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Mesenteric ischemia

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https://www.readbyqxmd.com/read/27901324/acute-mesenteric-ischemia-current-multidisciplinary-approach
#1
Ajay Savlania, Ramesh K Tripathi
The aim of this review is to describe and discuss the mechanisms of acute mesenteric ischemia (AMI) and the rationale and conduct of currently available endovascular and open surgical techniques in its management. We also propose an algorithm to support the current multidisciplinary approach in decision-making for mesenteric revascularization to manage this high-risk entity.
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27888303/dual-energy-ct-workflow-multi-institutional-consensus-on-standardization-of-abdominopelvic-mdct-protocols
#2
Bhavik N Patel, Lauren Alexander, Brian Allen, Lincoln Berland, Amir Borhani, Achille Mileto, Courtney Moreno, Desiree Morgan, Dushyant Sahani, William Shuman, Eric Tamm, Mitchell Tublin, Benjamin Yeh, Daniele Marin
PURPOSE: To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols. MATERIALS AND METHODS: 9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1-35) and 4.6 (1-14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4-contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0-not performing and shouldn't; 1-performing but not clinically useful; 2-performing but not sure if clinically useful; 3-not performing it but would like to; 4-performing and clinically useful) were used...
November 25, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27885390/ct-angiography-in-the-setting-of-suspected-acute-mesenteric-ischemia-prevalence-of-ischemic-and-alternative-diagnoses
#3
Frank Oliver Henes, Perry J Pickhardt, Andrzej Herzyk, Scott J Lee, Utaroh Motosugi, Thorsten Derlin, Meghan G Lubner, Gerhard Adam, Gerhard Schön, Peter Bannas
PURPOSE: The purpose of the study was to determine the prevalence of ischemic and alternative diagnoses and the diagnostic accuracy of CT angiography (CTA) in the setting of suspected acute mesenteric ischemia (AMI). MATERIAL AND METHODS: We included 959 patients undergoing CTA for the evaluation of suspected AMI. The final clinical diagnosis was used to determine the prevalence of ischemic and alternative diagnoses and to calculate the diagnostic accuracy of CTA...
November 24, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27865060/reducing-variation-in-feeding-newborns-with-congenital-heart-disease
#4
Janet M Simsic, Kirby-Rose Carpenito, Kristin Kirchner, Stephanie Peters, Holly Miller-Tate, Brian Joy, Mark Galantowicz
OBJECTIVE: Enteral feeding is associated with decreased infection rates, decreased mechanical ventilation, decreased hospital length of stay, and improved wound healing. Enteral feeding difficulties are common in congenital heart disease. Our objective was to develop experience-based newborn feeding guidelines for the initiation and advancement of enteral feeding in the cardiothoracic intensive care unit. DESIGN: This is a retrospective analysis of a quality improvement project...
November 16, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27864477/is-visceral-flow-during-intra-aortic-balloon-pumping-size-or-volume-dependent
#5
Sandro Gelsomino, Pieter W J Lozekoot, Monique M J de Jong, Fabiana Lucà, Orlando Parise, Francesco Matteucci, Mario Romano, Abdullrazak Hossien, Mark La Meir, Niccolò Marchionni, Jos G Maessen, Roberto Lorusso
AIM: We evaluated the influence of intra-aortic balloon size and volume on mesenteric and renal flows. METHODS: Thirty healthy swine underwent 120-minute ligation of the left anterior descending coronary artery followed by 6 hours of reperfusion. Then, they were randomly assigned to the following five groups of animals, with six animals in each group: no intra-aortic balloon pump (IABP), a short 35-mL IABP, a short 40-mL IABP, a long 35-mL IABP and a long 40-mL IABP...
November 17, 2016: Perfusion
https://www.readbyqxmd.com/read/27858375/diagnosis-of-non-occlusive-acute-mesenteric-ischemia-in-the-intensive-care-unit
#6
Simon Bourcier, Ammar Oudjit, Geoffrey Goudard, Julien Charpentier, Sarah Leblanc, Romain Coriat, Hervé Gouya, Bertrand Dousset, Jean-Paul Mira, Frédéric Pène
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is a common complication and accounts for a major cause of death in critically ill patients. The diagnosis of NOMI with respect to the eventual indications for surgical treatment is challenging. We addressed the performance of the diagnostic strategy of NOMI in the intensive care unit, with emphasis on contrast-enhanced abdominal CT-scan. METHODS: This was a retrospective monocenter study. Patients with clinically suspected acute mesenteric ischemia were included if a comprehensive diagnostic workup was carried out including surgical and/or endoscopic digestive explorations...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27858118/utility-of-amplatzer-vascular-plug-with-preoperative-common-hepatic-artery-embolization-for-distal-pancreatectomy-with-en-bloc-celiac-axis-resection
#7
Masafumi Toguchi, Masakatsu Tsurusaki, Isao Numoto, Syojiro Hidaka, Miho Yamakawa, Nobuyuki Asato, SungWoon Im, Yukinobu Yagyu, Mitsuru Matsuki, Yoshifumi Takeyama, Takamichi Murakami
PURPOSE: To evaluate the feasibility and safety of the Amplatzer vascular plug (AVP) for preoperative common hepatic embolization (CHA) before distal pancreatectomy with en bloc celiac axis resection (DP-CAR) to redistribute blood flow to the stomach and liver via the superior mesenteric artery (SMA). MATERIALS AND METHODS: Four patients (3 males, 1 female; median age 69 years) with locally advanced pancreatic body cancer underwent preoperative CHA embolization with AVP...
November 17, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27856668/endovascular-first-for-chronic-mesenteric-ischemia-and-the-importance-of-long-term-surveillance
#8
EDITORIAL
Jesse A Columbo, Ravinder Kang, Philip P Goodney
No abstract text is available yet for this article.
November 16, 2016: Angiology
https://www.readbyqxmd.com/read/27849300/ischemic-postconditioning-assessment-in-the-liver-of-rats-undergoing-mesenteric-ischemia-and-reperfusion
#9
Carlos Henrique Marques Dos Santos, Ricardo Dutra Aydos, Ed Nogueira, Luciana Nakao Odashiro Miiji, Pedro Carvalho Cassino, Isadora Ishaq Alves, Nádia Meneguesso Calheiros, Milena Garcia
Introduction: Ischemic postconditioning is a method that shows evidence of efficacy in minimizing reperfusion injury; however, its effectiveness in preventing injuries in distant organs is still unknown, especially in those who have undergone mesenteric ischemia and reperfusion. Objective: To evaluate the effect of ischemic postconditioning in preventing reperfusion injury in the liver of rats submitted to mesenteric ischemia and reperfusion, comparing two different methods of ischemic postconditioning...
July 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27842908/postconditioning-toll-erating-mesenteric-ischemia-reperfusion-injury
#10
Olivér Rosero, Péter Ónody, Tibor Kovács, Dávid Molnár, András Fülöp, Gábor Lotz, László Harsányi, Attila Szijártó
BACKGROUND: Postconditioning may prove to be a suitable method to decrease ischemia-reperfusion injury of intestine after mesenteric arterial occlusion. Toll-like-receptor-4 is involved in the pathophysiology of organ damage after ischemia-reperfusion; therefore, the aim of our study was to investigate the effect of postconditioning on the mucosal expression of toll-like-receptor-4. METHODS: Male Wistar rats (n = 10/group) underwent 60 minutes of superior mesenteric artery occlusion followed by 6 hours of reperfusion in 3 groups: sham-operated, ischemia-reperfusion, and a postconditioned group...
November 11, 2016: Surgery
https://www.readbyqxmd.com/read/27834292/mesenteric-vascular-dysregulation-and-intestinal-inflammation-accompanies-experimental-spinal-cord-injury
#11
Emily M Besecker, Gina M Deiter, Nicole Pironi, Timothy K Cooper, Gregory Michael Holmes
Cervical and high thoracic spinal cord injury (SCI) drastically impairs autonomic nervous system function. Individuals with SCI at thoracic spinal-level 5 (T5) or higher often present cardiovascular disorders that include resting systemic arterial hypotension. Gastrointestinal (GI) tissues are critically dependent upon adequate blood flow and even brief periods of visceral hypoxia triggers GI dysmotility. The aim of this study was to test the hypothesis that T3-SCI induces visceral hypoperfusion, diminished postprandial vascular reflexes and concomitant visceral inflammation...
November 9, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27832292/takayasu-arteritis-ta-first-presenting-with-intestinal-ischemia-a-case-report-and-review-of-gastrointestinal-tract-involvement-ischemic-and-non-ischemic-associated-with-ta
#12
REVIEW
Durga Prasanna Misra, Nagarajan Krishnan, Debasis Gochhait, Dantis Emmanuel, Vir Singh Negi
Takayasu arteritis (TA) is a large vessel vasculitis involving the aorta and its major branches. Insidious inflammation usually results in gradual arterial narrowing; however, critical organ ischemia is rare. We describe a young male with TA who presented with acute mesenteric ischemia requiring intestinal resection, followed by critical limb ischemia. In our literature review, we identified intestinal gangrene as a rare manifestation of TA. However, intestinal ischemia as the first manifestation of TA has been scarcely reported in the literature...
November 10, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27824535/update-on-the-management-of-intestinal-failure
#13
REVIEW
Shishira Bharadwaj, Parul Tandon, John M Rivas, Anne Furman, Lisa Moccia, Ashley Ratliff, Abdullah Shatnawei, Ezra Steiger, Donald F Kirby
Intestinal failure is a serious complication of conditions such as inflammatory bowel disease, mesenteric ischemia, and radiation enteritis--and of extensive bowel resection performed because of these diseases. Imbalances of fluids and electrolytes and poor nutritional status manifest as chronic diarrhea or increased ostomy output. Prompt referral to a center specializing in intestinal rehabilitation is key to achieving nutritional homeostasis and, in some cases, can help the patient return to oral food intake...
November 2016: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/27816167/inhibition-of-sphingosine-1-phosphate-receptors-in-ischemia-reperfusion-injured-autoimmunity-prone-mice
#14
Jess Edison, Sharon Frattalone, Christopher Tracy, Geoffrey E Woodard, Melissa Butts, C M Moratz
B6.MRL/lpr mice, an autoimmune strain, have an accelerated injury time course, increased intensity of tissue damage, and increased CD4+ T cell infiltration in the mesenteric ischemia/reperfusion injury model. In this study, the mechanism by which CD4+ T cells were recruited into injured tissue was addressed. Fingolimod (FTY720) was utilized to assess the role of infiltrating CD4+ T cells. FTY720 treatment was more effective in attenuating injury in B6.MRL/lpr mice then in control mice. Reduced CD4+ cell infiltration and tissue injury correlated with decreased neutrophil infiltration and pro-inflammatory cytokine generation...
October 27, 2016: Cellular Immunology
https://www.readbyqxmd.com/read/27816060/septic-shock-with-no-diagnosis-at-24-hours-a-pragmatic-multicenter-prospective-cohort-study
#15
Damien Contou, Damien Roux, Sébastien Jochmans, Rémi Coudroy, Emmanuel Guérot, David Grimaldi, Sylvie Ricome, Eric Maury, Gaëtan Plantefève, Julien Mayaux, Armand Mekontso Dessap, Christian Brun-Buisson, Nicolas de Prost
BACKGROUND: The lack of a patent source of infection after 24 hours of management of shock considered septic is a common and disturbing scenario. We aimed to determine the prevalence and the causes of shock with no diagnosis 24 hours after its onset, and to compare the outcomes of patients with early-confirmed septic shock to those of others. METHODS: We conducted a pragmatic, prospective, multicenter observational cohort study in ten intensive care units (ICU) in France...
November 6, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27807542/could-mean-platelet-volume-be-a-reliable-indicator-for-acute-mesenteric-ischemia-diagnosis-a-case-control-study
#16
Vermi Degerli, Isil Ergin, Fulya Yilmaz Duran, Mehmet Akif Ustuner, Ozgur Duran
Objective. Acute mesenteric ischemia (AMI) is a disease, usually seen in elderly people and accompanied by comorbid diseases. Mean platelet volume (MPV), the significant indicator of platelet activation and function, is associated with AMI. In this study, we considered that we can use MPV as a reliable indicator in the diagnosis of AMI. Methods. This study was conducted among AMI patients with two control groups. Age, gender, MPV, platelet count, concomitant diseases, abdominal computed tomography, and patient outcomes were recorded for evaluation...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27798536/influences-of-vagotomy-on-gut-ischemia-reperfusion-injury-in-mice
#17
Motonari Ri, Kazuhiko Fukatsu, Taiki Miyakuni, Masashi Yanagawa, Satoshi Murakoshi, Hiroshi Yasuhara, Yasuyuki Seto
BACKGROUND: How vagotomy affects host responses to gut ischemia-reperfusion (I/R) is unclear. MATERIALS AND METHODS: Exp.1: Male Institute of Cancer Research mice (n = 22) were assigned to the I/R or the vago-I/R group. The I/R mice underwent 45-minute superior mesenteric artery (SMA) occlusion. The vago-I/R mice received vagotomy before SMA occlusion. Survival was observed for 48 hours.Exp.2: Mice (n = 55) were divided into 4 groups (Sham, vago, I/R, vago-I/R)...
October 26, 2016: Shock
https://www.readbyqxmd.com/read/27795815/arterial-complication-of-irreversible-electroporation-procedure-for-locally-advanced-pancreatic-cancer
#18
Yahya Ekici, Tugan Tezcaner, Hüseyin Onur Aydın, Fatih Boyvat, Gökhan Moray
Irreversible electroporation (IRE) is a non-thermal ablation technique used especially in locally advanced pancreatic carcinomas that are considered surgically unresectable. We present the first case of acute superior mesenteric artery (SMA) occlusion secondary to pancreatic IRE procedure that has not been reported before in the literature. A 66-year-old man underwent neoadjuvant chemoradiotherapy for locally advanced pancreatic ductal adenocarcinoma. IRE procedure was applied to the patient during laparotomy under general anesthesia...
October 15, 2016: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27793620/concomitant-parallel-endografting-and-fenestrated-experience-in-a-regional-aortic-center
#19
Mathew Wooster, Adam Tanious, Shivangi Patel, Neil Moudgill, Martin Back, Murray Shames
BACKGROUND: Off-label parallel endografting (PE) has been increasingly criticized in favor of on-label custom fenestrated endografts. There remain limited direct comparisons, however, between concurrent patient populations treated by similarly experienced operators. Hence, we seek to evaluate the relative efficacy of the two techniques in treating complex aortic pathology. METHODS: All patients treated by PE or with Cook Zenith Fenestrated (Zfen) devices from January 2010 to June 2015 were reviewed, excluding those treated for rupture...
October 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27773774/does-management-of-true-aneurysms-of-peripancreatic-arteries-require-repair-of-associated-celiac-artery-stenosis
#20
Julia M Boll, Kenneth W Sharp, C Louis Garrard, Thomas C Naslund, John A Curci, R James Valentine
BACKGROUND: True aneurysms of the gastroduodenal (GDA) and pancreaticoduodenal (PDA) arteries have been attributed to increased collateral flow due to tandem celiac artery stenosis or occlusion. While GDA/PDA aneurysm exclusion is recommended because of the high reported risk of rupture, it remains uncertain whether simultaneous celiac artery reconstruction is necessary to preserve end-organ flow. STUDY DESIGN: A retrospective analysis of consecutive patients admitted 1996-2015 with true aneurysms of the GDA or PDA...
October 20, 2016: Journal of the American College of Surgeons
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