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Gilbert upchurch

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https://www.readbyqxmd.com/read/29642797/recurrent-aortic-dissection-in-a-patient-with-an-actin-mutation-treated-with-a-laser-fenestrated-aortic-arch-stent-graft
#1
J Michael Cullen, Gorav Ailawadi, John F Angle, Matthew Thomas, Gilbert R Upchurch
A 58-year-old African American female, who had previously undergone a valve-sparing aortic root replacement for a type A dissection, represented 2 months later with a new focal dissection and aneurysm with intramural hematoma just distal to the origin of the left subclavian artery. Since no landing zone distal to the subclavian artery existed, the patient underwent thoracic endovascular aortic repair with laser fenestration-aided stent-graft placement in the left subclavian artery. The patient recovered without complication, and 52 months later, she is doing well with normal renal function and ambulatory status...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29617537/practical-guide-to-surgical-data-sets-society-for-vascular-surgery-vascular-quality-initiative-svs-vqi
#2
Sapan S Desai, Amy H Kaji, Gilbert Upchurch
No abstract text is available yet for this article.
April 4, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29606569/preoperative-dementia-is-associated-with-increased-cost-and-complications-after-vascular-surgery
#3
J Hunter Mehaffey, Robert B Hawkins, Margaret C Tracci, William P Robinson, Kenneth J Cherry, John A Kern, Gilbert R Upchurch
OBJECTIVE: Dementia represents a major risk factor for medical complications and has been linked to higher rates of complication after surgery. Given the systemic nature of vascular disease, medical comorbidities significantly increase cost and complications after vascular surgery. We hypothesize that the presence of dementia is an independent predictor of increased postoperative complications and higher health care costs after vascular surgery. METHODS: The Vascular Quality Initiative database was queried for all patients undergoing vascular surgery at a single academic medical center from 2012 to 2017...
March 29, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29482999/surgeon-scientists-are-disproportionately-affected-by-declining-nih-funding-rates
#4
Adishesh K Narahari, J Hunter Mehaffey, Robert B Hawkins, Eric J Charles, Pranav K Baderdinni, Anirudha S Chandrabhatla, Joseph W Kocan, R Scott Jones, Gilbert R Upchurch, Irving L Kron, John A Kern, Gorav Ailawadi
BACKGROUND: Obtaining National Institutes of Health (NIH) funding over the last 10 years has become increasingly difficult due to a decrease in the number of research grants funded and an increase in the number of NIH applications. STUDY DESIGN: National Institutes of Health funding amounts and success rates were compared for all disciplines using data from NIH, Federation of American Societies for Experimental Biology (FASEB), and Blue Ridge Medical Institute. Next, all NIH grants (2006 to 2016) with surgeons as principal investigators were identified using the National Institutes of Health Research Portfolio Online Reporting Tools Expenditures and Results (NIH RePORTER), and a grant impact score was calculated for each grant based on the publication's impact factor per funding amount...
April 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29477203/invited-commentary
#5
Ashish K Sharma, Gilbert R Upchurch
No abstract text is available yet for this article.
March 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29472233/novel-role-of-il-interleukin-1%C3%AE-in-neutrophil-extracellular-trap-formation-and-abdominal-aortic-aneurysms
#6
Akshaya K Meher, Michael Spinosa, John P Davis, Nicolas Pope, Victor E Laubach, Gang Su, Vlad Serbulea, Norbert Leitinger, Gorav Ailawadi, Gilbert R Upchurch
OBJECTIVE: Neutrophils promote experimental abdominal aortic aneurysm (AAA) formation via a mechanism that is independent from MMPs (matrix metalloproteinases). Recently, we reported a dominant role of IL (interleukin)-1β in the formation of murine experimental AAAs. Here, the hypothesis that IL-1β-induced neutrophil extracellular trap formation (NETosis) promotes AAA was tested. APPROACH AND RESULTS: NETs were identified through colocalized staining of neutrophil, Cit-H3 (citrullinated histone H3), and DNA, using immunohistochemistry...
April 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29452629/continuous-betadine-bacitracin-irrigation-for-vascular-graft-infections-a-case-series
#7
David V Strider, Catherine R Ratliff, Kenneth J Cherry, Gilbert R Upchurch
The aim of the study was to conduct a retrospective chart review of patients who underwent betadine/bacitracin continuous irrigation (BBCI) for vascular graft infections (VGIs) to review its use as a treatment option. A retrospective chart review from 2013 to 2017 was conducted of patients with VGIs that were treated with BBCI postremoval of the infected graft. The BBCI is a continuous infusion of 0.25% betadine in normal saline at 0.3 mL/kg/h for 48 hours then followed by bacitracin infusion with a concentration of 50,000 units bacitracin/per liter normal saline at 0...
March 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/29195736/a-novel-reproducible-model-of-aortic-aneurysm-rupture
#8
Anna Z Fashandi, Robert B Hawkins, Morgan D Salmon, Michael D Spinosa, William G Montgomery, J Michael Cullen, Guanyi Lu, Gang Su, Gorav Ailawadi, Gilbert R Upchurch
INTRODUCTION: Given the unknown biologic antecedents before aortic aneurysm rupture, the purpose of this study was to establish a reproducible model of aortic aneurysm rupture. METHODS: We fed 7-week-old apolipoprotein E deficient mice a high-fat diet for 4 weeks and osmotic infusion pumps containing Angiotensin II were implanted. Angiotensin II was delivered continuously for 4 weeks at either 1,000 ng/kg/min (n = 25) or 2,000 ng/kg/min (n = 29). A third group (n = 14) were given Angiotensin II at 2,000 ng/kg/min and 0...
February 2018: Surgery
https://www.readbyqxmd.com/read/29117313/outcomes-in-asymptomatic-redo-carotid-endartectomy-a-word-of-caution
#9
Rishi A Roy, Gilbert R Upchurch
No abstract text is available yet for this article.
November 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29117077/vascular-graft-infection-incidence-and-potential-risk-factors
#10
Catherine R Ratliff, David Strider, Tanya Flohr, Danielle Moses, Virginia Rovnyak, Julie Armatas, Jennifer Johnson, Alison Okerlund, Mary Baldwin, Marian Lawson, Suzanne Fuhrmeister, Margaret C Tracci, Gilbert R Upchurch, Kenneth J Cherry
PURPOSE: The purpose of this study was to identify factors that increase the risk of vascular graft infections (VGI) in patients following abdominal or lower extremity revascularization surgery. DESIGN: Retrospective, descriptive study. METHODS: We reviewed the electronic health records of 223 patients who had undergone abdominal or lower extremity revascularization procedures from July 2012 to November 2014, looking for factors associated with VGI...
November 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29066242/estimating-risk-of-adverse-cardiac-event-after-vascular-surgery-using-currently-available-online-calculators
#11
Danielle A Moses, Lily E Johnston, Margaret C Tracci, William P Robinson, Kenneth J Cherry, John A Kern, Gilbert R Upchurch
BACKGROUND: The decision to proceed with vascular surgical interventions requires evaluation of cardiac risk. Recently, several online risk calculators were created to predict outcomes and to lead to a more informed conversation between surgeons and patients. The objective of this study was to compare and further validate these online calculators with actual adverse cardiac outcomes at a single institution. METHODS: All patients from January 2011 through December 2015 undergoing carotid endarterectomy (CEA), infrainguinal lower extremity bypass, open abdominal aortic aneurysm (AAA) repair, and endovascular aneurysm repair (EVAR) on the vascular surgical service were included using the Society for Vascular Surgery Vascular Quality Initiative database at our health system...
January 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28890062/national-utilization-and-outcomes-of-redo-lower-extremity-bypass-versus-endovascular-intervention-after-a-previous-failed-bypass
#12
J Hunter Mehaffey, Alexander Shannon, Robert B Hawkins, Anna Fashandi, Margret C Tracci, Irving L Kron, Gilbert R Upchurch, William P Robinson
BACKGROUND: Redo lower extremity bypass (LEB) and infrainguinal endovascular intervention (IEI) are options to treat critical limb ischemia after a failed prior LEB, but the utilization and outcomes of each are poorly described. The purpose of this study was to compare 30-day major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) after LEB and IEI in patients with a failed prior ipsilateral LEB and determine risk factors for each composite outcome. METHODS: Patients with prior failed ipsilateral LEB who underwent LEB or IEI involving the same arterial segment for critical limb ischemia were identified in the National Surgical Quality Improvement Program (NSQIP) Vascular Targeted File (2011-2014)...
February 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28765077/resolution-of-vascular-injury-specialized-lipid-mediators-and-their-evolving-therapeutic-implications
#13
REVIEW
Bian Wu, Giorgio Mottola, Melinda Schaller, Gilbert R Upchurch, Michael S Conte
Acute vascular injury occurs in a number of important clinical contexts, including spontaneous disease-related events (e.g. plaque rupture, thrombosis) and therapeutic interventions such as angioplasty, stenting, or bypass surgery. Endothelial cell (EC) disruption exposes the underlying matrix, leading to a rapid deposition of platelets, coagulation proteins, and leukocytes. A thrombo-inflammatory response ensues characterized by leukocyte recruitment, vascular smooth muscle cell (VSMC) activation, and the elaboration of cytokines, reactive oxygen species and growth factors within the vessel wall...
December 2017: Molecular Aspects of Medicine
https://www.readbyqxmd.com/read/28756047/effectiveness-of-surgical-interventions-for-thoracic-aortic-aneurysms-a-systematic-review-and-meta-analysis
#14
REVIEW
Mouaz Alsawas, Feras Zaiem, Laura Larrea-Mantilla, Jehad Almasri, Patricia J Erwin, Gilbert R Upchurch, M Hassan Murad
OBJECTIVE: A systematic review and meta-analysis was conducted to evaluate the effectiveness of thoracic endovascular aortic repair (TEVAR) and open repair in patients with descending thoracic aortic aneurysms (TAAs). METHODS: PubMed, Ovid MEDLINE, Ovid Embase, EBSCO Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from each database's inception to January 29, 2016. We selected studies that compared the two approaches in adults with TAAs and reported 30-day mortality or procedure complications...
October 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28655549/lower-extremity-bypass-for-critical-limb-ischemia-decreases-major-adverse-limb-events-with-equivalent-cardiac-risk-compared-with-endovascular-intervention
#15
COMPARATIVE STUDY
J Hunter Mehaffey, Robert B Hawkins, Anna Fashandi, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Lower extremity bypass (LEB) has traditionally been the "gold standard" in the treatment of critical limb ischemia (CLI). Infrainguinal endovascular intervention (IEI) has become more commonly performed than LEB, but comparative outcomes are limited. We sought to compare rates of major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) after LEB and IEI in a propensity score-matched, national cohort of patients with CLI. METHODS: The National Surgical Quality Improvement Program (NSQIP) vascular targeted files (2011-2014) for LEB and IEI were merged...
October 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28579290/improved-outcomes-and-value-in-staged-hybrid-extent-ii-thoracoabdominal-aortic-aneurysm-repair
#16
COMPARATIVE STUDY
Robert B Hawkins, J Hunter Mehaffey, Adishesh K Narahari, Amit Jain, Ravi K Ghanta, Irving L Kron, John A Kern, Gilbert R Upchurch
OBJECTIVE: Complex Crawford extent II thoracoabdominal aortic aneurysms (TAAAs) can be treated in a hybrid manner with proximal thoracic endovascular aneurysm repair, followed by staged distal open thoracoabdominal repair. This study evaluated the outcomes and health care-associated value of this new method compared with traditional open repair over 10 years. METHODS: A prospectively collected database was used to identify all patients with an extent II TAAA undergoing repair at a single institution between 2005 and 2015...
November 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28559173/surgeon-not-institution-case-volume-is-associated-with-limb-outcomes-after-lower-extremity-bypass-for-critical-limb-ischemia-in-the-vascular-quality-initiative
#17
Lily E Johnston, Margaret C Tracci, John A Kern, Kenneth J Cherry, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Studies from large administrative databases have demonstrated associations between institutional case volume and outcomes after lower extremity bypass (LEB). We hypothesized that increased institutional and surgeon volume would be associated with improved outcomes after LEB. Using a national, prospectively collected clinical database, the objective of this study was to determine the effects of both surgeon and institutional volume on outcomes after LEB. METHODS: The Vascular Quality Initiative (VQI) was queried to identify all LEBs for critical limb ischemia or claudication between 2004 and 2014...
November 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28342506/invited-commentary
#18
Gilbert R Upchurch
No abstract text is available yet for this article.
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28318554/decubitus-ulcers-in-patients-undergoing-vascular-operations-do-not-influence-mortality-but-affect-resource-utilization
#19
COMPARATIVE STUDY
J Hunter Mehaffey, Amani D Politano, Castigliano M Bhamidipati, Margaret C Tracci, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch
BACKGROUND: While it is anticipated that decubitus ulcers are detrimental to outcomes after vascular operations, the contemporary influence of perioperative decubitus ulcers in vascular surgery remains unknown. METHODS: Using the National Impatient Survey, all adult patients who underwent vascular operation were selected. Patients were stratified by the presence or absence (non-decubitus ulcers) of decubitus ulcer. Case-mix adjusted hierarchical mixed-models examined in-hospital mortality, the occurrence of any complication, and discharge disposition...
June 2017: Surgery
https://www.readbyqxmd.com/read/28274752/a-novel-chronic-advanced-stage-abdominal-aortic-aneurysm-murine-model
#20
Guanyi Lu, Gang Su, John P Davis, Basil Schaheen, Emily Downs, R Jack Roy, Gorav Ailawadi, Gilbert R Upchurch
OBJECTIVE: The purpose of this study was to establish a reliable, chronic model of abdominal aortic aneurysm (AAA). METHODS: Wild-type 8-week-old C56BL/6 male mice (n = 120) were equally divided into three groups: (1) BAPN group: 0.2% 3-aminopropionitrile fumarate salt (BAPN) drinking water was provided to mice 2 days before surgery until the end of study. Sham aneurysm induction surgery was performed using 5 μL of heat deactivated elastase. (2) Elastase group: mice were given regular drinking water without BAPN...
July 2017: Journal of Vascular Surgery
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