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11.
Cooper BZ Flores L Ramirez JA Najjar JG Abir F Rayham R Paladino L Nguyen M Panetta TF 《Annals of vascular surgery》2001,15(1):7-12
The use of nonpenetrating clips (NPC) for vascular anastomosis is quickly becoming accepted. Studies attest to decreased anastomotic
time, comparable patency rates, and decreased blood loss. Few human studies on the use of NPC have been done to date. The
purpose of this study was to evaluate primary patency rates, operative time, and complications associated with NPC compared
to those with standard sutures for arterial venous graft (AVG). We retrospectively reviewed the clinical course of 82 patients
with a mean age of 45 years (range, 22 to 87) from February 1996 to July 1999. All patients underwent upper extremity AVG
construction. The procedures were performed at a single institution, by a single, well-experienced surgeon who has extensive
experience with NPC. Primary patency rates, operative time, and complications were analyzed. Overall thrombotic incidence
of AVG when NPC were used (27/48, 56%) was similar to that of sutures (17/34, 50%). Thrombotic incidence within the first
year was similar as well (23/48, 48% and 13/34, 38%). The mean time to primary thrombosis was similar in both groups (6.9
and 6.8 months). The operative time required to construct an AVG with NPC (83 min) was significantly less than that with sutures
(96 min) (p = 0.015). There was no significant difference in incidence of graft infection or pseudoaneurysm formation. NPC for AVG reduced
operative time and resulted in primary patency and complication rates similar to those associated with use of sutures. The
mean time to primary thrombosis was similar for both groups. Our findings suggest an intimai hyperplastic response of a similar
nature resulting in thrombosis of both NPC and sutured AVGs.
Presented at the Twenty-fifth Annual Meeting of the Peripheral Vascular Surgery Society, Toronto, Ontario, Canada, June 10,
2000. 相似文献
12.
Vanam Sai Darden Douglas Munir Muhammad Bilal Aldaas Omar Hsu Jonathan C. Han Frederick T. Hoffmayer Kurt S. Raissi Farshad Birgersdotter-Green Ulrika Feld Gregory K. Krummen David E. Ho Gordon 《Journal of interventional cardiac electrophysiology》2022,64(3):715-722
Journal of Interventional Cardiac Electrophysiology - The mechanisms for atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) catheter ablation are unclear. Non-PV organized... 相似文献
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Context:
Pain management in cirrhotic patients is a major clinical challenge for medical professionals. Unfortunately there are no concrete guidelines available regarding the administration of analgesics in patients with liver cirrhosis. In this review we aimed to summarize the available literature and suggest appropriate evidence-based recommendations regarding to administration of these drugs.Evidence Acquisition:
An indexed MEDLINE search was conducted in July 2014, using keywords “analgesics”, “hepatic impairment”, “cirrhosis”, “acetaminophen or paracetamol”, “NSAIDs or nonsteroidal anti-inflammatory drugs”, “opioid” for the period of 2004 to 2014. All randomized clinical trials, case series, case report and meta-analysis studies with the above mentioned contents were included in review process. In addition, unpublished information from the Food and Drug Administration are included as well.Results:
Paracetamol is safe in patients with chronic liver disease but a reduced dose of 2-3 g/d is recommended for long-term use. Non-steroidal anti-inflammatory drugs (NSAIDs) are best avoided because of risk of renal impairment, hepatorenal syndrome, and gastrointestinal hemorrhage. Most opioids can have deleterious effects in patients with cirrhosis. They have an increased risk of toxicity and hepatic encephalopathy. They should be administrated with lower and less frequent dosing in these patients and be avoided in patients with a history of encephalopathy or addiction to any substance.Conclusions:
No evidence-based guidelines exist on the use of analgesics in patients with liver disease and cirrhosis. As a result pain management in these patients generates considerable misconception among health care professionals, leading under-treatment of pain in this population. Providing concrete guidelines toward the administration of these agents will lead to more efficient and safer pain management in this setting. 相似文献15.
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Nadja A. Farshad-Amacker Brett Lurie Richard J. Herzog Mazda Farshad 《The spine journal》2014,14(8):1470-1475
Background contextDifferent types of lumbosacral transitional vertebra (LSTV) are classified based on the relationship of the transverse process of the last lumbar vertebra to the sacrum. The Ferguson view (30° angled anteroposterior [AP] radiograph) is supposed to have a sufficient interreader reliability in classification of LSTV, but is not routinely available. Standard AP radiographs and magnetic resonance imaging (MRI) are often available, but their reliability in detection and classification of LSTV is unknown.PurposeThe purpose of this study was to evaluate the interreader reliability of detection and classification of LSTV with standard AP radiographs and report its accuracy by use of intermodality statistics compared with MRI as the gold standard.Study design/settingRetrospective case control study.Patient sampleA total of 155 subjects (93 cases: LSTV type 2 or higher; 62 controls).Outcome measuresInterreader reliability in detection and classification of LSTV using standard AP radiographs and coronal MRI as well as accuracy of radiographs compared with MRI.MethodsAfter institutional review board approval, coronal MRI scans and conventional AP radiographs of 155 subjects (93 LSTV type 2 or higher and 62 controls) were retrospectively reviewed by two independent, blinded readers and classified according to the Castellvi classification. Interreader reliability was assessed using kappa statistics for detection of an LSTV and identification of all subtypes (six variants; 1: no LSTV or type I, 2: LSTV type 2a, 3: LSTV type 2b, 4: LSTV type 3a, 5: LSTV type 3b, 6: LSTV type 4) for MRI scans and standard AP radiographs. Further, accuracy and positive and negative predictive values were calculated for standard AP radiographs to detect and classify LSTV using MRI as the gold standard.ResultsThe interreader reliability was at most moderate for the detection (k=0.53) and fair for classification (wk=0.39) of LSTV in standard AP radiograph. However, the interreader reliability was very good for detection (k=0.93) and classification (wk=0.83) of LSTV in MRI. The accuracy and positive and negative predictive values of standard AP radiograph were 76% to 84%, 72% to 86%, and 79% to 81% for the detection and 53% to 58%, 51% to 76%, and 49% to 55% for the classification of LSTV, respectively.ConclusionStandard AP radiographs are insufficient to detect or classify LSTV. Coronal MRI scans, however, are highly reliable for classification of LSTV. 相似文献
19.
Bagheri-Hosseinabadi Zahra Imani Danyal Yousefi Hassan Abbasifard Mitra 《Clinical rheumatology》2020,39(8):2267-2279
Clinical Rheumatology - Rheumatoid arthritis (RA) is the most common autoimmune rheumatic disease, in which an epigenetic implication in the disease etiopathogenesis has been noted. Here in this... 相似文献
20.
Bagheri-Hosseinabadi Zahra Imani Danyal Yousefi Hassan Abbasifard Mitra 《Clinical rheumatology》2020,39(12):3555-3569
Clinical Rheumatology - Vitamin D is involved in immune system modulation as well as in calcium and bone homeostasis, hence plays a role in rheumatoid arthritis (RA) etiopathogenesis. A bulk of... 相似文献