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https://www.readbyqxmd.com/read/28647631/a-prospective-randomized-multicenter-clinical-trial-on-the-safety-and-efficacy-of-a-ready-to-use-fibrin-sealant-as-an-adjunct-to-hemostasis-during-vascular-surgery
#1
Ian Chetter, Gerard Stansby, José Aurelio Sarralde, Vicente Riambau, Antonio Giménez-Gaibar, Kent MacKenzie, Francisco Acín, Jordi Navarro-Puerto
PURPOSE: Anastomotic or "stitch hole" bleeding is common during vascular surgery with synthetic material such as Dacron or polytetrafluoroethylene (PTFE). Hemostatic adjuncts such as fibrin sealant (FS) may reduce blood loss and operating time in such circumstances. We evaluated the safety and the hemostatic effectiveness of a ready-to-use human plasma-derived FS in vascular surgery. METHODS: Patients with mild / moderate suture line bleeding during elective, open, vascular surgery using synthetic grafts or patches were studied...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28646261/hepatic-arterial-infusion-chemotherapy-for-extensive-liver-metastases-of-breast-cancer-efficacy-safety-and-prognostic-parameters
#2
Mitra Tewes, Michael Wilhelm Peis, Simon Bogner, Jens M Theysohn, Marcus Paul Reinboldt, Martin Schuler, Anja Welt
PURPOSE: Hepatic arterial infusion chemotherapy (HAIC) is an option for patients with liver-predominant metastatic breast cancer (LMBC), when no further systemic treatment is available. But systematic reports are limited. Here we conducted a retrospective analysis of LMBC patients treated at an expert center. METHODS: Individual patient data were retrieved from the clinical data base of the West German Cancer Center. Primary endpoints included hepatic response (RECIST), progression-free survival (PFS), overall survival (OS), and toxicity...
June 23, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28644261/is-intravenous-thrombolysis-safe-and-effective-in-central-retinal-artery-occlusion-a-critically-appraised-topic
#3
Oana M Dumitrascu, Joanne F Shen, Madhavi Kurli, Maria I Aguilar, Lisa A Marks, Bart M Demaerschalk, Dean M Wingerchuk, Cumara B O'Carroll
BACKGROUND: Central retinal artery occlusion (CRAO) is a neurological and ophthalmologic emergency associated with poor visual recovery. There is a dilemma regarding the appropriate treatment, as formal guidelines are lacking. Despite being considered an ocular equivalent of cerebral infarction, the time window of intravenous (IV) thrombolysis administration for maximum efficacy and safety in CRAO remains uncertain. OBJECTIVE: To critically assess the current evidence regarding the safety and effectiveness of IV thrombolysis in the treatment of patients with CRAO...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28643305/-interventional-therapy-of-colorectal-liver-metastasis
#4
Qi Zhang, Gaojun Teng
Colorectal liver metastasis (CRLM) is one of the most difficult and key points in the treatment of colorectal cancer. Approximately 50% to 60% of patients diagnosed as colorectal cancer develops metastasis, and 80% to 90% of CRLM is unresectable. Surgical resection is the first-line treatment for CRLM, while it is only suitable for about 15% patients. Systemic chemotherapy can prolong the survival of CRLM patients, however, a part of CRLM patients are resistant to chemotherapy. With the development of technology and the update of clinical evidence, individual therapy with target drugs and multidisciplinary treatment (MDT) have became a tendency, and minimally invasive interventional therapy has gained more acceptance in the MDT mode of the treatment for CRLM...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28642261/transforming-growth-factor-beta-stimulates-smad1-5-signaling-in-pulmonary-artery-smooth-muscle-cells-and-fibroblasts-of-the-newborn-mouse-through-alk1
#5
Huili Zhang, Lili Du, Ying Zhong, Kathleen C Flanders, Jesse D Roberts
The intracellular signaling mechanisms through which TGFβ regulates pulmonary development are incompletely understood. Canonical TGFβ signaling involves Smad2/3 phosphorylation, Smad2/3·Smad4 complex formation and nuclear localization, and gene regulation. Here we show that physiologically relevant TGFβ1 levels also stimulate Smad1/5 phosphorylation, typically a mediator of bone morphogenetic protein (BMP) signaling, in mouse pup pulmonary artery smooth muscle cells (mPASMC) and lung fibroblasts and other interstitial lung cell lines...
June 22, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28640878/genetic-loci-associated-with-coronary-artery-disease-harbor-evidence-of-selection-and-antagonistic-pleiotropy
#6
Sean G Byars, Qin Qin Huang, Lesley-Ann Gray, Andrew Bakshi, Samuli Ripatti, Gad Abraham, Stephen C Stearns, Michael Inouye
Traditional genome-wide scans for positive selection have mainly uncovered selective sweeps associated with monogenic traits. While selection on quantitative traits is much more common, very few signals have been detected because of their polygenic nature. We searched for positive selection signals underlying coronary artery disease (CAD) in worldwide populations, using novel approaches to quantify relationships between polygenic selection signals and CAD genetic risk. We identified new candidate adaptive loci that appear to have been directly modified by disease pressures given their significant associations with CAD genetic risk...
June 2017: PLoS Genetics
https://www.readbyqxmd.com/read/28639415/anti-vascular-endothelial-growth-factor-for-diabetic-macular-oedema-a-network-meta-analysis
#7
REVIEW
Gianni Virgili, Mariacristina Parravano, Jennifer R Evans, Iris Gordon, Ersilia Lucenteforte
BACKGROUND: Diabetic macular oedema (DMO) is a common complication of diabetic retinopathy. Antiangiogenic therapy with anti-vascular endothelial growth factor (anti-VEGF) modalities can reduce oedema and thereby improve vision and prevent further visual loss. These drugs have replaced laser photocoagulation as the standard of care for people with DMO. OBJECTIVES: The 2014 update of this review found high-quality evidence of benefit with antiangiogenic therapy with anti-VEGF modalities, compared to laser photocoagulation, for the treatment of DMO...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28638156/goal-directed-perfusion-methodology-for-determining-oxygenator-performance-during-clinical-cardiopulmonary-bypass
#8
Alfred H Stammers, Randi Miller, Stephen G Francis, Laszlo Fuzesi, Anthony Nostro, Eric Tesdahl
New generation oxygenators incorporate arterial line filtration either sequential to, or directly in, the gas exchange module. This unique design may affect gas exchange performance by altering the operational characteristics of the device. The present study was designed to evaluate three oxygenators in a clinical setting using a goal-directed perfusion algorithm during cardiopulmonary bypass (CPB). After institutional review board approval, 60 adult patients undergoing cardiac surgery for acquired heart disease were matched for disease state and body size into three groups based on oxygenator type: Terumo SX18(™) (n = 20), Terumo FX15(™) (n = 20), and LivaNova Inspire6F(™) 6 Dual (n = 20)...
June 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28636427/liver-directed-therapy-in-metastatic-colorectal-cancer
#9
Ciara M Kelly, Nancy E Kemeny
Colorectal cancer is a significant global health issue with over 1 million cases diagnosed annually throughout the world. 15% of patients diagnosed with colorectal cancer will have liver metastases and 60% will develop liver metastases if they have metastatic disease. Oligometastatic colorectal cancer confined to the liver represents an intermediate state in the evolution of metastatic capacity that opens the opportunity for local interventions. Area's covered: The literature supports long-term survival if patients undergo liver resection of colorectal metastases...
June 21, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28633187/-development-and-validation-of-a-fully-automated-experimental-set-up-for-ex-vivo-burst-pressure-testing-after-surgical-vessel-closure
#10
Herbert Wallimann, Pia Menges, Bernard Hausen, Albert Linder
Background A growing number of operations are performed using minimally invasive techniques. Therefore, a lot of new requirements must be met by the staplers currently available. At the present time, the most widely used methods of minimally invasive vascular occlusion involve high-frequency energy, clips, and staplers. The most important quality parameter is burst pressure, which is measured with a variety of experimental set-ups, all of which are subject to criticism. With this study, we want to introduce a fully automated vascular burst pressure measuring system that largely mimics physiological conditions...
June 20, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28631316/recannulation-of-the-axillary-artery-in-aortic-and-complex-cardiac-surgery
#11
Philippa Jane Temple Bowers, Manu Narain Mathur
OBJECTIVES: Axillary artery cannulation has been used as an alternative site for cardiopulmonary bypass during surgery for aortic dissections and aneurysmal disease of the ascending aorta and arch. This study reports our experience with reusing the axillary artery for cardiopulmonary bypass during complex aortic and cardiac surgical procedures. METHODS: This was a retrospective review of a single surgeon's experience of recannulating the axillary artery for redo operations in complex aortic surgery...
June 19, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28625390/dopamine-protects-cerebral-autoregulation-and-prevents-hippocampal-necrosis-after-traumatic-brain-injury-via-block-of-erk-mapk-in-juvenile-pigs
#12
Victor Curvello, Hugh Hekierski, Philip Pastor, Monica S Vavilala, William M Armstead
Traumatic brain injury (TBI) contributes to morbidity in children, and more boys experience TBI. Cerebral autoregulation is impaired after TBI, contributing to poor outcome. Cerebral Perfusion Pressure (CPP) is often normalized by use of vasoactive agents to increase mean arterial pressure (MAP). In prior studies of newborn and juvenile pigs, vasoactive agent choice influenced outcome after TBI as a function of age and sex, with none protecting cerebral autoregulation in both ages and sexes. Dopamine (DA) prevents impairment of cerebral autoregulation in male and female newborn pigs via inhibition of upregulation of ERK mitogen activated protein kinase (MAPK) after fluid percussion injury (FPI)...
June 15, 2017: Brain Research
https://www.readbyqxmd.com/read/28625277/the-diagnosis-and-treatment-of-hemoptysis
#13
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/28625239/-effects-of-human-umbilical-cord-mesenchymal-stem-cells-on-vascular-endothelial-growth-factor-and-il-6-expression-in-tissue-of-ami-rats
#14
Haihuan Xu, Huajiang Dong, Mingliang Zhao
OBJECTIVE: To investigate the effects of human umbilical cord mesenchymal stem cells (UC-MSCs) on vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) expression in acute myocardium infarction (AMI) rats. METHODS: The human UC-MSCs were cultured to the 4th generation for experiment. Sixty male Sprague-Dawley (SD) rats were randomly divided into sham group, AMI model group and UC-MSCs group, with 20 in each group. AMI animal model was produced by ligation of anterior descending coronary artery; in the sham group, the threading vein was gone below without ligation...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28622280/elevated-central-venous-to-arterial-co2-difference-is-not-associated-with-poor-clinical-outcomes-after-cardiac-surgery-with-cardiopulmonary-bypass-in-children
#15
Takaaki Akamatsu, Yu Inata, Kazuya Tachibana, Takeshi Hatachi, Muneyuki Takeuchi
OBJECTIVE: To investigate whether elevated central venous to arterial CO2 difference is associated with delayed extubation and prolonged ICU stay in children after cardiac surgery with cardiopulmonary bypass. DESIGN: Retrospective review of medical records. SETTING: PICU in a tertiary children's hospital. PATIENTS: Pediatric patients younger than 18 years old who underwent cardiac surgery with cardiopulmonary bypass between January 2014 and December 2014...
June 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28619834/temporal-and-spatial-variances-in-arterial-spin-labeling-are-inversely-related-to-large-artery-blood-velocity
#16
A D Robertson, G Matta, V S Basile, S E Black, C K Macgowan, J A Detre, B J MacIntosh
BACKGROUND AND PURPOSE: The relationship between extracranial large-artery characteristics and arterial spin-labeling MR imaging may influence the quality of arterial spin-labeling-CBF images for older adults with and without vascular pathology. We hypothesized that extracranial arterial blood velocity can explain between-person differences in arterial spin-labeling data systematically across clinical populations. MATERIALS AND METHODS: We performed consecutive pseudocontinuous arterial spin-labeling and phase-contrast MR imaging on 82 individuals (20 - 88 years of age, 50% women), including healthy young adults, healthy older adults, and older adults with cerebral small vessel disease or chronic stroke infarcts...
June 15, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28618915/coronary-artery-disease-risk-stratification-and-patient-selection-for-more-aggressive-secondary-prevention
#17
François Schiele, Fiona Ecarnot, Romain Chopard
In patients with stable coronary artery disease, clinical outcomes are predominantly characterized by the consequences of atherosclerosis on the myocardium, but also by complications of atherosclerosis, notably recurrent acute coronary syndrome or stroke. Secondary prevention therapy is therefore key in this patient population. Intensification of secondary prevention therapy is possible, at the price of a therapeutic risk or a high cost, therefore justifying careful selection of patients with a high residual risk and low therapeutic risk...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28616838/assessment-of-renal-hemodynamic-toxicity-of-fluid-challenge-with-0-9-nacl-compared-to-balanced-crystalloid-plasmalyte-%C3%A2-in-a-rat-model-with-severe-sepsis
#18
Pierre-Yves Olivier, François Beloncle, Valérie Seegers, Maher Tabka, Mathilde Renou de La Bourdonnaye, Alain Mercat, Paul Cales, Daniel Henrion, Peter Radermacher, Lise Piquilloud, Nicolas Lerolle, Pierre Asfar
BACKGROUND: According to international guidelines, volume expansion with crystalloids is the first-line treatment for hemodynamic management in patients with severe sepsis or septic shock. Compared to balanced crystalloids, 0.9% sodium chloride (0.9% NaCl) induces hyperchloremia and metabolic acidosis and may alter renal hemodynamics and function. We compared the effects of 0.9% NaCl to a less chloride-concentrated fluid, PlasmaLyte(®) (PL) in targeted fluid resuscitation in a randomized, double-blind controlled study in an experimental model of severe sepsis in rats...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28615805/free-anteromedial-thigh-perforator-flap-complementing-and-completing-the-anterolateral-thigh-flap
#19
Dushyant Jaiswal, Amol Ghalme, Prabha Yadav, Vinaykant Shankhdhar, Akshay Deshpande
OBJECTIVE: Theobjective of this study was to determine the indications, utility, advantages and surgical approach for the anteromedial thigh (AMT) flap. MATERIALS AND METHODS: We reviewed the records of the patients in whom the AMT flap was used for head and neck reconstruction. We use an anterior approach to harvest the anterolateral thigh (ALT) flap with a non-committal straight line incision. This preserves both ALT and AMT flap territories intact, and further decision is based on the intraoperative anatomy of perforator and pedicle...
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28614269/comparison-of-preoperative-imaging-and-pathological-findings-for-pancreatic-head-adenocarcinoma-a-retrospective-analysis-by-the-association-fran%C3%A3-aise-de-chirurgie
#20
Marine Gilabert, Jean-Marie Boher, Jean-Luc Raoul, François Paye, Philippe Bachellier, Olivier Turrini, Jean Robert Delpero
Initial imaging of pancreatic ductal adenocarcinoma is of crucial importance in the decision-making process. The aim of this study was to compare preoperative imaging, pathological data, and outcomes in a series of patients who underwent resection for pancreatic head cancer.From January 2004 to December 2009, data were collected by the Association Française de Chirurgie on 1044 patients who received first-line R0 resection of pancreatic head cancer.On imaging (computed tomography scan 97%, echoendoscopic ultrasound 61...
June 2017: Medicine (Baltimore)
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