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https://read.qxmd.com/read/30760625/institutional-and-provider-variations-for-mechanical-thrombectomy-in-the-treatment-of-acute-ischemic-stroke-a-survey-analysis
#1
Tapan Mehta, Shailesh Male, Coridon Quinn, David F Kallmes, Adnan H Siddiqui, Aquilla Turk, Andrew Walker Grande, Ramachandra Prasad Tummala, Bharathi Dasan Jagadeesan
INTRODUCTION: Stent retriever combined with aspiration, or the 'Solumbra technique', has recently emerged as one of the popular methods of mechanical thrombectomy (MT). However, the variations in understanding and implementation of the Solumbra technique have not been reported. METHODS: An 18 part anonymous survey questionnaire was designed to extract information regarding technical variations of MT with a focus on the Solumbra technique. The survey link was posted on the Society of Neurointerventional Surgery (SNIS) website in 'SNIS connect'...
February 13, 2019: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/30706015/prostate-stereotactic-body-radiation-therapy-with-a-focal-simultaneous-integrated-boost-acute-toxicity-and-dosimetry-results-from-a-prospective-trial
#2
Andrew M McDonald, Michael C Dobelbower, Eddy S Yang, Grant M Clark, Rojymon Jacob, Robert Y Kim, Rex A Cardan, Richard Popple, Jeffrey W Nix, Soroush Rais-Bahrami, John B Fiveash
Purpose: This study aimed to report the early toxicity results of a prospective clinical trial of prostate stereotactic body radiation therapy (SBRT) to the entire prostate with a simultaneous integrated boost (SIB) to magnetic resonance imaging (MRI)-defined focal lesions. Methods and materials: Eligible patients included men with biopsy-proven prostate stage T1c to T2c adenocarcinoma, a Gleason score ≤7, and prostate-specific antigen values of ≤20 ng/mL, who had at least 1 focal lesion visible on MRI and a total prostate volume no greater than 120 cm3 ...
January 2019: Advances in Radiation Oncology
https://read.qxmd.com/read/30700178/does-timing-of-urinary-catheter-removal-after-elective-cesarean-section-affects-postoperative-morbidity-a-prospective-randomized-trial
#3
Nisreen Khaled Aref
OBJECTIVE: To assess whether immediate (0 h), intermediate (after 6 h), or delayed (after 24 h) removal of an urinary catheter after elective caesarian section (CS) regarding, the rate of urinary retention with recatheterization, rate of symptomatic urinary tract infections (UTI), time of ambulation, and the length of hospital stay. METHODS: Prospective randomized controlled trial conducted at King Abd Al-Aziz Hospital, KSA. Two hundred twenty-one women underwent for term elective CS and were randomly allocated into three groups by simple randomization using computer-generated random numbers...
January 30, 2019: Journal of Maternal-fetal & Neonatal Medicine
https://read.qxmd.com/read/30668769/radial-artery-access-for-treatment-of-posterior-circulation-aneurysms-using-the-pipeline-embolization-device-case-series
#4
Eytan Raz, Maksim Shapiro, Razvan Buciuc, Peter Kim Nelson, Erez Nossek
BACKGROUND: The treatment of selected wide-neck and fusiform posterior circulation aneurysms is challenging for clipping as well as for endovascular route. OBJECTIVE: To describe an endovascular approach for vertebral artery aneurysm treatment using transradial access (TRA) instead of the conventional transfemoral access. METHODS: We collected cases from two institutions in which TRA was used for posterior circulation Pipeline Embolization Device (Medtronic, Dublin, Ireland) deployment...
January 22, 2019: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/30628848/percutaneous-transhepatic-biliary-tract-embolization-using-gelatin-sponge
#5
Anne Marie Augustin, Victoria Cao, Friederika Fluck, Julian Kunz, Thorsten Bley, Ralph Kickuth
BACKGROUND: Percutaneous biliary drainage (PTBD) is a necessary procedure in several benign and malignant conditions. After PTBD removal biliocutaneous fistula is a rare but potential complication. Different embolization agents have been used for transhepatic catheter tract embolization in the past, while there is only little experience using gelatin sponge for this procedure. PURPOSE: To evaluate the feasibility and safety of PTBD tract embolization with gelatin sponge...
January 10, 2019: Acta Radiologica
https://read.qxmd.com/read/30619940/impact-of-the-site-of-necrosis-on-outcome-of-acute-pancreatitis
#6
Narendra Dhaka, Saroj K Sinha, Jayanta Samanta, Vikas Gupta, Thakur Deen Yadav, Ajay Gulati, Rakesh Kochhar
Objecives: To compare the clinical outcome of patients with extrapancreatic necrosis (EXPN) alone with that of acute interstitial pancreatitis (AIP), pancreatic parenchymal necrosis (PPN) alone, and combined PPN and EXPN. Background: There are only a few studies in the literature in which EXPN has been recently recognized as a subtype of acute necrotizing pancreatitis (ANP), with a better prognosis. Methods: We analyzed clinical data and outcome variables of 411 consecutive acute pancreatitis (AP) patients between January 2012 and December 2014...
December 2018: JGH open: an open access journal of gastroenterology and hepatology
https://read.qxmd.com/read/30619613/bacteraemia-due-to-microbacterium-paraoxydans-in-a-patient-with-chronic-kidney-disease-refractory-hypertension-and-sarcoidosis
#7
Matthew S Chorost, Nancy C Smith, Jack N Hutter, Ann C Ong, Jason A Stam, Patrick T McGann, Mary K Hinkle, Kurt E Schaecher, Edwin Kamau
Introduction: Microbacterium spp. are yellow-pigmented Gram-positive coryneform rods found in various environmental sources, such as soil and water samples. They rarely cause human infection, mostly infecting immunocompromised patients and catheter insertion sites, making them challenging to identify in clinical settings. Case presentation: We report a case of a 61-year-old female on long-term prednisone therapy for sarcoidosis with minimal exposure to environmental sources, who presented with an overtly infected Hickman catheter site and presyncope...
November 2018: JMM Case Reports
https://read.qxmd.com/read/30604166/clinical-risk-score-for-invasive-fungal-diseases-in-patients-with-hematological-malignancies-undergoing-chemotherapy-china-assessment-of-antifungal-therapy-in-hematological-diseases-caesar-study
#8
Ling Wang, Ying Wang, Jiong Hu, Yuqian Sun, He Huang, Jing Chen, Jianyong Li, Jun Ma, Juan Li, Yingmin Liang, Jianmin Wang, Yan Li, Kang Yu, Jianda Hu, Jie Jin, Chun Wang, Depei Wu, Yang Xiao, Xiaojun Huang
Invasive fungal disease (IFD) is a major infectious complication in patients with hematological malignancies. In this study, we examined 4889 courses of chemotherapy in patients with hematological diseases to establish a training dataset (n = 3500) by simple random sampling to develop a weighted risk score for proven or probable IFD through multivariate regression, which included the following variables: male patients, induction chemotherapy for newly diagnosed or relapsed disease, neutropenia, neutropenia longer than 10 days, hypoalbuminemia, central-venous catheter, and history of IFD...
January 2, 2019: Frontiers of Medicine
https://read.qxmd.com/read/30592942/-clinical-effect-of-checklist-for-early-recognition-and-treatment-of-acute-illness-in-department-of-intensive-care-unit-a-prospective-observational-study
#9
Xuesong Wen, Min Shao, Kashani Kianoush B Banaei
OBJECTIVE: To evaluate the clinical performance of checklist for early recognition and treatment of acute illness (CERTAIN) on patients in the intensive care unit (ICU). METHODS: A prospective observational study was performed. 100 patients (age > 18 years old, the length of ICU stay > 72 hours) admitted to ICU of the Second People's Hospital of Lu'an from January to July in 2018 were enrolled. By convenience sampling methods, 50 patients admitted to the hospital from January to April in 2018 were selected as the control group...
December 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/30580285/balloon-assisted-tracking-technique-to-overcome-intracranial-stenosis-during-thrombectomy-for-stroke
#10
Jan-Karl Burkhardt, Maksim Shapiro, Omar Tanweer, Miguel Litao, Breehan Chancellor, Eytan Raz, Howard A Riina, Peter Kim Nelson
Anatomical vessel obstacles such as an intracranial stenosis in stroke are challenging and may lead to delayed clot access for thrombectomy. We describe a simple and effective technique to overcome the step-off between the intermediate catheter and an intracranial vessel stenosis during thrombectomy. The patient presented with acute embolic left middle cerebral artery occlusion and a favorable penumbral pattern. Clot access was made challenging by focal stenosis in the ipsilateral cavernous segment. The balloon-assisted tracking technique was effective in traversing the step-off to enable TICI 3 aspiration thrombectomy...
December 22, 2018: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/30578170/trans-catheter-aortic-valve-replacement-and-surgical-aortic-valve-replacement-outcomes-in-patients-with-dialysis-systematic-review-and-meta-analysis
#11
Mohinder R Vindhyal, Paul Ndunda, Sinan Khayyat, Venkata Subbarao Boppana, Zaher Fanari
BACKGROUND: Dialysis is associated with higher rate of aortic valve calcification and higher cardiovascular mortality. Transcatheter aortic valve replacement (TAVR) is an established alternative for surgical aortic valve replacement (SAVR) in patients with higher and intermediate co-morbidities including dialysis. METHODS: Two independent investigators systematically searched Medline, Cochrane, and Web of Science. The ROBINS-I tool was used to analyze and assess the bias from the selected studies...
December 10, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://read.qxmd.com/read/30572402/-efficacy-and-safety-of-catheter-directed-interventional-therapy-in-patients-with-acute-pulmonary-embolism
#12
J F Chen, Y M Song, J Jin, S Y Yu, S Z Bian, P Li, L Huang
Objective: To evaluate the efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism(PE). Methods: PE was diagnosed by CT pulmonary angiography(CTPA). After risk stratification, a total of 79 PE patients (age (58.9±14.9) years old)were treated with catheter-directed interventional therapy via pulmonary vessels. The changes of pulmonary hemodynamics were compared before and after treatment. The risk of complications and side effects were observed. Results: The pulmonary artery pressure was changed followed by interventional therapy...
December 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://read.qxmd.com/read/30568646/an-azole-resistant-candida-parapsilosis-outbreak-clonal-persistence-in-the-intensive-care-unit-of-a-brazilian-teaching-hospital
#13
Danilo Yamamoto Thomaz, João Nobrega de Almeida, Glaucia Moreira Espindola Lima, Maína de Oliveira Nunes, Carlos Henrique Camargo, Rafaella de Carvalho Grenfell, Gil Benard, Gilda M B Del Negro
The incidence of candidemia by the Candida parapsilosis complex has increased considerably in recent decades, frequently related to use of indwelling intravascular catheters. The ability of this pathogen to colonize healthcare workers (HCW)' hands, and to form biofilm on medical devices has been associated with the occurrence of nosocomial outbreaks and high mortality rates. Fluconazole has been the leading antifungal drug for the treatment of invasive candidiasis in developing countries. However, azole-resistant C...
2018: Frontiers in Microbiology
https://read.qxmd.com/read/30567225/balloon-assisted-tracking-technique-to-overcome-intracranial-stenosis-during-thrombectomy-for-stroke
#14
Jan-Karl Burkhardt, Maksim Shapiro, Omar Tanweer, Miguel Litao, Breehan Chancellor, Eytan Raz, Howard A Riina, Peter Kim Nelson
Anatomical vessel obstacles such as an intracranial stenosis in stroke are challenging and may lead to delayed clot access for thrombectomy. We describe a simple and effective technique to overcome the step-off between the intermediate catheter and an intracranial vessel stenosis during thrombectomy. The patient presented with acute embolic left middle cerebral artery occlusion and a favorable penumbral pattern. Clot access was made challenging by focal stenosis in the ipsilateral cavernous segment. The balloon-assisted tracking technique was effective in traversing the step-off to enable TICI 3 aspiration thrombectomy...
December 10, 2018: BMJ Case Reports
https://read.qxmd.com/read/30549393/low-dose-systemic-thrombolytic-therapy-for-treatment-of-submassive-pulmonary-embolism-clinical-efficacy-but-attendant-hemorrhagic-risks
#15
Daniel P Rothschild, James A Goldstein, Terry R Bowers
OBJECTIVES: The purpose of the present study is to evaluate the safety and efficacy of "low-dose" systemic thrombolytic therapy (TT) for treatment of patients with intermediate-high risk submassive pulmonary embolism (PE). BACKGROUND: TT is increasingly utilized in acute submassive PE. Strategies for TT include catheter-directed administration as well as traditional IV systemic therapy. Regardless of the route, most studies document the attendant significant bleeding complication rates expected from induction of a systemic lytic state...
December 14, 2018: Catheterization and Cardiovascular Interventions
https://read.qxmd.com/read/30535109/the-antrack-technique-employing-a-compliant-balloon-or-stent-retriever-to-advance-a-large-bore-catheter-to-an-occlusion-during-thrombectomy-procedures-in-acute-stroke-patients
#16
Chuan-Min Lin, Yi-Ming Wu, Chien-Hung Chang, Ching-Chang Chen, Alvin Yi-Chou Wang
BACKGROUND: Stent retrievers and thrombosuction catheters have become the cornerstones of acute stroke therapy. A large-lumen catheter facilitates the passage of different instruments and the application of greater suction force to clots. However, positioning a flexible thrombosuction or intermediate catheter within a tortuous artery is difficult and time-consuming. OBJECTIVE: To evaluate the efficacy and safety of the ANchor TRACKing (ANTRACK) technique in achieving distal positioning of a large-lumen catheter in a tortuous cranial artery...
December 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/30529526/pipeline-embolization-of-a-giant-cavernous-ica-aneurysm-with-direct-carotid-puncture-and-arteriotomy-closure-device-neuroendovascular-surgical-video
#17
Denise Brunozzi, Sophia F Shakur, Ali Alaraj
Flow diversion technology has revolutionized the treatment of complex anterior circulation cerebral aneurysms. However, vessel tortuosity and atherosclerotic disease may hamper the standard transfemoral access used in these procedures. Percutaneous direct carotid puncture is a viable alternative, but adequate carotid closure must be achieved. Here, we present the first case of a giant partially thrombosed aneurysm of the cavernous internal carotid artery treated with Pipeline Embolization Device (PED; ev3 Neurovascular, Irvine, CA) via direct carotid puncture...
December 6, 2018: World Neurosurgery
https://read.qxmd.com/read/30527939/the-use-of-video-motion-analysis-to-determine-the-impact-of-anatomic-complexity-on-endovascular-performance-in-carotid-artery-stenting
#18
Alexander E Rolls, Celia V Riga, Sybghat U Rahim, Willem Willaert, Isabelle Van Herzeele, Danail V Stoyanov, Mohamad S Hamady, Nick J Cheshire, Colin D Bicknell
OBJECTIVE: Video motion analysis (VMA) uses fluoroscopic sequences to derive information on catheter and guidewire movement and is able to calculate two-dimensional catheter tip path length (PL) on the basis of frame-by-frame pixel coordinates. The objective of this study was to evaluate the effect of anatomic complexity on the efficiency of completion of defined stages of simulated carotid artery stenting as measured by VMA. METHODS: Twenty interventionists each performed a standardized easy, medium, and difficult carotid artery stenting case in random order on an ANGIO Mentor (Simbionix, Airport City, Israel) simulator...
December 4, 2018: Journal of Vascular Surgery
https://read.qxmd.com/read/30500582/effects-of-intermediate-catheter-evolution-on-technical-outcome-of-mechanical-thrombectomy-a-comparison-of-the-performance-of-two-distal-access-catheters-in-mechanical-thrombectomy-of-acute-ischemic-stroke
#19
Markus Le Blanc, Volker Maus, Christoph Kabbasch, Franziska Dorn, De-Hua Chang, Thomas Liebig, Anastasios Mpotsaris, Jan Borggrefe
OBJECTIVE: Fast and secure access to intracranial vessel occlusion is essential for mechanical thrombectomy (MT) in the treatment of acute ischemic stroke. We compared 2 intermediate distal access catheters (DAC: Distal Access Catheter [C1] and SOFIA: Soft torquable catheter Optimized For Intracranial Access [C2]) for procedural speed and safety of MT as well as clinical outcome at discharge and after 90 days. METHODS: This is a retrospective study of all 398 consecutive patients receiving MT with C1 or C2 for the treatment of acute ischemic stroke between September 2010 and June 2016, using a propensity score matched cohort...
November 27, 2018: World Neurosurgery
https://read.qxmd.com/read/30497539/effects-of-intrauterine-air-bubbles-on-embryonic-development-in-mice
#20
Hua Li, Rongyan Zhou, Yimeng Li, Ruonan Liu, Yanping Miao, Bin Zhang, Xinglong Wu, Shu Zhang, Fuchou Tang, Xiangyun Li
During murine embryo transfer, air bubbles frequently are loaded with embryos into the transfer catheter, but the role of air bubbles on embryonic development is unclear. This study shows that intrauterine air disrupted embryo spacing, induceddeciduoma, and impaired postimplantation development. RNA sequencing showed that the gene expression profile of air-induced deciduoma differed significantly from that of embryo-induced decidua but is similar to tetraploid-induced deciduoma. A subset of 33 common genes was upregulated in the embryo-induced decidua compared with air- or tetraploidinduced deciduoma...
November 29, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
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