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Direct flow Medical

Lucas Brien Chartier, Licinia Simoes, Meredith Kuipers, Barb McGovern
Over the last decade, patient volumes in the emergency department (ED) have grown disproportionately compared to the increase in staffing and resources at the Toronto Western Hospital, an academic tertiary care centre in Toronto, Canada. The resultant congestion has spilled over to the ED waiting room, where medically undifferentiated and potentially unstable patients must wait until a bed becomes available. The aim of this quality improvement project was to decrease the 90th percentile of wait time between triage and bed assignment (time-to-bed) by half, from 120 to 60 minutes, for our highest acuity patients...
2016: BMJ Quality Improvement Reports
Shahbaz R Arain, Julie K Freed, Jutta Novalija, Paul S Pagel, Thomas J Ebert
OBJECTIVE: The mechanism of perioperative hypotension in patients taking an angiotensin-receptor blocker up to the time of surgery remains unclear. This study tested the hypothesis that short-term angiotensin-receptor blocker treatment attenuated the sympathetic and vascular responses to autonomic stimuli in volunteers undergoing anesthesia. DESIGN: Randomized, crossover, blinded, pilot design. SETTING: Zablocki Veterans Affairs Medical Center, Milwaukee, WI...
August 11, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Leise Riber, Mette Burmølle, Martin Alm, Stefan M Milani, Peter Thomsen, Lars H Hansen, Søren J Sørensen
The spread of antimicrobial resistance, usually mediated by horizontal transfer of plasmids, limits the options of treating bacterial infections and thereby poses a crucial human health problem. The disturbance of plasmid stability within bacterial species in clinical environments serves as a novel strategy to reduce the development and dissemination of antibiotic resistance. We tested the ability of irgasan to destabilize plasmids from Escherichia coli K-12 cells when added directly into liquid growth medium at concentrations below levels of marked bacterial growth inhibition, or when released into liquid growth medium from irgasan-impregnated Interpenetrating Polymer Network (IPN) silicone hydrogel objects, a novel technology developed as drug-delivery platform...
October 12, 2016: Plasmid
Stephan Kische, Giuseppe D'Ancona, Hüseyin U Agma, Gihan El-Achkar, Martin Dißmann, Jasmin Ortak, Hüseyin Ince
OBJECTIVES: To analyze our single center experience with the Direct Flow Medical (DFM). BACKGROUND: The DFM has been recently introduced to the market and large real world experiences are lacking. METHODS: A total of 126 patients with severe aortic valve stenosis (AVS) were treated by the same team from March 2013 to May 2015. Device success and procedural safety were classified, according to valve academic research consortium (VARC) criteria, for the entire cohort, including patients treated in the early phases of our learning curve...
October 14, 2016: Catheterization and Cardiovascular Interventions
Giuseppe D'Ancona, Hüseyin U Agma, Hüseyin Ince, Gihan El-Achkar, Martin Dißmann, Jasmin Ortak, Stephan Kische
OBJECTIVES: We present our single center experience with the direct flow medical (DFM) prosthesis addressing the impact of native aortic valve (AV) calcification degree on outcomes. BACKGROUND: The DFM® has been introduced for transcatheter aortic valve implantation (TAVI). The valve has a nonmetallic and inflatable support structure. METHODS: Patients were divided in two groups according to preoperative cardiac computed tomography (CT): group I moderate calcification and group II heavy calcification of the total AV area...
October 14, 2016: Catheterization and Cardiovascular Interventions
Kirstin Borgerson
The volume of clinical research is increasing exponentially-far beyond our ability to process and absorb the results. Given this situation, it may be beneficial to consider reducing the flow at its source. In what follows, I will motivate and critically evaluate the following proposal: researchers should conduct fewer clinical trials. More specifically, I consider whether researchers should be permitted to conduct only clinical research of very high quality and, in turn, whether research ethics committees (RECs) should prohibit all other, lower-quality research, even when it might appear to meet some minimal ethical standard...
October 6, 2016: Hastings Center Report
Martin Lombardero, Ruth Henquin, Gabriel Perea, Mariana Corneli, Carlos Izurieta
INTRODUCTION: Quantification of mitral regurgitation (MR) by two-dimensional (2D) transthoracic echocardiography (TTE) is based on the analysis of the proximal flow convergence (PFC) and the "vena contracta" (VC). This method assumes geometries and can be misleading. In contrast, three-dimensional (3D) echocardiography directly measures flow volumes and does not assume geometries, which allows for more accurate MR evaluation. AIMS: To report the 3D transesophageal echocardiography (3DTEE) feasibility for MR quantification and evaluate its concordance with 2D echo...
October 4, 2016: Echocardiography
Jesús Romero-Maroto, Lidia Verdú-Verdú, Luis Gómez-Pérez, Carla Pérez-Tomás, Juan-José Pacheco-Bru, Ana López-López
BACKGROUND: Female urethral stricture is a rare condition. Different types of urethroplasty have been described. However, high quality studies are sparse. The most common technique used-the Blandy's technique-has resulted in our cases in a retrusive meatus and an inward urinary stream. OBJECTIVE: To show the efficacy and safety of an alternative vaginal wall flap urethroplasty. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional observational study was undertaken in a single University Hospital...
September 27, 2016: European Urology
Chongming Jiang, Chunyan Cui, Weirong Zhong, Gang Li, Li Li, Yuanzhi Shao
We study in silico the influence of host tissue inhomogeneity on tumor cell proliferation and diffusion by simulating the mobility of a tumor on percolation clusters with different homogeneities of surrounding tissues. The proliferation and diffusion of a tumor in an inhomogeneous tissue could be characterized in the framework of the percolation theory, which displays similar thresholds (0.54, 0.44, and 0.37, respectively) for tumor proliferation and diffusion in three kinds of lattices with 4, 6, and 8 connecting near neighbors...
October 2016: Journal of Biological Physics
Hassan Kamran, Vijay Nambi, Smita Negi, Eric Y Yang, Changyi Chen, Salim S Virani, Panos Kougias, Alan B Lumsden, Joel D Morrisett, Christie M Ballantyne, Gerd Brunner
The relation between the arterial and venous systems in patients with impaired lower extremity blood flow remains poorly described. The objective of this secondary analysis of the Effectiveness of Intensive Lipid Modification Medication in Preventing the Progression on Peripheral Artery Disease Trial was to determine the association between femoral vein (FV) volumes and measurements of peripheral artery disease. FV wall, lumen, and total volumes were quantified with fast spin-echo proton density-weighted magnetic resonance imaging scans in 79 patients with peripheral artery disease over 2 years...
August 13, 2016: American Journal of Cardiology
David Eisenbrey, Arthur B Eisenbrey, Patrick Pettengill
Endotracheal tubes are intended to protect the airway and assist with mechanical ventilation in sedated patients. The blood vessels of the tracheal mucosa can be compressed by high tracheal tube cuff pressures (> 30 cm H2O), leading to reduced mucosal blood flow with resulting ischemia and morbidity. Previous research showed a direct correlation between aircraft pressure altitude and the pressure reading from the tracheal cuff, with resulting pressures > 80 cm H2O at 10,000 ft. Standard practice is to periodically remove air from the cuff during ascent based on assumed increased pressure on the adjacent tracheal mucosa...
September 2016: Air Medical Journal
Zhenyu Chen, Ju Li, Jian Shen, Jiaxi Jin, Wei Zhang, Wan Zhong
OBJECTIVE: To evaluate direct puncture embolization of the internal iliac artery with hemostatic gelatin sponge particles to treat pernicious placenta previa coexisting with placenta accreta during cesarean delivery. METHODS: A retrospective study was conducted of data from women with pernicious placenta previa and placenta accreta who underwent direct puncture embolization of the internal iliac artery during cesarean delivery at a center in China between September 1, 2013, and February 28, 2015...
August 21, 2016: International Journal of Gynaecology and Obstetrics
Frank Braun, Sebastian Schwolow, Julia Seltenreich, Norbert Kockmann, Thorsten Röder, Norbert Gretz, Matthias Rädle
In process analytics, the applicability of Raman spectroscopy is restricted by high excitation intensities or the long integration times required. In this work, a novel Raman system was developed to minimize photon flux losses. It allows specific reduction of spectral resolution to enable the use of Raman spectroscopy for real-time analytics when strongly increased sensitivity is required. The performance potential of the optical setup was demonstrated in two exemplary applications: First, a fast exothermic reaction (Michael addition) was monitored with backscattering fiber optics under strongly attenuated laser power (7 mW)...
October 4, 2016: Analytical Chemistry
Hasan Bushnaq, Dietrich Metz, Asen Petrov, Stefan Frantz, Ulrich Hofmann, Christoph Raspé, Hendrik Treede
OBJECTIVE: The standard procedure of transcatheter aortic valve implantation involves transfemoral access. Nevertheless, the use of this access route is limited by the vessel diameter, calcification, and tortuosity, making a subgroup of patients ineligible for peripheral access. We report the first use of direct aortic transcatheter aortic valve implantation with the Direct Flow Medical valve (Direct Flow Medical, Inc, Santa Rosa, Calif) in 15 patients at the Halle-Wittenberg University...
August 12, 2016: Journal of Thoracic and Cardiovascular Surgery
S Carinelli, C Xufré, S Alegret, M Martí, M I Pividori
The Acquired Immune Deficiency Syndrome (AIDS) affects the life of millions of people around the world. Although rapid and low cost screening tests are widely available for the diagnosis of HIV infection, the count of CD4+ T lymphocytes remains a drawback in the areas mostly affected by the HIV, being this control imperative for assessing the deterioration of the immunological system and the progression towards AIDS, when the counting of cells falls down 200cellsμL(-1). This paper describes a high-throughput, simple and rapid method for CD4+ T lymphocytes quantification, directly in whole blood, based on a magneto ELISA...
November 1, 2016: Talanta
Jianjian Wei, Yuguo Li
BACKGROUND: Since the 2003 severe acute respiratory syndrome epidemic, scientific exploration of infection control is no longer restricted to microbiologists or medical scientists. Many studies have reported on the release, transport, and exposure of expiratory droplets because of respiratory activities. This review focuses on the airborne spread of infectious agents from mucus to mucus in the indoor environment and their spread as governed by airflows in the respiratory system, around people, and in buildings at different transport stages...
September 2, 2016: American Journal of Infection Control
Hirofumi Maeba, Takeshi Seno, Ichiro Shiojima
A 22-year-old male was admitted to our hospital with deep vein thrombosis that was complicated by antithrombin deficiency. This deficiency was refractory to anticoagulation therapy. Although catheter-directed thrombolysis could not reperfuse the total occlusion in the left deep vein, a combination of thrombectomy, catheter-directed thrombolysis, and antithrombin concentrate treatment was able to dissolve the clots and ameliorate the blood flow into the left deep vein. Antithrombin concentrate administration would be effective in the treatment of antithrombin deficiency with medical refractory deep vein thrombosis...
September 28, 2016: International Heart Journal
Vadim Krivitsky, Marina Zverzhinetsky, Fernando Patolsky
The detection of biomolecules is critical for a wide spectrum of applications in life sciences and medical diagnosis. Nonetheless, biosamples are highly complex solutions, which contain an enormous variety of biomolecules, cells, and chemical species. Consequently, the intrinsic chemical complexity of biosamples results in a significant analytical background noise and poses an immense challenge to any analytical measurement, especially when applied without prior efficient separation and purification steps. Here, we demonstrate the application of antigen-dissociation regime, from antibody-modified Si-nanowire sensors, as a simple and effective direct sensing mechanism of biomarkers of interest in complex biosamples, such as serum and untreated blood, which does not require ex situ time-consuming biosample manipulation steps, such as centrifugation, filtering, preconcentration, and desalting, thus overcoming the detrimental Debye screening limitation of nanowire-based biosensors...
October 12, 2016: Nano Letters
Kyung S Koh, Sung Woo Park, Tae Suk Oh, Jong Woo Choi
BACKGROUND: Flap survival is essential for the success of soft-tissue reconstruction. Accordingly, various surgical and medical methods aim to increase flap survival. Because flap survival is affected by the innate vascular supply, traditional preconditioning methods mainly target vasodilatation or vascular reorientation to increase blood flow to the tissue. External stress on the skin, such as an external volume expander or cupping, induces vascular remodeling, and these approaches have been used in the fat grafting field and in traditional Asian medicine...
August 2016: Journal of Surgical Research
Liuba Soldatova, Candace Hrelec, Laura Matrka
OBJECTIVE: To determine if the results of routine spirometry and flow volume loops (Pulmonary Function Tests (PFTs)) can be used to distinguish Paradoxic Vocal Fold Movement Disorder (PVFMD) from Subglottic Stenosis (SGS). METHODS: PFT records and medical history of 49 patients with diagnosis of PVFMD and 39 patients with SGS were compared. Groups were then subdivided to compare PFTs in patients with and without smoking history or lung disease. RESULTS: Peak expiratory flow rate (PEFR) and Expiratory Disproportion Index (ratio of forced expiratory volume in 1 second (FEV1) over PEFR (FEV1/PEFR)) were both significantly different between patients with SGS and those with PVFMD (p<0...
August 23, 2016: Annals of Otology, Rhinology, and Laryngology
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