scholarly journals Leadless Pacemaker Perforations: Clinical Consequences and Related Device and User Problems

2021 ◽  
Author(s):  
Robert G. Hauser ◽  
Charles C. Gornick ◽  
Raed H. Abdelhadi ◽  
Chuen Y. Tang ◽  
Melanie Kapphahn‐Bergs ◽  
...  
Keyword(s):  
Leadless Pacemaker ◽  
Clinical Consequences

The clinical consequences of the red cell storage lesion

2001 ◽  
Vol 15 (2) ◽  
pp. 91-107 ◽  
Author(s):  
Alan Tinmouth ◽  
Ian Chin-Yee
Keyword(s):  
Red Cell ◽  
Storage Lesion ◽  
Clinical Consequences ◽  
Cell Storage

Depression of Collateral Blood Flow Following Arterial Thrombosis

1977 ◽  
Vol 38 (04) ◽  
pp. 0850-0862 ◽  
Author(s):  
Robert G. Schaub ◽  
Ronald Sande ◽  
Kenneth M. Meyers
Keyword(s):  
Blood Flow ◽  
Arterial Thrombosis ◽  
Hind Limb ◽  
Therapeutic Interventions ◽  
Collateral Blood Flow ◽  
Serotonin Antagonist ◽  
Limb Perfusion ◽  
Clinical Consequences ◽  
Collateral Vessels ◽  
Iliac Bifurcation

SummaryPermanent ligation of the feline aorta at the iliac bifurcation is followed by rapid opening of pre-existing collateral blood vessels. However, if ligation is combined with formation of a clot, these protective collateral vessels do not function. This study was undertaken to determine if drugs which alter serotonin function can improve collateral blood flow after arterial thrombosis. Permanent ligations were placed at the iliac bifurcation, circumflex iliac and sixth lumbar arteries in all cats. A clot was produced in the aorta of 27 cats by injection of 0.1 ml of thromboplastin. Ligated clot-occluded cats were untreated (10); had blood serotonin depleted using a single dose of reserpine (0.1 mg/kg i. m.) followed by para-chlorophenylanine (p-CPA) (100 mg/kg orally) every 3 days (9) ; or were treated prior to surgery with a serotonin antagonist cinanserin HC1 (4 mg/kg i. v.) (8). Control cats (18) were acutely ligated. 9 of these cats were untreated, 5 were cinanserin HC1-treated, and 4 were reserpine/p-CPA-treated. Extent of collateral development was assessed by aortograms 3 days after occlusion and by neurologic rating. Aortograms of acutely ligated cats indicated a significant collateral blood flow around the segment of ligated aorta, while ligated clot-occluded cats had a severely depressed hind-limb perfusion. Reserpine/p-CPA-treated ligation clot-occluded cats had aortograms similar to acutely ligated cats. The cinanserin HC1-treated ligation clot-occluded cats had aortograms which indicated hind-limb perfusion was not as adequate as the acutely ligated cats. However, the perfusion of these animals was improved over untreated ligation clot-occluded cats. Neurologic rating correlated with aortograms. These results suggest: 1) the clinical consequences of arterial thrombosis cannot be entirely attributed to mechanical occlusion of an artery, but may be due to depression of protective collateral blood flow induced by thrombosis, 2) serotonin is an important factor in this depression of collateral blood flow, and 3) isolation of the factors responsible for collateral inhibition could permit the development of therapeutic interventions.

Intradural tumor recurrence after resection of extradural metastasis: a rare but potential complication of intraoperative durotomy

2014 ◽  
Vol 20 (6) ◽  
pp. 734-739 ◽  
Author(s):  
Manish K. Kasliwal ◽  
Lee A. Tan ◽  
John E. O'Toole
Keyword(s):  
Tumor Recurrence ◽  
Spinal Metastasis ◽  
Spinal Metastases ◽  
Intramedullary Tumor ◽  
Local Tumor ◽  
Local Tumor Recurrence ◽  
Tumor Dissemination ◽  
Intradural Tumor ◽  
Clinical Consequences ◽  
Clinical Awareness

Spinal metastases are the most common of spinal neoplasms and occur predominantly in an extradural location. Their appearance in an intradural location is uncommon and is associated with a poor prognosis. Cerebrospinal fluid dissemination accounts for a significant number of intradural spinal metastases mostly manifesting as leptomeningeal carcinomatoses or drop metastases from intracranial tumors. The occurrence of local tumor dissemination intradurally following surgery for an extradural spinal metastasis has not been reported previously. The authors describe 2 cases in which local intradural and intramedullary tumor recurrences occurred following resection of extradural metastases that were complicated by unintended durotomy. To heighten clinical awareness of this unusual form of local tumor recurrence, the authors discuss the possible etiology and clinical consequences of this entity.

Point-of-Care Diagnostic Assays and Novel Preclinical Technologies for Hemostasis and Thrombosis

2021 ◽  
Vol 47 (02) ◽  
pp. 120-128
Author(s):  
Christina Caruso ◽  
Wilbur A. Lam
Keyword(s):  
Point Of Care ◽  
Healing Process ◽  
Coagulation Factors ◽  
Wound Healing Process ◽  
Shear Stresses ◽  
Flow Conditions ◽  
Novel Technologies ◽  
Clinical Consequences ◽  
Complex Wound ◽  
Reproducible Analysis

AbstractHemostasis is a complex wound-healing process involving numerous mechanical and biochemical mechanisms and influenced by many factors including platelets, coagulation factors, and endothelial components. Slight alterations in these mechanisms can lead to either prothrombotic or bleeding consequences, and such hemostatic imbalances can lead to significant clinical consequences with resultant morbidity and mortality. An ideal hemostasis assay would not only address all the unique processes involved in clot formation and resolution but also take place under flow conditions to account for endothelial involvement. Global assays do exist; however, these assays are not flow based. Flow-based assays have been limited secondary to their large blood volume requirements and low throughput, limiting potential clinical applications. Microfluidic-based assays address the aforementioned limitations of both global and flow-based assays by utilizing standardized devices that require low blood volumes, offer reproducible analysis, and have functionality under a range of shear stresses and flow conditions. While still largely confined to the preclinical space, here we aim to discuss these novel technologies and potential clinical implications, particularly in comparison to the current, commercially available point-of-care assays.

scholarly journals Thermolabile drug storage in an ambulatory setting

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fernando do Pazo-Oubiña ◽  
Bartomeu Alorda-Ladaria ◽  
Ana Gomez-Lobon ◽  
Bàrbara Boyeras-Vallespir ◽  
María Margalida Santandreu-Estelrich ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Statistical Treatment ◽  
Storage Conditions ◽  
Ambulatory Setting ◽  
Temperature Record ◽  
Care Hospital ◽  
Data Logger ◽  
Data Loggers ◽  
Ambulatory Patients ◽  
Clinical Consequences

AbstractMore thermolabile drugs are becoming available, and in most cases, these medications are dispensed to ambulatory patients. However, there is no regulation once medications are dispensed to patients and little is known with regard to what happens during transport and home storage. Previous studies suggest that these drugs are improperly stored. The present study was designed to determine the storage conditions of thermolabile drugs once they are dispensed to the patient in the Hospital Pharmacy Department. This is a prospective observational study to assess the temperature profile of 7 thermolabile drugs once they are dispensed to ambulatory patients at a tertiary care hospital. A data logger was added to the medication packaging. Temperature was considered inappropriate if one of the following circumstances were met: any temperature record less than or equal to 0 °C or over 25 °C; temperatures between 0–2 or 8–25 °C for a continuous period over 30 min. The time series of temperature measurements obtained from each data logger were analyzed as statistically independent variables. The data shown did not undergo any statistical treatment and must be considered directly related to thermal measurements. One hundred and fourteen patients were included and 107 patients were available for the analysis. On the whole, a mean of 50.6 days (SD 18.3) were measured and the mean temperature was 6.88 °C (SD 2.93). Three data loggers (2.8%) maintained all the measurements between 2 and 8 °C with less than 3 continuous data (< 30 min) out of this range but no data over 25 °C or below or equal to 0 °C. 28 (26.2%) data loggers had at least one measurement below zero, 1 data logger had a measurement greater than 25 °C and 75 (70.1%) were between 0 and 2 °C and/or between 8 and 25 °C for more than 30 min. In conclusion, once dispensed to patients, most thermolabile drugs are improperly stored. Future studies should focus on clinical consequences and possible solutions.

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