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Unusual Techniques for Preserving Surgical and Oncologic Safety in Hepatectomy of Advanced Adrenal Malignancy with Vena Cava and Liver Invasion
We report herein three cases of major hepatectomy with IVC invasion and discuss several surgical tips.Patients and MethodsFrom March 2011 to February 2014, we retrospectively reviewed three cases of adrenal malignancy with liver and IVC invasion. Based on the severity of the malignant tumor, each case illustrates a different method to address surgical complications and maintain oncologic safety. Case 1: A 34-year-old woman was diagnosed with adrenocortical tumor during medical examination. Tumor invaded the right lobe of the liver and very close to the IVC. Fortunately, there was little thrombosis inside the IVC; we perfor...
Source: Annals of Surgical Oncology - October 1, 2018 Category: Cancer & Oncology Source Type: research
Minimally invasive aortic valve replacement through a right anterolateral mini-thoracotomy for the treatment of octogenarians with aortic valve stenosis
AbstractBecause of concerns about the high risk of perioperative complications, the feasibility of minimally invasive aortic valve replacement (MIAVR) for elderly patients remains controversial. Here, we review our results of MIAVR in octogenarians with aortic valve stenosis (AS). Between October 2012 and December 2017, 110 patients with AS underwent MIAVR via a right anterolateral mini-thoracotomy; 41 patients were octogenarian (Group O). The perioperative outcomes of these patients were compared with those of the 69 patients who were less than 80 years of age (Group Y). A preoperative contrast-enhanced computed tomogra...
Source: Heart and Vessels - September 17, 2018 Category: Cardiology Source Type: research
Dual-phase 16 slice CT angiography in stroke imaging: a poor man ’s multiphase study?
AbstractMultiphase CT angiography (CTA) in collateral assessment provides time-resolved cerebral angiograms of the intracranial vasculature, requiring a high-speed multidetector CT (MDCT) scanner with ≥ 64 slices. Unfortunately, many hospitals are equipped with lower speed MDCT scanners. Herein, we present our experience performing dual-phase CTA (d-CTA) on a 16 slice MDCT with a biphasic rate injection to grade intracranial collaterals as predictor of clinical outcome. 42 patients were evalu ated with both dual-phase CTA (d-CTA) and single-phase CTA (s-CTA) for occluded anterior intracranial circulation and collateral...
Source: Acta Neurologica Belgica - September 8, 2018 Category: Neurology Source Type: research
Unusual Techniques for Preserving Surgical and Oncologic Safety in Hepatectomy of Advanced Adrenal Malignancy with Vena Cava and Liver Invasion
We report herein three cases of major hepatectomy with IVC invasion and discuss several surgical tips.Patients and MethodsFrom March 2011 to February 2014, we retrospectively reviewed three cases of adrenal malignancy with liver and IVC invasion. Based on the severity of the malignant tumor, each case illustrates a different method to address surgical complications and maintain oncologic safety. Case 1: A 34-year-old woman was diagnosed with adrenocortical tumor during medical examination. Tumor invaded the right lobe of the liver and very close to the IVC. Fortunately, there was little thrombosis inside the IVC; we perfor...
Source: Annals of Surgical Oncology - September 6, 2018 Category: Cancer & Oncology Source Type: research
Association of lower leukocyte count before thrombolysis with early neurological improvement in acute ischemic stroke patients
Publication date: Available online 17 August 2018Source: Journal of Clinical NeuroscienceAuthor(s): Canhui Tian, Zhong Ji, Wei Xiang, Xiaomei Huang, Shengnan Wang, Yongmin Wu, Suyue Pan, Liang Zhou, Zhen DengAbstractEarly neurological improvement (ENI) after thrombolysis in acute ischemic stroke is associated with a favorable long-term outcome. With the goal to evaluate ENI, we aimed to investigate whether ENI bears a relationship with routine blood tests before thrombolysis. A total of 240 patients with confirmed early ischemic stroke and intravenous recombinant tissue plasminogen activator (rtPA) treatment were enrolled ...
Source: Journal of Clinical Neuroscience - August 17, 2018 Category: Neuroscience Source Type: research
Statins associated with improvement of rare lung disease
This study suggests that oral statin therapy may be a new approach for patients with autoimmune pulmonary alveolar proteinosis.AUTHORSThe study ’s co-senior authors are Dr. Elizabeth Tarling of UCLA and Dr. Bruce Trapnell of Children’s Hospital Medical Center of Cincinnati, Ohio. Other authors are listed in the journal article.JOURNALThe study was published in the journal Nature Communications. FUNDINGThe National Institutes of Health funded the research.Learn more about the cardiovascular research theme at UCLA.
Source: UCLA Newsroom: Health Sciences - August 17, 2018 Category: Universities & Medical Training Source Type: news
Artificial intelligence platform screens for acute neurological illnesses at Mount Sinai
(The Mount Sinai Hospital / Mount Sinai School of Medicine) An artificial intelligence platform designed to identify a broad range of acute neurological illnesses, such as stroke, hemorrhage, and hydrocephalus, was shown to identify disease in CT scans in 1.2 seconds, faster than human diagnosis.
Source: EurekAlert! - Biology - August 13, 2018 Category: Biology Source Type: news
Mobile Stroke Unit Reduces Time to Image Acquisition and Reporting INTERVENTIONAL
SUMMARY:
Timely administration of thrombolytic therapy is critical to maximizing the likelihood of favorable outcomes in patients with acute ischemic stroke. Although emergency medical service activation overall improves the timeliness of acute stroke treatment, the time from emergency medical service dispatch to hospital arrival unavoidably decreases the timeliness of thrombolytic administration. Our mobile stroke unit, a new-generation ambulance with on-board CT scanning capability, reduces key imaging time metrics and facilitates in-the-field delivery of IV thrombolytic therapy.
Source: American Journal of Neuroradiology - July 9, 2018 Category: Radiology Authors: Nyberg, E. M., Cox, J. R., Kowalski, R. G., Vela-Duarte, D., Schimpf, B., Jones, W. J. Tags: INTERVENTIONAL Source Type: research
Doctors Beware: Abbott & #039;s HeartMate 3 Has a Safety Problem
Just when it seemed the HeartMate 3 was gaining momentum, Abbott warned physicians that outflow graft twisting may occur after the left ventricular assist device (LVAD) is implanted. The problem can trigger a persistent low-flow alarm that may signal a potential safety risk to patients, such as blood flow or clotting.
The Abbott Park, IL-based company has not recalled any of the devices from patients or hospitals, but there have been 32 reports of outflow graft twisting (an incidence rate of 0.72%), including reports of low blood flow, clotting, and three patient deaths.
No devices are being recalled from patients or hosp...
Source: MDDI - May 7, 2018 Category: Medical Devices Authors: Amanda Pedersen Tags: Cardiovascular Implants Source Type: news
Northwestern Medicine hastens stroke care with mobile CT unit
The ambulatory CT unit of Northwestern Medicine Central DuPage Hospital has...Read more on AuntMinnie.comRelated Reading:
UCLA offers ambulatory stroke care with mobile CT
Mobile stroke units, spectral CT take spots on ECRI watch list
Mobile stroke unit with CT scanner speeds care in Cleveland
CT hits the road in Houston with stroke ambulance project
Ambulance with mobile CT cuts stroke treatment times
Source: AuntMinnie.com Headlines - May 4, 2018 Category: Radiology Source Type: news
AI Becoming Prevalent in Identifying Stroke, Head Trauma
Another company is throwing its hat into the ring to use artificial intelligence to help identify bleeds, fractures and other critical abnormalities in head CT scans. San Mateo, CA-based Qure.ai released the results of a clinical validation study confirming its algorithm’s near-radiologist performance on 21, 000 patients and has made a dataset of almost 500 AI-analyzed head CT scans available for download.
The results have been published in a research paper on Cornell University's online distribution system for research, arXiv.org. The paper is titled “Development and Validation of Deep Learning Algorithms for Detectio...
Source: MDDI - May 3, 2018 Category: Medical Devices Authors: Omar Ford Tags: Business Digital Health Source Type: news
Stroke Triage: EMS needs a diagnostic tool that goes beyond a simple history & physical exam
As a young EMT and paramedic, I had relatively little education about acute myocardial infarctions. In the age of the 3-lead ECG, education was largely focused on arrhythmia detection and how to differentiate heart blocks, tachycardia and bradycardia. Detection of heart attack was largely based upon history and physical exam findings.
Three decades later, the thought of relying on a physical exam to diagnose a ST- elevation myocardial infarction (STEMI) is hard to imagine. Although we’ve made remarkable progress in the prehospital detection of STEMI, we’ve made significantly less progress in the diagnosis of acute stro...
Source: JEMS Patient Care - May 2, 2018 Category: Emergency Medicine Authors: Mark E.A. Escott, MD, MPH, FACEP, NRP Tags: Patient Care Columns Source Type: news
Stroke Severity Affects Timing: Time From Stroke Code Activation to Initial Imaging is Longer in Patients With Milder Strokes
Optimizing the time it takes to get a potential stroke patient to imaging is essential in a rapid stroke response. At our hospital, door-to-imaging time is comprised of 2 time periods: the time before a stroke is recognized, followed by the period after the stroke code is called during which the stroke team assesses and brings the patient to the computed tomography scanner. To control for delays due to triage, we isolated the time period after a potential stroke has been recognized, as few studies have examined the biases of stroke code responders. This “code-to-imaging time” (CIT) encompassed the time from stroke code...
Source: The Neurologist - May 1, 2018 Category: Neurology Tags: Original Articles Source Type: research
