Flex HD

INTRODUCTION: Routine hemodialysis depends on well-functioning vascular access. In the event of vascular access dysfunction, percutaneous transluminal balloon angioplasty (PTA) is conducted to restore patency. Although an angioplasty procedure can provide an excellent immediate result by opening the access to allow dialysis to continue, the long-term patency rates are less than satisfactory. The goal of this study was to assess the outcomes of patients who underwent a novel vessel preparation via longitudinal, controlled-depth micro-incisions prior to PTA...

BACKGROUND: Patients with chronic Chagas disease present marked clinical and immunological heterogeneity. During the disease, multiple immune mechanisms are activated to fight the parasite. The purpose of this study was to investigate the expression patterns of genes involved in relevant immunological processes throughout the disease in patients with chronic Chagas disease. METHODOLOGY/PRINCIPAL FINDINGS: High-throughput RT-qPCR with QuantStudio 12K Flex real-time PCR system was used to evaluate the expression of 106 immune-related genes in PBMC from a cohort of cardiac Chagas disease patients (CCC I), asymptomatic patients (IND) and healthy donors (HD) after being stimulated with T...

PURPOSE/OBJECTIVES: The aim of this study was to improve the accuracy of the clinical target volume (CTV) and organs at risk (OARs) segmentation for rectal cancer preoperative radiotherapy. MATERIALS/METHODS: Computed tomography (CT) scans from 265 rectal cancer patients treated at our institution were collected to train and validate automatic contouring models. The regions of CTV and OARs were delineated by experienced radiologists as the ground truth. We improved the conventional U-Net and proposed Flex U-Net, which used a register model to correct the noise caused by manual annotation, thus refining the performance of the automatic segmentation model...

PURPOSE: To assess how eye axes and multifocal intraocular lens (MIOL) centration may impact the light distortion index (LDI) and ocular scatter index (OSI). METHODS: Fifty-eight subjects implanted with the trifocal MIOL Q-Flex M 640PM or Liberty 677MY (Medicontur) were included in this retrospective analysis. The following variables were collected with the Pentacam Wave (Oculus) considering the vertex normal as the coordinates center: chord-mu to the center of the pupil, chord-alpha to the geometrical center of the cornea, and chord-MIOL to the center of the diffractive ring...

BACKGROUND: Early non-motor features including anxiety, depression and altered social cognition are present in Huntington's disease (HD). The underlying neurobiological mechanisms are not known. Oxytocin (OXT) is involved in the regulation of emotion, social cognition, and metabolism and our previous work showed that the OXT system is affected early in HD. The aim of the study was to investigate the potential causal relationship between the selective expression of mutant huntingtin (mHTT) in OXT neurons and the development of non-motor features and neuropathology...

Severe salicylate intoxication usually presents with a high anion gap metabolic acidosis. We describe a patient with severe salicylate intoxication who presented with a surprisingly normal anion gap metabolic acidosis. Initial salicylate level was 594 mg/L (therapeutic range 50-300 mg/L). In this case, the anion gap was normal due to a falsely elevated chloride concentration measured using a direct ion-selective electrode (ISE; ABL90-flex). Since earlier case reports have shown that salicylate ions can interfere with chloride measurement using different ISEs, available samples were reanalysed using an indirect ISE (Roche Cobas 8000), in which salicylate levels up to 1000 mg/L were found to cause no significant interference...

BACKGROUND: In this case report, we present two chronic hemodialysis patients with upper extremity swelling due to central venous occlusions together with their clinical presentation, surgical management and brief review of the literature. METHODS: The first patient who was a 63-year-old female patient with a history of multiple bilateral arteriovenous fistulas (AVFs) was referred to our clinic. Physical examination demonstrated a functioning right brachio-cephalic AVF, with severe edema of the right arm, dilated venous collaterals, facial edema, and unilateral breast enlargement...

Introduction: Office cystoscopy is one of the most frequently performed procedures by a urologist. However, single-use cystoscopes remain quite undeveloped. Ambu® has developed single-use broncoscopes, rhinolaryngoscopes, and duodenoscopes. Recently, they released a single-use cystoscope. In this study, we performed a benchtop and an initial clinical assessment of the Ambu aScope™ (4) Cysto (aS4C) single-use cystoscope. Materials and Methods: Ten new, never-used aS4C single-use cystoscopes were assessed for optical performance, maximal tip flexion, and irrigation flow rate with empty working channel, 365 μm laser fiber, 0...

INTRODUCTION AND IMPORTANCE: Edward's syndrome (ES) occurs as a result of trisomy of chromosome 18 and is associated with multisystem congenital anomalies. The association of ES with various gastrointestinal malformations but Hirschsprung disease (HD) is well documented. CASE PRESENTATION: A female infant on her 5th day of life presented with episodes of bilious vomiting along with abdominal distension and no passage of stool. The child had a small head and prominent occiput, low set abnormal ears, small jaw, upturned nose, widely spaced eyes, small neck with widely spaced nipples, clenched hands with overlapping fingers, flexed big toe, and prominent heels...

BACKGROUND: Hirayama disease (HD) is a rare focal amyotrophy, commonly reported in adolescent Asian males and characterized by unilateral or asymmetric distal upper extremity weakness. This disease exhibits an indolent course of progression over the initial 3 to 4 years; followed by a stage of stabilization. The diagnosis is confirmed by demonstration of enhanced posterior epidural space and dynamic spinal cord compression on cervical flexion magnetic resonance imaging (MRI). Diffusion tensor imaging (DTI) is a functional imaging modality, which can potentially be utilized in the diagnosis of HD...

INTRODUCTION: Nonantigen-specific immunoadsorption (IA) has proven to be effective in acute antibody-mediated rejection (aAMR). However, there is a lack of solid studies evaluating the safety and efficacy of IA with antihuman Ig-columns in aAMR. For chronic-active AMR (cAMR), no studies have evaluated the efficacy of nonantingen-specific IA with antihuman Ig-columns. The purpose of this study was to evaluate the role of nonantigen-specific IA with antihuman Ig-columns in the treatment of both aAMR and cAMR in kidney transplantation...

PURPOSE: Hirayama disease (HD) is a rare motor disorder mainly affecting young men, characterized by atrophy and unilateral weakness of forearm and hand muscles corresponding to a C7-T1 myotome distribution. The progression is self-limited. The etiology of HD is unclear. The usefulness of motor evoked potentials (MEPs) in pyramidal tracts damage evaluation still appears to be somehow equivocal. METHODS: We searched PubMed for original articles, evaluating the use of transcranial magnetic stimulation elicited MEPs in HD using keywords "motor evoked potentials Hirayama" and "transcranial magnetic stimulation Hirayama...

It is difficult to distinguish Hirayama disease (HD) from other mimicking disorders in adolescent patients with distal upper limb weakness. The prevailing theory of HD postulates that the lower cervical cord is susceptible to compression during neck flexion because of insufficient growth of the dura relative to the spinal column. Confirmation of a dynamic change in the dorsal epidural space on magnetic resonance imaging (MRI) during neck flexion is essential for diagnosing HD. However, neck flexion MRI has not been routinely performed in juvenile patients with distal upper limb weakness in the absence of suspected HD...

BACKGROUND: Transoral treatment of benign and malignant lesions of laryngopharynx has limitations in exposure and access, partially due to the endotracheal tube (ETT). With a proper airway control to tailor ventilation and maximize exposure, transoral Flex robotic surgery (FLEX), using its 3D camera and instruments, can expand its ability. Choosing the right ETT, including a novel concept of using jet ventilation (JV) in FLEX, and placement technique can allow augmentation of the advantages that robotic surgery offers...

BACKGROUND: Hirayama disease (HD), characterized by insidiously progressive muscular atrophy of forearms and hands, is a self-limited cervical myelopathy that predominantly affects male adolescents, with female patients, especially middle-aged women, rarely affected. We present a rare case of HD with severe spinal cord injury in a 34-year-old woman. CASE DESCRIPTION: A 34-year-old woman presented with progressive weakness of both hands and forearms for a duration of 6 years and spastic gait for 1 year...

BACKGROUND: In the bilateral Nordic hamstring exercise (NHE), hamstrings operate at relatively short lengths, which may limit the efficacy of the NHE in hamstring injury prevention. OBJECTIVES: To examine knee flexion torque and biceps femoris long head (BFLH) and semitendinosus (ST) high-density electromyography (EMG) activity during the unilateral and bilateral NHE, performed with either neutral (NHE0) or 90°-flexed (NHE90) hips. METHODS: In this laboratory study, exercises were performed on a novel device at the eccentric 1-repetition maximum load defined for 90° to 15° of knee range of motion...

BACKGROUND: An optimal antifungal therapy for invasive candidiasis in critically ill patients is essential to reduce the high mortality rates. Acute kidney injury is common, and continuous renal replacement therapies are frequently used. Previous studies have demonstrated a lack of effect from different continuous renal replacement techniques on micafungin clearance. However, the use of high cutoff pore size membranes could potentially allow for the loss of albumin and alter micafungin pharmacokinetics...

The aim of this study was to examine and characterize the reversibility of the cervical somatosensory electrophysiological pathways during neutral and flexed neck positions. The parameters of somatosensory evoked potentials (SEPs) during neutral and flexed neck positions (N9, N13, and N20 SEP latencies; N9-N13 and N13-N20 inter-peak latencies; and the changes in N9-N13 and N13-N20 inter-peak latency during neutral and flexed neck positions) were measured in the patients with Hirayama disease (HD) and also in the healthy controls...

BACKGROUND/AIMS: Neighborhood walkability is associated with indicators of health in the general population. We explored the association between neighborhood walkability and daily steps in hemodialysis (HD) patients. METHODS: We measured daily steps over 5 weeks using Fitbit Flex (Fitbit, San Francisco, CA, USA) and retrieved Walk Score® (WS) data by patient's home ZIP code (www.walkscore.com; 0 = poorest walkability; 100 = greatest walkability). RESULTS: HD patients took a mean of 6,393 ± 3,550 steps/day (n = 46)...

Proper muscle activity quantification is highly relevant to monitor and treat spastic cocontraction. As activity may distribute unevenly within muscle volumes, particularly for pennate calf muscles, surface electromyograms (EMGs) detected by traditional bipolar montage may provide biased estimations of muscle activity. We compared cocontraction estimates obtained using bipolar vs grids of electrodes (high-density EMG, HD-EMG). EMGs were collected from medial gastrocnemius, soleus and tibialis anterior during isometric plantar and dorsi-flexion efforts at three levels (30%, 70% and 100% MVC), knee flexed and extended...