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Direct flow Medical

Xiao Huang, Qian-Xi Wang, A-Man Zhang, Jian Su
Acoustic bubbles have wide and important applications in ultrasonic cleaning, sonochemistry and medical ultrasonics. A two-microbubble system (TMS) under ultrasonic wave excitation is explored in the present study, by using the boundary element method (BEM) based on the potential flow theory. A parametric study of the behaviour of a TMS has been carried out in terms of the amplitude and direction of ultrasound as well as the sizes and separation distance of the two bubbles. Three regimes of the dynamic behaviour of the TMS have been identified in terms of the pressure amplitude of the ultrasonic wave...
May 2018: Ultrasonics Sonochemistry
Edmund Burke, Sanjeev A Datar
PURPOSE OF REVIEW: The essential role of the lymphatic system in fluid homeostasis, nutrient transport, and immune trafficking is well recognized; however, there is limited understanding of the mechanisms that regulate lymphatic function, particularly in the setting of critical illness. The lymphatics likely affect disease severity and progression in every condition, from severe systemic inflammatory states to respiratory failure. Here, we review structural and functional disorders of the lymphatic system, both congenital and acquired, as they relate to care of the pediatric patient in the intensive care setting, including novel areas of research into medical and procedural therapeutic interventions...
March 13, 2018: Current Opinion in Pediatrics
Jeffrey L Jarvis, John Gonzales, Danny Johns, Lauren Sager
STUDY OBJECTIVE: Peri-intubation hypoxia is an important adverse event of out-of-hospital rapid sequence intubation. The aim of this project is to determine whether a clinical bundle encompassing positioning, apneic oxygenation, delayed sequence intubation, and goal-directed preoxygenation is associated with decreased peri-intubation hypoxia compared with standard out-of-hospital rapid sequence intubation. METHODS: We conducted a retrospective, before-after study using data from a suburban emergency medical services (EMS) system in central Texas...
March 9, 2018: Annals of Emergency Medicine
Tigran Khachatryan, Marina Khachatryan, Ruben Fanarjyan, Mikayel Grigoryan, Arthur Grigorian
Background: Currently, transsphenoidal surgery (TSS) is the preferred method for surgical treatment of intrasellar pituitary adenomas. However, it carries some risk of intraoperative arterial injuries, which is mainly attributed to direct iatrogenic rupture of the internal carotid artery (ICA). There is anecdotal evidence suggesting that intracranial aneurysms are coincidentally found significantly more frequently in the setting of pituitary adenomas than when the incidence is compared to other intracranial neoplasms...
2018: Surgical Neurology International
Tingting Zhang, Rihui Li, Thomas Potter, Jin Keun Seo, Guanglin Li, Yingchun Zhang
Electrical properties of human tissues are usually linked with structure of thin insulating membranes and thereby reflect physiological function of the tissues or organs. It is clinically important to characterize electrical properties of tissues in vivo. Electrical impedance tomography (EIT) is a recently developed medical imaging technique which has been exploited to characterize electrical properties (conductivity and permittivity) of human tissues by injecting currents and measuring the resulting voltages at boundary electrodes...
March 8, 2018: International Journal for Numerical Methods in Biomedical Engineering
Gulraiz Chaudry, Anna P Lillis, Raja Shaikh, Horacio M Padua, Rush H Chewning, Ahmad I Alomari
PURPOSE: To characterize anatomy of congenital arterioportal fistulas (CAPF) and correlate this with technique and outcomes of transcatheter embolization (TCE). MATERIALS AND METHODS: Retrospective review was conducted of children with CAPF that underwent TCE in a 10-year period. Medical records, imaging and procedure details were reviewed. TCE was performed via transarterial (n = 5), portal (n = 5) or patent ductus venosus (n = 1) approach. Embolic agents used were coils (n = 10), Onyx (n = 1) and Amplatzer septal occluder (n = 1)...
March 6, 2018: Cardiovascular and Interventional Radiology
Andreas Hjelm Brandt
This PhD project is based on a longstanding collaboration between physicists and engineers from the Center of Fast Ultrasound Imaging (CFU) at the Technical University of Denmark and medical doctors from the department of Radiology at Rigshospitalet. The intent of this cooperation is to validate new ultrasonic methods for future clinical use. 
Study I compares two B-mode ultrasound methods: the new experimental technique Synthetic Aperture Sequential Beam-forming combined with Tissue Harmonic Imaging (SASB-THI), and a conventional technique combined with THI...
March 2018: Danish Medical Journal
Jian Luo, Ling Yang, Jing Yang, Dan Yang, Bi-Cui Liu, Dan Liu, Bin-Miao Liang, Chun-Tao Liu
Phosphodiesterase 4 (PDE4) inhibitors are a novel medication approved for airway inflammatory diseases including chronic obstructive pulmonary disease. Their role and application in asthma are controversial and not defined. A comprehensive search was performed in major databases (1946-2016) using the keywords: 'phosphodiesterase 4 inhibitor' or 'roflumilast' and 'asthma'. Placebo-controlled trials reporting lung function, airway hyperresponsiveness by direct challenge, asthma control and exacerbations, and adverse events were included...
March 4, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Isabel Cuesta-López, Marina Sánchez-Cuervo, Ángel Candela-Toha, Juana Benedí-González, Teresa Bermejo-Vicedo
OBJECTIVE: To evaluate the efficiency of the protocolization and centralization of  the preparation of intravenous vasoactive drug mixtures in the treatment of  critically ill patients. METHOD: A prospective interventional study (July 2012-December 2014) was  conducted to measure the impact of different vasoactive drug protocols on costs  in the treatment of critically ill patients. The economic impact was measured by  comparing the direct costs (fixed and variable) of the preparation of intravenous  vasoactive drug mixtures in the Pharmacy Department with their traditional  preparation in hospital care units...
March 1, 2018: Farmacia Hospitalaria
Andrea Fanelli, Rohan Jaishankar, Aristotelis Filippidis, James Holsapple, Thomas Heldt
OBJECTIVES:  Our objective was to develop, deploy, and test a data-acquisition system for the reliable and robust archiving of high-resolution physiological waveform data from a variety of bedside monitoring devices, including the GE Solar 8000i patient monitor, and for the logging of ancillary clinical and demographic information. MATERIALS AND METHODS:  The data-acquisition system consists of a computer-based archiving unit and a GE Tram Rac 4A that connects to the GE Solar 8000i monitor...
2018: Acta Neurochirurgica. Supplement
Ke Wang, Bryan Kestenbaum
The secretion of small molecules by the proximal tubules of the kidneys represents a vital homeostatic function for rapidly clearing endogenous solutes and medications from the circulation. After filtration at the glomerulus, renal blood flow is directed through a network of peritubular capillaries, where transporters of the proximal tubules actively secrete putative uremic toxins and hundreds of commonly prescribed drugs into the urine, including protein-bound substances that cannot readily cross the glomerular basement membrane...
February 28, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Lei Bao, Vamsi Spandan, Yantao Yang, Brendan Dyett, Roberto Verzicco, Detlef Lohse, Xuehua Zhang
The dissolution of liquid nanodroplets is a crucial step in many applied processes, such as separation and dispersion in the food industry, crystal formation of pharmaceutical products, concentrating and analysis in medical diagnosis, and drug delivery in aerosols. In this work, using both experiments and numerical simulations, we quantitatively study the dissolution dynamics of femtoliter surface droplets in a highly ordered array under a uniform flow. Our results show that the dissolution of femtoliter droplets strongly depends on their spatial positions relative to the flow direction, drop-to-drop spacing in the array, and the imposed flow rate...
February 28, 2018: Lab on a Chip
Santosh Kumar Sinha, Anupam Mahrotra, Nishant Kumar Abhishekh, Mahmodula Razi, Puneet Aggarwal, Sunil Tripathi, Lokendra Rekwaal, Anupam Singh
A 72-year-old male with diabetes and smoking as coronary risk factors was evaluated for chronic stable angina - Canadian Cardiovascular Society III - despite guideline directed medical treatment which revealed a diffuse, tortuous, calcified narrowing (90% stenosis) in left circumflex (LCx) coronary artery. After predilatation, a 3.0 - 2.5 × 60 mm BioMime Morph stent - long tapering stent (Sirolimus eluting stent, Meril life Sciences, India) - was tracked which failed and dislodged to right deep femoral artery during its pullback...
February 2018: Cardiology Research
Megumi Honjo, Hidenobu Tanihara
Rho-associated protein kinase (ROCK), a ubiquitously expressed signaling messenger and downstream effector of Rho, is activated by several bioactive factors in the aqueous humor (AH). Rho-ROCK signaling regulates a wide spectrum of fundamental cellular events, including cell adhesion, motility, proliferation, differentiation, and apoptosis. Previous studies, including our own, found that ROCK inhibitor lowers intraocular pressure (IOP) via a direct effect on the conventional AH outflow pathway, by regulation of contractile properties, fibrotic activity, and permeability of the trabecular meshwork (TM) and Schlemm's canal (SC) tissues, influencing extracellular matrix (ECM) production...
February 14, 2018: Japanese Journal of Ophthalmology
Lucia Rivera-Lara, Andres Zorrilla-Vaca, Ryan J Healy, Wendy Ziai, Charles Hogue, Romergryko Geocadin, Batya Radzik, Caitlin Palmisano, Marek A Mirski
OBJECTIVE: Critical care guidelines recommend a single target value for mean arterial blood pressure in critically ill patients. However, growing evidence regarding cerebral autoregulation challenges this concept and supports individualizing mean arterial blood pressure targets to prevent brain and kidney hypo- or hyperperfusion. Regional cerebral oxygen saturation derived from near-infrared spectroscopy is an acceptable surrogate for cerebral blood flow and has been validated to measure cerebral autoregulation...
February 6, 2018: Critical Care Medicine
Jake X Checketts, Mathew T Sims, Byron Detweiler, Kevin Middlemist, Jaclyn Jones, Matt Vassar
BACKGROUND: The responsibility for ensuring that studies are adequately reported is primarily that of those conducting the study; however, journal policies may influence how thoroughly authors choose to report their research. The use of reporting guidelines and prospective trial registration are promising avenues for ensuring that published studies adhere to the highest methodological standards. The purpose of this study is to evaluate orthopaedic surgery journal policies regarding reporting guidelines and trial registration, and to evaluate the effects that these policies have on adherence to reporting...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
Sajid A Shaikh, Richard D Robinson, Radhika Cheeti, Shyamanand Rath, Chad D Cowden, Frank Rosinia, Nestor R Zenarosa, Hao Wang
BACKGROUND: Prolonged hospital discharge boarding can impact patient flow resulting in upstream Emergency Department crowding. We aim to determine the risks predicting prolonged hospital discharge boarding and their direct and indirect effects on patient flow. METHODS: Retrospective review of a single hospital discharge database was conducted. Variables including type of disposition, disposition boarding time, case management consultation, discharge medications prescriptions, severity of illness, and patient homeless status were analyzed in a multivariate logistic regression model...
January 30, 2018: BMC Health Services Research
Lingdan Chen, Hanwei Liu, Mingjie Yuan, Wenju Lu, Jian Wang, Tao Wang
In peripheral arterial disease (PAD) patients, occlusions in the major arteries that supply the leg makes blood flow dependent on the capacity of neovascularization. There is no current medication that is able to increase neovascularization to the ischemic limb and directly treat the primary problem of PAD. An increasing body of evidence supports the notion that inflammation plays an important role in the vascular remodeling and perfusion recovery after PAD. Interleukins, a group of proteins produced during inflammation, have been considered to be important for angiogenesis and arteriogenesis after tissue ischemia...
January 22, 2018: Bioscience Reports
K Vogt, G Bachmann-Harildstad, A Lintermann, A Nechyporenko, F Peters, K D Wernecke
The report reflects an agreement based on the consensus conference of the International Standardization Committee on the Objective Assessment of the Nasal Airway in Riga, 2nd Nov. 2016. The aim of the conference was to address the existing nasal airway function tests and to take into account physical, mathematical and technical correctness as a base of international standardization as well as the requirements of the Council Directive 93/42/EEC of 14 June 1993 concerning medical devices. Rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow, Odiosoft-Rhino, optical rhinometry, 24-h measurements, computational fluid dynamics, nasometry and the mirrow test were evaluated for important diagnostic criteria, which are the precision of the equipment including calibration and the software applied; validity with sensitivity, specificity, positive and negative predictive values, reliability with intra-individual and inter-individual reproducibility and responsiveness in clinical studies...
January 21, 2018: Rhinology
A Valero, A M Navarro, A Del Cuvillo, I Alobid, J R Benito, C Colás, G de Los Santos, R Fernández Liesa, A García-Lliberós, R González-Pérez, A Izquierdo-Domínguez, A Jurado-Ramos, M M Lluch-Bernal, J R Montserrat Gili, J Mullol, A Puiggròs Casas, M C Sánchez-Hernández, F Vega, J M Villacampa, M Armengot-Carceller, M T Dordal
Nasal obstruction (NO) is defined as the subjective perception of discomfort or difficulty in the passage of air through the nostrils. It is a common reason for consultation in primary and specialized care, and it may affect up to 30-40% of the population. It affects the quality of life (it especially disturbs sleep) and lowers work efficiency. The aim of this document is to agree on how to treat NO, establish a methodology for evaluating and diagnosing it, and define an individualized approach to its treatment...
January 18, 2018: Journal of Investigational Allergology & Clinical Immunology
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