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Eva Magdalena Korf, Volker Martin Tronnier, Jan Gliemroth, Jan Nils Küchler
We report a misinterpretation of bilateral mydriasis as blown pupils related to elevated intracranial pressure (ICP) under volatile sedation with isoflurane (Anesthetic Conserving Device [AnaConDa], Hudson RCI, Uppland Vasby, Sweden) in a 59-year-old patient with a severe traumatic brain injury with frontal contusion. The patient showed bilateral mydriasis and a missing light reflex 8 hours after changing sedation from intravenous treatment with midazolam and esketamine to volatile administration of isoflurane...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
William Joyce, Michael Axelsson, Tobias Wang
Most vertebrates increase cardiac output during activity by elevating heart rate with relatively stable stroke volume. However, several studies have demonstrated 'intrinsic autoregulation' of cardiac output where artificially increased heart rate is associated with decreased stroke volume, leaving cardiac output unchanged. We explored the capacity of noradrenaline to overcome autoregulation in the anaconda heart. Electrically pacing in situ perfused hearts from the intrinsic heart rate to the maximum attainable resulted in a proportional decrease in stroke volume...
November 10, 2016: Journal of Experimental Biology
Arne de Niet, Michel Mpj Reijnen, Ignace Fj Tielliu, Jan Willem Hp Lardenoije, Clark J Zeebregts
Since the introduction of fenestrated endovascular aneurysm repair (FEVAR) in 1996, great advances have been made in endograft development. Custom-made and off-the-shelf fenestrated and branched endografts have been used to treat patients with complex abdominal aortic and thoraco-abdominal aneurysms. Most experience has been gained with the Cook Zenith® fenestrated endograft (Cook Medical Inc., Limerick, Ireland). The Cook Zenith® endograft is customized with fenestrations, (fixed) inner or outer branches, or a combination of them, to cover a wide range of complex aneurysms...
October 6, 2016: Surgical Technology International
S A Crawford, M Itkina, M G Doyle, L W Tse, C H Amon, G Roche-Nagle
BACKGROUND: Endovascular aneurysm repair is a minimally-invasive method for the treatment of abdominal aortic aneurysms. For aneurysms that involve the visceral arteries, a custom-made stent graft with fenestrations for the branch arteries is required. The purpose of the current study is to evaluate the structural impact of misaligned fenestrations with respect to luminal patency and proximal aortic neck apposition in an in vitro model. METHODS: A custom apparatus was used to evaluate seven Anaconda and three Zenith fenestrated stent grafts...
September 1, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Drosos Kotelis, Karina Schleimer, Houman Jalaie, Jochen Grommes, Michael J Jacobs, Johannes Kalder
PURPOSE: To report operative and midterm outcomes of fenestrated endovascular aneurysm repair (FEVAR) with the Anaconda device. METHODS: A retrospective analysis was conducted of 39 consecutive patients (median age 74 years; 36 men) treated with the fenestrated Anaconda stent-graft between July 2011 and December 2015 at a single center. Indications for FEVAR were abdominal aortic aneurysms (AAAs) with neck anatomy unsuitable for a standard stent-graft. Median infrarenal neck length was 4 mm (range 0-9)...
August 29, 2016: Journal of Endovascular Therapy
R Shahverdyan, D Gray, M Gawenda, J Brunkwall
OBJECTIVE: Fenestrated endovascular aneurysm repair (F-EVAR) has increased the number of patients with aneurysmal disease and a short or no existing neck being eligible for endovascular treatment. The aim of the study is to report experience using the Anaconda fenestrated device with special emphasis on target vessel patency and pitfalls with the device. METHODS: Between 2011 and 2016, 48 F-EVAR procedures were performed in 37 males and 11 females under general anaesthesia using the Anaconda custom made device (CMD)...
October 2016: European Journal of Vascular and Endovascular Surgery
Alexander P Keil, David B Richardson
BACKGROUND: Prior studies have indicated associations between ingestion of inorganic arsenic and ischemic heart disease, non-malignant respiratory disease, and lung, skin, bladder and kidney cancers. In contrast, inhaled arsenic has been consistently associated only with lung cancer. Evidence for health effects of inhaled arsenic derives mainly from occupational studies that are subject to unique biases that may attenuate or obscure such associations. OBJECTIVES: Estimate the excess mortality from respiratory cancers, heart disease, and other causes due to occupational arsenic exposure while controlling for confounding using the parametric g-formula...
August 19, 2016: Environmental Health Perspectives
Emiliano Chisci, Enrico Barbanti, Eugenio Romano, Nicola Troisi, Leonardo Ercolini, Stefano Michelagnoli
PURPOSE: To describe a technique that connects an Anaconda stentgraft (Vascutek, Terumo, Inchinnan, Scotland) to a target artery in a hybrid method. TECHNIQUE: The patient was a 65-year-old male with a huge pluri-relapsing iliac and femoral pseudoaneurysm of a previous aortobifemoral bypass. An Anaconda stentgraft was used to repair the lesion. After partial dissection of the femoral bifurcation, the Anaconda stentgraft was partially introduced via a direct puncture in the anterior wall of the femoral artery over a guidewire...
July 14, 2016: Annals of Vascular Surgery
Hagen Bomberg, Marcel Wessendorf, Martin Bellgardt, Max Veddeler, Stefan Wagenpfeil, Thomas Volk, Heinrich V Groesdonk, Andreas Meiser
With the AnaConDa™ and the MIRUS™ system, volatile anesthetics can be administered for inhalation sedation in intensive care units. Instead of a circle system, both devices use anesthetic reflectors to save on the anesthetic agent. We studied the efficiency of desflurane reflection with both devices using different tidal volumes (VT), respiratory rates (RR), and 'patient' concentrations (CPat) in a bench study. A test lung was ventilated with four settings (volume control, RR × VT: 10 × 300 mL, 10 × 500 mL, 20 × 500 mL, 10 × 1000 mL)...
July 8, 2016: Journal of Clinical Monitoring and Computing
Alba Palacios, Santiago Mencía, Ana M Llorente, Jaime Cruz, Blanca Toledo, Olga Ordóñez, Marta Olmedilla, Jesus Lopez-Herce
OBJECTIVES: To describe the effect of inhaled sevoflurane in the treatment of severe refractory bronchospasm in children. DESIGN: Retrospective case series. SETTING: Two PICUs of tertiary general university hospitals in Spain. PATIENTS: Ten patients ranging from 5 months to 14 years old with severe bronchospasm and acute respiratory failure requiring tracheal intubation and mechanical ventilation and treated with sevoflurane from 2008 to 2015...
August 2016: Pediatric Critical Care Medicine
William Joyce, Michael Axelsson, Jordi Altimiras, Tobias Wang
The ventricles of non-crocodilian reptiles are incompletely divided and provide an opportunity for mixing of oxygen-poor blood and oxygen-rich blood (intracardiac shunting). However, both cardiac morphology and in vivo shunting patterns exhibit considerable interspecific variation within reptiles. In the present study, we develop an in situ double-perfused heart approach to characterise the propensity and capacity for shunting in five reptile species: the turtle Trachemys scripta, the rock python Python sebae, the yellow anaconda Eunectes notaeus, the varanid lizard Varanus exanthematicus and the bearded dragon Pogona vitticeps To simulate changes in vascular bed resistance, pulmonary and systemic afterloads were independently manipulated and changes in blood flow distribution amongst the central outflow tracts were monitored...
July 15, 2016: Journal of Experimental Biology
Antoine Maudet, Anne Daoudal, Alain Cardon, Elodie Clochard, Antoine Lucas, Jean-Philippe Verhoye, Adrien Kaladji
BACKGROUND: The stent grafts used for endovascular abdominal aortic repair (EVAR) profited from many technological changes since their appearance. The objective of this study was to compare the medium-term results of the second- and third-generation stent grafts. METHODS: Three hundred thirty-four patients treated by EVAR between 2005 and 2013 were included in this retrospective study. Demographic, anatomical, perioperative, and follow-up data were collected in a prospective way in an electronic database and compared between 2 groups...
July 2016: Annals of Vascular Surgery
Hagen Bomberg, Heinrich V Groesdonk, Martin Bellgardt, Thomas Volk, Andreas Meiser
INTRODUCTION: With the AnaConDa™ system, inhalational sedation in the intensive care unit has become popular. The device can be used with common intensive care unit ventilators and is inserted between the Y-piece and the patient. Liquid isoflurane or sevoflurane are delivered by a syringe pump. 90 % of anesthetic exhaled by the patient is absorbed by a reflector and resupplied during the next inspiration. The new Mirus™ system also uses a reflector. Its control unit identifies end-tidal concentrations from the flow, injects anesthetics during early inspiration, controls anesthetic concentrations automatically, and can also apply desflurane...
2016: SpringerPlus
Adib Khanafer, Manar Khashram, Carmen-Maria Ruiz, Dana Mann, Andrew Laing
PURPOSE: To report the use of the off-the-shelf Zenith t-Branch Thoracoabdominal Endovascular Graft for the treatment of a symptomatic acute type Ia endoleak subsequent to previous infrarenal bifurcated endovascular aneurysm repair. CASE REPORT: A 72-year-old man presented 4 years after implantation of an Anaconda stent-graft with sac expansion and type II endoleak, which was treated over the next 18 months with repeated coil and glue embolization of the leak and sac...
February 2016: Journal of Endovascular Therapy
Brant C Faircloth
UNLABELLED: Targeted enrichment of conserved and ultraconserved genomic elements allows universal collection of phylogenomic data from hundreds of species at multiple time scales (<5 Ma to > 300 Ma). Prior to downstream inference, data from these types of targeted enrichment studies must undergo preprocessing to assemble contigs from sequence data; identify targeted, enriched loci from the off-target background data; align enriched contigs representing conserved loci to one another; and prepare and manipulate these alignments for subsequent phylogenomic inference...
March 1, 2016: Bioinformatics
R Shahverdyan, M P Majd, R Thul, N Braun, M Gawenda, J Brunkwall
OBJECTIVE: To compare the results of elective open surgical repair (OSR) and total endovascular repair of juxtarenal aortic aneurysms (JAA), with either the Cook Zenith or the Vascutek Anaconda fenestrated stent grafts (F-EVAR) in a university hospital setting. PATIENTS AND METHODS: Between April 1999 and July 2014, of 926 patients with an abdominal aortic aneurysm, 69 were juxtarenal, where 34 had an elective OSR and 35 had F-EVAR. A post-operative rise of baseline creatinine by >50% and/or deterioration of estimated glomerular filtration rate by 25% were defined as renal failure...
October 2015: European Journal of Vascular and Endovascular Surgery
Margaret E Hunter, Sara J Oyler-McCance, Robert M Dorazio, Jennifer A Fike, Brian J Smith, Charles T Hunter, Robert N Reed, Kristen M Hart
Environmental DNA (eDNA) methods are used to detect DNA that is shed into the aquatic environment by cryptic or low density species. Applied in eDNA studies, occupancy models can be used to estimate occurrence and detection probabilities and thereby account for imperfect detection. However, occupancy terminology has been applied inconsistently in eDNA studies, and many have calculated occurrence probabilities while not considering the effects of imperfect detection. Low detection of invasive giant constrictors using visual surveys and traps has hampered the estimation of occupancy and detection estimates needed for population management in southern Florida, USA...
2015: PloS One
J C Purrucker, J Renzland, L Uhlmann, T Bruckner, W Hacke, T Steiner, J Bösel
BACKGROUND: The anaesthetic conserving device, AnaConDa(®), allows use of inhaled anaesthetics for sedation in the intensive care unit. We prospectively measured cerebral and cardiopulmonary parameters in patients with acute stroke or subarachnoid haemorrhage during a switch from i.v. to inhalative sedation. METHODS: 25 patients were switched from i.v. to an indefinite period of inhaled sedation with sevoflurane. Mean arterial (MAP), intracranial (ICP), and cerebral perfusion pressure (CPP), middle cerebral artery mean flow velocity (MFV) and fractional tissue oxygen extraction (FTOE), systemic cardiopulmonary parameters, and administered drugs were assessed before and after the change (-6 to +12 h)...
June 2015: British Journal of Anaesthesia
Christos D Karkos, Dimitrios M Kapetanios, Prodromos Th Anastasiadis, Foteini S Grigoropoulou, Thomas E Kalogirou, Ioakeim T Giagtzidis, Konstantinos O Papazoglou
INTRODUCTION: We aimed to report our experience with the Anaconda™ stent graft (Vascutek, Terumo, Inchinnan, Scotland, UK) for the endovascular treatment of abdominal aortic aneurysms (AAAs). METHODS: The vascular unit database was interrogated to identify all AAA patients who underwent endovascular repair with the Anaconda™ device between March 2007 and June 2014. The peri-operative, short-term, and mid-term outcome was recorded focusing on complications and re-interventions...
December 2015: Cardiovascular and Interventional Radiology
Martin Bellgardt, Hagen Bomberg, Jenny Herzog-Niescery, Burkhard Dasch, Heike Vogelsang, Thomas P Weber, Claudia Steinfort, Waldemar Uhl, Stefan Wagenpfeil, Thomas Volk, Andreas Meiser
BACKGROUND: Isoflurane has shown better control of intensive care sedation than propofol or midazolam and seems to be a useful alternative. However, its effect on survival remains unclear. OBJECTIVE: The objective of this study is to compare mortality after sedation with either isoflurane or propofol/midazolam. DESIGN: A retrospective analysis of data in a hospital database for a cohort of consecutive patients. SETTING: Sixteen-bed interdisciplinary surgical ICU of a German university hospital...
January 2016: European Journal of Anaesthesiology
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