scholarly journals Access Route for Endovascular Neurointervention - Transfemoral to Transradial: Is it Worth the Effort and are we Ready for the Change?

Author(s):  
Chirag Kamal Ahuja ◽  
Vivek Agarwal ◽  
Sameer Vyas ◽  
Vivek Gupta

AbstractTransfemoral access for neurointerventions has been a time-tested technique of entering the vascular network of the body and reaching the intended targets. However, it has its own share of shortcomings in the form of long admission times leading to increased costs, patient inconvenience and local (though infrequent) adverse affects. Transradial route has taken the interventional cardiology domain by storm and is staring now at other vascular domains especially neurointervention. It has shown better outcomes than the transfemoral route in many aspects. The current article discusses the vascular access perspectives with an exhaustive overview of the transradial route concerning its historical perspectives, its requirement in the current clinical scenario, the procedure per se including the adverse effects and whether it has the real world charm to displace the transfemoral route into the backseat. Transradial access in neurointervention is here to stay, however it would require training, certain modifications in the standard catheters that one currently uses for cerebral procedures and constant practice by the operator to cross the learning curve and attain a certain level of competence before he becomes comfortable with the technique.

2019 ◽  
Vol 16 (3) ◽  
pp. 251-258 ◽  
Author(s):  
Javad Behravan ◽  
Atefeh Razazan ◽  
Ghazal Behravan

Breast cancer is the second leading cause of cancer death among women. National cancer institute of the US estimates that one in eight women will be diagnosed with breast cancer during their lifetime. Considering the devastating effects of the disease and the alarming numbers many scientists and research groups have devoted their research to fight breast cancer. Several recommendations are to be considered as preventing measures which include living a healthy lifestyle, regular physical activity, weight control and smoking cessation. Early detection of the disease by annual and regular mammography after the age of 40 is recommended by many healthcare institutions. This would help the diagnosis of the disease at an earlier stage and the start of the treatment before it is spread to other parts of the body. Current therapy for breast cancer includes surgical ablation, radiotherapy and chemotherapy which is often associated with adverse effects and even may lead to a relapse of the disease at a later stage. In order to achieve a long-lasting anticancer response with minimal adverse effects, development of breast cancer vaccines is under investigation by many laboratories. The immune system can be stimulated by a vaccine against breast cancer. This approach has attracted a great enthusiasm in recent years. No breast cancer vaccines have been approved for clinical use today. One breast cancer vaccine (NeuVax) has now completed clinical trial phase III and a few preventive and therapeutic breast cancer vaccines are at different steps of development. We think that with the recent advancements in immunotherapy, a breast cancer vaccine is not far from reach.


2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Vivek Sharma ◽  
Avinash P. S. Thakur ◽  
Vasantharaja Ramasamy ◽  
Pushpendra Kumar Shukla ◽  
Fanindra Singh Solanki ◽  
...  

Abstract Background Urothelial bladder carcinoma accounts for around 3.9% cases of all the male cancers in India. Non-muscle-invasive bladder carcinoma (NMIBC) is predominant group which constitute approximately three fourth of the urothelial bladder cancer. Intravesical BCG immunotherapy is the corner stone of today’s NMIBC management. However, as with any other therapy it has its own complications and its interruption due to these adverse effects is a major cause of suboptimal efficacy. The aim of this study was to assess the complications of intravesical BCG therapy and their management in NMIBC patients. Methods This was a retrospective descriptive study conducted between October 2016 and November 2019; a backward review of 149 patients with diagnosis of NMIBC that undergone intravesicle BCG therapy was performed. Patient’s demographical, clinical, diagnostic and procedural data regarding bladder tumour, BCG therapy, its complications and management were collected and analysed. Results Total 149 patients were analysed, comprising 116 males and 33 females. The mean age was of 57.2 ± 6.7 years. Total 85.23% were primary and 14.76% were recurrent tumours. Total 96 patients (64.42%) completed the planned course, while 53 (35.57%) interrupted. The reasons for BCG interruption includes adverse effects (15.4%), progression of disease (6.7%), disease refractory to BCG (4.6%) and disease recurrence during BCG (3.3%). Most of the adverse events occurred in first 6 months and most interruptions occurred after the induction period. Cystitis was the most common observed adverse effect seen in 39.6% patients. Frequency, urgency, haematuria were common presentation. Radical cystectomy was the most common (16.10%) further treatment with patients whose treatment was interrupted. Conclusion BCG is an indispensable therapy available for NMIBC, but it is associated with array of adverse effects and complications, which are the main reasons for poor compliance to BCG therapy. Although BCG-related complications can affect any organ in the body, potentially life-threatening systemic BCG-related infections are encountered in only < 5% of patients. There are some difficulties in diagnosis of the BCG complications because acid-fast staining, culture and PCR test are not always positive; tissue biopsies should be indicated sometimes to evaluate histopathology and presence of M. bovis. A persistently monitored multidisciplinary approach with high index of suspicion and prompt anti-TB therapy can help to derive the maximum benefits while keeping the complications at check.


2021 ◽  
Vol 14 (1) ◽  
pp. e236695 ◽  
Author(s):  
Rasmi Ranjan Sahoo ◽  
Sourav Pradhan ◽  
Akhil Pawan Goel ◽  
Anupam Wakhlu

Staphylococcus-associated glomerulonephritis (SAGN) occurs as a complication of staphylococcal infection elsewhere in the body. Dermatomyositis (DM) can be associated with glomerulonephritis due to the disease per se. We report a case of a 40-year-old male patient with DM who presented with acute kidney injury, and was initially pulsed with methylprednisolone for 3 days, followed by dexamethasone equivalent to 1 mg/kg/day prednisolone. He was subsequently found to have SAGN on kidney biopsy along with staphylococcus bacteraemia and left knee septic arthritis. With proof of definitive infection, intravenous immunoglobulin 2 g/kg over 2 days was given and steroids were reduced. He was treated with intravenous vancomycin. With treatment, the general condition of the patient improved. On day 38, he developed infective endocarditis and died of congestive heart failure subsequently. Undiagnosed staphylococcal sepsis complicating a rheumatological disease course can lead to complications like SAGN, infective endocarditis and contribute to increased morbidity and mortality, as is exemplified by our case.


Author(s):  
Nobuyoshi Yamabe

This chapter outlines the early form and development of Buddhist meditation. First, it discusses the “application of mindfulness,” especially “mindfulness of the body,” which can be largely classified into two types of practice. One is “mindfulness per se,” without reflective thought, and the other is a more reflective or visual approach. “Mindfulness per se” (in particular, mindful breathing) was transmitted to East Asia and remains the cardinal method there. The chapter discusses close ties between traditional mindfulness and Japanese Sōtō practice. It then moves on to describe meditation on the decomposition of a corpse, which is a representative form of the more reflective and visual type of practice, involving the observation of a dead body in its stages of decomposition. This is found in early scriptures. Later texts came to teach a more elaborate method of “grasping the images” of a corpse. A notable development in visualization is that the images seen by the practitioner came to include ones that were more enigmatic. The discussion finally turns to another significant development in Buddhist meditation, one which involves Buddha visualization. Its undeveloped form is found in early Mahayana sutras, but a fully developed version employing statues as aides for visualization is found in later meditation texts from the fifth century onward. This type of visualization was inherited by Esoteric Buddhism and is still practiced today.


1988 ◽  
Vol 2 (1) ◽  
pp. 25-28 ◽  
Author(s):  
I.A. Mjör

This discussion of a review paper on endodontic materials focuses on the need for standardization of this group of materials, including clinical and biological investigations. It was concluded that the search for endodontic materials that are both adhesive to dentin and insoluble must continue. When such materials become available, the defense mechanism of the body would take care of the healing per se. This approach as well as techniques and materials which induce dentin bridge formation in the apical area were considered feasible for improving endodontic treatment. The need to report side-effects of endodontic materials was stressed, and it was suggested that such reports should be mandatory for clinicians and for manufacturers of endodontic materials.


Ecclesiology ◽  
2013 ◽  
Vol 9 (1) ◽  
pp. 66-74
Author(s):  
Kenneth Wilson

Does Methodism want a distinctive ecclesiology? British Methodism assumes its ecclesiology from the Church of England which explains its lack of ecclesiological thinking, its genuine desire for reunification, and indeed its focus on ecclesia in actu. But there can be no ecclesia in actu apart from ecclesia per se. Being and doing are one in God. The Church, grounded in the dynamic being of God in Trinity, celebrates in the action of the Eucharist the wholeness of God’s presence with his world. Proleptically the Church includes the whole of creation and all people. Hence, when as the Body of Christ we pray the Our Father with our Lord, we pray on behalf of all, not just for ourselves. But what then do we mean by apostolicity? Perhaps in Methodism we would be well occupied exploring more keenly with the Roman Catholic Church what we each mean by being a society within the church. Outler may have been right when he opined that Methodism needed a Catholic Church within which to be church.


2021 ◽  
Vol 11 ◽  
Author(s):  
Andi Zhang ◽  
Tianyuan Zou ◽  
Dongye Guo ◽  
Quan Wang ◽  
Yilin Shen ◽  
...  

As a stressor widely existing in daily life, noise can cause great alterations to the immune system and result in many physical and mental disorders, including noise-induced deafness, sleep disorders, cardiovascular diseases, endocrine diseases and other problems. The immune system plays a major role in maintaining homeostasis by recognizing and removing harmful substances in the body. Many studies have shown that noise may play vital roles in the occurrence and development of some immune diseases. In humans, both innate immunity and specific immunity can be influenced by noise, and different exposure durations and intensities of noise may exert various effects on the immune system. Short-term or low-intensity noise can enhance immune function, while long-term or high-intensity noise suppresses it. Noise can lead to the occurrence of noise-induced hearing loss (NIHL) through the production of autoantibodies such as anti-Hsp70 and anti-Hsp60 and exert adverse effects related to other immune-related diseases such as some autoimmune diseases and non-Hodgkin lymphoma. The neuroendocrine system, mainly including the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic-adrenal-medullary (SAM) system, is involved in the mechanisms of immune-related diseases induced by noise and gut microbiota dysfunction. In addition, noise exposure during pregnancy may be harmful to the immune system of the fetus. On the other hand, some studies have shown that music can improve immune function and alleviate the adverse effects caused by noise.


REPORTS ◽  
2021 ◽  
Vol 2 (336) ◽  
pp. 54-60
Author(s):  
Zh. A. Zhonderbek ◽  
S. Zh. Kolumbayeva ◽  
A. V. Lovinskaya ◽  
N. Voronova

Increasing the body's resistance to various environmental pollutants' adverse effects is one of medicine's essential tasks. In this regard, an active search for antimutagens to eliminate or weaken mutagens' effect in the body is currently underway. One of the promising sources of antimutagenic compounds is the medicinal plant Rosa majalis Herrm (rosehips). The genotoxic and antigenotoxic activity of rosehips was studied on cells of bone marrow, spleen, liver, and kidneys of laboratory mice using an alkaline variant Comet assay. It was found that rosehip infusions in various concentrations (infusion, diluted infusion and herbal tea) do not have a genotoxic effect on the cells of the studied organs of laboratory animals. The medicinal rosehip's combined action with classical mutagen MMS significantly reduced (p<0.01) MMS-induced mutagenesis level. The various rosehip infusions used did not show statistically significant differences among themselves. The results obtained indicate the antigenotoxic activity of R. majalis infusions.


2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Atanas Totlyakov ◽  
◽  
◽  

The current article are discussed the problem of significant importance of the tactile feelings in the context of the ways in which they are used in drawing creation.The basis of the study is the theoretical and practical experience gained in the conditions of creative experimentation, derived as a specific artistic practice.The relationship between visual and mental images and their comparison with the sensory field of the active touch is analyzed.There are summarized a four experimental plans: Mastering practical tactil experience and its creativity interpretation; Comparison of the tactil execution of a creative act and optical perception of drawings obtained without visual contact; Reflection of a participation of the body in the creative process; Focusing attention on feeling and their emotional coloring as interpersonal interaction in the frame of the working environment.


Author(s):  
David Sedley

Epicureanism is one of the three dominant philosophies of the Hellenistic age. The school was founded by Epicurus (341–271 bc) (see Prolēpsis). Only small samples and indirect testimonia of his writings now survive, supplemented by the poem of the Roman Epicurean Lucretius, along with a mass of further fragmentary texts and secondary evidence. Its main features are an anti-teleological physics, an empiricist epistemology and a hedonistic ethics. Epicurean physics developed out of the fifth-century atomist system of Democritus. The only per se existents are bodies and space, each of them infinite in quantity. Space includes absolute void, which makes motion possible, while body is constituted out of physically indissoluble particles, ‘atoms’. Atoms are themselves further measurable into sets of absolute ‘minima’, the ultimate units of magnitude. Atoms are in constant rapid motion, at equal speed (since in the pure void there is nothing to slow them down). Stability emerges as an overall property of compounds, which large groups of atoms form by settling into regular patterns of complex motion. Motion is governed by the three principles of weight, collisions and a minimal random movement, the ‘swerve’, which initiates new patterns of motion and obviates the danger of determinism. Atoms themselves have only the primary properties of shape, size and weight. All secondary properties, for example, colour, are generated out of atomic compounds; given their dependent status, they cannot be added to the list of per se existents, but it does not follow that they are not real. Our world, like the countless other worlds, is an accidentally generated compound, of finite duration. There is no divine mind behind it. The gods are to be viewed as ideal beings, models of the Epicurean good life, and therefore blissfully detached from our affairs. The foundation of the Epicurean theory of knowledge (‘Canonic’) is that ‘all sensations are true’ – that is, representationally (not propositionally) true. In the paradigm case of sight, thin films of atoms (‘images’) constantly flood off bodies, and our eyes mechanically register those which reach them, neither embroidering nor interpreting. These primary visual data (like photographs, which ‘cannot lie’) have unassailable evidential value. But inferences from them to the nature of external objects themselves involves judgment, and it is there that error can occur. Sensations thus serve as one of the three ‘criteria of truth’, along with feelings, a criterion of values and psychological data, and prolēpseis, naturally acquired generic conceptions. On the basis of sense evidence, we are entitled to infer the nature of microscopic or remote phenomena. Celestial phenomena, for example, cannot be regarded as divinely engineered (which would conflict with the prolēpsis of god as tranquil), and experience supplies plenty of models adequate to explain them naturalistically. Such grounds amount to consistency with directly observed phenomena, and are called ouk antimarturēsis, ‘lack of counterevidence’. Paradoxically, when several alternative explanations of the same phenomenon pass this test, all must be accepted as true. Fortunately, when it comes to the foundational tenets of physics, it is held that only one theory passes the test. In ethics, pleasure is the one good and our innately sought goal, to which all other values are subordinated. Pain is the only bad, and there is no intermediate state. Bodily pleasure becomes more secure if we adopt a simple lifestyle which satisfies only our natural and necessary desires, with the support of like-minded friends. Bodily pain, when inevitable, can be outweighed by mental pleasure, which exceeds it because it can range over past, present and future enjoyments. The highest pleasure, whether of soul or of body, is a satisfied state, ‘static pleasure’. The short-term (‘kinetic’) pleasures of stimulation can vary this state, but cannot make it more pleasant. In striving to accumulate such pleasures, you run the risk of becoming dependent on them and thus needlessly vulnerable to fortune. The primary aim should instead be the minimization of pain. This is achieved for the body through a simple lifestyle, and for the soul through the study of physics, which offers the most prized ‘static’ pleasure, ‘freedom from disturbance’ (ataraxia), by eliminating the two main sources of human anguish, the fears of god and of death. It teaches us that cosmic phenomena do not convey divine threats, and that death is mere disintegration of the soul, with hell an illusion. Being dead will be no worse than not having yet been born. Physics also teaches us how to evade determinism, which would turn moral agents into mindless fatalists: the indeterministic ‘swerve’ doctrine (see above), along with the logical doctrine that future-tensed propositions may be neither true nor false, leaves the will free. Although Epicurean groups sought to opt out of public life, they respected civic justice, which they analysed not as an absolute value but as one perpetually subject to revision in the light of changing circumstances, a contract between humans to refrain from harmful activity in their own mutual interest.


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