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https://www.readbyqxmd.com/read/29460642/novel-targeted-therapy-strategies-for-biliary-tract-cancers-and-hepatocellular-carcinoma
#1
Thomas T DeLeon, Daniel H Ahn, James M Bogenberger, Panos Z Anastasiadis, Mansi Arora, Ramesh K Ramanathan, Bashar A Aqel, George Vasmatzis, Mark J Truty, Rahmi Oklu, Tanios S Bekaii-Saab, Mitesh J Borad
Worldwide hepatobiliary cancers are the second leading cause of cancer related death. Despite their relevance, hepatobiliary cancers have a paucity of approved systemic therapy options. However, there are a number of emerging therapeutic biomarkers and therapeutic concepts that show promise. In hepatocellular carcinoma, nivolumab appears particularly promising and recently received US FDA approval. In intrahepatic cholangiocarcinoma, therapies targeting FGFR2 and IDH1 and immune checkpoint inhibitors are the furthest along and generating the most excitement...
February 20, 2018: Future Oncology
https://www.readbyqxmd.com/read/29446669/segmental-arterial-mediolysis-abdominal-imaging-of-and-disease-course-in-111-patients
#2
Sailen G Naidu, Christine O Menias, Rahmi Oklu, Robert S Hines, Kinan Alhalabi, Gerges Makar, Fadi E Shamoun, Stanislav Henkin, Robert D McBane
OBJECTIVE: The purpose of this study is to identify the imaging characteristics of segmental arterial mediolysis (SAM) at presentation and establish the longitudinal course of disease. MATERIALS AND METHODS: We retrospectively identified patients with SAM at a single institution from 2000 through 2015. Diagnosis was based on published guidelines with multidisciplinary consensus. Imaging studies obtained at initial evaluation were reviewed to evaluate imaging findings and vascular territory distribution...
April 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29399537/bioengineered-in-vitro-models-of-thrombosis-methods-and-techniques
#3
REVIEW
Yu Shrike Zhang, Rahmi Oklu, Hassan Albadawi
Thrombosis is a prevailing vascular disorder that has been historically studied in vivo with conventional animal models. Here we review recent advances in methods and techniques that allow for engineering of biomimetic in vitro models of thrombosis, usually combined with microfluidic devices, termed thrombosis-on-a-chip systems, to reproduce such vascular pathology outside living organisms. These human cell-based thrombosis-on-a-chip platforms recapitulate the important characteristics of native thrombosis in terms of vascular structures, extracellular matrix properties, cellular composition, and pathophysiology, making them enabling in vitro models to study this important class of vascular disorders as well as to develop personalized treatment regimens...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399536/rationale-for-catheter-directed-therapy-in-pulmonary-embolism
#4
REVIEW
Sailen G Naidu, Martha-Gracia Knuttinen, J Scott Kriegshauser, William G Eversman, Rahmi Oklu
Pulmonary embolism (PE) is a widespread health concern associated with major morbidity and mortality. Catheter directed therapy (CDT) has emerged as a treatment option for acute PE adding to the current potential options of systemic thrombolysis or anticoagulation. The purpose of this review is to understand the rationale and indications for CDT in patients with PE. While numerous studies have shown the benefits of systemic thrombolysis compared to standard anticoagulation, these are balanced by the increased risk of major bleeding...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399534/hemodialysis-access-thrombosis
#5
REVIEW
Keith Bertram Quencer, Rahmi Oklu
For the over 400,000 patients in the United States dependent on hemodialysis, arteriovenous (AV) access thrombosis may lead to missed dialysis sessions, inpatient admissions and the need for placement of temporary dialysis catheters. It is also the leading cause of permanent access loss. Percutaneous declotting is generally preferred over surgical thrombectomy. Various percutaneous approaches can be employed including the lyse-and-wait technique, thromboaspiration, pulse spray aided pharmacomechanical thrombolysis, and use of mechanical thrombectomy device...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399532/paget-schroetter-syndrome-treatment-of-venous-thrombosis-and-outcomes
#6
REVIEW
Patrick Hangge, Lisa Rotellini-Coltvet, Amy R Deipolyi, Hassan Albadawi, Rahmi Oklu
Thoracic outlet syndrome (TOS) is a rare clinical entity with many etiologies. Venous thoracic outlet syndrome (VTOS), also called Paget-Schroetter syndrome (PSS), is a primary "effort" thrombosis. Here we will focus on the pathophysiology, anatomy, clinical presentation, treatments, and outcomes of VTOS. Treatment involves anticoagulation, catheter-directed thrombolysis, and surgical decompression. Early diagnosis and treatment can improve symptoms and quality of life.
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399531/deep-vein-thrombosis-pathogenesis-diagnosis-and-medical-management
#7
REVIEW
Jonathan Stone, Patrick Hangge, Hassan Albadawi, Alex Wallace, Fadi Shamoun, M Grace Knuttien, Sailendra Naidu, Rahmi Oklu
Deep vein thrombosis (DVT) is a major preventable cause of morbidity and mortality worldwide. Venous thromboembolism (VTE), which includes DVT and pulmonary embolism (PE), affects an estimated 1 per 1,000 people and contributes to 60,000-100,000 deaths annually. Normal blood physiology hinges on a delicate balance between pro- and anti-coagulant factors. Virchow's Triad distills the multitude of risk factors for DVT into three basic elements favoring thrombus formation: venous stasis, vascular injury, and hypercoagulability...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399530/hemostasis-and-nanotechnology
#8
REVIEW
Patrick Hangge, Jonathan Stone, Hassan Albadawi, Yu Shrike Zhang, Ali Khademhosseini, Rahmi Oklu
Hemorrhage accounts for significant morbidity and mortality. Various techniques have been employed to augment hemostasis from simple tourniquets to self-assembling nanoparticles. A growing understanding of the natural clotting cascade has allowed agents to become more targeted for potential use in different clinical scenarios. This review discusses current and developing hemostatic techniques, including matrix agents, external agents, biologically inspired agents, and synthetic and cell-derived nanoparticles...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399528/anti-fouling-strategies-for-central-venous-catheters
#9
REVIEW
Alex Wallace, Hassan Albadawi, Nikasha Patel, Ali Khademhosseini, Yu Shrike Zhang, Sailendra Naidu, Grace Knuttinen, Rahmi Oklu
Central venous catheters (CVCs) are ubiquitous in the healthcare industry and carry two common complications, catheter related infections and occlusion, particularly by thrombus. Catheter-related bloodstream infections (CRBSI) are an important cause of nosocomial infections that increase patient morbidity, mortality, and hospital cost. Innovative design strategies for intravenous catheters can help reduce these preventable infections. Antimicrobial coatings can play a major role in preventing disease. These coatings can be divided into two major categories: drug eluting and non-drug eluting...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399527/elastography-techniques-in-the-evaluation-of-deep-vein-thrombosis
#10
REVIEW
Peter Hoang, Alex Wallace, Mark Sugi, Andrew Fleck, Yash Pershad, Nirvikar Dahiya, Hassan Albadawi, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Deep venous thrombosis (DVT) is a significant medical problem with an incidence of 1 in 1,000 adults and greatly reduces quality of life through post-thrombotic syndrome. Treatment choice for DVT can be influenced by the age of the clot. While new endovascular catheter techniques treat venous clots to potentially prevent post-thrombotic syndrome, they require improved imaging techniques to accurately determine clot age. This review investigates experimental and clinical evidence of elastography techniques for aging DVT...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399526/catheter-directed-thrombolysis-of-deep-vein-thrombosis-literature-review-and-practice-considerations
#11
REVIEW
Drew Fleck, Hassan Albadawi, Fadi Shamoun, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Deep vein thrombosis (DVT) is a major health problem worldwide. The risk of pulmonary embolism following DVT is well established, but the long-term vascular sequelae of DVT are often underappreciated, costly to manage, and can have extremely detrimental effects on quality of life. Treatment of DVT classically involves oral anticoagulation, which reduces the risk of pulmonary embolism but does not remove the clot. Anticoagulation therefore does little to prevent the venous damage and scarring that occurs following DVT, leaving the patient at risk for permanent venous insufficiency and development of post-thrombotic syndrome (PTS)...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399525/transplant-artery-thrombosis-and-outcomes
#12
REVIEW
Mark D Sugi, Hassan Albadawi, Grace Knuttinen, Sailendra G Naidu, Amit K Mathur, Adyr A Moss, Rahmi Oklu
Post-transplantation allograft arterial thrombosis is a well-recognized complication associated with solid organ transplantation. Much of the literature is centered on liver and kidney transplantation, which will therefore serve as the principle basis for this review, with a brief discussion on pancreas transplantation and associated arterial complications. The number of solid organ transplants has been steadily increasing over the past decade in parallel with growing demand for organs and expansion of the transplantation criteria for both donors and recipients...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399524/statins-as-a-preventative-therapy-for-venous-thromboembolism
#13
REVIEW
Alex Wallace, Hassan Albadawi, Peter Hoang, Andrew Fleck, Sailendra Naidu, Grace Knuttinen, Rahmi Oklu
The anti-inflammatory effects of statins have likely not been used to their fullest extent, particularly in reducing venous thromboembolic events. Current therapy for thrombotic events hinges on anticoagulation via heparin, warfarin or new oral anticoagulants. Interventional procedures with thrombectomy may also play a critical role. Unfortunately, thrombotic events can occur and recur despite meticulous anticoagulation therapy. Venous thromboembolism (VTE) includes both deep vein thrombosis (DVT) and pulmonary embolism (PE), two complicated and prevalent diseases that can cause chronic disease states such as post-thrombotic syndrome (PTS)...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399523/animal-models-of-venous-thrombosis
#14
REVIEW
Hassan Albadawi, Avery A Witting, Yash Pershad, Alex Wallace, Andrew R Fleck, Peter Hoang, Ali Khademhosseini, Rahmi Oklu
Venous thrombosis (VT) is a prevalent clinical condition with significant adverse sequela or mortality. Anticoagulation and pharmacologic or pharmacomechanical thrombolytic therapies are the mainstays of VT treatment. An understanding of thrombosis biology will allow for more effective VT-tailored diagnosis and therapy. In vivo models of thrombosis provide indispensable tools to study the pathogenesis of thrombus formation and to evaluate novel therapeutic or preventive adjuncts for VT management or prevention...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399522/can-thrombus-age-guide-thrombolytic-therapy
#15
REVIEW
Christopher Czaplicki, Hassan Albadawi, Sasan Partovi, Ripal T Gandhi, Keith Quencer, Amy R Deipolyi, Rahmi Oklu
Venous thrombosis (VT) is a common yet complex clinical condition that has shown minimal alteration in clinical management for decades. It is well known that thrombus evolves structurally over time, with complex changes resulting from the interplay between coagulation factors, cytokines, leukocytes and a myriad of other factors. Our current treatment options are most effective in the acute thrombus, which is composed predominantly of a loose mesh of fibrin and red blood cells (RBCs), making current anticoagulation therapies and thrombolytics quite effective in treatment...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399521/thrombosis-in-cancer-patients-etiology-incidence-and-management
#16
REVIEW
Rahul A Sheth, Andrew Niekamp, Keith B Quencer, Fadi Shamoun, Martha-Gracia Knuttinen, Sailendra Naidu, Rahmi Oklu
Venous thromboembolism (VTE) is the second most common cause of mortality in cancer patients. The mechanisms of cancer-associated thrombosis (CAT), much like cancer itself, are multi-factorial and incompletely understood. Cancer type, stage, tumor-derived factors and genetics all affect CAT risk. Furthermore, cancer therapies as well as the indwelling vascular devices through which these therapies are delivered can increase the risk for CAT. In this review, we summarize mechanisms of hypercoagulability in cancer patients, patterns of thrombosis associated with cancer, current guidelines for the diagnosis and management of CAT, and important considerations regarding the placement of implantable vascular devices in the care of cancer patients with VTE...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399520/tumor-thrombus-incidence-imaging-prognosis-and-treatment
#17
REVIEW
Keith Bertram Quencer, Tamir Friedman, Rahul Sheth, Rahmi Oklu
Intravascular tumor extension, also known as tumor thrombus, can occur in many different types of cancer. Those with the highest proclivity include Wilm's tumor, renal cell carcinoma (RCC), adrenal cortical carcinoma (ACC) and hepatocellular carcinoma (HCC). The presence of tumor thrombus markedly worsens prognosis and impacts treatment approach. Imaging plays a key role in its diagnosis. Endovascular methods also play a large role in treatment.
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399519/may-thurner-diagnosis-and-endovascular-management
#18
REVIEW
M-Grace Knuttinen, Sailendra Naidu, Rahmi Oklu, Scott Kriegshauser, William Eversman, Lisa Rotellini, Patricia E Thorpe
Common left iliac vein compression, otherwise known as May-Thurner (MT), is an anatomical risk factor for lower extremity deep vein thrombosis (DVT). MT refers to chronic compression of the left iliac vein against the lumbar spine by the overlying right common iliac artery. The compression may be asymptomatic. The syndrome is a clinical spectrum of physical findings and history plus the lesion. It is characterized by the varying degrees of venous hypertension. This can be non-thrombotic, combined with acute DVT or post-thrombotic...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399517/neutrophil-extracellular-traps-are-increased-in-cancer-patients-but-does-not-associate-with-venous-thrombosis
#19
Rahmi Oklu, Rahul A Sheth, Keith H K Wong, Amin H Jahromi, Hassan Albadawi
Background: A single center, prospective tissue-based study was conducted to investigate an association between neutrophil extracellular traps (NETs) and venous thromboembolic disease in patients with malignancy. Methods: Plasma was collected from 65 patients in which 27 were cancer patients and 38 were age-matched non-cancer patients. Plasma NETs, circulating free DNA (cfDNA), DNase-1, endonuclease-G, endonuclease activity and thrombin-antithrombin III (TAT) complex levels was quantified...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399516/below-knee-deep-vein-thrombosis-dvt-diagnostic-and-treatment-patterns
#20
Drew Fleck, Hassan Albadawi, Alex Wallace, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Background: Guidelines are lacking for isolated below-knee deep vein thrombosis (BKDVT). The American College of Chest Physicians (ACCP) suggests anticoagulation only if symptoms are severe, otherwise surveillance with follow-up ultrasound in 2 weeks is recommended. Yet clinical practice remains highly variable. Little is known about the natural history of BKDVT and how to best manage these patients. Methods: A retrospective analysis was conducted of medical records from 2014-2016...
December 2017: Cardiovascular Diagnosis and Therapy
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