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Gabriel DeVela, J Michael Taylor, Bin Zhang, Luke L Linscott, Alan M Chen, Kunal B Karani, Andrew Furthmiller, James L Leach, Sudhakar Vadivelu, Todd Abruzzo
BACKGROUND AND PURPOSE: Quantitative arterial tortuosity (QAT) is a ratio of vessel length between 2 points to the shortest linear distance between same points. QAT has been reported as an imaging biomarker of arteriopathy in pediatric arterial ischemic stroke (AIS) because of dissection and transient cerebral arteriopathy. We sought to determine whether QAT abnormalities are present in other subtypes of pediatric AIS. METHODS: Children with AIS-absent conventional biomarkers of arteriopathy and case-controls who underwent magnetic resonance angiography were classified by stroke mechanism...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Hsiu-An Lee, Chun-Yu Lin, Yung-Chang Chen, Shao-Wei Chen, Yu-Yun Nan, Kuo-Sheng Liu, Meng-Yu Wu, Yu-Sheng Chang, Jaw-Ji Chu, Pyng-Jing Lin, Feng-Chun Tsai
The feasibility and durability of mitral valve (MV) repair in active infective endocarditis (IE) has been reported, but proper management of perioperative neurological complications and surgical timing remains uncertain and may crucially affect the outcome.In this single-center retrospective observational study, patients who underwent isolated MV surgery for active native IE in our institution between August 2005 and August 2015 were reviewed and analyzed. Patients who were operated on for healed IE or who required combined procedures were excluded from this study...
March 2018: Medicine (Baltimore)
G Rossi, M Salerno, D Granchi, E Cenni, G Facchini, N Baldini
Arterial embolization, aimed at the mechanical occlusion of tumor-feeding vessels, represents a satisfactory palliative therapy for bone metastases. In this study, we evaluated if the circulating levels of three factors related to the metastatic process change in response to embolization. Seven patients who underwent embolization of a single skeletal metastasis from carcinomas were analyzed prospectively. Circulating levels of Vascular Endothelial Growth Factor A (VEGF-A), Fibroblast Growth Factor 2 (FGF-2), and Tartrate-Resistant Acid Phosphatase-5b Isoform (TRACP5b) were evaluated before and after embolization at 1, 3, and 6 months...
2018: Neoplasma
Matthew J Price
Resection of the left atrial appendage (LAA) to prevent recurrent arterial emboli in patients with atrial fibrillation was first suggested more than 60 years ago. Longer-term follow-up from randomized studies of the safety and efficacy of transcatheter LAA occlusion has recently been completed; data from large, observational cohorts are being reported. These recent data provide further insights into procedural safety with current techniques and the ability of LAA closure to reduce thromboembolic stroke compared with warfarin anticoagulation...
April 2018: Interventional Cardiology Clinics
Khalid Gafoor, Shalin Patel, Francis Girvin, Nishant Gupta, David Naidich, Stephen Machnicki, Kevin K Brown, Atul Mehta, Bryan Husta, Jay Ryu, George Sarosi, Tomas Franquet, Johny Verschakelen, Takeshi Johkoh, William Travis, Suhail Raoof
Cavities are occasionally encountered on thoracic imaging. Their differential diagnosis is large and includes, among others, various infections, autoimmune conditions and primary and metastatic malignancies. We offer an algorithmic approach to their evaluation by initially excluding mimics of cavities then broadly classifying them according to the duration of clinical symptoms and radiological abnormalities.. An acute or subacute process (<12 weeks) suggests common bacterial and uncommon nocardial and fungal causes of pulmonary abscesses, necrotizing pneumonias, and septic emboli...
March 5, 2018: Chest
Babikir Kheiri, Ahmed Abdalla, Mohammed Osman, Sahar Ahmed, Mustafa Hassan, Ghassan Bachuwa
BACKGROUND: Cryptogenic strokes can be attributed to paradoxical emboli through patent foramen ovale (PFO). However, the effectiveness of PFO closure in preventing recurrent stroke is uncertain and the results of previous randomized clinical trials (RCTs) have been inconclusive. Hence, this study provides an updated meta-analysis of all RCTs comparing PFO closure with medical therapy for secondary prevention of cryptogenic stroke. METHODS: All RCTs were identified by a comprehensive literature search of PubMed, Embase, the Cochrane Collaboration Central Register of Controlled Trials, Scopus, and Clinicaltrials...
March 7, 2018: Cardiology Journal
Nidaa Mikail, Khadija Benali, Besma Mahida, Jonathan Vigne, Fabien Hyafil, François Rouzet, Dominique Le Guludec
PURPOSE OF REVIEW: This review analyzes recent studies evaluating the diagnostic value of18 F-FDG-PET/CT for the detection of peripheral emboli and secondary infectious foci in patients with infective endocarditis and cardiac device infections. RECENT FINDINGS: Detection of extracardiac septic localizations in patients with infective endocarditis and cardiac device infections is crucial, as it may impact the diagnosis, prognosis, and therapeutic management. Recent literature substantiated the clinical usefulness of18 F-FDG-PET/CT in this setting...
March 6, 2018: Current Cardiology Reports
David M Love, John S Sperry
Little is known about the ability of trees to recover hydraulic conductance (k) within a growing season by regrowth or refilling of embolized conduits. Recovery of k lost to drought or other causes would prevent chronic reductions in gas exchange and productivity. To test recovery ability we conducted a 2-year experiment (2014-15) on a cohort of aspen ramets (Populus tremuloides, Michx.). Whole-tree k was measured from mid-June through September from sapflow (Q) and pre-dawn and mid-day xylem pressure. We induced embolism in the treatment group with high air pressure delivered by a split pressure chamber sealed around the main trunk...
March 2, 2018: Tree Physiology
Albert C Lin, Bradley P Knight
Interventional catheter ablation approaches to the rhythm control of atrial fibrillation (AF) have advanced significantly in the past decade. The foundation of the catheter ablation in AF is electrical isolation of the pulmonary veins (PVI). However, PVI only in more advanced stages of AF (persistent AF) has only modest to poor success rates prompting a search for alternative and adjunctive procedures to improve the outcomes of ablation in persistent AF. The left atrial appendage (LAA) is well understood to be a primary source of emboli in AF but less well known be a trigger or driver for AF...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
Chieh-Lung Cheng, Yung-Cheng Su, Tsu-Yi Chao, Chung-Wu Lin, Sheng-Chieh Chou, Ming Yao, Sung-Hsin Kuo, Shan-Chi Yu
Intralymphatic spread is common in solid cancers, but has been rarely studied in lymphomas. Review of 635 extranodal specimens from 475 diffuse large B-cell lymphoma (DLBCL) patients revealed intralymphatic spread in 10 surgical resection specimens from 10 patients including 9 de novo DLBCLs and 1 Richter transformation. The prevalence in de novo DLBCL with extranodal involvements was 1.65%. The most common involved site of intralymphatic spread was the gastrointestinal tract, followed by the female genital tract and breasts...
March 2, 2018: American Journal of Surgical Pathology
Sho Takeshita, Toshiyasu Ogata, Hidekazu Mera, Jun Tsugawa, Mikiko Aoki, Morishige Takeshita, Yoshio Tsuboi
A 65-year-old woman presented to our emergency room because of sudden onset of right hemiparesis with severe fatigue. Neurological examination revealed right hemiparesis with right facial numbness and an extensor planter response on the right side.Magnetic resonance imaging with diffusion-weighted imaging revealed multiple highintensity areas in both cerebral hemispheres and the right cerebellum. A diagnosis of acute stage of multiple brain infarctions caused by emboli was made. An abdominal computed tomography showed a pancreatic tumor with multiple liver metastases...
March 1, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Melanie C Bois, Michael D Eckhardt, Vincent M Cracolici, Matthew J Loe, Joseph J Ocel, William D Edwards, Robert D McBane, Thomas C Bower, Joseph J Maleszewski
OBJECTIVE: Arterial neoplastic emboli are uncommon, accounting for <1% of thromboemboli in the current literature. Nonetheless, this event may be associated with significant morbidity and mortality. Herein, we report a series of 11 cases of arterial neoplastic emboli from a single tertiary care center along with a comprehensive review of the literature to date. The aim of this study was to document the incidence, clinical presentations, and complications of arterial neoplastic emboli as well as to highlight the importance of routine histologic examination of thrombectomy specimens...
March 1, 2018: Journal of Vascular Surgery
Nilesh H Pawar, Oliver J Nickalls, Keng Leong Tan, Vui K Ho, Shin Yi Ng, Jiashen Loh
Streptococcus pneumoniae (S. pneumoniae) is a significant human bacterial pathogen and the major cause of pneumonia. In the post-antibiotic era, S. pneumoniae endocarditis is rare but carries a high risk of central nervous system (CNS) involvement. We present a case of invasive S. pneumoniae infection, which led to a cardioembolic stroke in a young man from septic emboli. Diagnosing a disseminated S. pneumoniae infection at an early stage is crucial and may improve patient outcomes.
December 18, 2017: Curēus
Ali Alkan, Serap Talaz
Introduction Cancer is an important risk factor for venous and arterial thromboembolic events. Treatment with chemotherapy was associated with a 6.5-fold increase in the risk of thromboembolic events. Here, we present a patient with cilioretinal artery emboli during cisplatin-based therapy. Case report A 54-year-old male patient with a diagnosis of metastatic small cell carcinoma was under cisplatin-based regimen. He presented with visual disturbance. Retinal fluorescein angiography showed multiple plaques located in cilioretinal artery and cilioretinal artery occlusion...
January 1, 2018: Journal of Oncology Pharmacy Practice
Y Xing, B Xu, X Sheng, C Xu, F Peng, Y Sun, S Wang, H Guo
WHAT IS KNOWN AND OBJECTIVE: Uninterrupted warfarin during cryoballoon ablation (CB-A) of atrial fibrillation (AF) has been widely accepted. However, to our knowledge, no previous studies exist investigating the optimal intensity of anticoagulation with warfarin for CB-A. This study aimed to evaluate the efficacy and safety of uninterrupted low-intensity warfarin for CB-A of AF in the elderly. METHODS: Paroxysmal AF patients (age ≥ 70 years) who underwent CB-A were enrolled prospectively...
February 26, 2018: Journal of Clinical Pharmacy and Therapeutics
Shohei Okazaki, Takanori Abe, Natsuko Takayanagi, Masanori Yasuda, Fumikazu Sakai, Kunihiko Kobayashi, Shingo Kato
BACKGROUND/AIM: We report on a case of pulmonary tumor embolism caused by squamous cell carcinoma of the uterine cervix. PATIENTS AND METHODS: A 60-year-old female diagnosed with stage IVB (cT4N1M1) squamous cell carcinoma of the uterine cervix was admitted to our institution with a chief complaint of progressive dyspnea that developed within a few days after admission. RESULTS: A chest CT scan showed dilated pulmonary arteries, right ventricular enlargement and mosaic ground-glass opacities in both lungs...
March 2018: In Vivo
Michael Joner, Philipp Ruppelt, Philine Zumstein, Capucine Lapointe-Corriveau, Guy Leclerc, Anna Bulin, Maria Isabel Castellanos, Eric Wittchow, Michael Haude, Ron Waksman
AIMS: Because vascular restoration therapy using bioresorbable vascular scaffolds (BRS) remains an appealing concept to restore vasoreactivity, understanding of biodegradation remains paramount during preclinical testing. METHODS AND RESULTS: Qualitative characterization of biodegradation was performed in 41 DREAMS 1G up to 3 years, while degradation kinetics were acquired in 54 DREAMS 2G implanted into porcine coronary arteries for 28, 90 and 180 days, 1 and 2 years...
February 20, 2018: EuroIntervention
Kirby R Lattwein, Himanshu Shekhar, Willem J B van Wamel, Tammy Gonzalez, Andrew B Herr, Christy K Holland, Klazina Kooiman
Infective endocarditis (IE) is associated with high morbidity and mortality rates. The predominant bacteria causing IE is Staphylococcus aureus (S. aureus), which can bind to existing thrombi on heart valves and generate vegetations (biofilms). In this in vitro flow study, we evaluated sonobactericide as a novel strategy to treat IE, using ultrasound and an ultrasound contrast agent with or without other therapeutics. We developed a model of IE biofilm using human whole-blood clots infected with patient-derived S...
February 21, 2018: Scientific Reports
Ville Jokinen, Esko Kankuri, Sasha Hoshian, Sami Franssila, Robin H A Ras
Superhydrophobic surfaces repel water and, in some cases, other liquids as well. The repellency is caused by topographical features at the nano-/microscale and low surface energy. Blood is a challenging liquid to repel due to its high propensity for activation of intrinsic hemostatic mechanisms, induction of coagulation, and platelet activation upon contact with foreign surfaces. Imbalanced activation of coagulation drives thrombogenesis or formation of blood clots that can occlude the blood flow either on-site or further downstream as emboli, exposing tissues to ischemia and infarction...
February 21, 2018: Advanced Materials
Daniel Del Vecchio, Simeon Wall
INTRODUCTION: Despite rapid growth, gluteal fat transplantation is an operation in search of science and a teachable technique. Long operating times, tedious syringe transfers, inability to shape the recipient site and the risk of fat embolism all headline as impediments to clinical adoption of the procedure. Expansion Vibration Lipofilling - EVL - is a syringe-free surgical strategy which is a logical extension of SAFE® liposuction. In EVL, there is simultaneous disruption of recipient site connective tissue, internal expansion using exploded-tip cannulas and backfilling of these spaces with roller pump-propelled fat...
February 9, 2018: Plastic and Reconstructive Surgery
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