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https://www.readbyqxmd.com/read/28646445/update-on-neurocritical-care-of-stroke
#1
Jason Siegel, Michael A Pizzi, J Brent Peel, David Alejos, Nnenne Mbabuike, Benjamin L Brown, David Hodge, W David Freeman
PURPOSE OF REVIEW: This review will highlight the recent advancements in acute ischemic stroke diagnosis and treatment, with special attention to new features and recommendations of stroke care in the neurocritical care unit. RECENT FINDINGS: New studies suggest that pre-hospital treatment of stroke with mobile stroke units and telestroke technology may lead to earlier stroke therapy with intravenous tissue plasminogen activator (tPA), and recent studies show tPA can be given in previously contraindicated situations...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28642998/plastic-bronchitis-a-rare-complication-of-long-term-haemodialysis-catheter-placement-in-a-child
#2
Simon Carter, Dayna van de Hoef, Michael Temple, Elizabeth Harvey, Suhail Al-Saleh, Christoph Licht, Damien Noone
BACKGROUND: Despite peritoneal dialysis being the preferred mode of renal replacement therapy in neonates and infants, long-term haemodialysis may be necessary in a minority of patients with its attendant risks. CASE DIAGNOSIS/TREATMENT: This case identifies plastic bronchitis as a rare yet serious complication of long-term large bore vascular access when a vessel-sparing approach is not possible. CONCLUSIONS: An appropriately sized catheter should be used for the dialytic therapy required and to optimize access survival...
June 22, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28638222/corticotropin-releasing-factor-stimulates-colonic-motility-via-muscarinic-receptors-in-the-rat
#3
Kyung-Jo Kim, Ki Bae Kim, Soon Man Yoon, Joung-Ho Han, Hee Bok Chae, Seon Mee Park, Sei Jin Youn
AIM: To measure exogenous corticotropin-releasing factor (CRF)-induced motility of the isolated rat colon and to demonstrate the effect of pharmacologic inhibition on CRF-induced motility. METHODS: The isolated vascularly-perfused rat colon was used. Luminal pressure was monitored via microtip catheter pressure transducers in the proximal and distal colon. At first, exogenous CRF was administered in a stepwise manner and the concentration of CRF yielding maximal colonic motility was selected...
June 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28635237/-comparison-of-the-short-term-and-long-term-outcomes-of-laparoscopic-surgery-and-open-surgery-for-early-stage-cervical-cancer
#4
H Y He, Z J Yang, D Y Zeng, D S Yao, J T Fan, R F Zhao, J Q Zhang, X X Hu, Z Lin, Y M Jiang, L Li
Objective: To evaluate the short-term and long-term outcomes after laparoscopic surgery compared with traditional laparotomy in cases of stage ⅠA2-ⅡA2 cervical cancer. Methods: We conducted a retrospective study on the clinical data of 1 863 patients diagnosed as FIGO stages ⅠA2-ⅡA2 cervical cancer in 6 third-grade class-A hospitals in Guangxi province between January 2007 and May 2014. One thousand and seventy-one received laparoscopy, and 792 received laparotomy. T-test, U-test and χ(2) test were used to compare the short-term and long-term outcomes...
June 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28633595/central-venous-catheter-insertion-into-the-false-lumen-of-a-complicated-aortic-dissection
#5
Ahmet Bas, Deniz Goksedef, Sedat G Kandemirli, Fatih Gulsen, Furuzan Numan
Thoracic endovascular repair is considered the first-line treatment in complicated acute type B dissection. Central venous catheters provide valuable vascular access during endovascular treatments. However, central venous catheters are not without complications. Herein, we report a case of central venous catheter insertion into the false lumen of a complicated acute type B aortic dissection by direct aortic puncture. The tip of the central venous catheter was in the false lumen. The central venous catheter was left in place initially and was removed after graft stent deployment...
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28625402/comparison-between-catheter-based-delivery-of-paclitaxel-after-bare-metal-stenting-and-drug-eluting-stents-in-coronary-artery-disease-patients-at-high-risk-for-in-stent-restenosis
#6
Mostafa El-Mokadem, Mohamed El-Ramly, Amr Hassan, Hesham Boshra, Amir AbdelWahab
BACKGROUND: Drug eluting stents reduce the risk of in-stent restenosis but delay healing of the vascular wall. Recent data on late and very late stent thrombosis after drug-eluting stent (DES) implantation have raised concerns about the long-term safety. High lipophilicity of paclitaxel promotes rapid cellular uptake and prolongs its action. This makes paclitaxel a very promising candidate for local drug therapy intended to inhibit the proliferative and migratory processes involved in restenosis following PCI...
May 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28625266/-risk-factors-of-deep-venous-thrombosis-associated-with-peripherally-inserted-central-venous-catheter-in-upper-extremity-in-icu
#7
Ning Zhao, Jiale Zhang, Ting Jiang, Xia Chen, Jianning Wang, Chengzhi Ding, Fen Liu, Kejian Qian, Rong Jiang
OBJECTIVE: To analyze the incidence and its risk factors of peripherally inserted central venous catheter related upper extremity deep venous thrombosis (PICC-UEDVT) in intensive care unit (ICU). METHODS: Clinical data of the patients received PICCs in ICU of the First Affiliated Hospital of Nanchang University from August 2013 to August 2016 were retrospectively analysed. The inclusion criteria in the study included: the age > 18 years old, catheter indwelling time > 1 week and the complete relevant information...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#8
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28624422/endovascular-proximal-forearm-arteriovenous-fistula-for-hemodialysis-access-results-of-the-prospective-multicenter-novel-endovascular-access-trial-neat
#9
Charmaine E Lok, Dheeraj K Rajan, Jason Clement, Mercedeh Kiaii, Ravi Sidhu, Ken Thomson, George Buldo, Christine Dipchand, Louise Moist, Joanna Sasal
BACKGROUND: Hemodialysis arteriovenous fistulas (AVFs) are suboptimally used primarily due to problems with maturation, early thrombosis, and patient nonacceptance. An endovascular approach to fistula creation without open surgery offers another hemodialysis vascular access option. STUDY DESIGN: Prospective, single-arm, multicenter study (Novel Endovascular Access Trial [NEAT]). SETTINGS & PARTICIPANTS: Consecutive adult non-dialysis-dependent and dialysis-dependent patients referred for vascular access creation at 9 centers in Canada, Australia, and New Zealand...
June 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28623994/placement-of-tunneled-cuffed-vascular-catheter-through-superior-vena-cava-puncture
#10
Songhui Zhai, Qiuyan Zhao, Yanhuan Feng, Yang Yu, Li Zhou, Tianlei Cui, Ping Fu
OBJECTIVE: The purpose of this study was to assess the feasibility and safety of placement of tunneled cuffed catheters through direct percutaneous puncture of the superior vena cava (SVC) in patients with occluded right and left innominate veins. METHODS: This was a retrospective review of all patients with right and left innominate vein occlusions who underwent tunneled catheter placement with direct SVC puncture between January 2012 and December 2014. Under fluoroscopic guidance with the patient in a supine position, a 5F catheter was placed at the distal end of the SVC through the femoral vein, iliac vein, or hepatic vein...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28623882/peripheral-venous-catheter-related-bloodstream-infection-is-associated-with-severe-complications-and-potential-death-a-retrospective-observational-study
#11
Akihiro Sato, Itaru Nakamura, Hiroaki Fujita, Ayaka Tsukimori, Takehito Kobayashi, Shinji Fukushima, Takeshi Fujii, Tetsuya Matsumoto
BACKGROUND: The purpose of this study was to identify the clinical characteristics and outcomes of peripheral vascular catheter-related bloodstream infections (PVC-BSIs) and determine the risk of severe complications or death. METHODS: We performed a retrospective observational study from June 2010 to April 2015 at two regional university-affiliated hospitals in Tokyo. We studied the clinical manifestations, underlying diseases, laboratory results, treatment methods, recurrence rates, and complications in 62 hospitalized patients diagnosed with PVC-BSIs by positive blood cultures...
June 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28621637/surgical-techniques-and-procedures-for-kidney-transplant-recipients-with-severe-atherosclerosis
#12
Koji Nanmoku, Yoshihiko Watarai, Shunji Narumi, Norihiko Goto, Takayuki Yamamoto, Makoto Tsujita, Takahisa Hiramitsu, Akio Katayama, Takaaki Kobayashi, Kazuharu Uchida
OBJECTIVES: Atherosclerosis is becoming a more common problem for dialysis patients. Therefore, transplant surgeons are faced with the need to develop surgical techniques and procedures for severe atherosclerosis. This study aimed to clarify the clinical features, the usefulness of examinations, and operative procedures for kidney transplant recipients with the complication of severe atherosclerosis. MATERIALS AND METHODS: Among 220 kidney transplant candidates, 13 patients (severe atherosclerosis group) were predicted complications due to arterial calcification in the bilateral iliac arterial system using a computed tomographic scan...
June 16, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28619777/peripherally-inserted-central-catheter-dressing-and-securement-in-patients-with-cancer-the-pisces-trial-protocol-for-a-2x2-factorial-superiority-randomised-controlled-trial
#13
Claire M Rickard, Nicole M Marsh, Joan Webster, Nicole C Gavin, Raymond J Chan, Alexandra L McCarthy, Peter Mollee, Amanda J Ullman, Tricia Kleidon, Vineet Chopra, Li Zhang, Matthew R McGrail, Emily Larsen, Md Abu Choudhury, Samantha Keogh, Evan Alexandrou, David J McMillan, Merehau Cindy Mervin, David L Paterson, Marie Cooke, Gillian Ray-Barruel, Maria Isabel Castillo, Andrew Hallahan, Amanda Corley, E Geoffrey Playford
INTRODUCTION: Around 30% of peripherally inserted central catheters (PICCs) fail from vascular, infectious or mechanical complications. Patients with cancer are at highest risk, and this increases morbidity, mortality and costs. Effective PICC dressing and securement may prevent PICC failure; however, no large randomised controlled trial (RCT) has compared alternative approaches. We designed this RCT to assess the clinical and cost-effectiveness of dressing and securements to prevent PICC failure...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28616563/low-rate-of-access-site-complications-after-transradial-coronary-catheterization-a-prospective-ultrasound-study
#14
Violeta Mattea, Carsten Salomon, Niels Menck, Philipp Lauten, Frank Michael Malur, Anja Schade, Frank Steinborn, Lisa Costello-Boerrigter, Axel Neumeister, Harald Lapp
BACKGROUND: Transradial artery (TRA) left heart catheterization is an increasingly used technique for both diagnostic and interventional coronary procedures. This study evaluates the incidence of access site complications in the current interventional era. METHODS AND RESULTS: A total of 507 procedures were performed under standardized conditions. Each procedure was performed using high levels of anticoagulation, hydrophilic sheaths, and short post-procedural compression times...
March 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28605923/bacterial-sepsis-in-neonates-single-centre-study-in-a-neonatal-intensive-care-unit-in-bosnia-and-herzegovina
#15
Izeta Softić, Husref Tahirović, Vincenzo Di Ciommo, Cinzia Auriti
OBJECTIVE: The aim of the study was to evaluate the incidence, mortality, risk factors, aetiology and the susceptibility to antibiotics of the bacteria responsible for sepsis. MATERIAL AND METHODS: A single centre, prospective, observational study, involving 200 neonates admitted over 12 months to the NICU of the University Children's Hospital, Tuzla, Bosnia and Herzegovina. RESULTS: The crude incidence of all neonatal sepsis was 68.0% (136/200) and that of late-onset sepsis (LOS) was 48...
May 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/28604317/beware-the-femoral-haemodialysis-catheter-a-surgeon-s-perspective
#16
Tinus Du Toit, David Thomson, Elmi Muller
The ability to identify and address factors that threaten the optimal utilisation of donor organs is quintessential in obtaining satisfactory transplant outcomes. We share our concerns regarding the prolonged use of femoral haemodialysis catheters and its potential to jeopardise successful renal transplantation. Despite a paucity of literature on the topic, we review relevant aspects related to this pernicious form of vascular access and clarify its limited role in the modern haemodialysis unit, particularly in patients who are still considered for transplantation...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28600088/invasive-hemodynamics-of-pulmonary-disease-and-the-right-ventricle
#17
REVIEW
David Silber, Justine Lachmann
Pulmonary hypertension (PH) falls into 5 groups, as defined by the World Health Organization. Swan-Ganz catheters determine precapillary versus postcapillary PH. The hemodynamic values of PH at rest and with vasodilatory challenge categorize the etiology of PH and guide treatment. RV maladaptations to increased pulmonary vascular resistance (PVR) and the chronicity of the right ventricle's (RV) response to increased PH and/or increased PVR can be understood with pressure-volume (PV) loops constructed with use of conductance catheters...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28599902/cost-effectiveness-analysis-of-vascular-access-referral-policies-in-ckd
#18
Steven M Shechter, Talon Chandler, M Reza Skandari, Nadia Zalunardo
BACKGROUND: The optimal timing of vascular access referral for patients with chronic kidney disease who may need hemodialysis (HD) is a pressing question in nephrology. Current referral policies have not been rigorously compared with respect to costs and benefits and do not consider patient-specific factors such as age. STUDY DESIGN: Monte Carlo simulation model. SETTING & POPULATION: Patients with chronic kidney disease, referred to a multidisciplinary kidney clinic in a universal health care system...
June 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28598924/resuscitative-endovascular-balloon-occlusion-of-the-aorta-principles-initial-clinical-experience-and-considerations-for-the-anesthesiologist
#19
Srikanth Sridhar, Sam D Gumbert, Christopher Stephens, Laura J Moore, Evan G Pivalizza
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an endovascular technique that allows for temporary occlusion of the aorta in patients with severe, life-threatening, trauma-induced noncompressible hemorrhage arising below the diaphragm. REBOA utilizes a transfemoral balloon catheter inserted in a retrograde fashion into the aorta to provide inflow control and support blood pressure until definitive hemostasis can be achieved. Initial retrospective and registry clinical data in the trauma surgical literature demonstrate improvement in systolic blood pressure with balloon inflation and improved survival compared to open aortic cross-clamping via resuscitative thoracotomy...
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28598912/cardiac-output-measurements-based-on-the-pulse-wave-transit-time-and-thoracic-impedance-exhibit-limited-agreement-with-thermodilution-method-during-orthotopic-liver-transplantation
#20
Aurora Magliocca, Emanuele Rezoagli, Thomas Anthony Anderson, Sara Maria Burns, Fumito Ichinose, Hovig Vatche Chitilian
BACKGROUND: Orthotopic liver transplantation (OLT) is characterized by significant intraoperative hemodynamic variability. Accurate and real-time cardiac output (CO) monitoring aids clinical decision making during OLT. The purpose of this study is to compare accuracy, precision, and trending ability of CO estimation obtained noninvasively using pulse wave transit time (estimated continuous cardiac output [esCCO; Nihon Kohden, Tokyo, Japan]) or thoracic bioimpedance (ICON; Osypka Medical GmbH, Berlin, Germany) to thermodilution cardiac output (TDCO) measured with a pulmonary artery catheter...
June 8, 2017: Anesthesia and Analgesia
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