scholarly journals Transarterial Embolization in Neonatal Kasabach–Merritt Syndrome

2021 ◽  
Vol 9 ◽  
Author(s):  
Yinghao Wang ◽  
Song Wang ◽  
Lili Wang ◽  
Shaohua Bi ◽  
Jian Zhang ◽  
...  
Keyword(s):  
Clinical Course ◽  
Transarterial Embolization ◽  
Alternative Therapy ◽  
Major Complication ◽  
Maximum Size ◽  
Lower Leg ◽  
Upper Arm ◽  
Medical University ◽  
Embolization Procedure ◽  
Persistent Thrombocytopenia

Background: Kasabach–Merritt syndrome (KMS) is characterized by large hemangiomas and persistent thrombocytopenia, which may result in visceral hemorrhage and disseminated intravascular coagulation. This study aimed to evaluate the value of transarterial embolization (TAE) in neonatal KMS patients.Patients and Methods: The clinical course of 11 neonates with KMS who underwent TAE in the Department of Neonatology, Anhui Provincal Children's Hospital, Anhui Medical University, China, were reviewed retrospectively.Results: Eleven neonates with KMS (nine male and two female) were admitted to our hospital between the age of 1 h and 6 days. All were born with progressively enlarged hemangiomas and persistent thrombocytopenia. The largest lesion had its maximum size reached at 15 × 8 × 8 cm. Eight patients had cutaneous hemangiomas (1 right face, one oropharynx, one left upper arm, two back, one left lumbar, one right lower leg, and one right thigh), and three patients had liver hemangiomas. All 11 patients underwent TAE. Nine patients underwent two TAEs, and two patients underwent only one embolization procedure. They all obtained >80% devascularization of their lesions without a major complication. The platelet count increased at 2–5 days after treatment and reached normal count and coagulation profile at 18–28 days after the TAE.Conclusions: TAE is a safe and effective alternative therapy for neonatal KMS patients.

Kinematic Analysis of Olympic Sprint Performance: Men's 200 Meters

1985 ◽  
Vol 1 (2) ◽  
pp. 151-162 ◽  
Author(s):  
Ralph Mann ◽  
John Herman
Keyword(s):  
Elite Athlete ◽  
Olympic Games ◽  
Lower Leg ◽  
Lower Body ◽  
Upper Arm ◽  
Performance Variables ◽  
Stride Rate ◽  
Body Velocity ◽  
The Difference ◽  
Support Time

Selected kinematic variables in the performance of the Gold and Silver medalists and the eighth-place finisher in the men's 200-meter sprint final at the 1984 Summer Olympic Games were investigated. Cinematographic records were obtained for all track running events at the Games, with the 200-meter performers singled out for initial analysis. In this race, sagittal view filming records (100 fps) were collected at the middle (125-meter mark) and end (180-meter mark) of the performance. Computer-generated analysis variables included both direct performance variables (body velocity, stride rate, etc.) and upper and lower body kinematics (upper arm position, lower leg velocity, etc.) that have previously been utilized in the analysis of elite athlete sprinters. The difference in place finish was related to the performance variables body horizontal velocity (direct), stride rate (direct), and support time (indirect). The critical body kinematics variables related to success included upper leg angle at takeoff (indirect), upper leg velocity during support (direct), lower leg velocity at touchdown (direct), foot to body touchdown distance (indirect), and relative foot velocity at touchdown.

Continuous Ambulatory Peritoneal Dialysis in South Africa -A Four-Year Experience

1984 ◽  
Vol 4 (2) ◽  
pp. 78-81 ◽  
Author(s):  
I. Parsoo ◽  
Y.K. Seedat ◽  
S. Naicker ◽  
J.C. Kallmeyer
Keyword(s):  
South Africa ◽  
Developing Countries ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Chronic Renal Failure ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Minority Groups ◽  
Alternative Therapy ◽  
Major Complication

This study describes our experience with continuous ambulatory peritoneal dialysis (CAPD) over a four year period, during which 88 patients were offered CAPD. It compares and contrasts the response to CAPD among four racial groups in Natal viz asiatics, blacks, coloureds and whites. Peritonitis -the major complication, occurred with an overall incidence of one episode every 4.41 patient months. CAPD remains a useful alternative therapy in developing countries where a high percentage of patients with chronic renal failure would be denied a chronic renal failure program because of lack of expertise in hemodialysis and/or renal transplantation, or limited financial resources. Continuous ambulatory peritoneal dialysis (CAPD) was first described by Moncrief and Popovich (1) and, since its modification by Oreopoulos and his group (2), this technique has gained world wide usage. South Africa, like many developing countries has a high incidence of end-stage renal disease (ESRD) but because of lack of resources and economical problems, few patients with ESRD can be treated by dialysis or renal transplantation. CAPD affords a relatively simple and inexpensive form of therapy for these patients. At the present time about 200 patients are on CAPD in South Africa. Natal, the smallest of four provinces in South Africa, has a population of about five million, the majority being blacks. The minority groups include whites, asiatics and coloureds. There is only one chronic dialysis centre in Natal; situated in Durban, it serves the entire province including parts of the Transkei. This paper describes a four-year experience with CAPD in this mixed population and discusses problems unique to this situation.

Combined transvenous and transarterial embolization of a tentorial—incisural dural arteriovenous malformation followed by primary stent placement in the associated stenotic straight sinus

2003 ◽  
Vol 99 (3) ◽  
pp. 579-583 ◽  
Author(s):  
Neil A. Troffkin ◽  
Cole Blease Graham ◽  
Turgut Berkmen ◽  
Ajay K. Wakhloo
Keyword(s):  
Stent Placement ◽  
Clinical Course ◽  
Transarterial Embolization ◽  
Dural Sinus ◽  
Outflow Obstruction ◽  
Venous Outflow ◽  
Straight Sinus ◽  
Venous Outflow Obstruction ◽  
Aggressive Clinical Course ◽  
Dural Avm

✓ Dural arteriovenous malformations (AVMs) involving the tentoria—incisura are associated with an aggressive clinical course characterized by subarachnoid and intracranial hemorrhage (ICH). In these lesions, venous outflow obstruction precipitates leptomeningeal venous drainage, resulting in the arterialization of pial veins and the formation of venous aneurysms, both of which are prone to hemorrhage. Stenotic lesions of the dural sinuses also contribute to the development of retrograde leptomeningeal drainage, which is responsible for the aggressive clinical course of the dural AVM. Endovascular approaches are successful in the treatment of these lesions and of any potential venous outflow obstruction caused by stenosis of a dural sinus. The authors report on a patient with a tentorial—incisural dural AVM and an accompanying stenotic venous sinus. A combined transvenous and transarterial embolization procedure was performed, resulting in complete obliteration of the dural AVM, followed by primary stent placement across a stenotic segment of the straight sinus and normalization of venous outflow. The authors conclude that dural AVMs can be treated safely by using a combined transarterial and transvenous approach and that an extensive search for venous outflow obstruction often reveals stenosis of a draining sinus. Consideration should be given to primary stent placement in the stenotic sinus to protect against ICH.

scholarly journals IMPACT OF THE TREATMENT WITH COMBINATION OF TIOTROPIUM/OLODATEROL ON THE QUALITY OF LIFE IN PATIENTS WITH COPD

2021 ◽  
Vol 2021 (3) ◽  
pp. 36-42
Author(s):  
K. D. Dmytriiev
Keyword(s):  
Quality Of Life ◽  
Hospital Admissions ◽  
Clinical Course ◽  
Improve Quality ◽  
Sf 36 ◽  
Emotional Role ◽  
University Department ◽  
Medical University ◽  
E Mail

IMPACT OF THE TREATMENT WITH COMBINATION OF TIOTROPIUM/OLODATEROL ON THE QUALITY OF LIFE IN PATIENTS WITH COPD K. D. Dmytriiev Vinnytsia National Pirogov Memorial Medical University Vinnytsia, Ukraine Abstract. Materials and methods. 100 patients with the diagnosis of COPD were included into the study, their average age was (64.09 ± 1.94) years, there were 66 men (66 %) and 34 women (34 %). The average duration of COPD was (9.35 ± 2.42) years. Clinical course of COPD was assessed based on the clinical documentation of the patients. All patients filled out questionnaires for the assessment of the COPD severity — mMRC and CAT; and quality of life — SF-36, SGRQ at visit 1, visit 2 (4-6 weeks) and visit 3 (1 year). Results. Treatment with combination of tiotropium/olodaterol reliably improve COPD course, by decrease in the amount of exacerbations from (2.63 ± 0.29) to (1.63 ± 0.21) and hospital admissions from (1.2 ± 0.2) to (0.37 ± 0.11); dyspnea severity according to mMRC questionnaire from (2.3 ± 0.14) to (1.87 ± 0.15); САТfrom (23.28 ± 1.71) to (15.77 ± 1.58). Treatment with combination of tiotropium/olodaterol reliably improve quality of life according to SF-36 questionnaire, specifically physical and emotional role functioning from (16 ± 5.57) % to (35.10 ± 7.15) % and from (27.35 ± 7.83) % to (50.29 ± 7.99) %, exerted vitality from (38.26 ± 3.86) % to (49.49 ± 3.7) %, mental health from (51.56 ± 3.76) % to (61.49 ± 3.59) %, social functioning from (57.61 ± 5.93) % to (69.22 ± 5.08) % and pain intensity from (66.92 ± 5.99) % tо (81.00 ± 4.17) %. Treatment with combination of tiotropium/olodaterol reliably improve quality of life according to SGRQ questionnaire, specifically «Symptoms» scale from (76.72 ± 3.85) tо (61.37 ± 4.59), «Activity» from (65.26 ± 4.18) to (51.97 ± 3.86), «Impact» from (52.36 ± 4.65) to (35.19 ± 4.25) and Total score from(60.31 ± 3.95) tо (44.62 ± 3.89). Conclusions. Combination of tiotropium/olodaterol showed its efficacy in real clinical practice. This combination is effective in the improvement of the clinical course of COPD and decrease of symptoms intensity, which is also accompanied by the improvement of the quality of life. Key words: COPD, quality of life, tiotropium/olodaterol. K. D. Dmytriiev Vinnytsia National Pirogov Memorial University Department of the Propedeutics of Internal Medicine PhD student str. Khmelnytske highway 96, 20129, Vinnytsia, Ukraine e-mail: [email protected] Аsthma and Allergy, 2021, 3, P. 36–42.

scholarly journals Safety and Effectiveness of Transarterial Embolization for Blunt Abdominal Injuries: A Multicenter Study with Review of Literature

2017 ◽  
Vol 01 (01) ◽  
pp. 013-019 ◽  
Author(s):  
Mathew Cherian ◽  
Tejas Kalyanpur ◽  
Krishna Murali ◽  
Ashwin Garg ◽  
Yadav Munde ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Transarterial Embolization ◽  
Review Of Literature ◽  
Acute Renal Injury ◽  
The Mean ◽  
Imaging Signs ◽  
Embolization Procedure ◽  
Angiography And Embolization ◽  
Overall Mortality

Aims To evaluate the safety and effectiveness of transarterial embolization for blunt abdominal trauma in patients without the imaging signs of peritonitis or bowel injury. Materials and Methods A total of 45 patients (41 males and 4 females; mean age: 32.15) were studied, of which 48% were hemodynamically unstable. All patients underwent multidetector computed tomography prior to selective angiography and embolization. Outcomes were considered as favorable if embolization was successful in achieving hemostasis. The frequency of complications, mortality rates, and duration of hospital stay were calculated. Results Embolization was successful in achieving hemostasis in all patients. None of the patients required surgery to achieve hemostasis after embolization. The overall mortality rate was 13.3% and none related to persistent bleeding. The mean intensive care unit stay was 5.6 days and the median was 3.5 days. Only one patient required continued blood transfusion of more than 10 units after embolization. No major complications were encountered except for one patient who required hemodialysis for acute renal injury related to embolization procedure. Conclusion Transarterial embolization is very effective in treating bleeding related to blunt abdominal trauma even in hemodynamically unstable patients and is associated with minimal complications. Embolization should be considered as an integral part of resuscitative measures for bleeding related to trauma.

scholarly journals MO857HEMOPERFUSION IN HEMODIALYSIS PATIENTS WITH COVID-19 INFECTION:  IMPACT ON CLINICAL COURSE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ioannis Griveas ◽  
Antonis Schinas ◽  
Anthoula Balitsari ◽  
Gerasimos Asimakopoulos ◽  
Evangelos Pratilas
Keyword(s):  
Clinical Course ◽  
Therapeutic Option ◽  
Alternative Therapy ◽  
Purification Method ◽  
Dialysis Unit ◽  
Extracorporeal Blood Purification ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Abstract Background and Aims Our Nephrology Department during spring period on the first wave of COVID-19 was the referral Dialysis Unit for Covid-19 positive hemodialysis (HD) patients in the district area of Athens, Greece. We used hemoperfusion (HP) as a therapeutic option in our patients. The aims of this study are to report characteristics, rates and outcomes of all patients affected by infection with SARS-CoV-2 undergoing HD and were treated under our care focusing on the impact of HP on them. Method This is an observational study. Our Dialysis Unit has been assigned as a referral unit for Covid-19 positive HD patients. Patients divided to 2 groups: first group of patients underwent HD sessions with Hemoperfusion (A) and the second one received HD sessions without any other extracorporeal blood purification method (B). We used resin-directed hemoadsorption cartridges (HA-330 and HA-130) manufactured by the Jafron Biomedical Company, China. We registered all the data regarding the clinical course of our patients population. Age, primary cause of end stage renal disease, weight, clinical presentation, HD history, outcome, days of hospitalization. Results Group A 13 patients (4 males) have been enrolled in this group with mean age of 74 years old. 5 of them were presented asymptomatic at admission and 7 of them admitted with or developed during their stay pleural effusions. 4 of them were asymptomatic without effusions during the whole hospital stay. 12 patients received HP for 3 hours in our Dialysis Unit during the planned HD session and one patient received Hemoperfusion in ICU during CRRT. 6 patients had one session of Hemoperfusion (with HA130, 4 patients and with HA 330, 2 patients). 6 patients had 2 sessions (7 days interval) either with HA 130 both sessions (3 patients) or with HA 330 followed 7 days after with HA 130 (3 patients). The patients that admitted in ICU started HP the third day of her admission. The pattern was as follows: We used HA330 in 3 consecutive days during CRRT. In Day 10 we used HA130 and in Day 13 HA330. HP was performed for 3 hours. 24 days was the average hospitalization stay before starting HP for the 12 patients in boards. 9 patients discharged from the hospital after 43 days of hospitalization (range: 35-56 days). 30 days were the mean hospitalization stay for the diceased ones. We did not observe any side effects with HP cartridges (hypotension, reduction of platelets, bleeding). Group B 9 patients (7 males) with mean age of 75 years old did not receive HP during their hospitalization. All of them were presented symptomatic. 8 out of 9 patients died after 6 days of hospitalization (range: 1-14 days), 2 of them in ICU. Conclusion To sum up, HP seems to be a helpful, safe an quite efficient tool in the battle against Covid-19 in HD patients. Despite the method is unspecific, our lack of strong evidence, our views are with the opinion that is an reliable alternative therapy. However, the real impact of HP on the patient’s clinical course (time of initiation, therapeutic protocols, tools to evaluate response) has yet to be determined. The above notice does not minimize the great interest for the method that renal community should give.

scholarly journals Long-term follow-up patients with leukemia receiving platelet transfusions: identification of a large group of patients who do not become alloimmunized

Blood ◽  
1981 ◽  
Vol 58 (5) ◽  
pp. 1007-1011 ◽  
Author(s):  
JP Dutcher ◽  
CA Schiffer ◽  
J Aisner ◽  
PH Wiernik
Keyword(s):  
Induction Therapy ◽  
Clinical Course ◽  
Major Complication ◽  
Remission Induction ◽  
Transfusion Therapy ◽  
Long Term Follow Up ◽  
Lymphocytotoxic Antibody ◽  
Platelet Transfusions

Alloimmunization is the major complication of platelet transfusion therapy in patients with acute leukemia. To evaluate whether alloimmunization continues to be a long-term problem in patients surviving induction therapy, 114 patients with acute nonlymphocytic leukemia (ANLL) who survived more than 6 mo and who received multiple courses of chemotherapy and abundant platelet transfusions were studied. Clinical response to random donor platelets and lymphocytotoxic antibody (LCTAb) were measured pretreatment and serially throughout the study period. Fourteen patients (12%) were alloimmunized upon admission, 34 (30%) patients became alloimmunized during remission induction therapy, and 66 (58%) patients did not become alloimmunized during that period. Sixty-one of these 66 patients (92%) never became alloimmunized and responded to random donor platelets during their subsequent course despite the fact they received multiple further platelet transfusions, whereas the alloimmunized patients tended to remain alloimmunized for their entire clinical course. There was no difference in age or sex between groups, and prognostic factors predicting alloimmunization could not be detected. In greater than 90% of patients not alloimmunized at admission, the presence or absence of LCTAb after induction predicts later alloantibody production. This information can be used to plan the type of platelet transfusions (HLA-matched or random donor) needed for subsequent maintenance and induction therapy. It may also help to identify a group of patients to whom more aggressive maintenance chemotherapy may be more safely administered.

scholarly journals Intraoperative Blood Pressure Monitoring in Obese Patients

2020 ◽  
Author(s):  
Roman Schumann ◽  
Agnes S. Meidert ◽  
Iwona Bonney ◽  
Christos Koutentis ◽  
Wilbert Wesselink ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Lower Leg ◽  
Obese Patients ◽  
Upper Arm ◽  
Better Than

Background The optimal method for blood pressure monitoring in obese surgical patients remains unknown. Arterial catheters can cause potential complications, and noninvasive oscillometry provides only intermittent values. Finger cuff methods allow continuous noninvasive monitoring. The authors tested the hypothesis that the agreement between finger cuff and intraarterial measurements is better than the agreement between oscillometric and intraarterial measurements. Methods This prospective study compared intraarterial (reference method), finger cuff, and oscillometric (upper arm, forearm, and lower leg) blood pressure measurements in 90 obese patients having bariatric surgery using Bland–Altman analysis, four-quadrant plot and concordance analysis (to assess the ability of monitoring methods to follow blood pressure changes), and error grid analysis (to describe the clinical relevance of measurement differences). Results The difference (mean ± SD) between finger cuff and intraarterial measurements was −1 mmHg (± 11 mmHg) for mean arterial pressure, −7 mmHg (± 14 mmHg) for systolic blood pressure, and 0 mmHg (± 11 mmHg) for diastolic blood pressure. Concordance between changes in finger cuff and intraarterial measurements was 88% (mean arterial pressure), 85% (systolic blood pressure), and 81% (diastolic blood pressure). In error grid analysis comparing finger cuff and intraarterial measurements, the proportions of measurements in risk zones A to E were 77.1%, 21.6%, 0.9%, 0.4%, and 0.0% for mean arterial pressure, respectively, and 89.5%, 9.8%, 0.2%, 0.4%, and 0.2%, respectively, for systolic blood pressure. For mean arterial pressure and diastolic blood pressure, absolute agreement and trending agreement between finger cuff and intraarterial measurements were better than between oscillometric (at each of the three measurement sites) and intraarterial measurements. Forearm performed better than upper arm and lower leg monitoring with regard to absolute agreement and trending agreement with intraarterial monitoring. Conclusions The agreement between finger cuff and intraarterial measurements was better than the agreement between oscillometric and intraarterial measurements for mean arterial pressure and diastolic blood pressure in obese patients during surgery. Forearm oscillometry exhibits better measurement performance than upper arm or lower leg oscillometry. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Specific course of tuberculosis in elderly and senile patients

2020 ◽  
Vol 97 (12) ◽  
pp. 22-27
Author(s):  
L. N. Savonenkova ◽  
V. I. Ruzov ◽  
R. B. Asanov ◽  
O. V. Midlenko ◽  
B. M. Asanov ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Hiv Infection ◽  
Arterial Hypertension ◽  
Lung Diseases ◽  
Clinical Course ◽  
Major Complication ◽  
Cor Pulmonale ◽  
Continuous Sampling ◽  
Chronic Cor Pulmonale

The objective: to identify specific features of the clinical course of tuberculosis in elderly and senile patients under the current epidemic situation.The specific clinical course of tuberculosis was analyzed in 54 patients at the age of 61 years and older and compared with the course of 234 patients at the age from 18 to 39 years selected by the continuous sampling of all 472 patients discharged from hospital in 2018. The following features were found to be typical of patients of 61 years and older: more frequent chronic forms of the disease (37.0%) and complications (35.2%), the major complication was chronic cor pulmonale (33.3%); more frequent concurrent chronic nonspecific lung diseases (13.0%) and coronary heart disease/arterial hypertension (14.8%); more frequent deaths (31.5%), mainly due to pulmonary heart disease; less frequent generalization of tuberculosis (5.5%) and concurrent HIV infection (7.4%).

Balloon-Occluded Retrograde Transvenous Obliteration: Emergence as a Treatment for Gastric Varices and Medically Refractory Hepatic Encephalopathy

2017 ◽  
Vol 01 (04) ◽  
pp. 286-292
Author(s):  
Ronnie Chen ◽  
Edward Lee ◽  
Sung Cho
Keyword(s):  
Variceal Bleeding ◽  
Treatment Options ◽  
Alternative Therapy ◽  
Splenic Vein ◽  
Major Complication ◽  
The United States ◽  
Gastric Varices ◽  
Western World ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding

AbstractGastric or esophageal variceal bleeding is a major complication of portal hypertension in patients with liver cirrhosis. Currently, liver transplant is still considered a gold standard treatment for gastric or esophageal variceal bleeding. What about varices associated with splenic vein thrombosis? In the United States and Europe, endoscopic treatment and transjugular intrahepatic portosystemic shunt (TIPS) have been considered as effective treatment options for these variceal bleeding. However, in South Korea and Japan, balloon-occluded retrograde transvenous obliteration (BRTO) has been considered as a well-accepted treatment option for the gastric variceal bleeding. In recent years, based on favorable outcomes of BRTO in Asia and unfavorable outcomes/complications of TIPS, BRTO has emerged as an alternative therapy for gastric varices in the Western world. In this review, we describe the indications/contraindications, techniques, and outcomes of BRTO.

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