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https://www.readbyqxmd.com/read/29351682/radial-artery-fascial-flow-through-free-flap-for-combined-revascularization-in-moyamoya-disease
#1
Jonathan Russin, Joseph Carey
BACKGROUND: Free flaps are commonly used by other surgical subspecialties for soft tissue reconstruction and revascularization. Cranial applications of these flaps have been limited to only a single case report. OBJECTIVE: To present a new technique for combined revascularization in moyamoya disease using a flow-through free flap. METHODS: Data were obtained from an Institutional Review Board-approved, prospectively maintained database with informed consent from the patient...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29351677/use-of-risk-model-for-assessment-of-residents-perception-of-complexity-of-surgical-steps-example-of-modular-component-steps-of-lumbar-spinal-fusion-surgery
#2
Jeffrey S Raskin, Jesse J Liu, Katherine Holste, Sarah Brown, Fran Hardaway, Priscilla Pang, Ahmed M Raslan
BACKGROUND: Quality improvement projects increasingly emphasize standardization of surgical work flow to optimize operative room efficiency. Removing special cause variability resulting from nonsurgical waste is an obvious target; however, resident surgical education must be maintained, even in the setting of process improvement. OBJECTIVE: To describe the impact of resident-identified "risky" or "uncomfortable" procedural steps on operative time during transforaminal lumbar interbody fusion (TLIF)...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29351652/early-results-in-flow-diverter-sizing-by-computational-simulation-quantification-of-size-change-and-simulation-error-assessment
#3
Ana Paula Narata, Jordi Blasco, Luis San Roman, Juan Miguel Macho, Hector Fernandez, Raquel Kale Moyano, Renaud Winzenrieth, Ignacio Larrabide
BACKGROUND: Sizing of flow diverters (FDs) stent in the treatment of intracranial aneurysms is a challenging task due to the change of stent length after implantation. OBJECTIVE: To quantify the size change and assess the error in length prediction in 82 simulated FD deployments. METHODS: Eighty-two consecutive patients treated with FDs were retrospectively analyzed. Implanted FD length was measured from angiographic images and compared to the nominal sizes of the implanted device...
January 17, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29351418/red-blood-cell-antibody-induced-anemia-causes-differential-degrees-of-tissue-hypoxia-in-kidney-and-brain
#4
Nikhil Mistry, C David Mazer, John G Sled, Alan H Lazarus, Lindsay S Cahill, Max Solish, Yu-Qing Zhou, Nadya Romanova, Alexander Gm Hare, Allan Doctor, Joseph A Fisher, Keith R Brunt, Jeremy A Simpson, Gregory M T Hare
Moderate anemia is associated with increased mortality and morbidity, including acute kidney injury (AKI), in surgical patients. A red blood cell (RBC)-specific antibody model was utilized to determine if moderate subacute anemia could result in tissue hypoxia as a potential mechanism of injury. Cardiovascular and hypoxic cellular responses were measured in transgenic mice capable of expressing hypoxia-inducible factor-1α (HIF-1α)-luciferase activity in vivo. Antibody-mediated anemia was associated with mild intravascular hemolysis (6 hours) and splenic RBC sequestration (day 4), resulting in a nadir hemoglobin concentration of 89{plus minus}13 g/L at day 4...
January 10, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29351134/carotid-doppler-sonography-additional-tool-to-assess-hemodynamic-improvement-after-transcatheter-aortic-valve-implantation
#5
Valeria Cammalleri, Francesco Romeo, Massimo Marchei, Andrea Anceschi, Gianluca Massaro, Saverio Muscoli, Francesca De Persis, Massimiliano Macrini, Gian P Ussia
PURPOSE: The aim of our study was to assess the arterial cerebral blood flow variations in patients with aortic valve stenosis, immediately after the transcatheter aortic valve implantation (TAVI). METHODS: The study population includes 62 consecutive patients who underwent TAVI for aortic valve stenosis (95%) and sugical bioprosthesis degeneration (5%). Carotid Doppler examination was performed recording blood flow, systolic peak velocity, time average mean velocity and mean acceleration time at baseline, after balloon aortic valvuloplasty, and within 10 min after the device release...
January 17, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29351006/associations-between-microalbuminuria-and-parameters-of-flow-mediated-vasodilatation-obtained-by-continuous-measurement-approaches
#6
Rie Koyoshi, Yuka Hitaka-Yoshimine, Yuhei Shiga, Takashi Kuwano, Makoto Sugihara, Amane Ike, Atsushi Iwata, Hideto Sako, Natsumi Morito, Akira Kawamura, Shin-Ichiro Miura
The associations between microalbuminuria and various parameters of flow-mediated vasodilatation (FMD) are not completely understood. We retrospectively analyzed 265 consecutive patients who underwent coronary angiography and in whom we could measure FMD and the urine albumin-creatinine ratio (UACR). Using 15 continuous measurement approaches, we measured FMD as the magnitude of the percentage change in the brachial artery diameter from baseline to peak (bFMD), the maximum FMD rate calculated as the maximal slope of dilation (FMD-MDR), and the integrated FMD response calculated as the area under the dilation curve during the 60- and 120-s dilation periods (FMD-AUC60 and FMD-AUC120)...
January 19, 2018: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29350687/intraocular-currents-bernoulli-s-principle-and-non-drainage-scleral-buckling-for-rhegmatogenous-retinal-detachment
#7
D Wong, Y K Chan, T Bek, I Wilson, E Stefánsson
For many years, it is not fully understood how non-drainage scleral buckling surgery brings about spontaneous reattachment of the detached retina when retinal breaks remain open at the end of surgery. Various explanations have been put forward, but none more interesting than the effect of fluid currents associated with eye movements. One such explanation involved the physics of the Bernoulli's principle. Daniel Bernoulli was an eighteenth century Swiss mathematician and he described an equation based on the conservation of energy...
January 19, 2018: Eye
https://www.readbyqxmd.com/read/29350524/development-of-a-multiplexed-microsphere-pcr-for-rapid-culture-free-detection-and-gram-typing-of-bacteria-in-human-blood-samples
#8
Fang Liang, Daniel J Browne, Megan J Gray, Kate H Gartlan, David D Smith, Ross Barnard, Geoff R Hill, Simon Robert Corrie, Kate Markey
Blood stream infection is a significant clinical problem, particularly in vulnerable patient groups such as those undergoing chemotherapy and bone marrow transplantation. Clinical diagnostics for suspected blood stream infection remain centered around blood culture (highly variable timing, hours to days), and empiric use of broad-spectrum antibiotics is often employed for patients presenting with febrile neutropenia. Gram-typing provides the first opportunity to target therapy (e.g. combinations containing vancomycin or teicoplanin for Gram-positives; piperacillin-tazobactam or a carbapenem for Gram-negatives), however current approaches require blood culture...
January 19, 2018: ACS Infectious Diseases
https://www.readbyqxmd.com/read/29350388/chronic-statin-treatment-is-a-predictor-of-pre-interventional-infarct-related-artery-patency-in-patients-with-st-elevation-myocardial-infarction-treated-with-percutaneous-coronary-intervention
#9
Süleyman Özbiçer, Mustafa Gür, Gülhan Kalkan, Betül Özaltun, Murat Çaylı
BACKGROUND: Beyond lipid-lowering effects, early statin treatment has beneficial effects on prognosis after acute coronary syndrome. Infarct related artery patency before percutaneous coronary intervention is known to be a strong predictor of improved clinical outcome. AIM: We aimed to investigate the effects of chronic statin treatment before admission on the infarct related artery patency after infarction. METHODS: In this study, 938 ST elevation myocardial infarction patients admitted to the hospital within the first 12 hours of symptom onset were prospectively enrolled (682 male, 256 female; mean age 58...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350383/which-position-should-we-take-during-newborn-resuscitation-a-prospective-randomized-multicentre-simulation-trial
#10
Jacek Smereka, Halla Kaminska, Wojciech Wieczorek, Marek Dabrowski, Jerzy Robert Ladny, Kurt Ruetzler, Lukasz Szarpak, Oliver Robak, Michael Frass
BACKGROUND: Early bystander cardiopulmonary resuscitation (CPR) for cardiac arrest is crucial in the chain of survival. Cardiac arrest in infants is rare but CPR is also performed in severe bradycardia. The European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines recommend starting CPR and continuing it until the heart muscle is sufficiently oxygenated and regains sufficient contractility and function. Among the techniques of CPR that can be applied in newborns, the most common and therefore recommended by the ERC and AHA are the two-finger technique and two-thumb technique...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350104/the-importance-of-perfusion-index-monitoring-in-evaluating-the-efficacy-of-stellate-ganglion-blockage-treatment-in-raynaud-s-disease
#11
Ömer Fatih Şahin, Ebru Tarıkçı Kılıç, Yakup Aksoy, Ayhan Kaydu, Erhan Gökçek
Stellate ganglion blockage (SGB) is a method used for treating Raynaud's phenomenon (RP). This study primarily aimed to determine whether the perfusion index (PI) can be used an alternative to Horner's signs in evaluating the efficacy of SGB in patients diagnosed with RP. In a total of 40 patients, aged 18-65 years and diagnosed with primary RP, SGB was applied for 5 days on the same side with the 2-finger method, using 6 mL of 5% levobupivacaine at the 7th cervical vertebra level. The PI values were recorded from the distal end of the 2nd finger of the upper extremity on the side applied with the block at baseline and at 5, 15, 30, 60 and 120 min...
December 2018: Libyan Journal of Medicine
https://www.readbyqxmd.com/read/29350098/commentary-to-18f-gp1-a-novel-pet-tracer-designed-for-high-sensitivity-low-background-detection-of-thrombi-imaging-activated-platelets-in-clots-are-we-getting-there
#12
Andrew W Stephens, Norman Koglin, Ludger M Dinkelborg
Thrombus formation can lead to heart attacks, stroke and pulmonary embolism, which are major causes of mortality. Current standard diagnostic imaging methods detect anatomic abnormalities such as vascular flow impairment but have limitations. By using a targeted molecular imaging approach critical components of a pathology can be selectively visualized and exploited for an improved diagnosis and patient management. The GPIIb/IIIa receptor is abundantly and specifically exposed on activated platelets and is the key receptor in thrombus formation...
January 2018: Molecular Imaging
https://www.readbyqxmd.com/read/29349892/-can-the-patient-speak-postcolonialism-and-patient-involvement-in-undergraduate-and-postgraduate-medical-education
#13
Malika Sharma
CONTEXT: Patients are increasingly being engaged in providing feedback and consultation to health care institutions, and in the training of health care professionals. Such involvement has the potential to disrupt traditional doctor-patient power dynamics in significant ways that have not been theorised in the medical literature. Critical theories can help us understand how power flows when patients are engaged in the training of medical students. METHODS: This paper applies postcolonial theory to the involvement of patients in the development and delivery of medical education...
January 19, 2018: Medical Education
https://www.readbyqxmd.com/read/29349813/hla-b27-testing-a-journey-from-flow-cytometry-to-molecular-subtyping
#14
Pratiksha Chheda, Sandeep Warghade, Jyothi Mathias, Tavisha Dama, Sunmeet Matkar, Nilesh Shah, Rajesh Bendre
BACKGROUND: Determination of HLA-B27 status plays an important role as adjuvant in suspected cases for diagnosis of Ankylosing Spondilytis (AS). Objectives of this study were to evaluate (i) flow cytometry method in comparison with DNA microarray for HLA-B27 typing and (ii) EUROArray HLA-B27 Direct assay for HLA-B27 allele detection along with discrimination of AS/non-AS subtypes in Indian population. METHODS: A total of 7543 patients with a presumptive clinical diagnosis of AS were referred for screening of HLA-B27...
January 19, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29349805/hybrid-continuous-flow-total-artificial-heart
#15
Carson Fox, Steven Chopski, Nohra Murad, Paul Allaire, Robert Mentzer, Joseph Rossano, Francisco Arabia, Amy Throckmorton
Clinical studies using total artificial hearts (TAHs) have demonstrated that pediatric and adult patients derive quality-of-life benefits from this form of therapy. Two clinically-approved TAHs and other pumps under development, however, have design challenges and limitations, including thromboembolic events, neurologic impairment, infection risk due to large size and percutaneous drivelines, and lack of ambulation, to name a few. To address these limitations, we are developing a hybrid-design, continuous-flow, implantable or extracorporeal, magnetically-levitated TAH for pediatric and adult patients with heart failure...
January 18, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29349658/the-il-10-producing-regulatory-b-cells-b10-cells-and-regulatory-t-cell-subsets-in-neuromyelitis-optica-spectrum-disorder
#16
Eun Bin Cho, Hye-Jin Cho, Jin Myoung Seok, Ju-Hong Min, Eun-Suk Kang, Byoung Joon Kim
B cells contribute to the pathogenesis of neuromyelitis optica (NMO) by producing Aquaporin 4-specific autoantibodies (AQP4-ab); on the other hand, there are certain B cells that suppress immune responses by producing regulatory cytokines, such as IL-10. In this study, we investigated the presence of IL-10-producing Breg cells among lymphocyte subsets. Twenty-two seropositive NMO spectrum disorder (NMOSD) patients (29 samples) and 13 healthy controls (HCs) (14 samples) were enrolled. All NMOSD patients have received one or more immunosuppressive drugs...
January 19, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29349560/effect-of-fibrillatory-wave-amplitude-on-coronary-blood-flow-as-assessed-by-thrombolysis-in-myocardial-infarction-frame-count-in-patients-with-atrial-fibrillation
#17
Yoji Sumimoto, Satoshi Kurisu, Kazuhiro Hitta, Hiroki Ikenaga, Ken Ishibashi, Yukihiro Fukuda, Yukiko Nakano, Yasuki Kihara
Atrial fibrillation (AF) is the most common arrhythmia, characterized by a lack of atrial contraction and an irregular ventricular rhythm. We assessed the effect of fibrillatory wave amplitude on coronary blood flow in patients with AF using the thrombolysis in myocardial infarction (TIMI) frame count. Sixty-one patients with AF persisting for longer than 30 days were included. For controls, 61 age- and sex-matched patients with sinus rhythm were selected. Coarse AF was defined as any fibrillatory wave ≥ 1 mm and fine AF as any fibrillatory wave < 1 mm...
January 18, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29349437/staged-endovascular-repair-of-an-abdominal-aortic-aneurysm-adjacent-to-a-chronic-high-flow-iliocaval-traumatic-arteriovenous-fistula
#18
S Keisin Wang, Ashley R Gutwein, Tom Casciani, Michael P Murphy, Gary W Lemmon
Large-vessel chronic traumatic arteriovenous fistulas are a rare complication after trauma. Delayed presentation can consist of one or more features of high-output cardiac failure, pulsatile abdominal mass, bruit, limb ischemia, and venous congestion. We describe a patient with a complex iliocaval fistula secondary to a remote gunshot wound associated with a large 8.5-cm aortic aneurysm. Informed consent of the patient was obtained for publication of the case.
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349399/subclavian-steal-syndrome-without-subclavian-stenosis
#19
Matt Cwinn, Sudhir Nagpal, Prasad Jetty
Subclavian steal syndrome (SSS) has been well described in the setting of subclavian stenosis. We describe an unusual case of SSS caused by a high-flow arteriovenous dialysis fistula in the absence of subclavian stenosis, provide a review of the literature, and propose that arteriovenous fistula-induced SSS is an underdiagnosed cause of syncope in this population of patients.
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349386/successful-use-of-retrograde-branched-extension-limb-assembling-technique-in-endovascular-repair-of-pararenal-abdominal-aortic-aneurysm
#20
Jiang Xiong, Zhongzhou Hu, Hongpeng Zhang, Huanming Xu, Duanduan Chen, Wei Guo
Surgeon-modified retrograde branched extension limb assembling technique and bridged endografts were successfully used to exclude an asymptomatic pararenal abdominal aortic aneurysm and to reconstruct the superior mesenteric artery and bilateral renal arteries in a case with high-grade celiac artery stenosis, nondilated aorta above the superior mesenteric artery, and large lumen below the renal arteries. In patient-specific models for hemodynamics analysis, enhanced flow diversion to visceral arteries up to 6-month follow-up confirmed treatment feasibility; however, endograft configurations could be improved to avoid sharp corners at bifurcations, thereby ensuring smooth flow transport and possibly reducing risk for endograft narrowing or the development of thrombosis...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
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