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https://www.readbyqxmd.com/read/28427109/traveler-s-diarrhea-vision-abnormalities-and-unsteady-gait-in-a-young-woman
#1
Tobias Mühling, Felix Gundling, Thomas Helmberger, Wolfgang Schepp
We report on the course of disease in a young woman, originally admitted with suspected refractory infectious tropical traveler's diarrhea. However, symptoms did not resolve upon either symptomatic or subsequent antibiotic therapy. When neurologic deterioration was observed, imaging studies revealed a dramatic series of thromboembolic events, including intracranial hemorrhage caused by extensive sinus vein thrombosis as well as thrombi of the right cardiac ventricle. Colonic mucosal biopsy samples finally led to the histologic diagnosis of ulcerative colitis...
April 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28421242/ct-features-of-hepatic-metastases-from-hepatoid-adenocarcinoma
#2
Min-Yung Chang, Hye Jin Kim, Seung Hyun Park, Hyunki Kim, Dong Kyu Choi, Joon Seok Lim, Mi-Suk Park, Myeong-Jin Kim, Honsoul Kim
PURPOSE: The purpose of this study was to report the imaging presentation of hepatic metastases from hepatoid adenocarcinoma (HAC). METHODS: We retrospectively identified 11 patients (10 men and 1 woman; median age 66) with HAC liver metastasis who underwent contrast-enhanced computed tomography (CT) which included arterial phase and portal venous phase. Two radiologists analyzed the imaging parameters, which included the enhancement pattern on arterial and portal phase images, necrosis, venous thrombi, and overall imaging diagnosis, and arrived at a consensus...
April 18, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28417266/guided-longer-pulses-from-a-diagnostic-ultrasound-and-intraclot-microbubble-enhanced-catheter-directed-thrombolysis-in-vivo
#3
Shunji Gao, Qiong Zhu, Xiaoxiao Dong, Zhong Chen, Zheng Liu, Feng Xie
The mechanism of ultrasound thrombolysis (UT) is generally attributed to cavitation. The insufficiency of microbubbles (MB) to serve as cavitation nuclei in the vessel-obstructing thrombi significantly reduces the effectiveness of UT. Taking advantage of the widely performed catheter-directed therapy (CDT), in a thrombo-embolized rabbit IVC model with a simultaneous catheter directed rt-PA thrombolysis procedure, guided moderate mechanical index longer pulses from a modified diagnostic ultrasound transducer, combined with an intraclot infusion of MB, significantly accelerated the thrombolysis process...
April 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28416507/thrombotic-thrombocytopenic-purpura
#4
Bérangère S Joly, Paul Coppo, Agnes Veyradier
Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening thrombotic micro-angiopathy characterized by a microangiopathic hemolytic anemia, severe thrombocytopenia and organ ischemia linked to disseminated microvascular platelet rich-thrombi. TTP is specifically related to a severe deficiency in ADAMTS13 (A Disintegrin and Metalloprotease with ThromboSpondin type 1 repeats, member 13), the specific von Willebrand factor-cleaving pro-tease. ADAMTS13 deficiency is most frequently acquired via ADAMTS13 autoantibodies but rarely, it is inherited via mutations of ADAMTS13 gene...
April 17, 2017: Blood
https://www.readbyqxmd.com/read/28415397/surface-modified-bioresorbable-electrospun-scaffolds-for-improving-hemocompatibility-of-vascular-grafts
#5
Pablo C Caracciolo, María Isabel Rial-Hermida, Florencia Montini-Ballarin, Gustavo A Abraham, Angel Concheiro, Carmen Alvarez-Lorenzo
The replacement of small-diameter vessels is one of the main challenges in tissue engineering. Moreover, the surface modification of small-diameter vascular grafts (SDVG) is a key factor in the success of the therapy due to their increased thrombogenicity and infection susceptibility caused by the lack of a functional endothelium. In this work, electrospun scaffolds were prepared from blends of poly(L-lactic acid) (PLLA) and segmented polyurethane (PHD) with a composition designed to perform as SDVG inner layer...
June 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28413581/robotic-assisted-inferior-vena-cava-filter-retrieval
#6
Shahin Owji, Tony Lu, Thomas M Loh, Adeline Schwein, Alan B Lumsden, Jean Bismuth
Although anticoagulation remains the mainstay of therapy for patients with venous thromboembolism, guidelines recommend the use of inferior vena cava (IVC) filters in those who fail anticoagulation or have contraindications to its use. Short-term use of filters has proven effective in reducing the rate of pulmonary embolism. However, their extended use is associated with a variety of complications such as thrombosis, filter migration, or caval perforation, thus making a case for timely filter retrieval. This is the case of a 68-year-old female with a history of chronic oral anticoagulation use for multiple deep venous thrombi (DVT) and pulmonary emboli (PE) who required cervical and thoracic spinal intervention for spondylosis and foramina stenosis...
January 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28413360/the-cd31-molecule-a-possible-neuroprotective-agent-in-acute-ischemic-stroke
#7
Tobias Boeckh-Behrens, Justus Kleine, Johannes Kaesmacher, Claus Zimmer, Lucas Schirmer, Sophie Simon, Holger Poppert
BACKGROUND: The transmembrane receptor molecule CD31 is known to have immunomodulatory functions, suggesting a possible neuroprotective effect in the context of acute ischemic stroke by restricting an over-activation of secondary immunological processes. This study examines the density of CD31(+) cells in mechanically extracted thrombi of stroke patients with the aim to test whether the occurrence of CD31(+) cells was associated with a beneficial clinical outcome in those patients. METHODS: Thrombi of 122 consecutive patients with large anterior circulation stroke were collected during intracranial mechanical recanalization...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28413114/left-atrial-appendage-thrombi-relate-to-easily-accessible-clinical-parameters-in-patients-undergoing-atrial-fibrillation-transcatheter-ablation-a-multicenter-study
#8
Matteo Anselmino, Lucia Garberoglio, Sebastiano Gili, Emanuele Bertaglia, Giuseppe Stabile, Raffaella Marazzi, Sakis Themistoclakis, Franceso Solimene, Simone Frea, Walter Grosso Marra, Mara Morello, Marco Scaglione, Roberto De Ponti, Fiorenzo Gaita
BACKGROUND: Transesophageal echocardiography (TEE) is routinely performed before atrial fibrillation (AF) transcatheter ablation to exclude the presence of left atrial (LA) or LA appendage (LAA) thrombi. The aim of the study is to evaluate if easily accessible clinical parameters may relate to the presence of LA or LAA thrombi to identify patients who could potentially avoid TEE. METHODS AND RESULTS: Between January 2012 and September 2014, data from 1539 consecutive patients undergoing TEE, as a work-up before AF transcatheter ablation, in six large volume centers were collected...
April 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28408189/genetic-effects-on-the-correlation-structure-of%C3%A2-cvd-risk-factors-exome-wide-data-from-a-ghanaian-population
#9
REVIEW
Nuri Kodaman, Rafal S Sobota, Folkert W Asselbergs, Matthew T Oetjens, Jason H Moore, Nancy J Brown, Melinda C Aldrich, Scott M Williams
Plasma concentration of plasminogen activator inhibitor-1 (PAI-1) is highly correlated with several cardiovascular disease (CVD) risk factors. It also plays a direct role in CVD, including myocardial infarction and stroke, by impeding the dissolution of thrombi in the blood. Insofar as PAI-1 links CVD's risk factors to its endpoints, genetic variants modulating the relationship between PAI-1 and risk factors may be of particular clinical and biological interest. The high heritability of PAI-1, which has not been explained by genetic association studies, may also, in large part, be due to this relationship with CVD risk factors...
April 10, 2017: Global Heart
https://www.readbyqxmd.com/read/28403878/rescue-strategy-for-advanced-liver-malignancy-with-retrohepatic-inferior-vena-cava-thrombi-experience-to-promote-surgical-oncological-benefit
#10
Meng-Hsing Ho, Teng-Wei Chen, Kuang-Wen Ou, Jyh-Cherng Yu, Chung-Bao Hsieh
BACKGROUND: The prognosis of advanced liver malignancy with inferior vena cava (IVC) thrombi is poor. Many therapeutic policies are challenging for long-term prognosis. We performed the modified effective technique of transdiaphragmatic intrapericardial IVC isolation for curative resection of IVC tumors and prolonged survival time. METHODS: Between 2003 and 2015, 10 patients, sustained liver malignancy with IVC thrombi, underwent surgical intervention. Liver resection with thrombectomy under total hepatic vascular exclusion via the transdiaphragmatic intrapericardial IVC isolation method was performed for these 10 patients...
April 12, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28400861/revision-of-echocardiographic-indications-and-findings-in-neurologically-ill-patients
#11
Claudia Stöllberger, Christian Wegner, Josef Finsterer
BACKGROUND AND OBJECTIVE: Little is known about the general indications for echocardiography and the prevalence of abnormalities detected by echocardiography in patients who are referred from a neurological department. Left ventricular hypertrabeculation/noncompaction (LVHT) is associated with neuromuscular disorders and embolism. The aim of the study was to assess the indications for echocardiography in patients from a neurological department and to review the cine-loops of the examinations in order to assess the frequency of abnormal echocardiographic findings with special regard to LVHT...
2017: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/28400112/endothelial-specific-deletion-of-autophagy-related-7-atg7-attenuates-arterial-thrombosis-in-mice
#12
Jonathan W Yau, Krishna K Singh, Yan Hou, Xi Lei, Azza Ramadan, Adrian Quan, Hwee Teoh, Wolfgang M Kuebler, Mohammed Al-Omran, Bobby Yanagawa, Heyu Ni, Subodh Verma
BACKGROUND: Thrombosis persists as a leading cause of morbidity and mortality. Given that endothelial cells (ECs) play a central role in regulating thrombosis, understanding the molecular endothelial cues that regulate susceptibility or resistance to thrombosis have important translational implications. Accordingly, we evaluated the role of endothelial autophagy in the development of thrombosis. METHODS: We generated mice in which the essential autophagy-related 7 (ATG7) gene was conditionally deleted from ECs (EC-ATG7(-/-) mice)...
March 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28395964/inertial-cavitation-ultrasound-with-microbubbles-improves-reperfusion-efficacy-when-combined-with-tissue-plasminogen-activator-in-an-in%C3%A2-vitro-model-of-microvascular-obstruction
#13
Akash Goyal, Francois T H Yu, Mathea G Tenwalde, Xucai Chen, Andrew Althouse, Flordeliza S Villanueva, John J Pacella
We have previously reported that long-tone-burst, high-mechanical-index ultrasound (US) and microbubble (MB) therapy can restore perfusion in both in vitro and in vivo models of microvascular obstruction (MVO). Addition of MBs to US has been found to potentiate the efficacy of thrombolytics on large venous thrombi; however, the optimal US parameters for achieving microvascular reperfusion of MVO caused by microthrombi, when combined with tissue plasminogen activator (tPA), are unknown. We sought to elucidate the specific effects of US, with and without tPA, for effective reperfusion of MVO in an in vitro model using both venous and arterial microthrombi...
April 7, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28393617/residual-vein-thrombosis-echogenicity-is-associated-to-the-risk-of-dvt-recurrence-a-cohort-study
#14
Bruna M Mazetto, Fernanda L A Orsi, Sandra A F Silveira, Luis F Bittar, Mariane M C Flores-Nascimento, Kiara C S Zapponi, Marina P Colella, Erich V de Paula, Joyce M Annichino-Bizzacchi
Although deep vein thrombosis (DVT) recurrence is a common late complication of the disease, there are few predictive markers to risk-stratify patients long-term after the thrombotic event. The accuracy of residual vein thrombosis (RVT) in this context is controversial, possibly due to a lack of a standardized methodology. The objective of the study was to evaluate the accuracy of RVT echogenicity as a predictive marker of late DVT recurrence. To evaluate the accuracy of RVT echogenicity as a predictive marker of late DVT recurrence...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28387542/the-risk-of-bleeding-with-the-use-of-antiplatelet-agents-for-the-treatment-of-cardiovascular-disease
#15
Ashwin S Nathan, Sounok Sen, Robert W Yeh
In the presence of injured coronary vascular endothelium, platelets become activated to form hemostatic plugs. While this represents a normal healing response to disrupted vascular endothelium, occlusive cardiovascular disease, as a result of maladaptive thrombus formation, is a major cause of morbidity and mortality. Due to the platelet predominance of arterial thrombi, antiplatelet agents are the mainstay of therapy for arterial cardiovascular disease, though come with a significantly increased risk of bleeding...
April 7, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28386043/nongated-cardiac-computed-tomographic-angiograms-for-detection-of-embolic-sources-in-acute-ischemic-stroke
#16
Leonard L L Yeo, Staffan Holmin, Tommy Andersson, Erik Lundström, Anil Gopinathan, Er Luen Lim, Benjamin S H Leong, Win Sen Kuan, Eric Ting, Benjamin Y Q Tan, Sterling Ellis Eide, Edgar L K Tay
BACKGROUND AND PURPOSE: We assessed the feasibility of obtaining diagnostic quality images of the heart and thoracic aorta by extending the z axis coverage of a non-ECG-gated computed tomographic angiogram performed in the primary evaluation of acute stroke without increasing the contrast dose. METHODS: Twenty consecutive patients with acute ischemic stroke within the 4.5 hours of symptom onset were prospectively recruited. We increased the longitudinal coverage to the domes of the diaphragm to include the heart...
April 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28383307/the-thrombolytic-effect-of-diagnostic-ultrasound-induced-microbubble-cavitation-in-acute-carotid-thromboembolism
#17
Thomas R Porter, Feng Xie, John Lof, Jeffry Powers, Francois Vignon, William Shi, Matthew White
BACKGROUND: Acute ischemic stroke is often due to thromboembolism forming over ruptured atherosclerotic plaque in the carotid artery (CA). The presence of intraluminal CA thrombus is associated with a high risk of thromboembolic cerebral ischemic events. The cavitation induced by diagnostic ultrasound high mechanical index (MI) impulses applied locally during a commercially available intravenous microbubble infusion has dissolved intravascular thrombi, especially when using longer pulse durations...
April 5, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28380473/successful-management-of-a-patient-with-autoimmune-hemorrhaphilia-due-to-anti-factor-xiii-13-antibodies-complicated-by-pulmonary-thromboembolism
#18
Yoshiyuki Ogawa, Kunio Yanagisawa, Masayoshi Souri, Masahiro Mihara, Chiaki Naito, Makiko Takizawa, Takuma Ishizaki, Takeki Mitsui, Hiroshi Handa, Tsukasa Osaki, Yoshihisa Nojima, Akitada Ichinose
Autoimmune hemophilia-like disease (hemorrhaphilia) due to anti-factor XIII (FXIII) antibodies (AH13) is a very rare, life-threatening bleeding disorder. A 77-year-old woman developed macrohematuria and a right renal pelvic hematoma. The coagulation times were not prolonged, but FXIII activity and antigen levels were severely and moderately reduced to 9 and 29% of normal values, respectively. Accordingly, the FXIII-specific activity turned out to be low. FXIII inhibitor and anti-FXIII-A subunit autoantibodies were detected by a 1:1 crossmixing test and immunoblot and immunochromatographic assays...
April 6, 2017: Acta Haematologica
https://www.readbyqxmd.com/read/28373412/ventriculo-arterial-coupling-detects-occult-rv-dysfunction-in-chronic-thromboembolic-pulmonary-vascular-disease
#19
Richard G Axell, Simon J Messer, Paul A White, Colm McCabe, Andrew Priest, Thaleia Statopoulou, Maja Drozdzynska, Jamie Viscasillas, Elizabeth C Hinchy, James Hampton-Till, Hatim I Alibhai, Nicholas Morrell, Joanna Pepke-Zaba, Stephen R Large, Stephen P Hoole
Chronic thromboembolic disease (CTED) is suboptimally defined by a mean pulmonary artery pressure (mPAP) <25 mmHg at rest in patients that remain symptomatic from chronic pulmonary artery thrombi. To improve identification of right ventricular (RV) pathology in patients with thromboembolic obstruction, we hypothesized that the RV ventriculo-arterial (Ees/Ea) coupling ratio at maximal stroke work (Ees/Eamax sw) derived from an animal model of pulmonary obstruction may be used to identify occult RV dysfunction (low Ees/Ea) or residual RV energetic reserve (high Ees/Ea)...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28371144/laminar-crystal-deposition-in-large-vessels-in-a-patient-with-crystalglobulinemia
#20
Yukako Shintani-Domoto, Aya Shinozaki-Ushiku, Hidemi Okuma, Mineo Kurokawa, Masashi Fukayama
Crystalglobulinemia is an extremely rare complication of monoclonal gammopathy and is characterized by crystal thrombi within systemic organs. We herein report the first described case of crystalglobulinemia accompanied by laminar crystal deposition in the large vessels. A 44-year-old man presented with a history of numbness, pain, and swelling of the left leg in addition to visual impairment. Renal and skin biopsies revealed crystal thrombi within the capillary lumens. The patient was finally diagnosed with crystalglobulinemia associated with multiple myeloma...
March 31, 2017: Pathology International
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