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https://www.readbyqxmd.com/read/29035990/interruption-of-the-inferior-vena-cava-with-azygos-continuation
#1
Chien-Wei Kuo, Nan-Jing Peng, Yu-Li Chiu
This report describes a 19-year-old man with interruption of the inferior vena cava with azygos continuation. Both radionuclide venography and MRI clearly showed venous return of the lower limbs through prominent collateral systems.
October 13, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29035731/postoperative-adjuvant-sorafenib-or-sunitinib-for-nonmetastatic-renal-cell-carcinoma-with-venous-tumor-thrombus-a-prospective-cohort-study
#2
Liangyou Gu, Hongzhao Li, Luyao Chen, Xintao Li, Baojun Wang, Qingbo Huang, Fan Zhang, Yang Fan, Yu Gao, Cheng Peng, Xin Ma, Xu Zhang
PURPOSE: To evaluate the efficacy and safety of antiangiogenic agents (sorafenib and sunitinib) as postoperative adjuvant therapy in patients with nonmetastatic renal cell carcinoma (RCC) and venous tumor thrombus (VTT). MATERIAL AND METHODS: From March 2006 to January 2016, 147 patients who met the inclusion criteria were enrolled; 27 patients received sorafenib, and 17 patients received sunitinib. After radical nephrectomy and thrombectomy, the duration of maintenance targeted medication treatment was approximately 1 year...
October 13, 2017: Translational Oncology
https://www.readbyqxmd.com/read/29033272/graduating-surgical-residents-lack-competence-in-critical-care-ultrasound
#3
Renuka Tripu, Margaret H Lauerman, Daniel Haase, Syeda Fatima, Jacob Glaser, Cassandra Cardarelli, Thomas M Scalea, Sarah Murthi
OBJECTIVE: Ultrasound provides accessible imaging for bedside diagnostics and procedural guidance, but may lead to misdiagnosis in untrained users. The main objective of this study was to determine observed and self-perceived competence with critical care ultrasound in graduated general surgery residents. DESIGN: The design of this study was a retrospective review. Ultrasound training program records were reviewed for number of prior ultrasound examinations performed, self-perceived competence, observed competence on faculty examinations, and intended future use of individual critical care ultrasound examinations...
October 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29032910/venous-thromboembolism-after-laparoscopic-or-robotic-biliopancreatic-diversion-with-duodenal-switch-ninety-days-outcome-of-a-10-years-experience
#4
Hamzeh M Halawani, Charis F Ripley-Hager, Mary C Naglak, Fernando Bonanni, Gintaras Antanavicius
BACKGROUND: Venous thromboembolism (VTE) is a feared complication after bariatric surgery. Biliopancreatic diversion with duodenal switch (BPD-DS) is a complex bariatric procedure that is offered typically to super morbidly obese patients. Scarce data exist in reporting VTE outcome and identifying the risk factors associated with it after BPD-DS. OBJECTIVE: To determine the risk factors for VTE after BPD-DS at 90-day follow-up. SETTING: A nonprofit regional referral center and teaching hospital in Pennsylvania...
September 9, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29032036/relationship-between-the-subcostal-and-right-lateral-views-of-inferior-vena-cava-collapse-implications-for-clinical-use
#5
Rian Shah, Rory Spiegel, Christina Lu, Ivan Crnosija, Sahar Ahmad
BACKGROUND: The collapsibility index of the inferior vena cava (cIVC) is traditionally visualized in from the subcostal region in the sagittal plane (SS view), and is referred to here as cIVCSS. Alternatively, cIVC can be visualized from the right mid-axillary line in the coronal plane (RC view), referred to here as cIVCRC. It is unclear whether values of cIVCRC are comparable to values of cIVCSS as the IVC collapses asymmetrically into an elliptical form, quantified as the Flat Ratio of the IVC (F-IVC)...
October 11, 2017: Chest
https://www.readbyqxmd.com/read/29031927/particle-radiotherapy-a-novel-external-radiation-therapy-versus-liver-resection-for-hepatocellular-carcinoma-accompanied-with-inferior-vena-cava-tumor-thrombus-a-matched-pair-analysis
#6
Shohei Komatsu, Masahiro Kido, Sadaki Asari, Hirochika Toyama, Tetsuo Ajiki, Yusuke Demizu, Kazuki Terashima, Tomoaki Okimoto, Ryohei Sasaki, Takumi Fukumoto
BACKGROUND: Hepatocellular carcinoma accompanied with inferior vena cava tumor thrombus carries a dismal prognosis, and the feasibility of local treatment has remained controversial. The present study aimed to compare the outcomes of particle radiotherapy and liver resection in patients with hepatocellular carcinoma with inferior vena cava tumor thrombus. METHODS: Thirty-one and 19 patients, respectively, underwent particle radiotherapy and liver resection for hepatocellular carcinoma with inferior vena cava tumor thrombus...
October 11, 2017: Surgery
https://www.readbyqxmd.com/read/29030366/role-of-transoesophageal-echocardiography-in-renal-cell-carcinoma-a-brief-review
#7
Chitra Rajeswari Thangaswamy, Ramanitharan Manikandan, Sai Chandran Bathala Vedagiri
Transoesophageal echocardiography (TOE) is regularly used in cardiac and also increasingly in non-cardiac surgeries. It has a leading role in the perioperative management of renal cell carcinoma with tumour extension into inferior vena cava. We report two cases in which TOE was of immense help for patient management. This report highlights the two cases where intraoperative TOE was of immense help to establish diagnosis, to modify surgical plan, to guide the surgeon during clamp placement, to monitor cardiac function, to rule out tumour embolism and to confirm the complete removal of tumour thrombus...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29029715/the-role-of-inferior-vena-cava-filters-in-pulmonary-embolism
#8
Jonathan D Steinberger, Scott J Genshaft
Pulmonary embolism (PE) is a cause of significant morbidity and mortality, with an estimated 600,000 cases of clinically significant PE in the United States annually, and roughly 200,000 deaths per annum directly attributable to PE. By far the most frequent cause of PE is deep vein thrombosis originating in the lower extremities, which travels to the pulmonary vasculature. The mainstay of treatment is anticoagulation, but multiple additional treatments exist for patients in whom anticoagulation is inadequate or contraindicated...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29026877/prolonged-delayed-renal-graft-function-secondary-to-venous-hypertension
#9
Suraj Mishra, Gaurav Gupta, I Moinuddin, Brian Strife, Uma Prasad, D Massey, Anne King, Dhiren Kumar, Chandra S Bhati
The case of a 39-year-old highly sensitized woman who underwent second renal transplantation after being on warfarin because of a history of frequent thromboses of her left femoral arteriovenous graft (AVG) is reported here. The patient received a flow cytometric positive crossmatch kidney transplant from a deceased donor. Her posttransplant course was complicated by prolonged delayed graft function (DGF) lasting for 9 months. Antibody-mediated rejection occurred in the immediate postoperative period. This resolved after treatment, and resolution was confirmed by repeat biopsy...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29024379/can-a-renal-nurse-assess-fluid-status-using-ultrasound-on-the-inferior-vena-cava-a-cross-sectional-interrater-study
#10
Ulrich Steinwandel, Nicholas Gibson, Amanda Towell, James J R Rippey, Johan Rosman
INTRODUCTION: Ultrasound of the inferior vena cava (IVC-US) has been used to estimate intravascular volume status and fluid removal during a hemodialysis session. Usually, renal nurses rely on other, imprecise methods to determine ultrafiltration. To date, no study has examined whether renal nurses can reliably perform ultrasound for volume assessment and for potential prevention of intradialytic hypotension. This pilot study aimed to determine if a renal nurse could master the skill of performing and correctly interpreting Point of Care Ultrasound on patients receiving hemodialysis...
October 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29023812/polycystic-liver-disease-hepatic-venous-outflow-obstruction-lesions-of-the-non-cystic-parenchyma-have-major-consequences
#11
Louise Barbier, Maxime Ronot, Béatrice Aussilhou, François Cauchy, Claire Francoz, Prof Valérie Vilgrain, Olivier Soubrane, Valérie Paradis, Jacques Belghiti
BACKGROUND: In patients with polycystic liver disease, development of cysts induces hepatic venous outflow obstruction (HVOO) and parenchymal modifications, challenging the paradigm of a normal non-cystic liver parenchyma. The aims were to reappraise the pathology of the non-cystic parenchyma, by focusing on HVOO lesions; and to investigate the association with outflow obstruction at imaging and perioperative course after liver resection. METHODS: This is a retrospective study conducted in one tertiary center between 1993 and 2014...
October 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29019905/bezold-jarisch-reflex-occurred-in-a-pediatric-patient-with-giant-intra-abdominal-teratoma-during-induction-of-anesthesia-a-case-report
#12
Kai-Ming Yuan, Shu-Ying Fu, Jun Li, Wang-Ning Shangguan, Qing-Quan Lian
RATIONALE: Bezold-Jarisch reflex (BJR) occurs when the cardioinhibitory receptors in the walls of ventricles are activated by various stimuli, with typical features of bradycardia, vasorelaxation, and hypotension. This reflex usually happens in parturient intrathecal anesthesia, as a result of decreased venous return by compression of inferior vena cava, but it is only rarely reported during general anesthesia. PATIENT CONCERNS: Severe bradycardia and hypotension, indicating BJR, occurred during the induction of general anesthesia in a 3-month-old female child with giant intra-abdominal teratoma...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29019744/pediatric-liver-transplant-techniques-and-complications
#13
Natally Horvat, Antonio Sergio Zafred Marcelino, Joao Vicente Horvat, Tássia Regina Yamanari, Jose de Arimateia Batista Araújo-Filho, Pedro Panizza, Joao Seda-Neto, Eduardo Antunes da Fonseca, Francisco Cesar Carnevale, Luciana Mendes de Oliveira Cerri, Paulo Chapchap, Giovanni Guido Cerri
Liver transplant is considered to be the last-resort treatment approach for pediatric patients with end-stage liver disease. Despite the remarkable advance in survival rates, liver transplant remains an intricate surgery with significant morbidity and mortality. Early diagnosis of complications is crucial for patient survival but is challenging given the lack of specificity in clinical presentation. Knowledge of the liver and vascular anatomy of the donor and the recipient or recipients before surgery is also important to avoid complications...
October 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29016788/isolation-of-the-superior-vena-cava-from-the-right-atrial-posterior-wall-a-novel-ablation-approach
#14
Carola Gianni, Javier E Sanchez, Sanghamitra Mohanty, Chintan Trivedi, Domenico G Della Rocca, Amin Al-Ahmad, J David Burkhardt, G Joseph Gallinghouse, Patrick M Hranitzky, Rodney P Horton, Luigi Di Biase, Andrea Natale
Aims: Superior vena cava (SVC) isolation might be difficult to achieve because of the vicinity of the phrenic nerve (PN) and sinus node. Based on its embryogenesis, we hypothesized the presence of preferential conduction from the right atrial (RA) posterior wall, making it possible to isolate the SVC antrally, sparing its anterior and lateral aspect. Methods and results: This is a descriptive cohort study of 105 consecutive patients in which SVC isolation was obtained with radiofrequency ablation, starting in the septal aspect of the SVC-RA junction and continued posteriorly and inferiorly targeting sites of early activation until electrical isolation was obtained...
September 15, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28993967/outcomes-after-inferior-vena-cava-filter-placement-in-cancer-patients-diagnosed-with-pulmonary-embolism-risk-for-recurrent-venous-thromboembolism
#15
Catherine Coombs, Deborah Kuk, Sean Devlin, Robert H Siegelbaum, Jeremy C Durack, Rekha Parameswaran, Simon Mantha, Kathy Deng, Gerald Soff
Venous thromboembolism (VTE) is a common complication in cancer patients and anticoagulation (AC) remains the standard of care for treatment. Inferior vena cava (IVC) filters may also used to reduce the risk of pulmonary embolism, either alone or in addition to AC. Although widely used, data are limited on the safety and efficacy of IVC filters in cancer patients. We performed a retrospective review of outcomes after IVC filter insertion in a database of 1270 consecutive patients with cancer-associated pulmonary embolism (PE) at our institution between 2008 and 2009...
October 9, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28993841/extent-of-jugular-venous-distension-and-lower-extremity-edema-are-the-best-tools-from-history-and-physical-examination-to-identify-heart-failure-exacerbation
#16
H R Omar, M Guglin
INTRODUCTION: We aimed to identify the best tools from history and physical examination that predict severity of heart failure (HF) exacerbation among patients with an ejection fraction (EF) ≤ 30%. METHODS: Patients enrolled in the ESCAPE trial were divided into tertiles according to the combined value of pulmonary capillary wedge pressure (PCWP) and right atrial pressure (RAP) which we used as a marker of volume loading of both pulmonary and systemic compartments...
October 9, 2017: Herz
https://www.readbyqxmd.com/read/28990812/transjugular-intrahepatic-portosystemic-shunt-treatment-of-variceal-bleeding-in-an-unselected-patient-population
#17
K Rosenqvist, R Sheikhi, R Nyman, F Rorsman, P Sangfelt, C Ebeling Barbier
OBJECTIVE: To evaluate transjugular intrahepatic portosystemic shunt (TIPS) in variceal bleeding in a clinical setting. MATERIALS AND METHODS: Retrospective review of 131 patients (116 with liver cirrhosis) treated with TIPS with covered stent grafts in a single centre from 2002 to 2016. RESULTS: Survival at 1 and 2 years was 70% and 57% in patents with, and 100% at 2 years in patients without liver cirrhosis, respectively. A high Child-Pugh score and severe hepatic encephalopathy (HE) within 12 months post-TIPS were related to increased mortality...
October 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28985844/assessment-of-hemodynamic-response-to-fluid-resuscitation-of-patients-with-intra-abdominal-sepsis-in-low-and-middle-income-countries
#18
Egide Abahuje, Robert Munyaneza, Robert Riviello, Faustin Ntirenganya
BACKGROUND: Patients with intra-abdominal infections need to achieve adequate hemodynamic status before being taken to the operating room. Multiple parameters (urinary output [UOP], vital signs, inferior vena cava collapsibility index, and central venous pressure) may be used to assess hemodynamic response to fluid resuscitation, but the options are few in limited-resource settings. This study aimed at assessing if a bedside-performed ultrasound to assess the inferior vena cava collapsibility index is superior to UOP in assessing hemodynamic response to fluid resuscitation...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28984705/the-crashing-patient-hemodynamic-collapse
#19
Hitesh Gidwani, Hernando Gómez
PURPOSE OF REVIEW: Rapid restoration of tissue perfusion and oxygenation are the main goals in the resuscitation of a patient with circulatory collapse. This review will focus on providing an evidence based framework of the technological and conceptual advances in the evaluation and management of the patient with cardiovascular collapse. RECENT FINDINGS: The initial approach to the patient in cardiovascular collapse continues to be based on the Ventilate-Infuse-Pump rule...
October 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28984662/rapid-cardiothoracic-ultrasound-protocol-for-diagnosis-of-acute-heart-failure-in-the-emergency-department
#20
Jonas Öhman, Veli-Pekka Harjola, Pasi Karjalainen, Johan Lassus
OBJECTIVES: The aim of this study was to evaluate the performance of a rapid cardiothoracic ultrasound protocol (CaTUS), combining echocardiographically derived E/e' and lung ultrasound (LUS), for diagnosing acute heart failure (AHF) in patients with undifferentiated dyspnea in an emergency department (ED). PATIENTS AND RESULTS: We enrolled 100 patients with undifferentiated dyspnea from a tertiary care ED, who all had CaTUS done immediately upon arrival in the ED...
October 3, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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