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https://www.readbyqxmd.com/read/29752886/individual-funding-requests-a-flawed-process
#1
Matthew Cherko, Abigail Lamyman, Ian Bottrill
1.The Individual Funding Request (IFR) process was introduced by Clinical Commissioning Groups to regulate Procedures of Limited Clinical Value 2.In the South Buckinghamshire region, this affects common ENT procedures including adenotonsillectomy and grommet insertion 3.Only 3 of 118 applications for grommet insertion were rejected and the majority (23/27) of tonsillectomy rejections were due to insufficient supporting evidence from the patients' GPs 4.Despite the majority of applications eventually being accepted, the process has undoubtedly delayed treatment for our patients; impacting 18 week target times 5...
May 12, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29748874/correction-to-acc-aats-aha-ase-asnc-scai-scct-sts-2017-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-stable-ischemic-heart-disease
#2
Manesh R Patel, John H Calhoon, Gregory J Dehmer, James Aaron Grantham, Thomas M Maddox, David J Maron, Peter K Smith
To more clearly reflect the relationship between iFR (instantaneous wave-free ratio) and FFR (fractional flow reserve), this Correction document highlights the following changes to the original document published in the Journal of Nuclear Cardiology; the version available at JACC [1] has been updated to reflect the changes, with JACC's Correction document available at [2].
May 10, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29732217/comparison-of-cold-knife-optical-internal-urethrotomy-and-holmium-yag-laser-internal-urethrotomy-in-bulbar-urethral-strictures
#3
Mustafa Gurkan Yenice, Kamil Gokhan Seker, Emre Sam, Yunus Colakoglu, Feyzi Arda Atar, Selcuk Sahin, Abdulmuttalip Simsek, Volkan Tugcu
Introduction: To compare the results of cold-knife optical internal urethrotomy (OIU) and Holmium:YAG laser internal urethrotomy (HIU) in primary bulbar urethral strictures. Material and methods: A total of 63 patients diagnosed with primary bulbar urethral stricture between August 2014 and September 2015 were assigned to the OIU (n = 29) and HIU (n = 34) groups. The demographic variables, biochemistry panels, and preoperative and postoperative uroflowmetry results including the maximum flow rate (Qmax) and mean flow rate (Qmean) values, retrograde urethrography, and diagnostic flexible urethroscopy findings were recorded prospectively...
2018: Central European Journal of Urology
https://www.readbyqxmd.com/read/29707808/pooled-diagnostic-accuracy-of-resting-distal-to-aortic-coronary-pressure-referenced-to-fractional-flow-reserve-the-importance-of-resting-coronary-physiology
#4
Rohit Maini, John Moscona, Gursukhman Sidhu, Paul Katigbak, Camilo Fernandez, Anand Irimpen, Owen Mogabgab, Charisse Ward, Rohan Samson, Thierry LeJemtel
INTRODUCTION: Both resting and hyperemic physiologic methods to guide coronary revascularization improve cardiovascular outcomes compared with angiographic guidance alone. Fractional flow reserve (FFR) remains underutilized due to concerns regarding hyperemia, prompting study of resting distal to aortic coronary pressure (Pd/Pa). Pd/Pa is a vasodilator-free resting index unlike FFR. While Pd/Pa is similar to another resting index, instantaneous wave-free ratio (iFR), it is a whole-cycle measurement not limited to the wave-free diastolic period...
April 29, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29673507/pre-angioplasty-instantaneous-wave-free-ratio-pullback-predicts-hemodynamic-outcome-in-humans-with-coronary-artery-disease-primary-results-of-the-international-multicenter-ifr-gradient-registry
#5
Yuetsu Kikuta, Christopher M Cook, Andrew S P Sharp, Pablo Salinas, Yoshiaki Kawase, Yasutsugu Shiono, Alessandra Giavarini, Masafumi Nakayama, Salvatore De Rosa, Sayan Sen, Sukhjinder S Nijjer, Rasha Al-Lamee, Ricardo Petraco, Iqbal S Malik, Ghada W Mikhail, Raffi R Kaprielian, Gilbert W M Wijntjens, Shinsuke Mori, Arata Hagikura, Martin Mates, Atsushi Mizuno, Farrel Hellig, Kelvin Lee, Luc Janssens, Kazunori Horie, Shah Mohdnazri, Raul Herrera, Florian Krackhardt, Masahiro Yamawaki, John Davies, Hideo Takebayashi, Thomas Keeble, Seiichi Haruta, Flavio Ribichini, Ciro Indolfi, Jamil Mayet, Darrel P Francis, Jan J Piek, Carlo Di Mario, Javier Escaned, Hitoshi Matsuo, Justin E Davies
OBJECTIVES: The authors sought to evaluate the accuracy of instantaneous wave-Free Ratio (iFR) pullback measurements to predict post-percutaneous coronary intervention (PCI) physiological outcomes, and to quantify how often iFR pullback alters PCI strategy in real-world clinical settings. BACKGROUND: In tandem and diffuse disease, offline analysis of continuous iFR pullback measurement has previously been demonstrated to accurately predict the physiological outcome of revascularization...
April 23, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29581085/qualitative-resting-coronary-pressure-wave-form-analysis-to-predict-fractional-flow-reserve
#6
Mitsuaki Matsumura, Akiko Maehara, Nils P Johnson, William F Fearon, Bernard De Bruyne, Keith G Oldroyd, Nico H J Pijls, Paul Jenkins, Ziad A Ali, Gary S Mintz, Gregg W Stone, Allen Jeremias
AIMS: To evaluate the predictability of resting distal coronary pressure wave forms for fractional flow reserve (FFR). METHODS AND RESULTS: Resting coronary wave forms were qualitatively evaluated for the presence of (i) dicrotic notch; (ii) diastolic dipping; and (iii) ventricularization. In a development cohort (n=88) a scoring system was developed that was then applied to a validation cohort (n=428) using a multivariable linear regression model to predict FFR and receiver operating characteristics (ROC) to predict FFR ≤0...
March 27, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29577643/susceptibilities-of-candidatus-liberibacter-asiaticus-infected-and-noninfected-diaphorina-citri-to-entomopathogenic-fungi-and-their-detoxification-enzyme-activities-under-different-temperatures
#7
Mubasher Hussain, Komivi Senyo Akutse, Yongwen Lin, Shiman Chen, Wei Huang, Jinguan Zhang, Atif Idrees, Dongliang Qiu, Liande Wang
Some entomopathogenic fungi species, Isaria fumosorosea, and Hirsutella citriformis were found to be efficient against the Asian citrus psyllid, Diaphorina citri Kuwayama (Hemiptera: Liviidae). However, the susceptibility to these fungi increases when the psyllid infected with Candidatus Liberibacter asiaticus (Las), which is transmitted by D. citri and causes citrus greening disease. In this study, we examined the Las-infected and Las-uninfected D. citri susceptibility to entomopathogenic fungi at different temperature regimes (5-40°C)...
March 25, 2018: MicrobiologyOpen
https://www.readbyqxmd.com/read/29569332/the-impact-of-coronary-chronic-total-occlusion-percutaneous-coronary-intervention-upon-donor-vessel-fractional-flow-reserve-and-instantaneous-wave-free-ratio-implications-for-physiology-guided-pci-in-patients-with-cto
#8
Shah R Mohdnazri, Grigoris V Karamasis, Firas Al-Janabi, Christopher M Cook, James Hampton-Till, Jufen Zhang, Rasha Al-Lamee, Jason N Dungu, Swamy Gedela, Kare H Tang, Paul A Kelly, Justin E Davies, John R Davies, Thomas R Keeble
OBJECTIVE: To investigate the immediate and short term impact of right coronary artery (RCA) chronic total coronary occlusion (CTO) percutaneous coronary intervention (PCI) upon collateral donor vessel fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR). BACKGROUND: CTO PCI influences collateral donor vessel physiology, making the indication and/or timing of donor vessel revascularization difficult to determine. METHODS: In patients with RCA CTO, FFR, iFR, and collateral function index (FFRcoll ) were measured in LAD and LCx pre-CTO PCI, immediately post and at 4 month follow-up...
March 22, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29557104/functional-approach-for-coronary-artery-disease-filling-the-gap-between-evidence-and-practice
#9
REVIEW
Joo Myung Lee, Joon Hyung Doh, Chang Wook Nam, Eun Seok Shin, Bon Kwon Koo
The presence of myocardial ischemia is the most important prognostic factor in patients with coronary artery disease, and ischemia-directed revascularization has been a standard of care. Fractional flow reserve (FFR) is an invasive method used to detect the functionally significant epicardial coronary stenosis, and FFR-guided revascularization strategy has been proven to be superior to angiography-guided strategy. Recently, a hyperemia-free index, instantaneous wave free ratio (iFR), was developed and showed its non-inferiority for clinical outcomes compared with FFR-guided strategy...
March 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29497846/imaging-to-assess-ischemic-heart-disease-in-women
#10
REVIEW
Kaartiga Sivanesan, Subhi J Al'Aref, James K Min, Jessica M Peña, Fay Lin, Erica C Jones
PURPOSE OF REVIEW: Ischemic heart disease is a leading cause of morbidity and mortality for women and men around the world. However, traditional cardiovascular risk factors do not fully capture cardiac risk in women. This review summarizes sex-based differences in the clinical presentation, pathophysiology, and risk assessment of ischemic heart disease. We also examine the use of anatomic and functional imaging modalities in the diagnosis of ischemic heart disease in women. RECENT FINDINGS: Recent studies with women subjects have bolstered the predictive value of the coronary artery calcium (CAC) score in predicting atherosclerotic cardiovascular disease risk and major adverse cardiac events in a graded fashion...
March 2, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29482446/technical-aspects-and-limitations-of-fractional-flow-reserve-measurement
#11
Stepan Jerabek, Tomas Kovarnik
BACKGROUND: The only indication for coronary revascularization is elimination of ischaemia. Invasive hemodynamic methods (fractional flow reserve - FFR and instantaneous wave-free ratio (iFR) are superior to coronary angiography in detection of lesions causing myocardial ischaemia. Current European guidelines for myocardial revascularization recommend using of FFR for detection of functional assessment of lesions severity in category IA and number of these procedures increases. However, routine usage of these methods requires knowledge of technical requirements and limitations...
February 27, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29471949/impact-of-routine-invasive-physiology-at-time-of-angiography-in-patients-with-multivessel-coronary-artery-disease-on-reclassification-of-revascularization-strategy-results-from-the-define-real-study
#12
MULTICENTER STUDY
Eric Van Belle, Robert Gil, Volker Klauss, Mohammed Balghith, Martijn Meuwissen, Jérôme Clerc, Bernhard Witzenbichler, Miha Cercek, Marios Vlachojannis, Irene Lang, Philippe Commeau, Flavien Vincent, Luca Testa, Wojciech Wasek, Nicolas Debry, Stephan Kische, Gabriele Gabrielli, Gennaro Sardella
OBJECTIVES: This study sought to prospectively assess the impact of routine invasive physiology at the time of angiography on reclassification of therapeutic management of multivessel disease (MVD) patients, and to assess how implementation of instantaneous wave-free ratio (iFR) alters the process. BACKGROUND: Routine invasive physiology in intermediate coronary lesions at the time of diagnostic angiography, primarily in patients with single-vessel disease and using fractional flow reserve (FFR), reclassifies coronary revascularization management in 26% to 44% of patients...
February 26, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29469013/intermittent-food-restriction-in-female-rats-induces-srebp-high-expression-in-hypothalamus-and-immediately-postfasting-hyperphagia
#13
Mariana Alejandra Rosas Fernández, Carlos Marcelo Concha Vilca, Leandro Oliveira Batista, Viviane Wagner Ramos, Leonardo Paes Cinelli, Kelse Tibau de Albuquerque
OBJECTIVE: We investigated the effect of intermittent food restriction (IFR) cycles on hypothalamic expression of lipogenic proteins and induction of overeating. METHODS: Female Wistar rats were distributed in three groups: free access to feed (control, C), 2 d feed restriction at 50% of C intake followed by 3 d (restricted 3, R3) or 5 d (restricted 5, R5) ad libitum feeding. After 6 wk, the rats were submitted to euthanasia and collected the hypothalamus and blood...
April 2018: Nutrition
https://www.readbyqxmd.com/read/29442880/improving-the-thermal-stability-and-flame-retardancy-of-pp-ifr-composites-by-nial-layered-double-hydroxide
#14
Qinghong Kong, Ting Wu, Jiaqi Wang, Hong Liu, Junhao Zhang
Nickel and aluminum layered double hydroxide (NiAl-LDH) was synthesized via co-precipitation and modified by sodium dodecyl sulfate (SDS), which was marked as NiAl-OLDH. The structure of NiAl-LDH was characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM). In order to investigate the role of LDH on polymer/intumescent flame retardant (IFR) systems, polypropylene (PP)/IFR/NiAl-OLDH nanocomposites were prepared by melt intercalation. Thermal and flame retardant properties of PP/IFR/NiAl-OLDH nanocomposites were studied...
May 1, 2018: Journal of Nanoscience and Nanotechnology
https://www.readbyqxmd.com/read/29429843/invasive-in-the-cath-lab-assessment-of-myocardial-ischemia-in-patients-with-coronary-artery-disease-when-does-the-gold-standard-not-apply
#15
REVIEW
Stefano Benenati, Giovanni Luigi De Maria, Roberto Scarsini, Italo Porto, Adrian P Banning
International guidelines recommend that revascularization for coronary artery disease (CAD) should be guided by evidence of myocardial ischemia. Fractional flow reserve (FFR) and instantaneous free wave ratio (iFR) are the main invasive indices for assessing the ischemic potential of angiographically intermediate coronary stenosis as a large body of evidence supports their routine application. Both indices have been tested and validated in patients with isolated stable CAD, but notably their application outside this specific context is a matter of debate and investigation...
January 31, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29429831/predictors-of-poor-outcome-in-children-with-steroid-sensitive-nephrotic-syndrome
#16
Kirtisudha Mishra, Sandeep Kumar Kanwal, Sushma Veeranna Sajjan, Vikram Bhaskar, Bimbadhar Rath
BACKGROUND AND OBJECTIVE: Nearly 50% of the children with steroid sensitive nephrotic syndrome (SSNS) have a frequently relapsing (FR) or steroid dependent (SD) course, experiencing steroid toxicities and complications of immunosuppression. The study aimed to compare parameters between children with infrequent relapsing (IFR) and FR/SD nephrotic syndrome and to identify the factors associated with a FR/SD course. METHODS: A retrospective analysis of medical records from 2009 to 2014, of children with SSNS attending the pediatric nephrology clinic in a tertiary care medical college and hospital...
February 8, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29405535/directing-aluminum-atoms-into-energetically-favorable-tetrahedral-sites-in-a-zeolite-framework-by-using-organic-structure-directing-agents
#17
Koki Muraoka, Watcharop Chaikittisilp, Yutaka Yanaba, Takeshi Yoshikawa, Tatsuya Okubo
The Al location in zeolites can have massive influences on the zeolite properties because it directly correlates with the cationic active sites. Herein, the synthesis of IFR zeolites with controlled Al distribution at different tetrahedral sites (T sites) is reported. The computational calculations suggest that organic structure-directing agents (OSDAs) used for zeolite synthesis can alter the energetically favorable T sites for Al. Zeolite products synthesized under identical conditions but with different OSDAs are found to have altered fractions of Al at different T sites in accordance with the energies derived from the zeolite-OSDA complexes...
March 26, 2018: Angewandte Chemie
https://www.readbyqxmd.com/read/29384856/use-of-noncontact-infrared-thermography-to-measure-temperature-in-children-in-a-triage-room
#18
Emel Ataş Berksoy, Özlem Bağ, Selçuk Yazici, Tanju Çelik
We compared the accuracy and utility of 3 infrared (IFR) thermographs fitted with axillary digital thermometers used to measure temperature in febrile and afebrile children admitted to an emergency triage room.A total of 184 febrile and 135 afebrile children presenting to a triage room were consecutively evaluated. Axillary temperature was recorded using a digital electronic thermometer. Simultaneously, IFR skin scans were performed on the forehead, the neck (over the carotid artery), and the nape by the same nurse...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29371084/instantaneous-wave-free-ratio-as-an-alternative-to-fractional-flow-reserve-in-assessment-of-moderate-coronary-stenoses-a-meta-analysis-of-diagnostic-accuracy-studies
#19
Rohit Maini, John Moscona, Paul Katigbak, Camilo Fernandez, Gursukhmandeep Sidhu, Qusai Saleh, Anand Irimpen, Rohan Samson, Thierry LeJemtel
BACKGROUND/PURPOSE: Fractional flow reserve (FFR) remains underutilized due to practical concerns related to the need for hyperemic agents. These concerns have prompted the study of instantaneous wave-free ratio (iFR), a vasodilator-free index of coronary stenosis. Non-inferior cardiovascular outcomes have been demonstrated in two recent randomized clinic trials. We performed this meta-analysis to provide a necessary update of the diagnostic accuracy of iFR referenced to FFR based on the addition of eight more recent studies and 3727 more lesions...
December 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29333753/comparative-performance-of-different-scale-down-simulators-of-substrate-gradients-in-penicillium-chrysogenum-cultures-the-need-of-a-biological-systems-response-analysis
#20
Guan Wang, Junfei Zhao, Cees Haringa, Wenjun Tang, Jianye Xia, Ju Chu, Yingping Zhuang, Siliang Zhang, Amit T Deshmukh, Walter van Gulik, Joseph J Heijnen, Henk J Noorman
In a 54 m3 large-scale penicillin fermentor, the cells experience substrate gradient cycles at the timescales of global mixing time about 20-40 s. Here, we used an intermittent feeding regime (IFR) and a two-compartment reactor (TCR) to mimic these substrate gradients at laboratory-scale continuous cultures. The IFR was applied to simulate substrate dynamics experienced by the cells at full scale at timescales of tens of seconds to minutes (30 s, 3 min and 6 min), while the TCR was designed to simulate substrate gradients at an applied mean residence time (τc) of 6 min...
January 15, 2018: Microbial Biotechnology
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