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https://www.readbyqxmd.com/read/28431651/modified-inside-out-technique-for-continued-use-of-chronically-occluded-upper-central-veins
#1
Adnan Hadziomerovic, Zameer Hirji, Niamh Coffey
This report describes a 2-step, inside-out procedure for upper body central venous access in patients with chronic central venous occlusions. Blunt cephalad dissection through the mediastinum was achieved with a curved metal cannula and guide wire followed by percutaneous puncture of an open snare from a right supraclavicular approach and dilation of the tract for a tunneled central venous catheter insertion. Of 9 patients, all had a successful placement of a tunneled central venous catheter using this method...
May 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28430292/failure-of-the-vascular-hypothesis-of-multiple-sclerosis-in-a-rat-model-of-chronic-cerebrospinal-venous-insufficiency
#2
Maha M A Zakaria, Shahira Y Mikhael, Azza K Abu Hussein, Rania A Salah El-Din, Hany W Abd El-Malak, Iman H Hewedi, Hany S Nadim
<i>Chronic cerebrospinal venous insufficiency (CCSVI) is a series of stenotic malformations in the cerebrospinal venous outflow routes, which is postulated to cause multiple sclerosis (MS). The hypotheses assumed that CCSVI leads to iron deposition which triggers inflammation and demyelination in MS. Invasive endovascular treatment of CCSVI was initiated based on the previous theory. The present study was designed to validate this hypothesis using a rat model of CCSVI. Bilateral jugular vein ligation (JVL) was performed on female albino rats (n = 15), and sham-operated rats (n = 15) were used as a control group...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28424334/glycosaminoglycan-based-hydrogels-capture-inflammatory-chemokines-and-rescue-defective-wound-healing-in-mice
#3
Nadine Lohmann, Lucas Schirmer, Passant Atallah, Elke Wandel, Ruben A Ferrer, Carsten Werner, Jan C Simon, Sandra Franz, Uwe Freudenberg
Excessive production of inflammatory chemokines can cause chronic inflammation and thus impair cutaneous wound healing. Capturing chemokine signals using wound dressing materials may offer powerful new treatment modalities for chronic wounds. Here, a modular hydrogel based on end-functionalized star-shaped polyethylene glycol (starPEG) and derivatives of the glycosaminoglycan (GAG) heparin was customized for maximal chemokine sequestration. The material is shown to effectively scavenge the inflammatory chemokines MCP-1 (monocyte chemoattractant protein-1), IL-8 (interleukin-8), and MIP-1α (macrophage inflammatory protein-1α) and MIP-1β (macrophage inflammatory protein-1β) in wound fluids from patients suffering from chronic venous leg ulcers and to reduce the migratory activity of human monocytes and polymorphonuclear neutrophils...
April 19, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28423063/vitamin-d-status-and-its-association-with-insulin-resistance-among-type-2-diabetics-a-case-control-study-in-ghana
#4
Linda Ahenkorah Fondjo, William K B A Owiredu, Samuel Asamoah Sakyi, Edwin Ferguson Laing, Michael Acquaye Adotey-Kwofie, Enoch Odame Antoh, Eric Detoh
BACKGROUND: Vitamin D plays a major role in physiological processes that modulate mineral metabolism and immune function with probable link to several chronic and infectious conditions. Emerging data suggests a possible influence of vitamin D on glucose homeostasis. This study sought to provide preliminary information on vitamin D status among Ghanaian type 2 diabetics and assessed its association with glucose homeostasis. METHODS: In a case control study, 118 clinically diagnosed Type 2 Diabetes Mellitus (T2DM) patients attending Diabetic Clinic at the Nkawie Government Hospital were enrolled between October and December 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28421746/multifunctional-enzymatically-generated-hydrogels-for-chronic-wound-application
#5
Ivaylo Stefanov, Sílvia Pérez-Rafael, Javier Hoyo, Jonathan Cailloux, Orlando O Santana Perez, Dolores Hinojosa-Caballero, Tzanko Tzanov
The healing of chronic wounds requires intensive medical intervention at huge healthcare costs. Dressing materials should consider the multifactorial nature of these wounds comprising deleterious proteolytic and oxidative enzymes, and high bacterial load. In this work, multifunctional hydrogels for chronic wound application were produced by enzymatic crosslinking of thiolated chitosan and gallic acid. The hydrogels combine several beneficial to wound healing properties, controlling the matrix metalloproteinases (MMPs) and myeloperoxidase (MPO) activities, oxidative stress and bacterial contamination...
April 19, 2017: Biomacromolecules
https://www.readbyqxmd.com/read/28420633/fibrin-sheath-associated-endovascular-infection-of-the-heart-the-trojan-horse-of-indwelling-central-venous-catheters
#6
Muhammad Adil Sheikh, Mohamed Shokr, Walid Ibrahim, Shaun Cardozo
Chronic indwelling central venous catheters can result in formation of fibrin sheaths increasing risk of occlusion, thrombosis and infection. Endovascular infection of right-sided heart structures induced by such sheaths is very rare. A 48-year-old woman with end-stage renal disease initially treated for diabetic ketoacidosis developed persistent Staphylococcus epidermidis bacteraemia without an identifiable source. Although transthoracic echocardiography was unremarkable, transoesophageal echocardiography revealed a fibrin sheath and vegetations in superior vena cava-right atrium junction, which was the site of the tip of a central catheter that had been removed 2 months prior, consistent with fibrin sheath-associated endovascular infection...
April 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28418265/global-health-resource-utilization-associated-with-pacemaker-complications
#7
Catherine Waweru, Anna Steenrod, Claudia Wolff, Simon Eggington, David Jay Wright, Kathleen W Wyrwich
AIM: To estimate health resource utilization (HRU) associated with the management of pacemaker complications in various healthcare systems. METHODS: Electrophysiologists (EPs) from four geographical regions (Western Europe, Australia, Japan, and North America) were invited to participate. Survey questions focused on HRU in the management of three chronic pacemaker complications (i.e., pacemaker infections requiring extraction, lead fractures/insulation breaches requiring replacement, and upper extremity deep venous thrombosis [DVT])...
April 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28414672/a-strong-and-fortuitous-case-of-dyspnea
#8
R Hammer, M Sciaudone
CASE: A 48 year-old man with no past medical history was sent to our emergency department (ED); from a primary care clinic for hypertensive urgency of 200/130. The man reported an intermittent non-productive cough of approximately one year's duration and worsening dyspnea on exertion and orthopnea over the last month with lower extremity swelling. Of note, he emigrated from Honduras twenty years ago. Blood pressure normalized with administration of Lasix in the ED. Physical exam revealed rales in lung bases bilaterally, jugular venous distension, lower extremity pitting edema with serpiginous patches of erythema and excoriation, and a cardiac gallop...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414670/diulafoy-s-lesion-an-uncanny-etiology-of-gastrointestinal-bleed
#9
V Gasia, O Lamendola
INTRODUCTION: Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2 percent of acute gastrointestinal (GI); bleeding. CASE: A 99-year-old woman was initially admitted due to left lower extremity cellulitis related to chronic venous stasis ulcer and was receiving broad-spectrum IV antibiotics. Upon admission to the medical floor, she had an episode of hematemesis and multiple bowel movements with black-tarry stools...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413775/an-interesting-case-of-mycoplasma-pneumonia-associated-multisystem-involvement-and-diffuse-alveolar-hemorrhage
#10
Rashmi Mishra, Edison Cano, Sindhaghatta Venkatram, Gilda Diaz-Fuentes
Severe mycoplasma pneumonia is a rare entity with only 0.5-2% of cases having a fulminant course. We present a 74-year-old woman with hypertension, diabetes mellitus and remote history of marginal zone B-cell lymphoma admitted with abdominal pain and diarrhea of 1-2 days associated with body-aches, dyspnea, dry cough and weight loss for 2-3 weeks. On physical exam, she was febrile, tachypneic, tachycardic and hypoxic on room air. Chest examination revealed diffuse crackles and end-expiratory wheezes. Laboratory tests showed anemia, acute-on-chronic kidney injury and hyaline casts and epithelial cells in the urine analysis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28413581/robotic-assisted-inferior-vena-cava-filter-retrieval
#11
Shahin Owji, Tony Lu, Thomas M Loh, Adeline Schwein, Alan B Lumsden, Jean Bismuth
Although anticoagulation remains the mainstay of therapy for patients with venous thromboembolism, guidelines recommend the use of inferior vena cava (IVC) filters in those who fail anticoagulation or have contraindications to its use. Short-term use of filters has proven effective in reducing the rate of pulmonary embolism. However, their extended use is associated with a variety of complications such as thrombosis, filter migration, or caval perforation, thus making a case for timely filter retrieval. This is the case of a 68-year-old female with a history of chronic oral anticoagulation use for multiple deep venous thrombi (DVT) and pulmonary emboli (PE) who required cervical and thoracic spinal intervention for spondylosis and foramina stenosis...
January 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28413031/matrix-metalloproteinases-in-remodeling-of-lower-extremity-veins-and-chronic-venous-disease
#12
Yunfei Chen, Wei Peng, Joseph D Raffetto, Raouf A Khalil
The veins of the lower extremity are equipped with efficient wall, contractile vascular smooth muscle (VSM), and competent valves in order to withstand the high venous hydrostatic pressure in the lower limb and allow unidirectional movement of deoxygenated blood toward the heart. The vein wall structure and function are in part regulated by matrix metalloproteinases (MMPs). MMPs are zinc-dependent endopeptidases that are secreted as inactive pro-MMPs by different cells in the venous wall including fibroblasts, VSM, and leukocytes...
2017: Progress in Molecular Biology and Translational Science
https://www.readbyqxmd.com/read/28411864/extended-anticoagulation-in-venous-thromboembolism-disease-in-favour
#13
M C Fernández Capitan
Venous thromboembolism disease can be considered a chronic disease because, after the first episode, there is a life-long risk of recurrence. Recurrence is a severe complication. Anticoagulation is effective while it is maintained, but when it is discontinued, the risk of new thrombotic events persists indefinitely. Clinical practice guidelines offer specific recommendations on the treatment duration for patients with provoked or recurrent disease but are not specific for those with a first unprovoked episode...
April 12, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28411715/proposal-for-a-national-coverage-determination-for-the-treatment-of-varicose-veins-and-venous-disease-due-to-disparate-centers-for-medicare-and-medicaid-services-local-coverage-determination-policies
#14
Harold J Welch, Lowell Kabnick, Michael A Vasquez, Daniel L Monahan, Fedor Lurie, Glenn Jacobowicz
Varicose veins and chronic venous disease are common problems in the United States. Persons with these conditions often have an adversely affected quality of life. There are a number of proven interventions to treat varicose veins and to improve patients' life quality, but these interventions are often restricted by the Centers for Medicare and Medicaid Services and private third-party payers. The Centers for Medicare and Medicaid Services have private contractors that administer Medicare policies in 10 jurisdictions across the United States...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28411711/an-update-on-the-currently-available-nonthermal-ablative-options-in-the-management-of-superficial-venous-disease
#15
REVIEW
Nathan W Kugler, Kellie R Brown
BACKGROUND: Chronic venous insufficiency affects millions of Americans with symptoms spanning a broad range. Saphenous incompetence resulting in chronic reflux is at the root of most disease and is amenable to surgical correction. METHODS: We conducted a systematic review of the literature on nonthermal ablative techniques using a MEDLINE (Ovid) search from January 2000 to August 2016. Only prospective studies and literature review articles in the English language were included for final analysis...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28411709/chronic-refractory-venous-ulcer-exacerbated-by-a-congenital-pelvic-arteriovenous-malformation-successfully-treated-by-transarterial-onyx-embolization
#16
Naiem Nassiri, Dustin T Crystal, Catherine Hoyt, Randy Shafritz
Congenital arteriovenous malformations (AVMs) are an important but often neglected cause of lower extremity venous hypertension. A case of a chronic refractory venous stasis ulcer of the lower extremity exacerbated by a pelvic AVM is presented. Healing of the ulcer was achieved at 2 months without recurrence at 1 year after superselective ethylene vinyl alcohol copolymer (Onyx 34; ev3, Covidien, Plymouth, Minn) embolization of the AVM nidus. Chronic venous arterialization should be considered in cases of refractory, nonhealing venous ulcers...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28411707/the-evidence-supporting-treatment-of-reflux-and-obstruction-in-chronic-venous-disease
#17
REVIEW
Neil M Khilnani, Mark H Meissner, Suresh Vedanatham, Gregory Piazza, Suman M Wasen, Sean Lyden, Marlin Schul, Joshua A Beckman
On July 20, 2016, a Medicare Evidence Development and Coverage Advisory Committee panel convened to assess the evidence supporting treatment of chronic venous disease. Several societies addressed the questions posed to the panel. A multidisciplinary coalition, representing nine societies of venous specialists, reviewed the literature and presented a consensus opinion regarding the panel questions. The purpose of this paper is to present our coalition's consensus review of the literature and recommendations for chronic venous disease...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28411706/report-of-the-society-for-vascular-surgery-and-the-american-venous-forum-on-the-july-20-2016-meeting-of-the-medicare-evidence-development-and-coverage-advisory-committee-panel-on-lower-extremity-chronic-venous-disease
#18
Peter Gloviczki, Michael C Dalsing, Peter Henke, Brajesh K Lal, Thomas F O'Donnell, Cynthia K Shortell, Ying Huang, Jovan Markovic, Thomas W Wakefield
On July 20, 2016, a Medicare Evidence Development and Coverage Advisory Committee panel assessed the benefits and risks of currently used lower extremity chronic venous disease (CVD) treatments and their effects on health outcome of the American adult population. The main purpose of the meeting was to advise the Centers for Medicare & Medicaid Services on coverage determination for interventions used for treatment of CVD. A systematic review of the Agency for Healthcare Research and Quality was presented, followed by lectures of invited experts and a public hearing of representatives of professional societies and the industry...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28411703/a-novel-duplex-finding-of-superficial-epigastric-vein-flow-reversal-to-diagnose-iliocaval-occlusion
#19
Raghu Kolluri, Brian Fowler, Gary Ansel, Mitchell Silver
OBJECTIVE: Although duplex ultrasound (DUS) imaging is the current gold standard in the diagnosis of femoropopliteal deep venous thrombosis, it is not an optimal diagnostic modality to diagnose iliocaval occlusion. Screening for iliocaval occlusion thus remains a challenge for clinicians because of the lack of a reliable noninvasive technique. This challenge results in most patients undergoing computed tomography venography or magnetic resonance venography or invasive venography and intravascular ultrasound imaging...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28411701/lack-of-symmetry-in-the-major-lower-limb-veins
#20
Anirudh Chandrashekar, Antonios Gasparis, Nicos Labropoulos
BACKGROUND: Contemporary texts frequently present the venous system of the lower limb as a prime example of bilateral symmetry. However, overt bilateral asymmetry may be noted. This study was designed to examine and to quantify the level of symmetry in the lower extremity veins. METHODS: This prospective cohort study evaluated major anatomic differences between right and left lower extremity veins in adult patients. Two hundred patients presenting with signs and symptoms of chronic venous disease (CVD; class 2-6) and venous reflux on duplex ultrasound were examined...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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