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41.
Dermoscopic difficult lesions: an objective evaluation of reflectance confocal microscopy impact for accurate diagnosis
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Anuj Shrestha Zeeshan Jawa Kathryn L. Koch Amy B. Rankin Qun Xiang Anand Padmanabhan Matthew S. Karafin Joshua J. Field 《Journal of clinical apheresis》2015,30(6):353-358
Red cell exchange (RCE) is a common procedure in adults with sickle cell disease (SCD). Implantable dual lumen Vortex (DLV) ports can be used for RCE in patients with poor peripheral venous access. We performed a retrospective cohort study of RCE procedures performed in adults with SCD. The main objective of the study was to compare the inlet speed, duration of procedures and rate of complications performed through DLV ports to those performed through temporary central venous and peripheral catheters. Twenty‐nine adults with SCD underwent a total of 318 RCE procedures. Twenty adults had DLV ports placed and 218 procedures were performed using DLV ports. Mean length of follow‐up after DLV port placement was 397 ± 263 days. Six DLV ports were removed due to infection and 1 for malfunction after a mean of 171 ± 120 days. Compared to temporary central venous and peripheral catheters, DLV port procedures had a greater rate of procedural complications, a longer duration, and a lower inlet speed (all P < 0.01). When accounting for the maximum allowable inlet speed to avoid citrate toxicity, 40% of DLV port procedures were greater than 10% below maximum speed, compared to 7 and 14% of procedures performed through temporary central venous and peripheral catheters (P < 0.0001). In conclusion, DLV ports can be used for RCE in adults with SCD, albeit with more procedural complications and longer duration. The smaller internal diameter and longer catheter of DLV ports compared to temporary central venous catheters likely accounts for the differences noted. J. Clin. Apheresis 30:353–358, 2015. © 2015 Wiley Periodicals, Inc. 相似文献
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B.B. Damian T.C.S. Bonetti D.D.G. Horovitz 《Brazilian journal of medical and biological research》2015,48(1):25-33
Preimplantation genetic diagnosis (PGD) was originally developed to diagnose
embryo-related genetic abnormalities for couples who present a high risk of a
specific inherited disorder. Because this technology involves embryo selection, the
medical, bioethical, and legal implications of the technique have been debated,
particularly when it is used to select features that are not related to serious
diseases. Although several initiatives have attempted to achieve regulatory
harmonization, the diversity of healthcare services available and the presence of
cultural differences have hampered attempts to achieve this goal. Thus, in different
countries, the provision of PGD and regulatory frameworks reflect the perceptions of
scientific groups, legislators, and society regarding this technology. In Brazil,
several texts have been analyzed by the National Congress to regulate the use of
assisted reproduction technologies. Legislative debates, however, are not conclusive,
and limited information has been published on how PGD is specifically regulated. The
country requires the development of new regulatory standards to ensure adequate
access to this technology and to guarantee its safe practice. This study examined
official documents published on PGD regulation in Brazil and demonstrated how little
direct oversight of PGD currently exists. It provides relevant information to
encourage reflection on a particular regulation model in a Brazilian context, and
should serve as part of the basis to enable further reform of the clinical practice
of PGD in the country. 相似文献
48.
Sophocarpine attenuates toll‐like receptor 4 in steatotic hepatocytes to suppress pro‐inflammatory cytokines synthesis
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Discordant Electrocardiogram Left Ventricular Wall Thickness and Strain Findings in Influenza Myocarditis
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Nael Hawwa M.D. Zoran B. Popovic M.D. Ph.D. Hussain A. Isma'eel M.D. 《Echocardiography (Mount Kisco, N.Y.)》2015,32(12):1880-1884
A 42‐year‐old man presented with a viral prodrome and tested positive for influenza A. He rapidly deteriorated developing cardiogenic shock, rhabdomyolysis, and acute kidney injury. Patient improved 1 week later with supportive measures including vasopressors, inotropes, and an intraaortic balloon pump. We report this case as it highlights the discordance between echocardiographic ventricular wall thickening as a result of myocardial edema, and electrocardiographic findings at presentation, with a reversal in findings at time of resolution. Additionally, there was some suggestion of a regional pattern to the reduced longitudinal strain. 相似文献