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https://www.readbyqxmd.com/read/28548474/aortic-aneurysm-endovascular-treatment-with-the-parallel-graft-technique-from-the-aortic-arch-to-the-iliac-axis
#1
Gian F Fadda, Mario Marino, Holta Kasemi, Costantino L DI Angelo, Carlo P Dionisi, Valeria Cammalleri, Carlo Setacci
BACKGROUND: The chimney technique has been developed for the treatment of complex aortic aneurysms. We analyzed the midterm to long-term outcomes of this approach from a single- centre experience. METHODS: From October 2008 to July 2016, 58 patients underwent endovascular aortic aneurysm repair using the chimney technique. Indications for treatment were thoracic aortic aneurysm (TAA) (n = 11), thoracoabdominal aortic aneurysm (TAAA) (n = 2), pararenal aortic aneurysm (PAAA) (n= 15), aortoiliac/isolated hypogastric artery aneurysm (n = 25), type I endoleak after previous TEVAR/EVAR (n=4), proximal pseudoaneurysm after AAA open repair (n = 1)...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28541431/emerging-safety-of-intramedullary-transplantation-of-human-neural-stem-cells-in-chronic-cervical-and-thoracic-spinal-cord-injury
#2
Allan D Levi, David O Okonkwo, Paul Park, Arthur L Jenkins, Shekar N Kurpad, Ann M Parr, Aruna Ganju, Bizhan Aarabi, Dong Kim, Steven Casha, Michael G Fehlings, James S Harrop, Kim D Anderson, Allyson Gage, Jane Hsieh, Stephen Huhn, Armin Curt, Raphael Guzman
BACKGROUND: Human central nervous system stem cells (HuCNS-SC) are multipotent adult stem cells with successful engraftment, migration, and region-appropriate differentiation after spinal cord injury (SCI). OBJECTIVE: To present data on the surgical safety profile and feasibility of multiple intramedullary perilesional injections of HuCNS-SC after SCI. METHODS: Intramedullary free-hand (manual) transplantation of HuCNS-SC cells was performed in subjects with thoracic (n = 12) and cervical (n = 17) complete and sensory incomplete chronic traumatic SCI...
May 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28533989/iatrogenic-spinal-subdural-extra-arachnoid-hygroma-following-uncomplicated-lumbar-decompression
#3
Benjamin D Elder, Wataru Ishida, Rory C Goodwin, Ali Bydon
Intradural spinal arachnoid cysts (ISACs) have been reported in the current literature as either an idiopathic disease or exceedingly rare sequelae after lumbar puncture, spinal trauma, or meningitis. Other studies have more appropriately termed the iatrogenic pathology as a spinal subdural extra-arachnoid hygroma (SSEH), as there is not often a clear cyst wall as in a true arachnoid cyst. However, to the best of our knowledge, none of the previous studies described an SSEH following uncomplicated posterior lumbar surgery, as they have previously involved clear durotomies during the initial operation...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28529903/immunotherapy-and-radiation-therapy-for-malignant-pleural-mesothelioma
#4
REVIEW
Evan W Alley, Sharyn I Katz, Keith A Cengel, Charles B Simone
Malignant pleural mesothelioma (MPM) is a particularly aggressive thoracic malignancy with limited survival following combination chemotherapy. As a result, there has been increased interested in immunotherapy for mesothelioma, both in the first-line and salvage settings. Early investigations of interleukin-2 (IL-2) and interferon alfa-2a/b have been limited by modest response rates and toxicity, whereas cytokine gene therapy is currently being investigated and shows early promise. The most prominent class of immunotherapies to be trialed with mesothelioma in the past half-decade has been immune checkpoint inhibitors (CPI)...
April 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28523383/anterior-sacral-meningocele-presenting-as-intracystic-bleeding
#5
Ignacio Javier Gilete-Tejero, Marta Ortega-Martínez, Jacinto Mata-Gómez, María Rico-Cotelo, Luis Miguel Bernal-García, Beatriz Yerga-Lorenzana, Ignacio Casado-Naranjo
PURPOSE: To report a case of anterior sacral meningocele with intralesional bleeding secondary to sacrococcygeal trauma. Likewise, there is a discussion about the physiopathology and the surgical approach to these types of lesions. METHODS: A 43-year-old man diagnosed with Marfan syndrome suffered sacrococcygeal trauma. He was admitted to the emergency room due to symptoms of headache, nausea, and lower limb subjective weakness. CT and MRI showed a large retroperitoneal mass with hemorrhagic content close to the sacrum...
May 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28515954/a-prospective-cohort-study-of-thoracic-ultrasound-in-acute-respiratory-failure-the-c3po-protocol
#6
Peter D Wallbridge, Simon A Joosten, Liam M Hannan, Daniel P Steinfort, L Irving, J Goldin, Mark Hew
OBJECTIVES: This study was performed to assess the clinical utility of a standardised thoracic ultrasound examination when added to standard care in patients with acute respiratory failure admitted to an intermediate care unit. This study aimed to assess the impact on clinical diagnosis, clinician confidence and management. Ultrasound has been shown to have utility in patients admitted to intensive care and emergency; however, utility in a ward setting is unknown. DESIGN: Prospective cohort study...
May 2017: JRSM Open
https://www.readbyqxmd.com/read/28515757/emergency-heartware-ventricular-assist-device-hvad-exchange-due-to-pump-thrombosis-using-minimally-invasive-technique
#7
Remigiusz Antończyk, Ewa Trejnowska, Jerzy Pacholewicz, Tomasz Wolny, Paweł Nadziakiewicz, Karolina Antończyk, Izabela Copik, Magdalena Piontek, Małgorzata Jasińska, Krzysztof Filipiak, Maciej Głowacki, Maciej Gawlikowski, Marcin Borowicz, Roman Kustosz, Jacek Waszak, Piotr Przybyłowski, Marian Zembala, Michał Zakliczyński, Michał Oskar Zembala
Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8-12% depending on the pump type and patient's comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchange remains the only alternative. This short report documents an emergency LVAD exchange in a 55-year-old man who underwent LVAD (HeartWare Inc) implantation in 2013 as a bridge to transplantation. Four months after the initial surgery, he suffered from a hemorrhagic stroke despite properly managed anticoagulation...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28515745/new-aspects-in-the-diagnosis-and-treatment-of-primary-spontaneous-pneumothorax
#8
Agata Dżeljilji, Wojciech Rokicki, Marek Rokicki, Krzysztof Karuś
This paper provides a recapitulation of the position of the British Thoracic Society and the American College of Chest Physicians based on a review of the literature concerning the current methods of diagnosing and treating primary spontaneous pneumothorax (PSP). The previously developed guidelines were re-evaluated in 2015 by a task force of the European Respiratory Society (ERS). They are intended to be used by surgeons as well as emergency and pulmonary ward physicians, and they apply largely to emergency procedures...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28507176/bts-guideline-for-oxygen-use-in-adults-in-healthcare-and-emergency-settings
#9
B R O'Driscoll, L S Howard, J Earis, V Mak
No abstract text is available yet for this article.
June 2017: Thorax
https://www.readbyqxmd.com/read/28504622/-severe-cervical-kyphosis-causing-sudden-inspiratory-stridor
#10
Karen Lise Dahl Andersen, Allan Bach, Rikke Haahr Iversen, Søren Helbo Skaarup
An 85-year-old woman was brought to an accident and emergency department with breathing difficulties accompanied by inspiratory stridor. She was being treated for hypertension and severe osteoporosis which had caused thoracal and cervical fractures of the columna. Intubation was initiated as she desaturated and deteriorated despite maximum oxygen therapy. The intubation revealed a subglottic stenosis as a consequence of a recent osteoporotic fracture in the cervical columna. This represents a rare cause of respiratory failure as all other cardial, pulmonary and allergic aetiologies had been eliminated...
May 8, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28502544/first-experience-with-the-double-chimney-technique-in-the-treatment-of-aortic-arch-diseases
#11
Tun Wang, Chang Shu, Quan-Ming Li, Ming Li, Xin Li, Hao He, Alan Dardik, Jian Qiu
OBJECTIVE: The objective of this study was to summarize our initial experience using the double chimney technique to treat aortic arch diseases. METHODS: From December 2009 to October 2016, 23 patients with aortic arch diseases, including 20 acute aortic dissections, 2 aortic arch aneurysms, and 1 type I endoleak after thoracic endovascular aortic repair (TEVAR), were treated using a double chimney technique. An emergent operation was performed in only one patient with an acute aortic dissection for severe left lower extremity ischemia...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502542/contemporary-evaluation-of-mortality-and-stroke-risk-after-thoracic-endovascular-aortic-repair
#12
Frances Y Hu, Zachary B Fang, Bradley G Leshnower, Yazan Duwayri, William D Jordan, Theresa W Gillespie, Ravi K Veeraswamy
OBJECTIVE: During the past decade, thoracic endovascular aortic repair (TEVAR) has increased as a treatment option for a variety of aortic pathologic processes. Despite this rise in the use of thoracic stent grafts, real-world outcomes from a robust, adjudicated, contemporary data set have yet to be reported. Previous studies have shown periprocedural mortality rates between 1.5% and 9.5% and procedure-related stroke rates of 2.3% to 8.2%. With advances in device engineering and increased experience of physicians, we hypothesized that the rates of these complications would be reduced in a more recent sample set...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501386/atrioesophageal-fistula-after-ablation-for-atrial-fibrillation
#13
Trisha Mackle, Kevin Pistawka
BACKGROUND: Atrioesophageal fistula (AEF) is a rare and highly fatal complication of ablation procedures for atrial fibrillation. We report a diagnostically challenging case of AEF that highlights the unfortunate outcome that can be expected when this condition is not promptly diagnosed and managed accordingly. The varied clinical presentations are reviewed and recommended diagnostic and management approaches are presented. CASE REPORT: A 79-year-old female who was 5 weeks post-ablation presented to a community emergency department with chest pain and a transient episode of left-arm weakness...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28499737/endovascular-repair-as-a-bridge-to-open-repair-of-a-ruptured-descending-thoracic-aspergilus-aortitis
#14
Philippe Tresson, Arnaud Roussel, Pierre Mordant, Pierre Cerceau, Yves Castier, Quentin Pellenc
Invasive aspergillosis rarely involves the thoracic aorta, and is associated with a poor prognosis. A heart-transplanted 56-year old patient presented with invasive aspergillosis, primary aspergillus aortitis, and ruptured thoracic aorta pseudoaneurysm. Open surgery was not possible due to severe sepsis. A sequential surgical strategy was therefore decided, including emergency thoracic endovascular aneurysm repair, followed by antifungal treatment, and definitive open repair with explantation of the endograft and placement of a cryopreserved arterial allograft under extra-corporeal membrane oxygenator support...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28498904/the-acef-ii-risk-score-for-cardiac-surgery-updated-but-still-parsimonious
#15
Marco Ranucci, Valeria Pistuddi, Sabino Scolletta, Carlo de Vincentiis, Lorenzo Menicanti
Aims: The age, creatinine, and ejection fraction (ACEF) score was introduced in 2009 and is presently included in the guidelines for myocardial revascularization of the European Society of Cardiology and Association for Cardio-Thoracic Surgery as a risk stratification tool for surgical and percutaneous myocardial revascularization. The present study introduces an updated version of the ACEF (ACEF II) inclusive of emergency surgery and pre-operative anaemia. Methods and results: The development series includes 7011 consecutive cardiac surgery patients operated at a single institution...
May 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28497233/standardization-and-optimization-of-intraoperative-molecular-imaging-for-identifying-primary-pulmonary-adenocarcinomas
#16
Jarrod D Predina, Olugbenga Okusanya, Andrew D Newton, Philip Low, Sunil Singhal
PURPOSE: Intraoperative molecular imaging (IMI) is an emerging technology used to locate pulmonary adenocarcinomas and identify positive margins during surgery. Background noise and tissue autofluorescence have been major obstacles. The goal of this study is to optimize the image quality of folate receptor alpha (FRα) targeted IMI for pulmonary adenocarcinomas by modifying emission data. PROCEDURES: A total of 15 lung cancer patients were enrolled in a pilot study...
May 11, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28496083/-retrograde-type-a-aortic-dissection-after-thoracic-endovascular-aortic-repair-report-of-a-case
#17
Sei Morizumi, Takafumi Inoue, Satoshi Nishi, Akihiro Yoshimoto, Masashi Fujisaki, Yoshihiro Suematsu
A 72-year-old man presented with aneurysms of the distal aortic arch and the distal descending aorta due to chronic type B aortic dissection. We first performed thoracic endovascular aortic repair (TEVAR) in the distal descending aorta, and the aneurysm was successfully excluded using a Gore Tag stentgraft. Seven days after TEVAR, computed tomography revealed retrograde type A aortic dissection occurring from the ascending aorta to the distal aortic arch. In emergency surgery, ascending aorta and total arch replacement were performed under selective cerebral perfusion with moderate hypothermia, and after coming off cardiopulmonary bypass, the distal aortic arch aneurysm was excluded using a Gore Tag stentgraft...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28489797/a-previously-published-propofol-remifentanil-response-surface-model-does-not-predict-patient-response-well-in-video-assisted-thoracic-surgery
#18
Hsin-Yi Wang, Chien-Kun Ting, Jing-Yang Liou, Kun-Hui Chen, Mei-Young Tsou, Wen-Kuei Chang
Modern anesthesia usually employs a hypnotic and an analgesic to produce synergistic sedation and analgesia. Two remifentanil-propofol interaction response surface models were used to predict sedation using Observer's Assessment of Alertness/Sedation (OAA/S) scores; one predicts an OAA/S <2 and the other <4. We hypothesized that both models would predict regained responsiveness (RR) after video-assisted thoracic surgery (VATS) to reduce total anesthesia time and make early extubation clinically relevant...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28489208/profile-of-thoracic-trauma-victims-submitted-to-chest-drainage
#19
Cesar Augusto Broska, Adriane Barbosa Botelho, André DE Castro Linhares, Mariana Santos DE-Oliveria, Gabriela Veronese, Carlos Roberto Naufel, Lislaine Cruz Batista, Maria Angélica Kurpel Diogo
Objective: to describe and compare the variables involved in trauma victims undergoing thoracic drainage. Methods: we conducted a retrospective, analytical, descriptive, cross-sectional study, with medical records of patients attended at the Trauma Service of the Curitiba Evangelical University Hospital between February 2011 and January 2014. Results: there were 488 patients undergoing chest drainage, 84.7% men and 15.3% women, with an average age of 38...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28483615/severe-mesenteric-ischemia-in-a-pregnant-woman-with-antiphospholipid-syndrome
#20
Andrea Padricelli, Anna Maria Giribono, Doriana Ferrara, Flavia Spalla, Umberto Bracale, Luca Del Guercio, Giuseppe Servillo, Carlo Ruotolo, Umberto Marcello Bracale
The antiphospholipid syndrome (APS), either primary or secondary form, is considered an autoimmune disease with presence of at least one clinical and one laboratory abnormalities as defined by The Sydney criteria. Clinical criteria include vascular thrombosis of venous, artery, small vessel in any organ and recurrent pregnancy pathologies. Mesenteric ischemia is a rare and threatening manifestation of APS. We herein report a case of 34-years old pregnant woman referred to our Emergency Room with thoracic and abdominal acute pain...
May 5, 2017: Annals of Vascular Surgery
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