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https://www.readbyqxmd.com/read/28634641/a-novel-technique-for-ultrasound-guided-central-venous-catheterization-under-short-axis-out-of-plane-approach-stepwise-flashing-with-triangulation
#1
Toshinori Horiuchi, Chie Okuda, Naoko Kurita, Ayako Yamaguchi, Kazuhiko Kitagawa, Masafumi Takeda, Keiichi Sha, Toshihiro Nagahata
In ultrasound-guided central venous catheterization, there is no standard technique either for the needle tip visualization or for the adequate needle angle and entry to the skin with short-axis view under out-of-plane technique. In the present study, we propose a novel technique named "stepwise flashing with triangulation", and the efficacy of this technique is assessed. Before and after a didactic session in which the technique was explained, 12 novice residents were asked to position the needle tip on or into the imitation vessels and to avoid deeper penetration by using an agar tissue phantom with ultrasound guidance...
June 20, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28633595/central-venous-catheter-insertion-into-the-false-lumen-of-a-complicated-aortic-dissection
#2
Ahmet Bas, Deniz Goksedef, Sedat G Kandemirli, Fatih Gulsen, Furuzan Numan
Thoracic endovascular repair is considered the first-line treatment in complicated acute type B dissection. Central venous catheters provide valuable vascular access during endovascular treatments. However, central venous catheters are not without complications. Herein, we report a case of central venous catheter insertion into the false lumen of a complicated acute type B aortic dissection by direct aortic puncture. The tip of the central venous catheter was in the false lumen. The central venous catheter was left in place initially and was removed after graft stent deployment...
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28633248/endobronchial-guided-vascularized-tissue-flaps-for-a-bronchopleural-fistula
#3
Sarah M Elswick, Basel Sharaf, Ziyad S Hammoudeh, Ali I Saeed, Eric S Edell, David E Midthun, Shanda H Blackmon
The management of bronchopleural fistulas can be challenging. The initial treatment is usually conservative, but operative intervention with transposition of vascularized pedicled flaps may be required in refractory cases. We present the case of a 67-year-old man with stage IIIa squamous cell carcinoma of the lung who underwent a lower and middle bilobectomy after receiving neoadjuvant chemoradiation. His postoperative course was complicated by empyema and a bronchopleural fistula. Because of difficulty accessing the fistula, endobronchial-guided vascularized tissue flaps were successfully used to close the fistula...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28629995/intraosseous-compared-to-intravenous-drug-resuscitation-in-out-of-hospital-cardiac-arrest
#4
Bryan A Feinstein, Benjamin A Stubbs, Tom Rea, Peter J Kudenchuk
AIMS: Although the intraosseous (IO) route is increasingly used for vascular access in out-of-hospital cardiac arrest (OHCA), little is known about its comparative effectiveness relative to intravenous (IV) access. We evaluated clinical outcomes following OHCA comparing drug administration via IO versus IV routes. METHODS: This retrospective cohort study evaluated Emergency Medical Services (EMS)-treated adults with atraumatic OHCA in a large metropolitan EMS system between 9/1/2012-12/31/2014...
June 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28629676/percutaneous-nephrolithotomy-puncture-and-tract-dilation-evidence-on-the-safety-of-approaches-to-the-infundibulum-of-the-middle-renal-calyx
#5
Panagiotis Kallidonis, Christina Kalogeropoulou, Iason Kyriazis, Dimitrios Apostolopoulos, Panagiotis Kitrou, Dimitrios Kotsiris, Panteleimon Ntasiotis, Evangelos Liatsikos
OBJECTIVES: To investigate the anatomical relations of the papillary, infundibular and pelvic approach to percutaneous nephrolithotomy (PCNL) and evaluate the amount of vascularization at the respective sites. MATERIALS: (99m)Tc-dimercaptosuccinic acid SPECT/CT renal scintigraphies or Computerized tomographies perfusion (CTP) were performed in 40 patients (prone n=20 or supine position n=20). The angle of approach (AoA) for access tracts the respective regions of interest (ROIs) to the mid-calyceal papilla and infundibulum as well as renal pelvis were designed and compared...
June 16, 2017: Urology
https://www.readbyqxmd.com/read/28626366/current-developments-in-mobilization-of-hematopoietic-stem-and-progenitor-cells-and-their-interaction-with-niches-in-bone-marrow
#6
REVIEW
Rudolf Richter, Wolfgang Forssmann, Reinhard Henschler
The clinical application of hematopoietic stem and progenitor cells (HSPCs) has evolved from a highly experimental stage in the 1980s to a currently clinically established treatment for more than 20,000 patients annually who suffer from hematological malignancies and other severe diseases. Studies in numerous murine models have demonstrated that HSPCs reside in distinct niches within the bone marrow environment. Whereas transplanted HSPCs travel through the bloodstream and home to sites of hematopoiesis, HSPCs can be mobilized from these niches into the blood either physiologically or induced by pharmaceutical drugs...
June 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28625819/outcomes-of-relocation-of-basilic-vein-in-brachiobasilic-fistulas-in-chronic-renal-failure
#7
Farzad Kakaei, Ahad Hasankhani, Mir-Salim Seyyed-Sadeghi, Peyman Virani, Tooraj Asvadi, Sina Zarrintan
BACKGROUND: In patients without or with injured cephalic vein, using the basilic vein for creating arteriovenous fistula (AVF) is the best way for hemodialysis. In order to create AVF, the basilic vein should be superficialized and lateralized. This study sought to examine outcome of relocation of basilic vein in brachiobasilic fistulas in patients with chronic renal failure (CRF). METHODS: We evaluated the outcome of creation of brachiobasilic fistula with transposition of basilic vein in 27 patients (14 males and 13 females with mean age of 60...
June 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28625277/the-diagnosis-and-treatment-of-hemoptysis
#8
Harald Ittrich, Maximilian Bockhorn, Hans Klose, Marcel Simon
BACKGROUND: Hemoptysis, i.e., the expectoration of blood from the lower airways, has an annual incidence of approximately 0.1% in ambulatory patients and 0.2% in inpatients. It is a potentially life-threatening medical emergency and carries a high mortality. METHODS: This review article is based on pertinent publications retrieved by a selective search in PubMed. RESULTS: Hemoptysis can be a sign of many different diseases. Its cause remains unknown in about half of all cases...
June 5, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28624422/endovascular-proximal-forearm-arteriovenous-fistula-for-hemodialysis-access-results-of-the-prospective-multicenter-novel-endovascular-access-trial-neat
#9
Charmaine E Lok, Dheeraj K Rajan, Jason Clement, Mercedeh Kiaii, Ravi Sidhu, Ken Thomson, George Buldo, Christine Dipchand, Louise Moist, Joanna Sasal
BACKGROUND: Hemodialysis arteriovenous fistulas (AVFs) are suboptimally used primarily due to problems with maturation, early thrombosis, and patient nonacceptance. An endovascular approach to fistula creation without open surgery offers another hemodialysis vascular access option. STUDY DESIGN: Prospective, single-arm, multicenter study (Novel Endovascular Access Trial [NEAT]). SETTINGS & PARTICIPANTS: Consecutive adult non-dialysis-dependent and dialysis-dependent patients referred for vascular access creation at 9 centers in Canada, Australia, and New Zealand...
June 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28623994/placement-of-tunneled-cuffed-vascular-catheter-through-superior-vena-cava-puncture
#10
Songhui Zhai, Qiuyan Zhao, Yanhuan Feng, Yang Yu, Li Zhou, Tianlei Cui, Ping Fu
OBJECTIVE: The purpose of this study was to assess the feasibility and safety of placement of tunneled cuffed catheters through direct percutaneous puncture of the superior vena cava (SVC) in patients with occluded right and left innominate veins. METHODS: This was a retrospective review of all patients with right and left innominate vein occlusions who underwent tunneled catheter placement with direct SVC puncture between January 2012 and December 2014. Under fluoroscopic guidance with the patient in a supine position, a 5F catheter was placed at the distal end of the SVC through the femoral vein, iliac vein, or hepatic vein...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28618138/expansion-of-umbilical-cord-blood-aldehyde-dehydrogenase-expressing-cells-generates-myeloid-progenitor-cells-that-stimulate-limb-revascularization
#11
David M Putman, Tyler T Cooper, Stephen E Sherman, Ayesh K Seneviratne, Mark Hewitt, Gillian I Bell, David A Hess
Uncompromised by chronic disease-related comorbidities, human umbilical cord blood (UCB) progenitor cells with high aldehyde dehydrogenase activity (ALDH(hi) cells) stimulate blood vessel regeneration after intra-muscular transplantation. However, implementation of cellular therapies using UCB ALDH(hi) cells for critical limb ischemia, the most severe form of severe peripheral artery disease, is limited by the rarity (<0.5%) of these cells. Our goal was to generate a clinically-translatable, allogeneic cell population for vessel regenerative therapies, via ex vivo expansion of UCB ALDH(hi) cells without loss of pro-angiogenic potency...
June 15, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28618060/clinical-validation-of-the-nursing-diagnosis-of-ineffective-protection-in-hemodialysis-patients
#12
Jéssica Dantas de Sá Tinôco, Maria das Graças Mariano Nunes de Paiva, Cecília Maria Farias de Queiroz Frazão, Kadyjina Daiane Batista Lucio, Maria Isabel da Conceição Dias Fernandes, Marcos Venicios de Oliveira Lopes, Ana Luisa Brandão de Carvalho Lira
AIMS AND OBJECTIVES: The aim of this study was to evaluate the clinical validity of indicators of the nursing diagnosis of "ineffective protection" in hemodialysis patients. BACKGROUND: Hemodialysis patients have reduced protection. Studies on the nursing diagnosis of "ineffective protection" are scarce in the literature. The use of indicators to diagnose "ineffective protection" could improve the care of hemodialysis patients. The clinical usefulness of the indicators requires clinical validation...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28616563/low-rate-of-access-site-complications-after-transradial-coronary-catheterization-a-prospective-ultrasound-study
#13
Violeta Mattea, Carsten Salomon, Niels Menck, Philipp Lauten, Frank Michael Malur, Anja Schade, Frank Steinborn, Lisa Costello-Boerrigter, Axel Neumeister, Harald Lapp
BACKGROUND: Transradial artery (TRA) left heart catheterization is an increasingly used technique for both diagnostic and interventional coronary procedures. This study evaluates the incidence of access site complications in the current interventional era. METHODS AND RESULTS: A total of 507 procedures were performed under standardized conditions. Each procedure was performed using high levels of anticoagulation, hydrophilic sheaths, and short post-procedural compression times...
March 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28616344/vascular-approaches-for-transcatheter-aortic-valve-implantation
#14
REVIEW
Isaac Pascual, Amelia Carro, Pablo Avanzas, Daniel Hernández-Vaquero, Rocío Díaz, Jose Rozado, Rebeca Lorca, María Martín, Jacobo Silva, César Morís
Transcatheter aortic valve implantation (TAVI) is a rapidly evolving therapeutic modality currently available for patients with severe aortic stenosis (AS) that are unsuitable for surgery because of technical/anatomical issues or high-estimated surgical risk. Transfemoral approach is the preferred TAVI delivery route when possible. Alternative non-transfemoral access options include transaortic, trans-subclavian and transapical access. Other approaches are also feasible (transcarotid, transcaval, and antegrade aortic) but are restricted to operators and hospitals with experience...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28612412/ending-poke-until-you-get-a-gusher-part-ii-the-evidence-based-approach-to-vascular-access-revisited
#15
EDITORIAL
Zoltan G Turi
Puncture above the common femoral bifurcation and below the inguinal ligament is optimal A vast majority of femoral bifurcations occur below the middle third of the femoral head while the inferior epigastric artery rarely descends below the middle third Fluoroscopy or if possible, ultrasound, should be used for femoral access to optimize safe puncture.
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28611425/pancreatic-adenocarcinoma-response-to-chemotherapy-enhanced-with-non-invasive-radio-frequency-evaluated-via-an-integrated-experimental-computational-approach
#16
Matthew J Ware, Louis T Curtis, Min Wu, Jason C Ho, Stuart J Corr, Steven A Curley, Biana Godin, Hermann B Frieboes
Although chemotherapy combined with radiofrequency exposure has shown promise in cancer treatment by coupling drug cytotoxicity with thermal ablation or thermally-induced cytotoxicity, limited access of the drug to tumor loci in hypo-vascularized lesions has hampered clinical application. We recently showed that high-intensity short-wave capacitively coupled radiofrequency (RF) electric-fields may reach inaccessible targets in vivo. This non-invasive RF combined with gemcitabine (Gem) chemotherapy enhanced drug uptake and effect in pancreatic adenocarcinoma (PDAC), notorious for having poor response and limited therapeutic options, but without inducing thermal injury...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28607581/pembrolizumab-in-cervical-cancer-latest-evidence-and-clinical-usefulness
#17
REVIEW
Edith Borcoman, Christophe Le Tourneau
Cervical cancer is the fourth most common cause of cancer-related deaths in women worldwide. With the development of detection of precancerous lesions and preventive human papillomavirus (HPV) vaccination program, a survival improvement has been observed in these patients in developed countries, although disparities in accessibility to treatments exist across countries. While early-stage cervical cancer can be curable with surgery, prognosis of patients who recur remains poor, with limited treatment options...
June 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/28606889/parallel-suture-technique-with-proglide-a-novel-method-for-management-of-vascular-access-during-transcatheter-aortic-valve-implantation-tavi
#18
Ilka Ott, Anupama Shivaraju, Nina R Schäffer, Antonio H Frangieh, Jonathan Michel, Oliver Husser, Christian Hengstenberg, Patrick Mayr, Roisin Colleran, Constanza Pellegrini, Salvatore Cassese, Massimilliano Fusaro, Heribert Schunkert, Adnan Kastrati, Albert M Kasel
AIMS: Aim of this study was to evaluate vascular complications using the "parallel suture technique" in patients receiving Edwards SAPIEN XT (SXT) or SAPIEN S3 (S3) transcatheter heart valve (THV). METHODS AND RESULTS: Two hundred consecutive patients with symptomatic severe aortic stenosis treated with TF-TAVI were included in this study where the "parallel suture technique" was applied for vascular access site closure. This was achieved by placing the sutures medial and lateral to the puncture site...
June 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28604988/efficacy-of-statin-on-vascular-access-patency-in-diabetic-hemodialysis-patients
#19
Satoru Sanada, Yasunori Miyasaka, Atsuhiro Kanno, Kozo Sato, Mitsuhiro Sato, Hisako Sugai, Hiroshi Kitamura, Toshinobu Sato, Yoshio Taguma
INTRODUCTION: An effective approach to prevent hemodialysis vascular access dysfunction is still unclear despite previous studies, which have shown conflicting results of several drugs on vascular access outcomes. In this study, we focused on diabetic hemodialysis patients with native arteriovenous fistula and evaluated the impact of statin treatment on vascular access patency. METHODS: A retrospective cohort study of 268 consecutive patients who newly started hemodialysis due to diabetic nephropathy between January 2011 and December 2013 at Japan Community Health Care Organization Sendai Hospital was performed and the patients were followed for two years...
June 7, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28604317/beware-the-femoral-haemodialysis-catheter-a-surgeon-s-perspective
#20
Tinus Du Toit, David Thomson, Elmi Muller
The ability to identify and address factors that threaten the optimal utilisation of donor organs is quintessential in obtaining satisfactory transplant outcomes. We share our concerns regarding the prolonged use of femoral haemodialysis catheters and its potential to jeopardise successful renal transplantation. Despite a paucity of literature on the topic, we review relevant aspects related to this pernicious form of vascular access and clarify its limited role in the modern haemodialysis unit, particularly in patients who are still considered for transplantation...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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