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https://www.readbyqxmd.com/read/29340275/timing-of-transjugular-intrahepatic-portosystemic-shunt-for-budd-chiari-syndrome-an-italian-hepatologist-s-perspective
#1
Andrea Mancuso
Budd-Chiari syndrome (BCS) management flow-chart is derived from experts' opinion and is not evidence-based. Guidelines suggest BCS management should follow a stepwise strategy: medical therapy as first-line treatment, revascularization or transjugular intrahepatic portosystemic shunt (TIPS) if no response to medical therapy, and liver transplant as rescue therapy. Recent evidence suggests that only medical therapy results in a bad long-term outcome. The biggest criticism of guidelines is the indication that BCS should receive further treatment only when hemodynamic consequences of portal hypertension become clinically evident...
December 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29336366/potential-value-of-datura-stramonium-agglutinin-recognized-glycopatterns-in-urinary-protein-on-differential-diagnosis-of-diabetic-nephropathy-and-nondiabetic-renal-disease
#2
Xiao-Li Yang, Han-Jie Yu, Han-Yu Zhu, Ying Zheng, Qiu-Xia Han, Guang-Yan Cai, Xiang-Mei Chen
BACKGROUND: Diabetic nephropathy (DN) is the most common and serious microvascular complication of diabetes. To date, the gold standard for identifying DN and nondiabetic renal disease (NDRD) is a renal biopsy; however, there is currently no reliable diagnostic marker to identify DN and NDRD in a noninvasive manner. This study aimed to investigate the different glycopatterns in urine specimens of DN patients and NDRD patients for a differential diagnosis. METHODS: In total, 19 DN patients and 18 NDRD patients who underwent renal biopsies between March 2015 and March 2016 at the Chinese People's Liberation Army General Hospital were enrolled in this study...
January 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29333783/-application-of-preoperative-vascular-localization-techniques-for-perforator-flaps
#3
Wu Lianjun, Wang Huiming
With the development of microvascular technology, perforator flaps have gradually become a good alternative for reconstruction of tissue defects. However, the major limitations of perforator flaps include uncertainty in predicting anatomical location of perforators and high variability in perforator size and course, which require preoperative localization techniques. Recently, as one of the preoperative localization techniques, computed tomography angiography was used to determine the number, size, course, and exact emerging point of perforator flaps...
December 1, 2017: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
https://www.readbyqxmd.com/read/29333660/interventions-to-increase-attendance-for-diabetic-retinopathy-screening
#4
REVIEW
John G Lawrenson, Ella Graham-Rowe, Fabiana Lorencatto, Jennifer Burr, Catey Bunce, Jillian J Francis, Patricia Aluko, Stephen Rice, Luke Vale, Tunde Peto, Justin Presseau, Noah Ivers, Jeremy M Grimshaw
BACKGROUND: Despite evidence supporting the effectiveness of diabetic retinopathy screening (DRS) in reducing the risk of sight loss, attendance for screening is consistently below recommended levels. OBJECTIVES: The primary objective of the review was to assess the effectiveness of quality improvement (QI) interventions that seek to increase attendance for DRS in people with type 1 and type 2 diabetes.Secondary objectives were:To use validated taxonomies of QI intervention strategies and behaviour change techniques (BCTs) to code the description of interventions in the included studies and determine whether interventions that include particular QI strategies or component BCTs are more effective in increasing screening attendance;To explore heterogeneity in effect size within and between studies to identify potential explanatory factors for variability in effect size;To explore differential effects in subgroups to provide information on how equity of screening attendance could be improved;To critically appraise and summarise current evidence on the resource use, costs and cost effectiveness...
January 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29329523/early-commitment-of-cardiovascular-autonomic-modulation-in-brazilian-patients-with-congenital-generalized-lipodystrophy
#5
Clarisse Mourão Melo Ponte, Virgínia Oliveira Fernandes, Maria Helane Costa Gurgel, Izabella Tamira Galdino Farias Vasconcelos, Lia Beatriz de Azevedo Souza Karbage, Christiane Bezerra Rocha Liberato, Carlos Antônio Negrato, Marília de Brito Gomes, Ana Paula Dias Rangel Montenegro, Renan Magalhães Montenegro Júnior
BACKGROUND: Metabolic abnormalities in congenital generalized lipodystrophy (CGL) are associated with microvascular complications. However, the evaluation of different types of neuropathy in these patients, including the commitment of cardiovascular autonomic modulation, is scarce. The objective of the present study was to determine the prevalence of cardiovascular autonomic neuropathy (CAN) in patients with CGL compared with individuals with type 1 diabetes and healthy subjects. METHODS: Ten patients with CGL, 20 patients with type 1 diabetes and 20 healthy subjects were included in the study...
January 12, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29326539/microvascular-outcomes-of-pediatric-onset-type-1-diabetes-mellitus-a-single-center-observational-case-reviews-in-sana-a-yemen
#6
Abdallah Ahmed Gunaid
Microvascular complications of pediatric-onset type 1 diabetes are common in low-income countries. In this study, we aimed at reviewing microvascular outcomes in 6 cases with type 1 diabetes over 14 to 31 years of follow-up. Severe proliferative diabetic retinopathy (PDR) and/or diabetic macular edema (maculopathy) (DME) and overt diabetic nephropathy (macroalbuminuria) were seen among 4 of 6 patients, whereas severe diabetic peripheral neuropathy with Charcot neuroarthropathy was seen in 1 patient only, who had the longest duration of follow-up...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
https://www.readbyqxmd.com/read/29326023/exploring-quality-of-care-and-social-inequalities-related-to-type-2-diabetes-in-hungary-nationwide-representative-survey
#7
Attila Nagy, Nóra Kovács, Anita Pálinkás, Valéria Sipos, Ferenc Vincze, Gergő Szőllősi, Orsolya Csenteri, Róza Ádány, János Sándor
AIMS: The study aimed to launch a T2DM adult cohort that is representative of Hungary through a cross-sectional study, to produce the most important quality indicators for T2DM care, to describe social inequalities, and to estimate the absolute number of T2DM adult patients with uncontrolled HbA1c levels in Hungary. METHODS: A representative sample of the Hungarian T2DM adults (N=1280) was selected in 2016. GPs collected data on socio-demographic status by questionnaire, and on history and laboratory parameters from medical records...
January 8, 2018: Primary Care Diabetes
https://www.readbyqxmd.com/read/29325551/relationship-between-cardiac-microvascular-dysfunction-measured-with-82rubidium-pet-and-albuminuria-in-patients-with-diabetes-mellitus
#8
Louis Potier, Renata Chequer, Ronan Roussel, Kamel Mohammedi, Souad Sismail, Agnès Hartemann, Chloé Amouyal, Michel Marre, Dominique Le Guludec, Fabien Hyafil
BACKGROUND: Albuminuria is of one the strongest predictors of cardiovascular disease (CVD) in diabetes. Diabetes is associated with cardiac microvascular dysfunction (CMD), a powerful, independent prognostic factor for cardiac mortality. The aim of this study was to evaluate the relationship between CMD and microvascular complications in patients without known CVD. METHODS: In this monocentric study, myocardial flow reserve (MFR) was measured with cardiac 82Rubidium positron emission tomography (Rb-PET) in 311 patients referred to nuclear medicine department of Bichat University Hospital for screening of coronary artery disease from 2012 to 2014...
January 11, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29324883/masp-1-of-the-complement-system-enhances-clot-formation-in-a-microvascular-whole-blood-flow-model
#9
Lorenz Jenny, József Dobó, Péter Gál, Gábor Pál, Wilbur A Lam, Verena Schroeder
The complement and coagulation systems closely interact with each other. These interactions are believed to contribute to the proinflammatory and prothrombotic environment involved in the development of thrombotic complications in many diseases. Complement MASP-1 (mannan-binding lectin-associated serine protease-1) activates coagulation factors and promotes clot formation. However, this was mainly shown in purified or plasma-based static systems. Here we describe the role of MASP-1 and complement activation in fibrin clot formation in a microvascular, whole blood flow model...
2018: PloS One
https://www.readbyqxmd.com/read/29323186/combination-of-high-fat-high-fructose-diet-and-low-dose-streptozotocin-to-model-long-term-type-2-diabetes-complications
#10
David André Barrière, Christophe Noll, Geneviève Roussy, Farah Lizotte, Anissa Kessai, Karyn Kirby, Karine Belleville, Nicolas Beaudet, Jean-Michel Longpré, André C Carpentier, Pedro Geraldes, Philippe Sarret
The epidemic of type 2 diabetes mellitus (T2DM) is fueled by added fructose consumption. Here, we thus combined high-fat/high-fructose diet, with multiple low-dose injections of streptozotocin (HF/HF/Stz) to emulate the long-term complications of T2DM. HF/HF/Stz rats, monitored over 56 weeks, exhibited metabolic dysfunctions associated with the different stages of the T2DM disease progression in humans: an early prediabetic phase characterized by an hyperinsulinemic period with modest dysglycemia, followed by a late stage of T2DM with frank hyperglycemia, normalization of insulinemia, marked dyslipidemia, hepatic fibrosis and pancreatic β-cell failure...
January 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29322547/improvement-of-the-salvage-rate-of-flap-after-venous-thrombosis-with-intraparenchymatous-venous-pressure-monitoring
#11
Hajime Matsumine, Mariko Mogami, Osamu Fujiwara, Masahiro Hasegawa, Hiroshi Ito, Hiroyuki Sakurai
PURPOSE: Intraparenchymatous venous pressure (IVP) monitoring in flap can measure venous pressure with catheter placement. Among patients with IVP monitoring, this study reviewed postoperative microvascular complications for investigating the transplanted-tissue salvage-rate. PATIENTS AND METHODS: Two hundred and seventy-one patients (male, 132; female, 139; mean age, 52.3 years; age range, 9-82 years) underwent free flap transfer and postoperative continuous IVP monitoring, which performed as follows; a venous catheter was connected to a transducer, and venous pressure in the flap was recorded for three consecutive days postoperatively...
January 11, 2018: Microsurgery
https://www.readbyqxmd.com/read/29322300/glycemic-control-in-type-2-diabetes-from-medication-nonadherence-to-residual-vascular-risk
#12
Dario Giugliano, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito
Despite the availability of many new treatment options for type 2 diabetes, the proportion of patients achieving the HbA1c target < 7.0% remains around 50%. We put forward the hypothesis that the unchanged HbA1c results, observed in the last decade in type 2 diabetes patients, are also a consequence of medication nonadherence and clinical inertia. Poor medication-taking behavior is usually defined as medication nonadherence and is responsible for uncontrolled hemoglobin A1c level in 23% of cases. Medication nonadherence may also affect clinical outcomes, as diabetic patients with good adherence (≥80%) had a significant 10% lower rate of hospitalization events and a significant 28% lower rate of all-cause mortality when compared with patients with poor adherence (<80%)...
January 10, 2018: Endocrine
https://www.readbyqxmd.com/read/29319579/how-big-is-too-big-pushing-the-obesity-limits-in-microsurgical-breast-reconstruction
#13
Jamie A Spitz, Perry S Bradford, Frank Aguilar, Sergey Y Turin, Marco F Ellis
PURPOSE: Obesity is a major public health concern in the United States, affecting nearly 79 million people. There have been promising results performing microvascular breast reconstruction in patients with obesity; however, the definition of obesity is often poorly defined or does not extend above a body mass index (BMI) of 35. Our goal was to examine outcomes of microvascular breast reconstruction in this questionably more risky population. METHODS: A retrospective review from 2013 to 2016 was performed of 2 surgeons' experience with abdominally based microvascular breast reconstructions...
February 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29311660/defining-phenotypes-in-diabetic-nephropathy-a-novel-approach-using-a-cross-sectional-analysis-of-a-single-centre-cohort
#14
Rosa M Montero, Athula Herath, Ashfaq Qureshi, Ehsanollah Esfandiari, Charles D Pusey, Andrew H Frankel, Frederick W K Tam
The global increase in Diabetes Mellitus (DM) has led to an increase in DM-Chronic Kidney Disease (DM-CKD). In this cross-sectional observational study we aimed to define phenotypes for patients with DM-CKD that in future may be used to individualise treatment We report 4 DM-CKD phenotypes in 220 patients recruited from Imperial College NHS Trust clinics from 2004-2012. A robust principal component analysis (PCA) was used to statistically determine clusters with phenotypically different patients. 163 patients with complete data sets were analysed: 77 with CKD and 86 with DM-CKD...
January 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29311397/short-and-long-term-outcomes-between-young-and-older-hcc-patients-exceeding-the-milan-criteria-after-hepatectomy
#15
Junyi Shen, Chuan Li, Lvnan Yan, Bo Li, Mingqing Xu, Jiayin Yang, Wentao Wang, Tianfu Wen
AIM: The objective of this study was to evaluate short- and long-term survival after surgical treatment between young and older hepatocellular carcinoma (HCC) patients beyond the Milan criteria. MATERIAL AND METHODS: One hundred fifty-seven HCC patients (≤ 55 years old) were categorized into group A, and one hundred fifty-eight HCC patients (> 55 years old) were categorized into group B. Postoperative complications and overall survival were retrospectively analyzed...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29306791/empagliflozin-rescues-diabetic-myocardial-microvascular-injury-via-ampk-mediated-inhibition-of-mitochondrial-fission
#16
Hao Zhou, Shuyi Wang, Pingjun Zhu, Shunying Hu, Yundai Chen, Jun Ren
Impaired cardiac microvascular function contributes to diabetic cardiovascular complications although effective therapy remains elusive. Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor recently approved for treatment of type 2 diabetes, promotes glycosuria excretion and offers cardioprotective actions beyond its glucose-lowering effects. This study was designed to evaluate the effect of empagliflozin on cardiac microvascular injury in diabetes and the underlying mechanism involved with a focus on mitochondria...
December 30, 2017: Redox Biology
https://www.readbyqxmd.com/read/29305779/evidence-of-glucuronidation%C3%A2-of-the-glycation-product-lw-1-tentative-structure-and-implications-for-the-long-term-complications-of-diabetes
#17
David R Sell, Ina Nemet, Zhili Liang, Vincent M Monnier
LW-1 is a collagen-linked blue fluorophore whose skin levels increase with age, diabetes and end-stage renal disease (ESRD), and correlate with the long-term progression of microvascular disease and indices of subclinical cardiovascular disease in type 1 diabetes. The chemical structure of LW-1 is still elusive, but earlier NMR analyses showed it has a lysine residue in an aromatic ring coupled to a sugar molecule reminiscent of advanced glycation end-products (AGEs). We hypothesized and demonstrate here that the unknown sugar is a N-linked glucuronic acid...
January 5, 2018: Glycoconjugate Journal
https://www.readbyqxmd.com/read/29303857/reconstruction-of-a-compound-oromandibular-defect-by-means-of-chimeric-scapular-parascapular-free-flap-assisted-by-virtual-surgical-planning
#18
Josué Hernando, Antonio Aguilar-Salvatierra, Ignacio Osoitz Leizaola-Cardesa, Juan Antonio Rad, Amaya Vicuña, Rafael Gómez, Javier Martín, Gerardo Gómez-Moreno
BACKGROUND: Reconstruction of an oromandibular defect presents a considerable surgical challenge. But since the advent of microvascularized free flap reconstructive surgery, outcomes have improved significantly so that today almost any defect may be reconstructed. Recently, virtual surgical planning has reduced surgical time, the morbidity associated with surgery, and surgical precision. OBJECTIVE: This article reports a complex patient with a composite oromandibular defect...
January 4, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29301251/the-role-of-microglia-in-diabetic-retinopathy-inflammation-microvasculature-defects-and-neurodegeneration
#19
REVIEW
Christine Altmann, Mirko H H Schmidt
Diabetic retinopathy is a common complication of diabetes mellitus, which appears in one third of all diabetic patients and is a prominent cause of vision loss. First discovered as a microvascular disease, intensive research in the field identified inflammation and neurodegeneration to be part of diabetic retinopathy. Microglia, the resident monocytes of the retina, are activated due to a complex interplay between the different cell types of the retina and diverse pathological pathways. The trigger for developing diabetic retinopathy is diabetes-induced hyperglycemia, accompanied by leukostasis and vascular leakages...
January 1, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29301132/optical-measurements-during-deep-brain-stimulation-lead-implantation-safety-aspects
#20
Peter Zsigmond, Simone Hemm-Ode, Karin Wårdell
BACKGROUND: Intracerebral hemorrhage (ICH) is the most feared complication in deep brain stimulation (DBS) surgery. The aim of the study was to evaluate patient safety and outcome using laser Doppler flowmetry (LDF) as guidance tool during DBS implantations. METHODS: An LDF probe adapted for the stereotactic system was used as guide for creation of the trajectory. The microcirculation along 83 preplanned trajectories was measured with the guide during DBS surgery for movement disorders...
January 5, 2018: Stereotactic and Functional Neurosurgery
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