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[PMID]: 25374804
[Au] Autor:Cotogni P; Pittiruti M
[Ad] Address:Paolo Cotogni, Anesthesiology and Intensive Care, Department of Medicine, S. Giovanni Battista Hospital, University of Turin, 10123 Turin, Italy.
[Ti] Title:Focus on peripherally inserted central catheters in critically ill patients.
[So] Source:World J Crit Care Med;3(4):80-94, 2014 Nov 4.
[Is] ISSN:2220-3141
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings (emergency, intensive care, surgery) and for different purposes (fluids or drugs infusions, parenteral nutrition, antibiotic therapy, hemodynamic monitoring, procedures of dialysis/apheresis). However, healthcare professionals are commonly worried about the possible consequences that may result using a central venous access device (CVAD) (mainly, bloodstream infections and thrombosis), both peripherally inserted central catheters (PICCs) and centrally inserted central catheters (CICCs). This review aims to discuss indications, insertion techniques, and care of PICCs in critically ill patients. PICCs have many advantages over standard CICCs. First of all, their insertion is easy and safe -due to their placement into peripheral veins of the arm- and the advantage of a central location of catheter tip suitable for all osmolarity and pH solutions. Using the ultrasound-guidance for the PICC insertion, the risk of hemothorax and pneumothorax can be avoided, as well as the possibility of primary malposition is very low. PICC placement is also appropriate to avoid post-procedural hemorrhage in patients with an abnormal coagulative state who need a CVAD. Some limits previously ascribed to PICCs (i.e., low flow rates, difficult central venous pressure monitoring, lack of safety for radio-diagnostic procedures, single-lumen) have delayed their start up in the intensive care units as common practice. Though, the recent development of power-injectable PICCs overcomes these technical limitations and PICCs have started to spread in critical care settings. Two important take-home messages may be drawn from this review. First, the incidence of complications varies depending on venous accesses and healthcare professionals should be aware of the different clinical performance as well as of the different risks associated with each type of CVAD (CICCs or PICCs). Second, an inappropriate CVAD choice and, particularly, an inadequate insertion technique are relevant-and often not recognized-potential risk factors for complications in critically ill patients. We strongly believe that all healthcare professionals involved in the choice, insertion or management of CVADs in critically ill patients should know all potential risk factors of complications. This knowledge may minimize complications and guarantee longevity to the CVAD optimizing the risk/benefit ratio of CVAD insertion and use. Proper management of CVADs in critical care saves lines and lives. Much evidence from the medical literature and from the clinical practice supports our belief that, compared to CICCs, the so-called power-injectable peripherally inserted central catheters are a good alternative choice in critical care.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1411
[Da] Date of entry for processing:141106
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.5492/wjccm.v3.i4.80

  2 / 157275 MEDLINE  
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[PMID]: 25372526
[Au] Autor:Lee JC; Wang MY; Damodar D; Sadun AA; Sadda S
[Ad] Address:Department of Ophthalmology, Doheny Eye Institute/Keck Medical Center of The University of Southern California, Los Angeles, California.
[Ti] Title:Headache and whiteout vision as the presenting symptoms in a case of takayasu retinopathy.
[So] Source:Retin Cases Brief Rep;8(4):273-5, 2014.
[Is] ISSN:1937-1578
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To report a case of Takayasu retinopathy presenting as chronic headache and whiteout of vision. METHODS: A case report of a 28-year-old woman with no medical history diagnosed with Takayasu retinopathy after a complete ophthalmologic examination, including widefield fluorescein angiography. RESULTS: Dilated fundus examination revealed sharp margins in both eyes and mildly attenuated arterioles and distended veins. The peripheral examination was significant for several white-centered intraretinal hemorrhages. A widefield fluorescein angiogram showed numerous small microaneurysms in the periphery. A computer tomography angiogram of the chest showed central wall thickening of the aortic arch, proximal branch vessels of the aortic arch, including left common carotid and right common carotid, and middle lower lobe of the right pulmonary artery, all of which were consistent with the diagnosis of Takayasu disease. The patient underwent cardiovascular bypass surgery and her ocular symptoms resolved. CONCLUSION: Up to one third of patients with Takayasu disease experience visual disturbances, and as a result, ophthalmologists may be the first physicians to encounter and diagnose this condition. The various stages of Takayasu retinopathy are characterized by dilation of small vessels, capillary microaneurysm formation, and development of arterial-venous anastomoses. The initial clinical presentation of Takayasu disease can be varied and nonspecific, therefore a high index of clinical suspicion is essential for diagnosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1097/ICB.0000000000000091

  3 / 157275 MEDLINE  
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[PMID]: 25372785
[Au] Autor:Alten F; Motte J; Ewering C; Osada N; Clemens CR; Kadas EM; Eter N; Paul F; Marziniak M
[Ad] Address:Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany....
[Ti] Title:Multimodal Retinal Vessel Analysis in CADASIL Patients.
[So] Source:PLoS One;9(11):e112311, 2014.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To further elucidate retinal findings and retinal vessel changes in Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) patients by means of high resolution retinal imaging. METHODS: 28 eyes of fourteen CADASIL patients and an equal number of control subjects underwent confocal scanning laser ophthalmoscopy (cSLO), spectral-domain optical coherence tomography (SD-OCT), retinal nerve fibre layer (RNFL) measurements, fluorescein and indocyanine angiography. Three vessel measurement techniques were applied: RNFL thickness, a semiautomatic software tool based on cSLO images and manual vessel outlining based on SD-OCT. RESULTS: Mean age of patients was 56.2±11.6 years. Arteriovenous nicking was present in 22 (78.6%) eyes and venous dilation in 24 (85.7%) eyes. Retinal volume and choroidal volume were 8.77±0.46 mm3 and 8.83±2.24 mm3. RNFL measurements showed a global increase of 105.2 µm ( CONTROL GROUP: 98.4 µm; p = 0.015). Based on semi-automatic cSLO measurements, maximum diameters of arteries and veins were 102.5 µm (106.0 µm; p = 0.21) and 128.6 µm (124.4 µm; p = 0.27) respectively. Manual SD-OCT measurements revealed significantly increased mean arterial 138.7 µm (125.4 µm; p<0.001) and venous 160.0 µm (146.9; p = 0.003) outer diameters as well as mean arterial 27.4 µm (19.2 µm; p<0.001) and venous 18.3 µm (15.7 µm; p<0.001) wall thicknesses in CADASIL patients. CONCLUSIONS: The findings reflect current knowledge on pathophysiologic changes in vessel morphology in CADASIL patients. SD-OCT may serve as a complementary tool to diagnose and follow-up patients suffering from cerebral small-vessel diseases.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1371/journal.pone.0112311

  4 / 157275 MEDLINE  
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[PMID]: 25374725
[Au] Autor:Sharma B; Raina S; Sharma R
[Ad] Address:Department of Gastroenterology, Indira Gandhi Medical College, Shimla, Himachal Pradesh 171001, India.
[Ti] Title:Bleeding ectopic varices as the first manifestation of portal hypertension.
[So] Source:Case Reports Hepatol;2014:140959, 2014.
[Is] ISSN:2090-6587
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Ectopic varices are defined as dilated portosystemic collateral veins in locations other than the gastroesophageal region. We present a case of recurrent upper gastrointestinal bleeding as the first manifestation of portal hypertension. We diagnosed ectopic duodenal varices without gastroesophageal varices on upper GI endoscopy and extrahepatic portal venous obstruction (EHPVO) on CT angiography and managed this case.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Da] Date of entry for processing:141106
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1155/2014/140959

  5 / 157275 MEDLINE  
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[PMID]: 24798128
[Au] Autor:Saad WE; Schwaner S; Lippert A; Sabri SS; Al-Osaimi A; Matsumoto AH; Angle JF; Caldwell S
[Ad] Address:Department of Radiology and Medical Imaging, University of Virginia Health System, 1215 Lee St, PO Box 800170, Charlottesville, VA, 22908, USA, wspikes@yahoo.com.
[Ti] Title:Management of stomal varices with transvenous obliteration utilizing sodium tetradecyl sulfate foam sclerosis.
[So] Source:Cardiovasc Intervent Radiol;37(6):1625-30, 2014 Dec.
[Is] ISSN:1432-086X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The management of parastomal varices is not established. Transjugular intrahepatic portosystemic shunt (TIPS) creation is the most commonly described treatment; however, the rebleed rate after TIPS is 21-37 %. The purpose of the study is to determine the effectiveness of transvenous obliteration using sodium tetradecyl sulfate (STS) and to describe a new simplified technique in obliterating these varices. Four patients are presented who underwent transvenous obliteration using STS. One was obliterated using balloon occlusion from the systemic veins, the second was obliterated without balloon from a transhepatic antegrade approach, and the last two patients were obliterated using the direct antegrade technique. This simplified technique requires only a micropuncture kit (not requiring balloons or coils) and ultrasound transducer compression of the systemic draining veins, relying on high portal pressure to keep the sclerosant confined to the varices. The sclerosant is essentially trapped between the portal pressure and the ultrasound-transducer compression (10-15 min). Technical success was achieved in all four patients without procedural or postprocedural complications and no rebleeding for a mean follow-up of 17 (range 2-33) months. Transvenous obliteration of parastomal varices utilizing STS as a sclerosant is safe and effective. The newly described technique is simple, feasible, and requires minimal equipment (no balloons or coils or catheters).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00270-014-0880-7

  6 / 157275 MEDLINE  
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[PMID]: 24722896
[Au] Autor:Kariya S; Komemushi A; Nakatani M; Yoshida R; Kono Y; Tanigawa N
[Ad] Address:Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan, kariyas@hirakata.kmu.ac.jp.
[Ti] Title:Intranodal lymphangiogram: technical aspects and findings.
[So] Source:Cardiovasc Intervent Radiol;37(6):1606-10, 2014 Dec.
[Is] ISSN:1432-086X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To report the technical results and imaging findings of intranodal lymphangiogram (INL). MATERIALS AND METHODS: we studied four patients (three men, one woman) who had persistent chylous leakage despite conservative treatment after esophageal cancer surgery. Their mean age was 68 years (range 61-74 years). The inguinal or femoral lymph node was punctured under ultrasound guidance using a 60-mm-long, 23-gauge needle. If the lipiodol injected via the needle showed granular nodules on fluoroscopy, lipiodol injection was continued manually at a rate of 1 mL/3 min for INL. If the cisterna chyli was detectable on the lymphangiogram, it was punctured percutaneously via the abdomen by a needle under fluoroscopy, and thoracic duct embolization was performed. RESULTS: INL was successful in all patients. Lymphaticovenous anastomoses at the femoral or pelvic region were confirmed in all four patients. In one case, a different ipsilateral lymph node was punctured because major flow of lipiodol into the veins through a lymphaticovenous anastomosis occurred. Catheter cannulation and embolization were successful for three of the four patients. In unsuccessful procedures, the cisterna chyli was not visualized, and puncture was not possible. CONCLUSIONS: INL succeeded in all patients. Lipiodol leaked into the vein through a lymphaticovenous anastomosis at the femoral or pelvic region in all patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00270-014-0888-z

  7 / 157275 MEDLINE  
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[PMID]: 24352864
[Au] Autor:Park SI; Rhee Y; Lim JS; Park S; Kang SW; Lee MS; Lee M; Lee SJ; Kim IJ; Lee do Y; Cho JS
[Ad] Address:Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea, astarte@yuhs.ac.
[Ti] Title:Right Adrenal Venography Findings correlated with C-arm CT for Selection During C-arm CT-assisted Adrenal Vein Sampling in Primary Aldosteronism.
[So] Source:Cardiovasc Intervent Radiol;37(6):1469-75, 2014 Dec.
[Is] ISSN:1432-086X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: This study was designed to evaluate retrospectively the efficacy of C-arm CT to confirm right adrenal vein catheterization during adrenal vein sampling (AVS) and to correlate adrenal venography findings with C-arm CT and/or biochemical results for right adrenal vein selection. METHODS: Forty-two consecutive primary aldosteronism patients (M:F = 21:21; age: 29-70 years) underwent C-arm CT assisted sequential AVS. After catheterization of right adrenal vein, C-arm CT was performed to confirm catheter position. Catheter was repositioned when right adrenal gland was not opacified. Radiological images, medical records, and biochemical results were reviewed for technical/biochemical success rates and complications. Right adrenal venography findings of pinnate pattern, visualization of renal capsular vein, and retroperitoneal vein other than renal capsular vein were correlated with C-arm CT and/or biochemical results for right adrenal vein selection. RESULTS: Both the technical and biochemical success of AVS was achieved in 40 patients (95.2 %). C-arm CT failed due to catheter instability in one, and adrenal/vena cava cortisol gradient was <3 in one patient. Catheter was repositioned in four patients (9.5 %) according to C-arm CT findings. Right adrenal venography finding of renal capsular vein significantly correlated with C-arm CT and/or biochemical results (100 %) for right adrenal vein selection (p = 0.011, χ (2) test), whereas pinnate pattern (p = 0.099) and other retroperitoneal veins (p = 0.347) did not. There was no procedure-related complication. CONCLUSIONS: C-arm CT increases confidence of right adrenal vein catheterization during AVS. Visualization of renal capsular vein on adrenal venography suggests right adrenal vein catheterization and C-arm CT may not be required.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00270-013-0820-y

  8 / 157275 MEDLINE  
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[PMID]: 23567791
[Au] Autor:Balasubramaniyam N; Garg J; Rawat N; Chugh S; Mittal V; Baby B; Aronow WS; Lehrman SG
[Ad] Address:Departments of 1Internal Medicine; 2Pulmonary and Critical Care; and 3Cardiology, Westchester Medical Center, New York Medical College, Valhalla, NY.
[Ti] Title:Dual stent migration to the heart and pulmonary artery.
[So] Source:Am J Ther;21(6):e199-203, 2014 Nov-Dec.
[Is] ISSN:1536-3686
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The practice of intravascular stenting largely grew out of the concept of stenting the coronaries in acute myocardial infarction. According to the recent United States Renal Data System data registry, there has been a significant increase in endovascular intervention (1.8-fold increase-from 52,380 to 98,148) with a 2.2-fold increase in stent deployment in hemodialysis access (3792-8514). With the increasing use of endovascular stents in the management of dialysis access stenosis, the incidence of stent-related complications has increased significantly. Stent-related complications include stent restenosis, thrombosis (narrowing of the vessel lumen and being a nidus for thombus formation), stent shortening, stent fracture, stent infection, and stent migration. Physiologic variation in the diameter of veins due to respiration, which along with the geometry of the stent, can lead to a shortening lengthening of the stent-resulting in poor wall contact or high-speed impact of shock; in the case of trauma, mechanical bucking can result in tortuous blood vessels thereby resulting in stent migration (however proving this association was not the aim of this article). We report a case of a 44-year-old female with end-stage renal disease on hemodialysis, with stent placement to treat a compromised arteriovenous graft. There have been many cases of stent migration in the past; however, this is the first case of dual stent migration to the heart and pulmonary artery from an unusual (lower extremity) arteriovenous graft location.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1097/MJT.0b013e3182785fc3

  9 / 157275 MEDLINE  
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[PMID]: 25344786
[Au] Autor:Wang H; Guan H; Wang DW
[Ti] Title:Partial anomalous pulmonary venous connection to superior vena cava that overrides across the intact atrial septum and has bi-atrial connection in a 75-year-old female presenting with pulmonary hypertension.
[So] Source:BMC Cardiovasc Disord;14(1):149, 2014.
[Is] ISSN:1471-2261
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Partial anomalous venous connection (PAPVC) is a rare congenital heart disease where the blood flow from one or more pulmonary veins (but not all) returns to the right atrium or systemic venous circulation and is often associated with a sinus venosus atrial defect (SVD). Transthoracic echocardiography (TTE) can provide limited information for this anomaly and the diagnosis of this congenital defect has been a clinical challenge. CASE PRESENTATION: We report here a case of a 75-year-old female with adult-onset pulmonary arterial hypertension (PAH), hypoxemia and right-sided chamber dilatation. The diagnosis of PAPVC was made incidentally by multidetector computed tomographic angiography (MCTA) that was performed to exclude pulmonary embolism. In this type of PAPVC, the atrial septum is intact, the right upper pulmonary vein (RUPV) connects to the superior vena cava (SVC), and the SVC overrides across the atrial septum and has bi-atrial connection, all of which are clearly manifested by MCTA. CONCLUSIONS: This case indicates the need to exclude a PAPVC and SVD in unexplained pulmonary hypertension, and MCTA is a reliable non-invasive imaging technique with high resolution and wide anatomic coverage. The case also demonstrates that the coexisting SVD with PAPVC is an anomalous venous connection instead of atrial septal defect (ASD) and its key feature is the overriding of SVC or IVC across the intact atrial septum.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1186/1471-2261-14-149

  10 / 157275 MEDLINE  
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[PMID]: 25149602
[Au] Autor:Roschzttardtz H; Paez-Valencia J; Dittakavi T; Jali S; Reyes FC; Baisa G; Anne P; Gissot L; Palauqui JC; Masson PH; Bednarek SY; Otegui MS
[Ad] Address:Department of Botany (H.R., J.P.-V., T.D., F.C.R., M.S.O.), Department of Genetics (S.J., P.H.M., M.S.O.), and Department of Biochemistry (G.B., S.Y.B.), University of Wisconsin, Madison, Wisconsin 53706;Great Lakes Bioenergy Research Center, Madison, Wisconsin 53706 (H.R., S.J., G.B.); andInstitut ...
[Ti] Title:The VASCULATURE COMPLEXITY AND CONNECTIVITY Gene Encodes a Plant-Specific Protein Required for Embryo Provasculature Development.
[So] Source:Plant Physiol;166(2):889-902, 2014 Oct.
[Is] ISSN:1532-2548
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The molecular mechanisms by which vascular tissues acquire their identities are largely unknown. Here, we report on the identification and characterization of VASCULATURE COMPLEXITY AND CONNECTIVITY (VCC), a member of a 15-member, plant-specific gene family in Arabidopsis (Arabidopsis thaliana) that encodes proteins of unknown function with four predicted transmembrane domains. Homozygous vcc mutants displayed cotyledon vein networks of reduced complexity and disconnected veins. Similar disconnections or gaps were observed in the provasculature of vcc embryos, indicating that defects in vein connectivity appear early in mutant embryo development. Consistently, the overexpression of VCC leads to an unusually high proportion of cotyledons with high-complexity vein networks. Neither auxin distribution nor the polar localization of the auxin efflux carrier were affected in vcc mutant embryos. Expression of VCC was detected in developing embryos and procambial, cambial, and vascular cells of cotyledons, leaves, roots, hypocotyls, and anthers. To evaluate possible genetic interactions with other genes that control vasculature patterning in embryos, we generated a double mutant for VCC and OCTOPUS (OPS). The vcc ops double mutant embryos showed a complete loss of high-complexity vascular networks in cotyledons and a drastic increase in both provascular and vascular disconnections. In addition, VCC and OPS interact physically, suggesting that VCC and OPS are part of a complex that controls cotyledon vascular complexity.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1410
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1104/pp.114.246314


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