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EXIT procedure

Jorge Aramburu, Raúl Antón, Alejandro Rivas, Juan Carlos Ramos, Bruno Sangro, José Ignacio Bilbao
Liver radioembolization is a treatment option for patients with primary and secondary liver cancer. The procedure consists of injecting radiation-emitting microspheres via an intra-arterially placed microcatheter, enabling the deposition of the microspheres in the tumoral bed. The microcatheter location and the particle injection rate are determined during a pretreatment work-up. The purpose of this study was to numerically study the effects of the injection characteristics during the first stage of microsphere travel through the bloodstream in a patient-specific hepatic artery (i...
October 5, 2016: Journal of Biomechanics
S M Johnson, G M Garnett, R K Woo
Maintenance of central venous access in patients with chronic medical conditions such as short bowel syndrome demands forethought and ingenuity. We describe an innovative technique for re-utilizing central venous access sites in patients who have chronic central venous access needs. Records of patients undergoing this technique were reviewed between August 2012 and December 2015. The technique involves "cutting-down" to the sterile fibrous tunnel that naturally forms around tunneled catheters. The fibrous sheath is then isolated and controlled much as would be done for a venous "cut-down...
October 14, 2016: Pediatric Surgery International
Thandar Aye, Thanh Trung Phan, Douglas Findlay Muir, Nicholas John Linker, Richard Hartley, Andrew John Turley
AIM: This new laser facilitated 'inside-out' technique was used for transvenous pacemaker insertion in a pacemaker-dependent patient with bilateral subclavian occlusion and a failed epicardial system who is not suitable for a transfemoral approach. METHOD AND RESULTS: Procedure was undertaken under general anaesthesia with venous access obtained from right femoral vein and left axillary vein. 7F multipurpose catheter was used to enter proximal edge of the occluded segment of subclavian vein via femoral approach, which then supported stiff angioplasty wires and microcatheters to tunnel into the body of occlusion...
October 14, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Jennifer E Pelletier, Caitlin E Caspi, Liana R N Schreiber, Darin J Erickson, Lisa Harnack, Melissa N Laska
BACKGROUND: Customer intercept interviews are increasingly used to characterize food purchases at retail food outlets and restaurants; however, methodological procedures, logistical issues and response rates using intercept methods are not well described in the food environment literature. The aims of this manuscript were to 1) describe the development and implementation of a customer intercept interview protocol in a large, NIH-funded study assessing food purchases in small and midsize food retailers in Minneapolis and St...
October 5, 2016: BMC Public Health
Vivek Kumbhari, Irene Peñas, Alan H Tieu, Carlos De la Serna-Higuera, Manie Juneja, Fuad Maufa, Saowanee Ngamruengphong, Mohamad H El-Zein, Nadim Haddad, Sandeep Krishnan, Susana Gonzalez, Peter V Renny, Payal Saxena, Linda Howard, Christopher J DiMaio, Jonathan M Buscaglia, Manuel Perez-Miranda, Mouen A Khashab
BACKGROUND AND AIMS: To facilitate access for interventional EUS, flexible (nitinol) 19-G needles have been introduced to permit needle puncture even when the echoendoscope is in an angulated position, such as in the second part of the duodenum. The aims of the study were to evaluate the performance of a flexible 19-G needle during interventional EUS procedures and compare outcomes when the echoendoscope was in the straight versus angulated position. METHODS: A retrospective review was undertaken of 162 consecutive patients that underwent a variety of interventional EUS procedures with a flexible 19-G needle across five centers...
October 6, 2016: Digestive Diseases and Sciences
Dan Valsky, Odeya Marmor-Levin, Marc Deffains, Renana Eitan, Kim T Blackwell, Hagai Bergman, Zvi Israel
BACKGROUND: Microelectrode recordings along preplanned trajectories are often used for accurate definition of the subthalamic nucleus (STN) borders during deep brain stimulation (DBS) surgery for Parkinson's disease. Usually, the demarcation of the STN borders is performed manually by a neurophysiologist. The exact detection of the borders is difficult, especially detecting the transition between the STN and the substantia nigra pars reticulata. Consequently, demarcation may be inaccurate, leading to suboptimal location of the DBS lead and inadequate clinical outcomes...
October 6, 2016: Movement Disorders: Official Journal of the Movement Disorder Society
G E Simon, B R Hoar, C B Tucker
Epidemiological studies can be used to identify risk factors for livestock welfare concerns but have not been conducted in the cow-calf sector for this purpose. The objectives of this study were to investigate the relationships of 1) herd-level management, facilities, and producer perspectives with cattle health and behavior and stockperson handling and 2) stockperson handling on cattle behavior at the individual cow level. Cow ( = 3,065) health and behavior and stockperson handling during a routine procedure (e...
August 2016: Journal of Animal Science
Y Chen, J Stookey, R Arsenault, E Scruten, P Griebel, S Napper
Stresses imposed on livestock have significant impact on their health and productivity as well as public perceptions of animal welfare. Understanding stress responses in livestock may help refine management procedures and facilitate selection of stress-tolerant animals. In this study, behavioral (chute entry order, chute behavior, and exit velocity), physiological (serum cortisol), and biochemical (kinome) responses were evaluated in cattle ( = 20) subjected to three 5-min restraint periods with weekly intervals...
August 2016: Journal of Animal Science
Camille Nebeker, Tiffany Lagare, Michelle Takemoto, Brittany Lewars, Katie Crist, Cinnamon S Bloss, Jacqueline Kerr
Researchers utilize mobile imaging, pervasive sensing, social media, and location tracking (MISST) technologies to observe and intervene with participants in their natural environment. The use of MISST methods and tools introduces unique ethical issues due to the type and quantity of data, and produces raising new challenges around informed consent, risk assessment, and data management. Since MISST methods are relatively new in behavioral research, there is little documented evidence to guide institutional review board (IRB) risk assessment and inform appropriate risk management strategies...
September 29, 2016: Translational Behavioral Medicine
Sung Hye Byun, So Young Lee, Seong Yeon Hong, Taeha Ryu, Baek Jin Kim, Jin Yong Jung
INTRODUCTION: In fetuses who are predicted to be at risk of catastrophic airway obstruction at delivery, the ex utero intrapartum treatment (EXIT) procedure is useful for securing the fetal airway while maintaining fetal oxygenation via placental circulation. Factors, including poor posture of the fetus and physician, narrow visual field, and issues of contamination in the aseptic surgical field, make fetal intubation during the EXIT procedure difficult. Herein, we report our experience of the usefulness of the GlideScope video laryngoscope (GVL) for intubation during the EXIT procedure...
September 2016: Medicine (Baltimore)
Mohammad F Huque, Thamban Valappil, Mohamed Alosh, Guoxing Soon
Unmet medical need exits for serious bacterial diseases caused by multi-drug resistant infections necessitating urgent need for newer therapies with greater treatment benefits to patients. For meeting this need, the usual approach has been to conduct separate clinical trials, each trial targeting infection at a single body-site, e.g., for respiratory tract, intra-abdominal site, urinary tract, or blood. However, for the unmet medical need situations, this approach seems inefficient for developing antibacterial drugs with activity against single species or against multiple species of bacteria for a broader indication...
September 26, 2016: Journal of Biopharmaceutical Statistics
Prabhat Kumar, Ayotunde M Bamimore, Jennifer D Schwartz, Eugene H Chung, Anil K Gehi, Andy C Kiser, James P Hummel, J Paul Mounsey
BACKGROUND: The left atrial posterior wall (PW) often contains sites required for maintenance of atrial fibrillation (AF). Electrical isolation of the PW is an important feature of all open surgeries for AF. This study assessed the ability of current ablation techniques to achieve PW isolation (PWI) and its effect on recurrent AF. METHODS AND RESULTS: Fifty-seven consecutive patients with persistent or high-burden paroxysmal AF underwent catheter ablation, which was performed using an endocardial-only (30) or a hybrid endocardial-epicardial procedure (27)...
2016: Journal of the American Heart Association
D Saldivar-Rodriguez, A Guzman, J A Soria-Lopez, I V Davila-Escamilla, G Villagomez Martinez, O R Treviño-Montemayor, C Flores Acosta, R Ambriz, A Villarreal, J L Iglesias-Benavides
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
K Maeda, D Nakaoku, M Murakami, A Kondo, M Morine, K Hinokio, T Kaji
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
Tomasz Gaszynski
INTRODUCTION: We report on the anesthetic management using opioid-free method of a patient with Steinert syndrome (myotonic dystrophy, MD), autosomal dominant dystrophy which is characterized by consistent contracture of muscle following stimulation. A myotonic crisis can be induced by numerous factors including hypothermia, shivering, and mechanical or electrical stimulation. In patients with MD, hypersensitivity to anesthetic drugs, especially muscle relaxants and opioids, may complicate postoperative management...
September 2016: Medicine (Baltimore)
David Rabago, Laura van Leuven, Lane Benes, Luke Fortney, Andrew Slattengren, Jessica Grettie, Marlon Mundt
OBJECTIVE: Randomized and open-label studies assessing prolotherapy for knee osteoarthritis have found quantitative improvement on the validated Western Ontario McMaster University Osteoarthritis Index (WOMAC) compared with baseline status and control therapies. This study assessed the qualitative response of participants receiving prolotherapy, an injection-based complementary treatment for symptomatic knee osteoarthritis (OA). DESIGN: Qualitative study using semi-structured in-depth interviews at 52 weeks after enrollment; transcribed responses were discussed by coauthors to identify themes; disagreement was resolved by consensus...
September 7, 2016: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Dingding Wang, Mitsunori Ogihara, Carlos Gallo, Juan A Villamar, Justin D Smith, Wouter Vermeer, Gracelyn Cruden, Nanette Benbow, C Hendricks Brown
BACKGROUND: To improve the quality, quantity, and speed of implementation, careful monitoring of the implementation process is required. However, some health organizations have such limited capacity to collect, organize, and synthesize information relevant to its decision to implement an evidence-based program, the preparation steps necessary for successful program adoption, the fidelity of program delivery, and the sustainment of this program over time. When a large health system implements an evidence-based program across multiple sites, a trained intermediary or broker may provide such monitoring and feedback, but this task is labor intensive and not easily scaled up for large numbers of sites...
2016: Implementation Science: IS
Andrzej Ratajczak, Małgorzata Lange-Ratajczak, Adam Bobkiewicz, Adam Studniarek
This report reviews the most common surgical interventions and complications of chronic peritoneal dialysis (PD) patients. Based on the current knowledge as well as our experience we detail the role of these surgical procedures. We supplement the reported knowledge in the field with our own experience in this area. The areas discussed include early complications such as surgical wound hemorrhage, bleeding from the catheter, intestinal perforation and urinary bladder perforation, dialysate leakage through the wound, as well as late complications including catheter kinking or occlusion, retention of fluid in the peritoneal recess, hernias and hydrothorax, and encapsulating peritoneal sclerosis...
September 6, 2016: Seminars in Dialysis
Can Halil, Kırcelli Atilla, Kavadar Gülis, Civelek Erdinç, Cansever Tufan, Aydoseli Aydin, Önal Mehmet Bülent, Yılmaz Cem
AIM: Conjoined nerve roots (CNR) can be damaged during lumbar disc surgery and lead to neuropathic pain due to excessive retraction. The purpose of this study was to investigate the factors that facilitate the identification of CNRs which can lead to the loss of fragments in the secondary axilla, nerve root injury or unpleasant surprises during lumbar disc surgery. Accordingly, we aimed to measure the thicknesses and exit angles of the nerve roots close to the pedicle, to obtain scientific data regarding rare double roots...
December 28, 2015: Turkish Neurosurgery
Anil S Menon, David Jourdan, Derek M Nusbaum, Alejandro Garbino, Daniel M Buckland, Sean Norton, Johnathan B Clark, Erik L Antonsen
The StratEx program used a self-contained space suit and balloon system to loft pilot Alan Eustace to a record-breaking altitude and skydive from 135,897 feet (41,422 m). After releasing from the balloon and a stabilized freefall, the pilot safely landed using a parachute system based on a modified tandem parachute rig. A custom spacesuit provided life support using a similar system to NASA's (National Aeronautics and Space Administration; Washington, DC USA) Extravehicular Mobility Unit. It also provided tracking, communications, and connection to the parachute system...
October 2016: Prehospital and Disaster Medicine
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