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https://www.readbyqxmd.com/read/29782406/population-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine-in-children-undergoing-ambulatory-surgery
#1
María-Gabriela Pérez-Guillé, Alejandra Toledo-López, Liliana Rivera-Espinosa, Radames Alemon-Medina, Chiharu Murata, Ismael Lares-Asseff, Juan Luis Chávez-Pacheco, Josefina Gómez-Garduño, Ana-Lilia Zamora Gutiérrez, Claudia Orozco-Galicia, Karina Ramírez-Morales, Gustavo Lugo-Goytia
BACKGROUND: Dexmedetomidine (DEX) is an α-2 adrenergic agonist with sedative and analgesic properties. Although not approved for pediatric use by the Food and Drug Administration, DEX is increasingly used in pediatric anesthesia and critical care. However, very limited information is available regarding the pharmacokinetics of DEX in children. The aim of this study was to investigate DEX pharmacokinetics and pharmacodynamics (PK-PD) in Mexican children 2-18 years of age who were undergoing outpatient surgical procedures...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29773496/reflections-on-methodical-approaches-to-hematopoietic-stem-cell-collection-in-children
#2
REVIEW
Claudia Del Fante, Jerard Seghatchian, Cesare Perotti
Pediatric peripheral blood stem cell collection (PBSC) is challenging because it has potentially more side effects than in adults due to the small body mass and unique physiology of children. The extracorporeal volume of the cell separator device, poor venous access and metabolic complications due to citrate toxicity are the main problems to face during PBSC collection. These aspects are more relevant in very low body weight (BW) children of 20 kg or lower. An efficient, experienced and well-prepared team of pediatricians, apheresis physicians and nurses, and physicians involved in CVC positioning is crucial to performing a safe PBSC collection...
May 9, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29772317/haemodialysis-catheter-related-central-venous-thrombosis-clinical-approach-to-evaluation-and-management
#3
REVIEW
Dinesha Himali Sudusinghe, Dilushi Rowena Wijayaratne, Nalaka Gunawansa
Central venous catheter use is common among patients undergoing haemodialysis. Catheter related vascular thrombosis is a frequent complication, which results in catheter dysfunction. This may eliminate the affected vein as a potential route of vascular access and leads to significant morbidity of the limbs involved. Despite increasing prevalence, there is a dearth of evidence-based guidelines for managing such catheter related thrombi, often leading to treatment dilemmas in clinical practice. Minimizing the use of central venous catheters for haemodialysis remains the best approach in preventing such adverse complications...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29767569/teaching-tip-development-of-veterinary-anesthesia-simulations-for-pre-clinical-training-design-implementation-and-evaluation-based-on-student-perspectives
#4
Jana L Jones, Jim Rinehart, Jacqueline Jordan Spiegel, Ryane E Englar, Brian K Sidaway, Joie Rowles
Anesthesia simulations have been used in pre-clinical medical training for decades to help learners gain confidence and expertise in an operating room environment without danger to a live patient. The authors describe a veterinary anesthesia simulation environment (VASE) with anesthesia scenarios developed to provide a re-creation of a veterinarian's task environment while performing anesthesia. The VASE uses advanced computer technology with simulator inputs provided from standard monitoring equipment in common use during veterinary anesthesia and a commercial canine training mannequin that allows intubation, ventilation, and venous access...
2018: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/29766680/c-arm-computed-tomography-assisted-adrenal-venous-sampling-improved-right-adrenal-vein-cannulation-and-sampling-quality-in-primary-aldosteronism
#5
Chung Hyun Park, Namki Hong, Kichang Han, Sang Wook Kang, Cho Rok Lee, Sungha Park, Yumie Rhee
BACKGROUND: Adrenal venous sampling (AVS) is a gold standard for subtype classification of primary aldosteronism (PA). However, this procedure has a high failure rate because of the anatomical difficulties in accessing the right adrenal vein. We investigated whether C-arm computed tomography-assisted AVS (C-AVS) could improve the success rate of adrenal sampling. METHODS: A total of 156 patients, diagnosed with PA who underwent AVS from May 2004 through April 2017, were included...
May 4, 2018: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29765794/femoral-access-for-central-venous-port-system-implantation
#6
Mikhail Cherkashin, Natalia Berezina, Denis Puchkov, Kirill Suprun, Petr Yablonsky
Totally implanted venous access port (TIVAP) systems provide adequate quality of care and life, especially for oncology patients. Long-term vascular access is very important and easy to perform, but in some clinical situations, if patients have a superior caval system occlusion, femoral insertion may be the only option. We present a case of a 70-year-old colorectal adenocarcinoma patient diagnosed with subclavian vein hypoplasia. Her care team decided intraoperatively to implant a port system by the right femoral access...
March 14, 2018: Curēus
https://www.readbyqxmd.com/read/29761338/-journey-of-the-s%C3%A2-icd-to-first-line-therapy
#7
REVIEW
Elif Kaya, Reza Wakili, Tienush Rassaf
The subcutaneous implantable cardioverter-defibrillator (S-ICD®, Boston Scientific, Marlborough, MA, USA, previously Cameron Health, San Clemente, CA, USA) represents an important milestone in ICD therapy for prevention of sudden cardiac death (SCD). Since the introduction of the S‑ICD in 2010, the device has undergone further development. Based on the unique feature of an entirely extracardiac implantation, the S‑ICD is able to reduce the common perioperative and long-term complications of the usual endovascular implanted ICD systems...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29758323/why-do-vascular-surgeons-get-sued-analysis-of-claims-and-outcomes-in-malpractice-litigation
#8
John Phair, Eric B Trestman, Eddie Skripochnik, Evan C Lipsitz, Issam Koleilat, Larry A Scher
OBJECTIVE: To analyze causes and outcomes of malpractice claims against vascular surgeons in the United States. METHODS: Cases entered into the Westlaw database from January 1st 1999 to December 31st 2014 were reviewed. Search terms "vascular" and "surgeon" were used. Data was compiled on the allegation, subject matter and outcome of each case. Additional data including demographics of the defendant was obtained from U.S. News Health Reports on practicing physicians...
May 11, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29758322/endovascular-repair-of-an-inadvertent-right-vertebral-artery-rupture-during-dialysis-catheter-insertion
#9
Kalliopi-Maria Tasopoulou, Christos Argyriou, Michael Mantatzis, Konstantia Kantartzi, Ploumis Passadakis, George S Georgiadis
Central venous (CV) catheterization is not only an invaluable diagnostic modality but also an essential therapeutic tool for the treating physician, enabling rapid and reliable intravenous administration of drugs and fluids, providing venous access to patients undergoing long-term continuous or repeated intravenous treatment such as chemotherapy or it can be used for haemodialysis in patients suffering from acute or chronic renal disease. On the other hand, CV catheterization can lead to a wide range of life-threatening complications for the patient especially if left untreated or become late-diagnosed...
May 11, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29756168/transsplenic-splenoportography-and-portal-venous-interventions-in-pediatric-patients
#10
Eric J Monroe, Ethan J Speir, C Matthew Hawkins, Giri Shivaram, Kevin S H Koo, Anne E Gill
BACKGROUND: Data regarding transsplenic portal venous access for diagnostic imaging and endovascular intervention in children are limited, possibly due to concerns regarding high bleeding risks and resultant underutilization. OBJECTIVE: To investigate the safety and utility of transsplenic splenoportography and portal venous interventions in children. MATERIALS AND METHODS: A retrospective review was performed of all pediatric patients undergoing percutaneous transsplenic portal venous access and intervention at two large tertiary pediatric institutions between January 2012 and April 2017 was performed...
May 13, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29755961/correlation-and-interchangeability-of-venous-and-capillary-blood-gases-in-non-critically-ill-neonates
#11
Ratna N G B Tan, Steffen C Pauws, Evelyne van Loon, Vivanne E H J Smits, Enrico Lopriore, Arjan B Te Pas
Background: Venous blood gas (VBG) is frequently used in the neonatal unit as alternative for capillary blood gas (CBG). However, studies reporting correlation are conflicting and data on interchangeability in neonates are lacking. Objective: We investigated the correlation and interchangeability of the components between VBG and CBG in infants admitted to the neonatal intensive care unit. Methods: In a prospective study in the neonatal unit in Leiden University Medical Center (Netherlands), simultaneously VBG and CBG were withdrawn in neonates when both venous puncture and intravenous access as blood gas monitoring was indicated...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29750827/self-cannulation-of-the-vascular-access-in-home-hemodialysis-overcoming-patient-level-barriers
#12
Frank L Ward, Rose Faratro, Rory F McQuillan
Patients with end-stage kidney disease who are considering home hemodialysis (HHD) face the challenge of learning to self-cannulate their arteriovenous access. Current practice discourages the use of tunneled central venous catheters, with recent indications that self-cannulating patients have superior outcomes. Patient-level barriers do not appear to preclude a successful HHD program and should not be viewed as insurmountable by healthcare staff or patients. The healthcare team must address patient fears while instructing the patient to perform self-cannulation safely...
May 11, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29749950/a-completely-epicardial-biventricular-defibrillator-for-a-pacing-dependent-patient-with-no-superior-central-venous-access
#13
Jonathan M Behar, Shahed Islam, Ben Adams, Edward Rowland, Rakesh Uppal, Anthony Chow
No abstract text is available yet for this article.
February 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29748081/day-of-week-site-of-service-and-patient-complexity-differences-in-venous-ultrasound-interpreted-by-radiologists-versus-nonradiologists
#14
Anand M Prabhakar, Ravi V Gottumukkala, Wenyi Wang, Danny R Hughes, Richard Duszak
OBJECTIVE: Nationally, nonradiologists interpret an increasing proportion of lower extremity venous duplex ultrasound (LEVDU) examinations. We aimed to study day of week, site of service, and patient complexity differences in LEVDU services interpreted by radiologists versus nonradiologists. MATERIALS AND METHODS: Using carrier claims files for a 5% national sample of Medicare beneficiaries from 2012 to 2015, we retrospectively classified all LEVDU examinations by physician specialty (radiologist versus nonradiologist), day of week (weekday versus weekend), site of service, and patient Charlson Comorbidity Index (CCI) scores...
May 7, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29744732/central-venous-access-port-placement-by-translumbar-approach-using-angio-ct-unit-in-patients-with-superior-vena-cava-syndrome
#15
Shuji Kariya, Miyuki Nakatani, Takuji Maruyama, Yasuyuki Ono, Yutaka Ueno, Atsushi Komemushi, Noboru Tanigawa
PURPOSE: To evaluate the clinical results of central venous access port (CV port) placement by translumbar inferior vena cava cannulation using angio-CT unit for cancer patients with superior vena cava syndrome. MATERIALS AND METHODS: A CV port was placed by translumbar inferior vena cava cannulation using an angio-CT unit, in 14 consecutive patients. All patients had occlusion or advanced stenosis of the superior vena cava due to cancer progression. RESULTS: The technical success rate of the percutaneous translumbar CV port placement was 100%...
May 9, 2018: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29744099/a-port-a-cath-in-aorta
#16
Dominika Zoltowska, Jagadeesh Kalavakunta
Totally implantable venous access ports are valuable invention for oncological patients. Erroneous arterial malposition rate is estimated from 1.1% to 3.7% (Bowen et al. Am. J. Surg., 2014, 208, 937). Early recognition and management are crucial to prevent further complications.
May 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29739749/prevalence-of-central-vein-stenosis-in-patients-referred-for-vein-mapping
#17
Fasika M Tedla, Guerrier Clerger, Dale Distant, Moro Salifu
BACKGROUND AND OBJECTIVES: Central vein stenosis is considered to be common in patients on hemodialysis but its exact prevalence is not known. In this study, we report the prevalence of central vein stenosis in patients with CKD referred for vein mapping. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective study of adult patients who had bilateral upper extremity venographic vein mapping from September 1, 2011 to December 31, 2015. Patients with and without stenosis were compared for differences in clinical or demographic characteristics...
May 8, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29738353/spleen-stiffness-differentiates-between-acute-and-chronic-liver-damage-and-predicts-hepatic-decompensation
#18
Phil Meister, Alexander Dechêne, Matthias Büchter, Julia Kälsch, Guido Gerken, Ali Canbay, Christoph Jochum
OBJECTIVES: Spleen stiffness (SS) correlates with liver stiffness (LS) and hepatic venous pressure gradient. The latter is currently the most accurate predictor of hepatic decompensation. Our study aims to check whether SS has a similar predictive capability, while being an easy-to-perform noninvasive test in a real-life patient cohort. METHODS: Concomitantly, 210 successive patients were examined and received liver and SS measurements and a standard laboratory...
April 17, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29732179/cannulation-technique-femoro-femoral
#19
REVIEW
Aidan J C Burrell, Joshua F Ihle, Vincent A Pellegrino, Jayne Sheldrake, Paul T Nixon
The cannulation technique used during veno-venous extracorporeal membrane oxygenation (VV ECMO) insertion can have a major impact on a patients' overall outcome. We have developed a technique that aims to combine speed and effectiveness, with minimal risk. The steps include: (I) percutaneous cannulation using the Seldinger technique; (II) ultrasound guided access and positioning of cannulas; (III) femoro-femoral circuit configuration with a later option of high flow; (IV) a no skin cut serial dilation technique; (V) non-suturing securing of cannulas and (VI) a non-surgical manual pressure technique of explantation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29728316/cognitive-impairment-in-non-dialysis-dependent-ckd-and-the-transition-to-dialysis-findings-from-the-chronic-renal-insufficiency-cohort-cric-study
#20
Meera N Harhay, Dawei Xie, Xiaoming Zhang, Chi-Yuan Hsu, Eric Vittinghoff, Alan S Go, Stephen M Sozio, Jacob Blumenthal, Stephen Seliger, Jing Chen, Rajat Deo, Mirela Dobre, Sanjeev Akkina, Peter P Reese, James P Lash, Kristine Yaffe, Manjula Kurella Tamura
BACKGROUND: Advanced chronic kidney disease is associated with elevated risk for cognitive impairment. However, it is not known whether and how cognitive impairment is associated with planning and preparation for end-stage renal disease. STUDY DESIGN: Retrospective observational study. SETTING & PARTICIPANTS: 630 adults participating in the CRIC (Chronic Renal Insufficiency Cohort) Study who had cognitive assessments in late-stage CKD, defined as estimated glome-rular filtration rate ≤ 20mL/min/1...
May 2, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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