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Chronic dissection

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https://www.readbyqxmd.com/read/27922951/anatomic-and-ultrasonographic-evaluation-of-the-knee-sensory-innervation-a-cadaveric-study-to-determine-anatomic-targets-in-the-treatment-of-chronic-knee-pain
#1
Jorge M Orduña Valls, Ricardo Vallejo, Pablo López Pais, Eliezer Soto, Daniel Torres Rodríguez, David L Cedeño, Carlos Tornero Tornero, Maximino Quintáns Rodríguez, Aurora Baluja González, Julián Álvarez Escudero
BACKGROUND AND OBJECTIVES: Osteoarthrosis is a main cause of knee pain in the elderly. Pain associated with this condition is often refractory to conservative treatment. Total knee replacement may be the best option for severe pathologies; however, the occurrence of a chronic pain state after knee replacement has been well documented in the literature. The previous descriptions of the genicular nerves have been considered somewhat inaccurate. This innervation is complex and exhibits significant interindividual variability...
December 5, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27921203/treatment-of-uncomplicated-type-b-aortic-dissection
#2
REVIEW
Hitoshi Matsuda
Hospital mortality after the replacement of chronic type B aortic dissection is around 8-10% and adverse outcomes include paraplegia and stroke. However, the level of evidence for indication of thoracic endovascular aortic repair (TEVAR) for type B chronic aortic dissection is Class IIa. Results of the INSTEAD-XL trial have verified that preemptive TEVAR for uncomplicated type B aortic dissection improves prognosis. The indication for this procedure is reportedly a maximum aortic diameter >40 mm during the acute phase and a patent primary entry site in the thoracic aorta, while the optimal timing for TEVAR would be the subacute phase, from 2 weeks to 3-6 months after onset...
December 5, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27920250/renal-anemia-model-mouse-established-by-transgenic-rescue-with-erythropoietin-gene-lacking-kidney-specific-regulatory-elements
#3
Ikuo Hirano, Norio Suzuki, Shun Yamazaki, Hiroki Sekine, Naoko Minegishi, Ritsuko Shimizu, Masayuki Yamamoto
The erythropoietin (Epo) gene is under tissue-specific inducible regulation. Because kidney is the primary EPO-producing tissue in adults, impaired EPO production in chronic kidney disorders results in serious renal anemia. The Epo gene contains a liver-specific enhancer in the 3' region, but the kidney-specific enhancer for gene expression in renal EPO-producing (REP) cells remains elusive. Here, we examined a Conserved-Upstream-element for Renal-Epo-regulation (CURE) region that spans 17.4 kb to 3.6 kb upstream of the Epo gene and harbors several phylogenetically conserved elements...
December 5, 2016: Molecular and Cellular Biology
https://www.readbyqxmd.com/read/27920228/exploring-novel-paths-towards-protein-signatures-of-chronic-pain
#4
David Gomez-Varela, Manuela Schmidt
Pain is a major symptom of many medical conditions and the worldwide number one reason for people to seek medical assistance. It affects the quality of life of patients and poses a heavy financial burden on society with high costs of treatment and lost productivity. Furthermore, the treatment of chronic pain presents a big challenge as pain therapeutics often lack efficacy and exhibit minimal safety profiles. The latter can be largely attributed to the fact that current therapies target molecules with key physiological functions throughout the body...
2016: Molecular Pain
https://www.readbyqxmd.com/read/27908812/original-off-label-endovascular-solution-to-occlude-false-lumen-rupture-in-chronic-type-b-aortic-dissection
#5
E M Marone, M Leopardi, L Bertoglio, D Mascia, R Chiesa
After Thoracic Endovascular Aortic Repair (TEVAR) for chronic type B aortic dissection (cTBD) the patency of the false lumen is quite common and its presence is associated with the risk of developing complications and is a predictor of death by aortic rupture. We report a case of a patient treated in emergency for the rupture of the false lumen in cTBD. He had previous TEVAR with persisting distal dissection and retrograde reperfusion of the false lumen. We performed an original endovascular treatment with graft relining and false lumen occlusion with a home-made "candy plug" obtained with two commercially available stent grafts...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908808/emergency-hybrid-approach-to-ruptured-femoral-pseudoaneurysm-in-hiv-positive-intravenous-drug-abusers
#6
Maurizio Domanin, Giovanni Romagnoni, Silvia Romagnoli, Antonio Rolli, Livio Gabrielli
PURPOSE: Chronic traumatism of the common femoral artery due to intravenous injection in drug abusers, in association with local infections and arterial wall weakening caused by HIV, can lead to the development of pseudoaneurysms. Rupture of pseudoaneurysm is a dramatic event in such patients and its correction is difficult and controversial. Most of the cases reported describe open surgical elective options, that consist in ligation, repair or substitution of the damaged arterial segment, employing when possible biological grafts...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903476/rapid-aneurysmal-sac-expansion-following-endovascular-repair-of-a-dissecting-thoracoabdominal-aneurysm
#7
Pau Bargay-Juan, Teresa Martin-Gonzalez, Rachel Clough, Rafaëlle Spear, Jonathan Sobocinski, Stephan Haulon
Endovascular repair of dissecting thoracoabdominal aneurysms (TAAA) is challenging and often requires multiple procedures. A 61-year-old man with a dissecting type-II TAAA treated first by placement of a thoracic endograft, and subsequently implantation of a fenestrated endograft. Six months postoperatively, a 10mm increase of the aorta was observed. A re-entry tear in left external iliac artery(EIA) was perfusing the false lumen in a retrograde fashion connecting with the endoleak caused by the inferior mesenteric artery and lumbar arteries...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27896410/low-incidence-of-lymph-node-metastasis-after-resection-of-hepatitis-virus-related-intrahepatic-cholangiocarcinoma
#8
Hiroya Iida, Masaki Kaibori, Shogo Tanaka, Shigekazu Takemura, Hiroshi Wada, Fumitoshi Hirokawa, Takuya Nakai, Michihiro Hayashi, Hidetoshi Eguchi, Shoji Kubo
BACKGROUND AND OBJECTIVES: We determined the rates of initial lymph node metastasis following curative resection of mass-forming type-intrahepatic cholangiocarcinoma (ICC) in patients with and without hepatitis virus infection. METHODS: We enrolled 87 patients between January 2000 and December 2013 with ICC without preoperative lymph node metastasis and without lymph node dissection. Patients included 32 who were seropositive for hepatitis B or C virus (virus group) and 55 who had no evidence of hepatitis virus infection (nonvirus group)...
November 28, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#9
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin Gonzalez, Jonathan Sobocinski, Stéphan Haulon
OBJECTIVE: To describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. METHODS: In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27889845/randomized-trial-comparing-self-gripping-semi-re-absorbable-mesh-progrip-with-polypropylene-mesh-in-open-inguinal-hernioplasty-the-6%C3%A2-years-result
#10
J K M Fan, J Yip, D C C Foo, O S H Lo, W L Law
OBJECTIVES: The use of absorbable polylactic acid hook self-gripping polypropylene mesh in open inguinal hernia may potentially reduce operative time and enhance patient recovery. The objective of this randomized trial is to compare the outcomes following self-gripping mesh repair to polypropylene mesh secured with sutures in open inguinal hernioplasty. METHOD: Eligible patients aged 18-80 years old, who had primary unilateral uncomplicated inguinal hernia, were randomized into either Polypropylene (PL) group or PROGRIP (PG) group just before the placement of mesh intra-operatively by computer generated code...
November 26, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27889286/computational-fluid-analysis-of-symptomatic-chronic-type-b-aortic-dissections-managed-with-the-streamliner-multilayer-flow-modulator
#11
Florian Stefanov, Sherif Sultan, Liam Morris, Ala Elhelali, Edel P Kavanagh, Violet Lundon, Mohamed Sultan, Niamh Hynes
OBJECTIVE: Managing symptomatic chronic type B aortic dissection (SCTBAD) by the Streamliner Multilayer Flow Modulator (SMFM) stent (Cardiatis, Isnes, Belgium) is akin to provisional structural support to induce complete attachment of the dissection flap, but with the ability of aortic remolding. This study investigated the SMFM's capability to enact healing of SCTBAD. METHODS: Clinical data for 12 cases comprising preoperative and postoperative treatment of SCTBAD were obtained from a multicenter database hosted by the Multilayer Flow Modulator Global Registry, Ireland...
November 23, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27887899/association-of-preoperative-right-and-left-ventricular-diastolic-dysfunction-with-postoperative-atrial-fibrillation-in-patients-undergoing-lung-surgery-a-prospective-observational-study
#12
Norikatsu Mita, Masataka Kuroda, Sohtaro Miyoshi, Shigeru Saito
OBJECTIVES: To clarify the relationship between right and left ventricular (RV and LV) diastolic function and postoperative atrial fibrillation (POAF). The early effects of major lung surgery on cardiac function in the intraoperative period during lung surgery were evaluated, using transesophageal echocardiography. DESIGN: Single-center prospective observational study. SETTING: A public hospital. PARTICIPANTS: Patients undergoing elective lobectomy with lymph node dissection for lung cancer (n = 116)...
September 13, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27887799/procedural-and-longer-term-outcomes-of-wire-versus-device-based-antegrade-dissection-and-re-entry-techniques-for-the-percutaneous-revascularization-of-coronary-chronic-total-occlusions
#13
Lorenzo Azzalini, Rustem Dautov, Emmanouil S Brilakis, Soledad Ojeda, Susanna Benincasa, Barbara Bellini, Aris Karatasakis, Jorge Chavarría, Bavana V Rangan, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
BACKGROUND: There are few data regarding the procedural and follow-up outcomes of different antegrade dissection/re-entry (ADR) techniques for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We compiled a multicenter registry of consecutive patients undergoing ADR-based CTO PCI at four high-volume specialized institutions. Patients were divided according to the specific ADR technique used: subintimal tracking and re-entry (STAR), limited antegrade subintimal tracking (LAST), or device-based with the CrossBoss/Stingray system (Boston Scientific, Marlborough, MA)...
November 16, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27885426/prospective-cohort-study-assessing-chronic-pain-in-patients-following-minor-surgery-for-breast-cancer
#14
Régis Fuzier, Floriane Puel, Philippe Izard, Agnès Sommet, Sébastien Pierre
PURPOSE: Pain after tumorectomy and sentinel lymph node dissection is poorly reported in the literature. We carried out a prospective survey aimed at assessing pain three months after such minor surgery for breast cancer. METHODS: The study was approved by the local ethics committee. Most surgeries followed a standard protocol involving general anesthesia with no regional analgesia technique, laryngeal mask, sufentanil and propofol for induction, and multimodal analgesia during the postoperative period...
November 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27885386/wrist-denervation-of-the-posterior-interosseous-nerve-through-a-volar-approach-a-new-technique-with-anatomical-considerations
#15
Stephan Grechenig, Surjit Lidder, Manuel Dreu, Claudia Dolcet, Lucy Marguerite Cooper, Georg Feigl
PURPOSE: Full or selective wrist denervation is an effective treatment for chronic wrist pain. In this cadaveric study, a volar approach for prophylactic denervation of the posterior interosseous nerve (PIN) and the anterior interosseous nerve (AIN) was assessed, which can simultaneously be performed during volar approaches for distal radius fracture fixation or in combination with metalwork removal. MATERIALS AND METHODS: In total 40 adult upper limbs, embalmed using Thiel's method, were investigated...
November 24, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27884493/initial-genetic-dissection-of-serum-neuroactive-steroids-following-chronic-intermittent-ethanol-across-bxd-mouse-strains
#16
Patrizia Porcu, Todd K O'Buckley, Marcelo F Lopez, Howard C Becker, Michael F Miles, Robert W Williams, A Leslie Morrow
Neuroactive steroids modulate alcohol's impact on brain function and behavior. Ethanol exposure alters neuroactive steroid levels in rats, humans, and some mouse strains. We conducted an exploratory analysis of the neuroactive steroids (3α,5α)-3-hydroxypregnan-20-one (3α,5α-THP), (3α,5α)-3,21-dihydroxypregnan-20-one (3α,5α-THDOC), and pregnenolone across 126-158 individuals and 19 fully inbred strains belonging to the BXD family, which were subjected to air exposure, or chronic intermittent ethanol (CIE) exposure...
November 10, 2016: Alcohol
https://www.readbyqxmd.com/read/27882742/esophageal-adenocarcinoma-and-barrett-esophagus-in-a-neurologically-impaired-teenager
#17
Jae-Yeon Hwang, Yeoun Joo Lee, Peter Chun, Dong Hoon Shin, Jae Hong Park
Esophageal adenocarcinoma (EAC) accompanied by Barrett esophagus (BE) is rare in patients younger than 20 years old. EAC in the upper esophagus is also rare. We report a rare case of EAC with BE that developed in the upper esophagus after chronic, untreated gastroesophageal reflux disease in a neurologically impaired teenager. A 19-year-old neurologically impaired man underwent endoscopy for evaluation of dysphagia and vomiting, and was diagnosed with EAC with BE. He underwent transthoracic esophagectomy, extensive lymph node dissection, and cervical esophagogastric anastomosis, but the prognosis was poor...
November 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27879958/evaluation-of-a-6-year-old-multicentric-standard-endovascular-treatment-of-critical-limb-ischemia-in-the-drug-eluting-era
#18
Vincenzo Brizzi, Caroline Caradu, Xavier Berard, Gerard Sassoust, Dominique Midy, Eric Ducasse
BACKGROUND: There has been increasing evidence to support the endovascular- first approach in the treatment of below the knee (BTK) lesions. Plain Old Balloon Angioplasty (POBA), with bailout bare-metal stent scaffolding in case of flow limiting dissection or recoil, have been considered the standard treatment of choice but industries are continually developing innovative equipment and dedicated technologies, such as drug-eluting platforms whose use is increasingly extended, despite significant costs and lack of high-quality evidence to support a well- established strategy...
November 23, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27875853/use-of-endoscopic-septotomy-for-the-treatment-of-late-staple-line-leaks-after-laparoscopic-sleeve-gastrectomy
#19
Mati Shnell, Nathan Gluck, Subhi Abu-Abeid, Erwin Santo, Sigal Fishman
Background: Staple-line leak following laparoscopic sleeve gastrectomy is a dire adverse event. While the treatment of acute and early leaks is well established, there is still dispute regarding late and chronic leaks. We describe an endoscopic approach combining septotomy and sleeve stricture dilation for treating late/chronic leaks. Methods: Ten consecutive patients with late/chronic proximal leaks were treated at our center. The septum separating the sleeve lumen from the perigastric cavity was progressively dissected over several sessions and the downstream stricture was pneumatically dilated...
November 22, 2016: Endoscopy
https://www.readbyqxmd.com/read/27875729/-seesaw-balloon-wire-cutting-technique-is-superior-to-tornus-catheter-in-balloon-uncrossable-chronic-total-occlusions
#20
Jingyi Xue, Jianqiang Li, Hongjun Wang, Li Sheng, Yongtai Gong, Danghui Sun, Shuang Li, Weimin Li, Dingyu Wang, Yue Li
BACKGROUND: Inability to advance a balloon is a well-recognized cause leading to a failure in recanalization of chronic total occlusions (CTOs) despite successfully passing a guidewire. A few techniques and devices have been introduced to facilitate balloon passage, especially the use of Tornus catheter. However, complex manipulation, expensive cost, and availability limit the application of these methods. This study was to evaluate the efficiency and safety of "seesaw balloon-wire cutting" technique in comparison with Tornus catheter for balloon uncrossable CTOs...
November 2, 2016: International Journal of Cardiology
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