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Device therapy

Shingo Hashimoto, Masaki Katsurada, Rie Muramatsu, Kumiko Asai, Kenichiro Tanaka, Kensuke Hayashi, Yoshiaki Kibe, Koichiro Nakajima, Yukiko Hattori, Hiromitsu Iwata, Jun-Etsu Mizoe, Hiroyuki Ogino, Yuta Shibamoto
PURPOSE: Suppression of respiratory movement of the liver would be desirable for high-precision radiation therapy for liver tumors. We aimed to investigate the effect of our original device-free compressed shell fixation method and breathing instruction on suppression of respiratory movement. The characteristics of liver motion based on the movement of a fiducial marker were also analyzed. METHODS: First, respiratory amplitudes of the liver with the device-free compressed shell were analyzed from the data of 146 patients...
October 15, 2018: Practical Radiation Oncology
Justyna Swol, Jan Belohlávek, Daniel Brodie, Joseph Bellezzo, Scott D Weingart, Zachary Shinar, Andreas Schober, Matthew Bachetta, Jonathan W Haft, Shingo Ichiba, Tetsuya Sakamoto, Giles J Peek, Roberto Lorusso, Steven A Conrad
BACKGROUND: Extracorporeal life support (ECLS) describes the use of blood perfusion devices to provide advanced cardiac or respiratory support. Advances in percutaneous vascular cannula insertion, centrifugal pump technologies, and the miniaturization of extracorporeal devices have simplified ECLS. The intention of this discussion is to review the role of ECLS as a potential rescue method for emergency department (ED) clinicians in critical clinical scenarios and to focus on the prerequisites for managing an ECLS program in an ED setting...
October 15, 2018: Resuscitation
Jingyan Zhao, Hongfeng Mu, Liqiang Liu, Xiaoyan Jiang, Di Wu, Yejie Shi, Rehana K Leak, Xunming Ji
Ischemic injury can be alleviated by the judicious use of hypothermia. However, the optimal regimens and the temporal kinetics of post-stroke neurovascular responses to hypothermic intervention have not been systematically studied. These gaps slow the clinical translation of hypothermia as an anti-stroke therapy. Here, we characterized the effects of transient selective brain hypothermia (TSBH) from the hyperacute to chronic stages of focal ischemia/reperfusion brain injury induced by transient middle cerebral artery occlusion in mice...
October 18, 2018: Journal of Cerebral Blood Flow and Metabolism
Ralf Schiel, Rolf Bambauer, Antje Steveling
Worldwide the number of people with diabetes mellitus is increasing. There are estimations that diabetes is one of the leading causes of death. The most important goals for the treatment of diabetes are self-management of the disease and an optimal quality of diabetes control. In the therapy new technologies, like real-time continuous interstitial glucose monitoring, continuous subcutaneous insulin infusion (CSII), electronic tools for the monitoring of therapeutic approaches, automated bolus calculators for insulin and electronic tools for education and information of patients, have become widespread and play important roles...
October 18, 2018: Artificial Organs
Jeremy Moskovitch, Aleksandr Voskoboinik
Despite improved understanding of heart failure (HF) and advances in medical treatments, its prevalence continues to rise, and the role of implantable devices continues to evolve. While cardiac resynchronization therapy (CRT) is an accepted form of treatment for many suffering from HF, there is an ever-evolving body of evidence examining novel indications, optimization of lead placement and device programming, with several competing technologies now also on the horizon. This review aims to take a clinical perspective on the major trials, current indications, controversies and emerging aspects of CRT in the treatment of HF...
October 11, 2018: Minerva Medica
Joanne D Stekler, James M Scanlan, Jane M Simoni, Heidi M Crane, Rob J Fredericksen, Jenna Marquard, Barry G Saver
We examined adherence, medication-taking practices, and preferences to inform development of a wrist-worn adherence system. Two convenience samples of persons taking antiretroviral therapy and HIV pre-exposure prophylaxis completed a survey. Additional online questions asked about willingness to use a wrist-worn device and reminder and feedback preferences. Among 225 participants, 13% reported adherence < 90%; this was associated with younger age and clinic sample. Compared to pill bottle-using participants, mediset users less commonly reported adherence < 90% (aOR = 0...
October 2018: AIDS Education and Prevention: Official Publication of the International Society for AIDS Education
Xuewei Wang, Aaron Jolliffe, Benjamin Carr, Qi Zhang, Mark Bilger, Yu Cui, Jianfeng Wu, Xianglong Wang, Mollie Mahoney, Alvaro Rojas-Pena, Mark J Hoenerhoff, Justin Douglas, Robert H Bartlett, Chuanwu Xi, Joseph L Bull, Mark E Meyerhoff
Semi-crystalline thermoplastics are an important class of biomaterials with applications in creating extracorporeal and implantable medical devices. In situ release of nitric oxide (NO) from medical devices can enhance their performance via NO's potent anti-thrombotic, bactericidal, anti-inflammatory, and angiogenic activity. However, NO-releasing semi-crystalline thermoplastic systems are limited and the relationship between polymer crystallinity and NO release profile is unknown. In this paper, the functionalization of poly(ether-block-amide) (PEBA), Nylon 12, and polyurethane tubes, as examples of semi-crystalline polymers, with the NO donor S-nitroso-N-acetylpenicillamine (SNAP) within, is demonstrated via a polymer swelling method...
October 17, 2018: Biomaterials Science
Małgorzata Szulc, Aneta Zakrzewska, Jacek Zborowski
Traditional methods of non-surgical treatment of periodontitis, including mechanical scaling/root planing (SRP), do not guarantee remission of the disease. Local delivery of antimicrobial agents in periodontitis entails antimicrobial therapy placed directly in periodontal pockets. The advantage of this form of treatment is that the concentration of the drug after application significantly exceeds the minimum inhibitory concentration (MIC) and persists for up to several weeks. Therefore, many systems of locally applied devices, using a variety of antibiotics or antiseptics have been developed...
July 2018: Dental and medical problems
Belén Alvarez-Alvarez, Javier García-Seara, Jose L Martínez-Sande, Moisés Rodríguez-Mañero, Xesús A Fernández López, Laila González-Melchor, Rosa M Agra Bermejo, Diego Iglesias-Alvarez, Francisco Gude Sampedro, Carla Díaz-Louzao, José R González-Juanatey
Background: Cardiac resynchronization therapy (CRT) is indicated in symptomatic heart failure (HF) patients after achieving optimal medical therapy (OMT). However, many patients may not be under OMT when the CRT device is implanted. Here, we evaluate the long-term benefits of CRT in symptomatic HF patients receiving or not OMT. Methods: We investigated the effect of OMT on HF developing or death in 328 consecutive patients with a CRT device implanted between 2005 and 2015 in a single tertiary center...
October 2018: Journal of Arrhythmia
Vincenzo Russo, Francesco Solimene, Gabriele Zanotto, Ennio C Pisanò, Paolo Della Bella, Saverio Iacopino, Carlo Pignalberi, Valeria Calvi, Giampiero Maglia, Fabio Quartieri, Mauro Biffi, Antonio Curnis, Daniele Giacopelli, Alessio Gargaro, Antonio D'Onofrio
BACKGROUND: The occurrence of sustained ventricular arrhythmias (SVA) may be influenced by environmental factors. We aimed to investigate annual periodic trends of SVA from the intracardiac electrograms (IEGMs) stored in the implantable defibrillators (ICDs) or cardiac resynchronization therapy (CRT-D) recipients. METHODS: Data from the Home Monitoring Expert Alliance project, a pooled repository of remote monitoring transmissions were analyzed. All IEGMs stored were independently adjudicated by three cardiac electrophysiologists...
October 10, 2018: International Journal of Cardiology
David O Draper, Dominic Klyve, Ralph Ortiz, Thomas M Best
BACKGROUND: Wearable long-duration low-intensity ultrasound is an emerging non-invasive and non-narcotic therapy for the daily treatment of musculoskeletal pain. The aim of this randomized, double-blind, placebo-controlled study was to examine whether long-duration low-intensity ultrasound was effective in treating pain and improving function in patients with knee osteoarthritis. METHODS: Ninety patients with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade I/II) were randomized for treatment with active (n = 55) or placebo (n = 35) devices applied daily to the treated knee...
October 16, 2018: Journal of Orthopaedic Surgery and Research
Andrew A Pavlina, Jared W Peacock, Saad A Ranginwala, Peter M Pavlina, Joshua Ahier, Courtney R Hanak
BACKGROUND: Fungal endocarditis is a rare and lethal cardiac infection which most commonly presents in immunocompromised patients or patients with other predisposing conditions. In a small subset of these patients, lesions present as mural masses and do not have any involvement with native valves or implanted devices. Here we present one such case which was diagnosed in the antemortem period in time to be managed with surgical resection. CASE PRESENTATION: A 70 year-old female patient who presented with multiple cerebral abscesses and was found on echocardiography to have a mass along the inferior wall of the left ventricle...
October 16, 2018: Journal of Cardiothoracic Surgery
Felix J Hüttner, Pascal Probst, Hannes G Kenngott, Phillip Knebel, Thilo Hackert, Alexis Ulrich, Markus W Büchler, Markus K Diener
BACKGROUND: Postoperative pancreatic fistula (POPF) remains a frequent problem especially after distal pancreatectomy. The application of 2-octyl cyanoacrylate showed promising results in the reduction of POPF after pancreatoduodenectomy prompting an expansion of this technique to distal pancreatectomy. Thus, the objective of the current study was to assess safety, feasibility and preliminary efficacy of an intraoperative 2-octyl cyanoacrylate application after distal pancreatectomy. METHODS: Between April 2015 and June 2016 adult patients scheduled for elective distal pancreatectomy were considered eligible for the study...
2018: PloS One
Francesco F Faletra, Laura A Leo, Vera L Paiocchi, Susanne A Schlossbauer, Maria G Borruso, Giovanni Pedrazzini, Tiziano Moccetti, Siew Y Ho
Interest on tricuspid valve (TV) (and hence in TV anatomy) has increased in the last two decades with the awareness that functional tricuspid regurgitation (FTR) is an insidious disease progressively leading to untreatable right heart failure and eventually to death. Medical therapy may alleviate symptoms, while surgical therapy may improve outcome but it is associated with high mortality and recurrence of significant regurgitation. Nowadays, an increasing number of left valve diseases are successfully treated through a percutaneous transcatheter approach...
October 15, 2018: European Heart Journal Cardiovascular Imaging
Marlies Ostermann, Michael Connor, Kianoush Kashani
PURPOSE OF REVIEW: The use of extracorporeal membrane oxygenation (ECMO) is increasing rapidly. Patients on ECMO have a high risk of developing acute kidney injury (AKI) and needing renal replacement therapy (RRT). The aim of this review is to describe different strategies of combining RRT and ECMO and to outline their advantages and drawbacks. RECENT FINDINGS: Fluid overload is the most common indication for RRT during ECMO, and continuous renal replacement therapy (CRRT) is the most commonly used modality...
October 12, 2018: Current Opinion in Critical Care
Puppala Niharika, N Venugopal Reddy, P Srujana, K Srikanth, V Daneswari, K Sai Geetha
Objective: The aim of this study was to evaluate the influence of using virtual reality (VR) eyeglasses on severity of pain and anxiety during pulp therapy in pediatric patients considering childhood anxiety-related disorders as an important confounding factor in the dental setting. Materials and Methods: A total of 40 children aged between 4 and 8 years with no previous anxiety disorder were randomly divided into two groups. The study consisted of three consecutive treatment sessions...
October 2018: Journal of the Indian Society of Pedodontics and Preventive Dentistry
Mieczyslaw Pokorski, Giovanni Barassi, Rosa G Bellomo, Loris Prosperi, Matteo Crudeli, Raoul Saggini
This review updates the knowledge on the use of bioprogressive philosophy in current rehabilitation paradigms, focusing on age-related ailments and antiaging strategies. It is a holistic approach that combines aspects of biology and function into the realm of rehabilitation therapy. The bioprogressive philosophy, with assistance of modern technological developments, such as microgravity-producing devices and techniques, enables personalized and targeted therapeutic approach that seems the most effective in rehabilitation and prevention of neuro-myo-sensory disorders that compromise the homeostatic body harmony, particularly in old age...
October 16, 2018: Advances in Experimental Medicine and Biology
Anne L Peters, Andrew J Ahmann, Irl B Hirsch, Jennifer K Raymond
Endocrine Society guideline recommendations on diabetes technology in adults originate from the 2016 guideline titled "Diabetes Technology-Continuous Subcutaneous Insulin Infusion Therapy and Continuous Glucose Monitoring in Adults: An Endocrine Society Clinical Practice Guideline." Society recommendations on diabetes technology in children are contained in the 2011 guideline titled "Continuous Glucose Monitoring: An Endocrine Society Clinical Practice Guideline." The field of diabetes technology is a rapidly advancing one, with new devices released annually and data from clinical trials published frequently...
November 1, 2018: Journal of the Endocrine Society
Jen Jen Chen, Dan M Cooper, Fadia Haddad, Anna Sladkey, Eliezer Nussbaum, Shlomit Radom-Aizik
Introduction: Cross-infection risk from contact exposure limits exercise opportunities in children with cystic fibrosis (CF). The purpose of this study is to evaluate the feasibility of a new live-streamed platform which delivered supervised and interactive group exercise sessions to CF children via digital devices while avoiding contact exposure. Methods: Ten CF children participated in a 6-week tele-exercise program. The program consisted of three 30-min sessions per week for a total of 18 sessions and included aerobic, resistance, and flexibility exercises...
2018: Frontiers in Public Health
Hiroki Umezawa, Takeshi Matsutani, Kazuhiko Yokoshima, Munenaga Nakamizo, Rei Ogawa
Background: Patients with head and neck or esophageal cancer who undergo resection and reconstructive surgery sometimes develop fistulae that exhibit delayed wound healing. We developed a novel negative pressure wound therapy (NPWT) that employs a Penrose drain. This case series report describes its effect on the wound healing and treatment duration of cancer patients with postoperative fistulae. Methods: This consecutive case series consisted of all patients from February 2014 to February 2017 who underwent resection and reconstruction for head and neck or esophageal cancer and who then developed a fistula that was treated with either NPWT or a second flap that did not resolve the fistula or led to fistula recurrence and was then treated with NPWT...
August 2018: Plastic and Reconstructive Surgery. Global Open
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