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https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#1
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29132880/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-peripheral-or-carotid-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#2
Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf
BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29109626/action-and-resistance-mechanisms-of-antibiotics-a-guide-for-clinicians
#3
REVIEW
Garima Kapoor, Saurabh Saigal, Ashok Elongavan
Infections account for a major cause of death throughout the developing world. This is mainly due to the emergence of newer infectious agents and more specifically due to the appearance of antimicrobial resistance. With time, the bacteria have become smarter and along with it, massive imprudent usage of antibiotics in clinical practice has resulted in resistance of bacteria to antimicrobial agents. The antimicrobial resistance is recognized as a major problem in the treatment of microbial infections. The biochemical resistance mechanisms used by bacteria include the following: antibiotic inactivation, target modification, altered permeability, and "bypass" of metabolic pathway...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29107024/relaxant-effect-of-the-prostacyclin-analogue-iloprost-on-isolated-human-radial-artery-an-approach-for-the-reversal-of-graft-spasm
#4
Ersoy Engin, F İlkay Alp Yildirim, Deniz Kalelі Durman, Suat Nail Ömeroğlu, Deniz Göksedef, Önder Teskіn, Ozan Onur Balkanay, Gökhan İpek, B Sönmez Uydeş Doğan
Radial artery graft spasm in the perioperative or postoperative period of coronary bypass surgery necessitates urgent treatment due to risk of graft failure and mortality. Herein, we evaluated the effect of iloprost, a prostacyclin (PGI2) analogue, against the contractions produced by noradrenaline and potassium chloride on isolated human radial artery. Following the determination of endothelial and vascular relaxing capacities of the arteries, iloprost (10(-9)M-10(-6)M) was cumulatively applied on rings precontracted submaximally with the spasmogens...
October 26, 2017: Prostaglandins & Other Lipid Mediators
https://www.readbyqxmd.com/read/29102362/drug-eluting-stents-in-elderly-patients-with-coronary-artery-disease-senior-a-randomised-single-blind-trial
#5
Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve
BACKGROUND: Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The aim of this study was to compare outcomes between these two types of stents with a short duration of DAPT in such patients. METHODS: In this randomised single-blind trial, we recruited patients from 44 centres in nine countries. Patients were eligible if they were aged 75 years or older; had stable angina, silent ischaemia, or an acute coronary syndrome; and had at least one coronary artery with a stenosis of at least 70% (≥50% for the left main stem) deemed eligible for percutaneous coronary intervention (PCI)...
October 31, 2017: Lancet
https://www.readbyqxmd.com/read/29099857/knockout-of-apolipoprotein-e-in-rabbit-promotes-premature-intervertebral-disc-degeneration-a-new-in-vivo-model-for-therapeutic-approaches-of-spinal-disc-disorders
#6
Anja Beierfuß, Hermann Dietrich, Christian Kremser, Monika Hunjadi, Andreas Ritsch, Thomas Rülicke, Claudius Thomé, Demissew Shenegelegn Mern
Intervertebral disc (IVD) degeneration that accelerates the loss of disc structural and functional integrities is recognized as one of the major factors of chronic back pain. Cardiovascular risk factors, such as deficits of apolipoproteins that elevate the levels of cholesterol and triglycerides, are considered critical for the progress of atherosclerosis; notably in the abdominal aorta and its lumbar branching arteries that supply lumbar vertebrae and IVDs. Obstruction of the lumbar arteries by atherosclerosis is presumed to promote lumbar disc degeneration and low back pain...
2017: PloS One
https://www.readbyqxmd.com/read/29098094/severe-undifferentiated-vasoplegic-shock-refractory-to-vasoactive-agents-treated-with-methylene-blue
#7
Farheen Manji, Benjamin Wierstra, Juan Posadas
Methylene blue is a phenothiazine-related heterocyclic aromatic molecule presently used in the treatment of methemoglobinemia. Recently, it has been implicated in the treatment of severe refractory vasoplegic shock caused by anaphylaxis, sepsis, or postcardiopulmonary bypass. We present a case of a 27-year-old male with profound vasoplegic shock of unknown etiology which was refractory to vasopressors who responded within hours to a single dose of methylene blue. Additionally, we review the evidence of methylene blue's role in the treatment of shock...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29094008/total-joint-replacement-in-inhibitor-positive-haemophilia-long-term-outcome-analysis-in-fifteen-patients
#8
Heidi Danielson, Riitta Lassila, Pekka Ylinen, Timo Yrjönen
AIM: To collect data from joint replacement in inhibitor patients, evaluate haemostatic and patient outcomes, and analyse the costs. METHODS: We report our 21-year, single-centre cumulative experience of 15 joint arthroplasties in six inhibitor patients. RESULTS: Two low responder inhibitor patients were in the early days treated with FVIII, whereas bypassing agents were used in the rest of the high responder patients. The primary haemostatic outcome was good in 8/15, fair in 4/15 and poor in 3/15 operations...
October 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29079863/the-ste12-like-transcription-factor-maste12-is-involved-in-pathogenicity-by-regulating-the-appressorium-formation-in-the-entomopathogenic-fungus-metarhizium-acridum
#9
Qinglv Wei, Yanru Du, Kai Jin, Yuxian Xia
Homeodomain transcription factor Ste12 is a key target activated by the pathogenic mitogen-activated-protein kinase pathway, and the activated Ste12p protein regulates downstream gene expression levels to modulate phenotypes. However, the functions of Ste12-like genes in entomopathogenic fungi remain poorly understood and little is known about the downstream genes regulated by Ste12. In this study, we characterized the functions of a Ste12 orthologue in Metarhizium acridum, MaSte12, and identified its downstream target genes...
October 28, 2017: Applied Microbiology and Biotechnology
https://www.readbyqxmd.com/read/29051804/review-of-recombinant-anti-haemophilic-porcine-sequence-factor-viii-in-adults-with-acquired-haemophilia-a
#10
REVIEW
Emma Fosbury, Anja Drebes, Anne Riddell, Pratima Chowdary
Acquired haemophilia A (AHA) is a rare, serious bleeding disorder most often encountered in elderly patients. The mainstay of haemostatic management is with bypassing agents (BPAs) including recombinant activated factor VII (rFVIIa) and activated prothrombin complex concentrates (aPCCs). Their major limitation is incomplete efficacy, potential risk for thrombosis and the lack of routine laboratory assays for monitoring treatment response. Plasma-derived porcine FVIII (pd-pFVIII, Hyate C(®)), first used in the 1950s for the management of congenital haemophilia, has sufficient sequence homology to be haemostatic in humans, but the lack of complete homology facilitates efficacy even in the presence of human allo- and autoantibodies against human FVIII (hFVIII)...
September 2017: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/29042366/emicizumab-a-bispecific-antibody-recognizing-coagulation-factors-ix-and-x-how-does-it-actually-compare-to-factor-viii
#11
Peter J Lenting, Cécile V Denis, Olivier D Christophe
During the last decade, the development of improved and novel approaches for the treatment of hemophilia A has expanded tremendously. These approaches include factor VIII (FVIII) with extended half-life (e.g. FVIII-Fc and PEGylated FVIII), monoclonal antibodies targeting tissue factor pathway inhibitor, si-RNA to reduce antithrombin expression and the bispecific antibody ACE910/Emicizumab. Emicizumab is a bispecific antibody recognizing both the enzyme factor IXa (FIXa) and the substrate factor X (FX). By simultaneously binding enzyme and substrate, Emicizumab mimics some part of the function exerted by the original cofactor FVIII, in that it promotes co-localization of the enzyme/substrate complex...
October 17, 2017: Blood
https://www.readbyqxmd.com/read/29033836/delivery-of-antioxidant-and-anti-inflammatory-agents-for-tissue-engineered-vascular-grafts
#12
REVIEW
Kenyatta S Washington, Chris A Bashur
The treatment of patients with severe coronary and peripheral artery disease represents a significant clinical need, especially for those patients that require a bypass graft and do not have viable veins for autologous grafting. Tissue engineering is being investigated to generate an alternative graft. While tissue engineering requires surgical intervention, the release of pharmacological agents is also an important part of many tissue engineering strategies. Delivery of these agents offers the potential to overcome the major concerns for graft patency and viability...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29025825/comparison-of-the-cerebroprotective-effect-of-inhalation-anaesthesia-and-total-intravenous-anaesthesia-in-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-a-systematic-review-and-meta-analysis
#13
Feng Chen, Guangyou Duan, Zhuoxi Wu, Zhiyi Zuo, Hong Li
OBJECTIVE: Neurological dysfunction remains a devastating postoperative complication in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), and previous studies have shown that inhalation anaesthesia and total intravenous anaesthesia (TIVA) may produce different degrees of cerebral protection in these patients. Therefore, we conducted a systematic literature review and meta-analysis to compare the neuroprotective effects of inhalation anaesthesia and TIVA. DESIGN: Searching in PubMed, EMBASE, Science Direct/Elsevier, China National Knowledge Infrastructure and Cochrane Library up to August 2016, we selected related randomised controlled trials for this meta-analysis...
October 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/29016380/comparison-of-del-nido-cardioplegia-with-blood-cardioplegia-in-adult-combined-surgery
#14
Raphael Hamad, Anthony Nguyen, Éric Laliberté, Denis Bouchard, Yoan Lamarche, Ismail El-Hamamsy, Philippe Demers
OBJECTIVE: del Nido solution (DNS) is a single-dose cardioplegia designed for pediatric use proposed to offer superior myocardial protection in adults. However, few data support this claim. We hypothesized that DNS and modified blood cardioplegia solution (BS) provide equivalent safety in combined adult valve surgery. METHODS: Between November 2014 and December 2015, 25 patients underwent primary aortic valve replacement and concomitant coronary artery bypass grafting (CABG) with DNS...
September 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28994673/an-innovative-technique-to-improve-safety-of-volatile-anesthetics-suction-from-the-cardiopulmonary-bypass-circuit
#15
Francesco De Simone, Luigi Cassarà, Salvatore Sardo, Elena Scarparo, Omar Saleh, Caetano Nigro Neto, Alberto Zangrillo, Giovanni Landoni
CONTEXT: Myocardial injury during cardiac surgery on cardiopulmonary bypass (CPB) is a major determinant of morbidity and mortality. Preclinical and clinical evidence of dose- and time-related cardioprotective effects of volatile anesthetic drugs exist and their use during the whole surgery duration could improve perioperative cardiac protection. Even if administering volatile agents during CPB are relatively easy, technical problems, such as waste gas scavenging, may prevent safe and manageable administration of halogenated vapors during CPB...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28992285/remote-ischaemic-preconditioning-for-renal-and-cardiac-protection-in-adult-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#16
Giacomo Deferrari, Alice Bonanni, Maurizio Bruschi, Cristiano Alicino, Alessio Signori
Background: The main aim of this systematic review was to assess whether remote ischaemic preconditioning (RIPC) protects kidneys and the heart in cardiac surgery with cardiopulmonary bypass (CPB) and to investigate a possible role of anaesthetic agents. Methods: Randomized clinical trials (RCTs) on the effects of RIPC through limb ischaemia in adult patients undergoing cardiac surgery with CPB were searched (1965-October 2016) in PubMed, Cochrane Library and article reference lists...
July 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28979044/use-of-volatile-anesthetic-agent-in-extracorporeal-circuit-as-a-cause-of-break-in-polycarbonate-connector-lessons-learnt
#17
Deepak Gowda, K Rashmi, Naveen Pandarinathan, Neelam Desai
Mishaps, near misses, and lethal incidents are known to occur during cardiopulmonary bypass. We share one such rare case of break in polycarbonate connector because of the use of isoflurane in extracorporeal circuit and its successful management.
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28976519/therapeutic-effects-of-a-novel-sirna-based-anti-vegf-sivegf-nanoball-for-the-treatment-of-choroidal-neovascularization
#18
Na-Kyung Ryoo, Jihwang Lee, Hyunjoo Lee, Hye Kyoung Hong, Hyejin Kim, Jong Bum Lee, Se Joon Woo, Kyu Hyung Park, Hyuncheol Kim
Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries and is characterized by the development of choroidal neovascularization (CNV). Therapies for AMD have focused on suppressing angiogenic factors, such as vascular endothelial growth factor (VEGF), mainly via conventional anti-VEGF antibody agents. However, additional efforts have been made to develop effective small-interfering RNA (siRNA)-based intracellular therapeutic agents. In this study, we have manufactured a novel siRNA-based anti-VEGF nanoball (siVEGF NB)...
October 19, 2017: Nanoscale
https://www.readbyqxmd.com/read/28971172/the-use-of-monocyte-to-hdl-ratio-to-predict-postoperative-atrial-fibrillation-after-aortocoronary-bypass-graft-surgery
#19
Ahmet Ilker Tekkesin, Mert Ilker Hayiroglu, Regayip Zehir, Ceyhan Turkkan, Muhammed Keskin, Goksel Cinier, Ahmet Taha Alper
OBJECTIVE: Postoperative atrial fibrillation (POAF) is a frequent and serious complication after aortocoronary bypass graft (ACBG) surgery and one that, unfortunately, increases morbidity and mortality. Postoperative stroke, hemodynamic instability, renal failure, infection, need for inotropic agent and coronary unit are complications caused by POAF. Inflammation and oxidative stress are among several mechanisms that contribute to pathogenesis of POAF. Monocyte to HDL (M/H) ratio is a newly defined parameter of both inflammation and oxidative stress...
2017: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/28970816/direct-visualization-of-arterial-emboli-in-moyamoya-syndrome
#20
Julie G Shulman, Samuel Snider, Henri Vaitkevicius, Viken L Babikian, Nirav J Patel
BACKGROUND: Hemodynamic insufficiency is often considered the cause of ischemic stroke in patients with moyamoya syndrome. While high-intensity transient signals (HITS) on transcranial Doppler (TCD) have been reported in this population, the relationship between these signals and ischemic symptoms is not clearly established. Accordingly, current treatment is directed at improving perfusion. CLINICAL PRESENTATION: We present two patients with symptoms of cerebral ischemia and angiographic findings of moyamoya syndrome...
2017: Frontiers in Neurology
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