February 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29452118/long-term-outcome-of-interrupted-arch-repair-with-direct-anastomosis-and-homograft-augmentation-patch
#2
Mohammed Mohsin Uzzaman, Natasha E Khan, Ben Davies, John Stickley, Timothy J Jones, William J Brawn, David J Barron
BACKGROUND: We analysed outcomes of IAA repair using a standardised technique in order to interpret the role of the arch repair on late outcomes in this complex and heterogeneous group. METHODS: Single institution study from 1988-2015. 120 cases of IAA were divided into four groups: IAA with VSD (iVSD, n=38), IAA with Norwood/DKS (iNor, n=41), IAA with Truncus (iTruncus, n=24) and miscellaneous group (iMisc, n=17). Arch repair performed using a standard technique of direct anastomosis with homograft patch augmentation...
February 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29452099/a-systematic-review-and-meta-analysis-comparing-pigtail-catheter-and-chest-tube-as-the-initial-treatment-for-pneumothorax
#3
Su-Huan Chang, Yi-No Kang, Hsin-Yi Chiu, Yu-Han Chiu
BACKGROUND: The optimal initial treatment approach for pneumothorax remains controversial. This systemic review and meta-analysis investigated the effectiveness of small-bore pigtail catheter (PC) drainage in comparison with that of large-bore chest tube (LBCT) drainage as the initial treatment approach for all subtypes of pneumothorax. METHODS: We systematically searched PubMed and Embase for observational studies and randomized controlled trials published up to October 9, 2017, that compared PC and LBCT as the initial treatment for pneumothorax...
February 13, 2018: Chest
https://www.readbyqxmd.com/read/29451373/regional-structural-and-functional-specialisations-in-the-urethra-of-the-female-rat-evidence-for-complex-physiological-control-systems
#4
Monica Eggermont, Stefan De Wachter, Jane Eastham, James Gillespie
The present study characterises the complex structural and functional elements of the female rat urethra that may be involved in controlling urethral closure and continence. Urethras were dissected from female Sprague-Dawley rats (n=12) euthanized by pentobarbital overdose. Tissues were fixed (4% paraformaldehyde), frozen and sectioned (8μm) for light microscopy and immunohistochemistry. Antibodies were used to detect immunoreactivity to calcitonin gene related peptide, nitric oxide synthase, vesicular acetylcholine transporter and tyrosine hydroxylase...
February 16, 2018: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/29451168/percutaneous-catheter-drainage-followed-by-endoscopic-transluminal-drainage-necrosectomy-for-treatment-of-infected-pancreatic-necrosis-in-early-phase-of-illness
#5
Surinder Singh Rana, Rajesh Gupta, Mandeep Kang, Vishal Sharma, Ravi Sharma, Ujjwal Gorsi, Deepak K Bhasin
Background and Objectives: Infected pancreatic necrosis (IPN) in the early phase is treated with "step up approach" involving initial percutaneous catheter drainage (PCD) followed by necrosectomy. There is a paucity of data on a combined approach of initial PCD followed by endoscopic drainage and necrosectomy. A retrospectively study on safety and efficacy of initial PCD followed by endoscopic transluminal drainage and necrosectomy in IPN. Methods: Retrospective analysis of data of 23 patients with IPN who were treated with a combined approach...
January 2018: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29450695/a-clinical-approach-to-arrhythmias-revisited-in-2018-from-ecg-over-noninvasive-and-invasive-electrophysiology-to-advanced-imaging
#6
REVIEW
L Jordaens
Understanding arrhythmias and their treatment is not always easy. The current straightforward approach with catheter ablation and device therapy is an amazing achievement, but does not make management of underlying or other cardiac disease and pharmacological therapy unnecessary. The goal of this paper is to describe how much of the knowledge of the 1980s and early 1990s can and should still be applied in the modern treatment of patients with arrhythmias. After an introduction, this review will focus on paroxysmal atrial fibrillation and a prototype of 'idiopathic' ventricular arrhythmias, two diseases with a striking similarity, and will discuss the arrhythmogenesis...
February 15, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29449367/load-independent-systolic-and-diastolic-right-ventricular-function-in-heart-failure-with-preserved-ejection-fraction-as-assessed-by-resting-and-handgrip-exercise-pressure-volume-loops
#7
Karl-Philipp Rommel, Maximilian von Roeder, Christian Oberueck, Konrad Latuscynski, Christian Besler, Stephan Blazek, Thomas Stiermaier, Karl Fengler, Volker Adams, Marcus Sandri, Axel Linke, Gerhard Schuler, Holger Thiele, Philipp Lurz
BACKGROUND: Although systolic right ventricular (RV) dysfunction has been shown to be a potent predictor for adverse outcomes in patients with heart failure with preserved ejection fraction (HFpEF), RV functional abnormalities in the course of the syndrome are not well characterized. We, therefore, sought to assess load-independent and load-dependent systolic and diastolic characteristics of RV function in stable outpatients with HFpEF. METHODS AND RESULTS: We invasively obtained RV and left ventricular pressure-volume loops in 24 HFpEF patients and 9 patients without heart failure symptoms with a conductance catheter during basal conditions and handgrip exercise...
February 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29449354/high-resolution-infrared-thermography-of-esophageal-temperature-during-radiofrequency-ablation-of-atrial-fibrillation
#8
Matthew G Daly, Iain Melton, Graham Roper, Gary Lim, Ian G Crozier
BACKGROUND: Catheter ablation for atrial fibrillation has potential to cause esophageal thermal injury. Esophageal temperature monitoring during ablation is commonly used; however, it has not eliminated thermal injuries, possibly because conventional sensors have poor spatial sampling and response characteristics. To enhance understanding of temperature dynamics that may underlie esophageal injury, we tested a high-resolution, intrabody, infrared thermography catheter to continuously image esophageal temperatures during ablation...
February 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29449353/ten-year-clinical-outcome-after-circumferential-pulmonary-vein-isolation-utilizing-the-hamburg-approach-in-patients-with-symptomatic-drug-refractory-paroxysmal-atrial-fibrillation
#9
Roland Richard Tilz, Christian-Hendrik Heeger, Alexander Wick, Ardan M Saguner, Andreas Metzner, Andreas Rillig, Peter Wohlmuth, Bruno Reissmann, Christine Lemeš, Tilman Maurer, Francesco Santoro, Johannes Riedl, Christian Sohns, Shibu Mathew, Karl-Heinz Kuck, Feifan Ouyang
BACKGROUND: Circumferential pulmonary vein isolation (CPVI) is increasingly performed for the treatment of symptomatic drug-refractory paroxysmal atrial fibrillation. Long-term data for >10 years after CPVI are sparse. We investigated the long-term clinical outcome and progression of paroxysmal atrial fibrillation after double-lasso and 3-dimensional electroanatomical mapping-guided CPVI. METHODS AND RESULTS: From 2003 to 2004, 161 patients (mean age: 60±10 years) with symptomatic drug-refractory paroxysmal atrial fibrillation were prospectively enrolled and underwent electroanatomical mapping-guided CPVI...
February 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29449331/lipid-lowering-therapy-with-ezetimibe-decreases-spontaneous-atherothrombotic-occlusions-in-a-rabbit-model-of-plaque-erosion-a-role-of-serum-oxysterols
#10
Katsuya Honda, Tetsuya Matoba, Yoshibumi Antoku, Jun-Ichiro Koga, Ikuyo Ichi, Kaku Nakano, Hiroyuki Tsutsui, Kensuke Egashira
OBJECTIVE: Plaque erosion is increasing its importance as one of the mechanisms of acute coronary syndromes in this statin era. However, the clinical efficacy of currently used lipid-lowering agents in the prevention of thrombotic complications associated with plaque erosion has not been clarified. Therefore, we examined the therapeutic effects of ezetimibe or rosuvastatin monotherapy on spontaneous atherothrombotic occlusion. APPROACH AND RESULTS: Femoral arteries of Japanese white rabbits, fed a high-cholesterol diet, were injured by balloon catheter, and then angiotensin II was continuously administrated...
February 15, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29447988/escmid-study-group-for-infections-in-compromised-hosts-esgich-consensus-document-on-the-safety-of-targeted-and-biological-therapies-an-infectious-diseases-perspective-agents-targeting-lymphoid-cells-surface-antigens-i-cd19-cd20-and-cd52
#11
REVIEW
Małgorzata Mikulska, Simone Lanini, Carlota Gudiol, Lubos Drgona, Giuseppe Ippolito, Mario Fernández-Ruiz, Bernd Salzberger
BACKGROUND: The present review is part of the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies. AIMS: To review, from an Infectious Diseases perspective, the safety profile of agents targeting CD19, CD20 and CD52 and to suggest preventive recommendations. SOURCES: Computer-based MEDLINE searches with MeSH terms pertaining to each agent or therapeutic family...
February 12, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29447854/risk-factors-associated-complications-for-postoperative-urinary-retention-after-lumbar-surgery-for-lumbar-spinal-stenosis
#12
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29447772/the-optimal-anti-coagulation-for-enhanced-risk-patients-post-catheter-ablation-for-atrial-fibrillation-ocean-trial
#13
Atul Verma, Andrew C T Ha, Paulus Kirchhof, Gerhard Hindricks, Jeff S Healey, Michael D Hill, Mukul Sharma, D George Wyse, Jean Champagne, Vidal Essebag, George Wells, Dhiraj Gupta, Hein Heidbuchel, Prashanthan Sanders, David H Birnie
BACKGROUND: The optimal long-term antithrombotic regimen for patients after successful catheter-based atrial fibrillation (AF) ablation is not well defined. Presently, practice variation exists, and the benefits of oral anticoagulation over antiplatelet therapy across the entire spectrum of stroke risk profile remain undefined in the postablation population. To date, there are no randomized trials to inform clinicians on this therapeutic question. OBJECTIVE: The objective was to assess whether rivaroxaban is superior to acetylsalicylic acid (ASA) in reducing the risk of clinically overt stroke, systemic embolism, or covert stroke among patients without apparent recurrent atrial arrhythmias for at least 1 year after their most recent AF ablation procedure...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29446865/european-guidance-on-paediatric-use-of-probiotics-states-that-benefits-are-limited-to-several-conditions-and-urges-caution-with-specific-vulnerable-groups
#14
REVIEW
Iva Hojsak, Valentina Fabiano, Tudor Lucian Pop, Olivier Goulet, Gian Vincenzo Zuccotti, Fugen Cullu Çokuğraş, Massimo Pettoello-Mantovani, Sanja Kolaček
AIM: The use of probiotics has been covered by many guidelines, position papers and evidence-based recommendations, but few have referred to specific patient groups or clinical indications. This European study summarises recommendations and scientifically credited guidelines on the use of probiotics for children and provides practice points. METHODS: An expert panel was convened by the European Paediatric Association in June 2017 to define the relevant clinical questions for using probiotics in paediatric healthcare and review and summarise the guidelines, recommendations, position papers and high-quality evidence...
February 15, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29446842/epidemiology-and-risk-factors-for-outpatient-acquired-catheter-related-bloodstream-infections-in-children-receiving-home-parenteral-nutrition
#15
Laura J Wozniak, Hannah M Bechtold, Laurie E Reyen, Alvin P Chan, Elizabeth A Marcus, Jorge H Vargas
BACKGROUND: Few studies have examined the epidemiology and risk factors for the development of outpatient-acquired catheter-related bloodstream infections (CRBSIs) in children receiving home parenteral nutrition. This study aimed to (1) characterize the incidence, clinical presentation, and epidemiology of CRBSIs and (2) identify risk factors for CRBSIs in children receiving home parenteral nutrition. METHODS: A longitudinal database approved by our Institutional Review Board was created to prospectively track CRBSIs in the UCLA pediatric population from January to December 2012...
February 15, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29446710/early-versus-late-cardiac-remodelling-during-right-ventricular-pressure-load-and-impact-of-preventive-versus-rescue-therapy-with-endothelin-1-receptor-blockers
#16
Sara Roldan Ramons, Guido Ehrenfried Pieles, Mei Sun, Cameron Slorach, Wei Hui, Mark K Friedberg
BACKGROUND: Pulmonary artery banding (PAB) causes right ventricular (RV) dysfunction, biventricular fibrosis and apoptosis which are attenuated by endothelin-1 (ET1) receptor blockade (ERB). Little is known about the time-course of remodelling and whether early versus late ERB confers improved outcome. MATERIALS AND METHODS: PAB was performed in 5-groups of rabbits: Shams, 3W (3-weeksPAB), 6W (6-weeksPAB), 6WERB1 (6-weeksPAB+ERB from day-1) and 6WERB21 (6-weeksPAB+ERB from day-21)...
February 15, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29446182/catheter-ablation-of-ventricular-arrhythmias-with-qrs-morphology-resembling-that-of-aortic-sinus-cusp-arrhythmias-significance-of-mapping-the-left-pulmonary-sinus-cusp
#17
Zhuo Liang, Wang Yunlong, Tao Zhang, Zhihong Han, Jianzeng Dong, Xuejun Ren
BACKGROUND: There is a close anatomical relationship between aortic sinus cusp (ASC) and the left pulmonary sinus cusp (LPSC). PURPOSE: The study was to investigate the significance of mapping and ablation of LPSC for VAs with QRS morphology resembling that of ASC arrhythmias. METHODS: In 33 consecutive patients undergoing successful catheter ablation of idiopathic VAs with ASC arrhythmia-like QRS morphology, LPSC was mapped carefully. RESULTS: Among the 33 patients studied, QRS morphology resembled that of arrhythmias of either right or left coronary cusp (LCC or RCC) origin in 17 and 16 patients, respectively...
February 15, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29445984/impact-of-antibiotic-prophylaxis-on-catheter-associated-urinary-tract-infections-during-atrial-fibrillation-ablation
#18
David E Lewandowski, David Pierce, Anne Barnett, Emmanuel Sampene, Nasia Safdar, Michael E Field, Jennifer M Wright
PURPOSE: Urinary catheter placement is common during atrial fibrillation (AF) ablation when performed under general anesthesia. Whether patients undergoing AF ablation would benefit from prophylactic antibiotics is unknown. METHODS: Patients undergoing AF ablation in a single center from December 2011 until June 2016 were included. All patients received urinary catheters and general anesthesia. After June 2014, patients received antibiotic prophylaxis with a single dose of oral nitrofurantoin and a catheter insertion checklist performed prior to urinary catheter placement...
February 14, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29445983/impact-of-the-pulmonary-vein-orifice-area-assessed-using-intracardiac-echocardiography-on-the-outcome-of-radiofrequency-catheter-ablation-for-atrial-fibrillation
#19
Takashi Nakashima, Masanori Kawasaki, Hiroyuki Toyoshi, Nobuhiro Takasugi, Tomoki Kubota, Hiromitsu Kanamori, Hiroaki Ushikoshi, Takuma Aoyama, Kazuhiko Nishigaki, Shinya Minatoguchi
PURPOSE: The purposes of this study were to investigate pulmonary vein cross-sectional orifice area (PV-CSOA) using intracardiac echocardiography (ICE) and to determine its association with atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA). METHODS: We studied 77 patients undergoing initial RFCA for AF (55 paroxysmal and 22 persistent AF patients, mean age 61 ± 12 years, 59 men). The PV-CSOA was measured in each patient and expressed as an index divided by the body surface area-left superior (LSPV-CSOA), left inferior (LIPV-CSOA), right superior (RSPV-CSOA), and right inferior (RIPV-CSOA)...
February 14, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29445973/is-heart-rate-response-a-reliable-marker-of-adenosine-induced-coronary-hyperemia
#20
Bhavik N Modi, Haseeb Rahman, Sara Abou Sherif, Howard Ellis, Kseniia Eruslanova, Amedeo Chiribiri, Divaka Perera
Introduction Growing evidence supports ischemia-guided management of chest pain, with invasive and non-invasive tests reliant upon achieving adenosine-induced coronary hyperemia (defined as increased blood flow to an organ's perfusion bed). In the non-invasive setting, surrogate markers of hyperemia, such as increases in heart rate, are often used, despite not being formally validated. We tested whether heart rate and other non-invasive indices are reliable markers of coronary hyperemia. Methods The first part involved Doppler flow-based validation of the best pressure-wire markers of hyperemia in 53 patients...
February 14, 2018: International Journal of Cardiovascular Imaging
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