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The Stent Is Not to Blame: Lessons Learned With a Simplified US Version of the Frozen Elephant Trunk.
CONCLUSIONS: With the advent of endovascular technology, there is a clinical shift toward increased use of FET to eliminate or facilitate the second surgical stage in treating patients with extensive aortic pathology. The addition of FET to the surgical armamentarium does not seem to pose additional risk (although larger studies are needed), but judicious use is advised nonetheless. A single-piece endoprosthesis for FET instead of a customized one should be considered. PMID: 28648532 [PubMed - indexed for MEDLINE]
Source: The Annals of Thoracic Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Preventza O, Coselli JS, Mayor J, Simpson K, Carillo J, Price MD, Cornwell LD, Omer S, de la Cruz KI, Bakaeen FG, Jobe A Tags: Ann Thorac Surg Source Type: research

Lateral medullary infarction with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and Klippel–Feil syndrome: A case report
Rationale: Patients with Klippel–Feil syndrome (KFS) are always anomaly associated with vertebrobasilar dysplasia. That may present commonly as infarction of brainstem, medulla, and cerebellum. In this article, we reported a rare case of lateral medullary infarction (LMI) with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and KFS, and the 2 rare conditions that are causally related. The case is being reported because of its unusual and rare presentation. Patient concerns: A 38-year-old female presented with acute unsteadiness, along with a tendency to lean to the left side while walk...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Degeneration of paramedian nuclei in the thalamus induces Holmes tremor in a case of artery of Percheron infarction
Abstract Rationale: Holmes’ tremor is an uncommon neurologic disorder following brain insults, and its pathogenesis is undefined. The interruption of the dento-rubro-thalamic tract and secondary deterioration of the nigrostriatal pathway are both required to initiate Holmes’ tremor. We used nuclear medicine imaging tools to analyze a patient with concurrent infarction in different zones of each side of the thalamus. Finding whether the paramedian nuclear groups of the thalamus were injured was a decisive element for developing Holmes’ tremor. Patient concerns: A 36-year-old woman was admitted to our department d...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Recovery of akinetic mutism and injured prefronto-caudate tract following shunt operation for hydrocephalus and rehabilitation: A case report
Rationale: A 76-year-old female patient was diagnosed with an aneurysmal subarachnoid hemorrhage following rupture of a right posterior communicating artery aneurysm. Patient concerns: She was treated surgically with clipping of the aneurysmal neck. Six months after onset, when starting rehabilitation at our hospital, she showed no spontaneous movement or speech. Diagnoses: aneurysmal subarachnoid hemorrhage following rupture of a right posterior communicating artery aneurysm. Interventions: During 2 months’ rehabilitation, her AM did not improve significantly. As there was no apparent change, she underwent a ...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Cardiovascular risk factors in patients with combined central retinal vein occlusion and cilioretinal artery occlusion: Case report
AbstractRationale:To analyze cardiovascular risk factors and comorbidity of acute unilateral visual loss due to combined central retinal vein occlusion (CRVO) and cilioretinal artery occlusion (CLRAO).Patient concerns:Among patients with retinal vein or artery occlusion hospitalized at the Department of Ophthalmology between January 2011 and August 2017, subjects with combined CRVO/CLRAO were selected. All of them underwent ophthalmologic and cardiologic examination, including fluorescein angiography, optical coherence tomography, 12-lead electrocardiogram, transthoracic and transesophageal echocardiography, carotid Dopple...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Rapid improvement of angiostenosis due to isolated middle cerebral artery dissection: A case report
AbstractRationale:Intracranial arterial dissection is a rare cause of ischemic stroke, and isolated middle cerebral artery dissection (MCAD) is extremely rare, having been described only in sparse case reports. The etiology, clinicoradiological features, and treatment strategies are not yet well understood.Patient concerns:A 49-year-old man presented with rapidly progressive aphasia and motor disturbance of the right limbs.Diagnoses:Neuroimaging evaluation confirmed a diagnosis of MCAD and cerebral infarction.Interventions:The patient underwent oral anti-platelet therapy (100 mg aspirin daily).Outcomes:The patient recove...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Neurointerventional “Near Morbidity”: A Candid Appraisal of an Early Case Series
Conclusions:“Minor”/technical complications – NNM – can be as instructive and illustrative as major complications despite not resulting in permanent morbidity. In reviewing case series, particularly early in one’s career, these cases should be highlighted.Intervent Neurol 2018;7:419 –430
Source: Interventional Neurology - July 11, 2018 Category: Neurology Source Type: research

The different association of allocentric and egocentric neglect with dorsal and ventral pathways: A case report
Rationale: Egocentric neglect is characterized by responses missing on the contralateral side with respect to the viewer, while allocentric neglect is characterized in responses missing on the contralateral side with respect to the object . However, little has been reported about the neural tracts associated with egocentric and allocentric neglect. We investigated which neural tracts were involved in two types of neglect (egocentric and allocentric) in a stroke patient who showed allocentric neglect by using the Apple Cancellation test, a specialized test to distinguish between egocentric and allocentric neglect. Patien...
Source: Medicine - September 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Hemichorea associated with cavernous angioma and a small errhysis: A case report and literature review
Rationale: Chorea is a movement disorder characterized by randomly appearing involuntary movements of the face, neck, limbs, or trunk. Hemichorea is unilateral, involving one side of the body. Hemichorea is commonly caused by non-ketotic hyperglycemia and/or cerebrovascular injury to the contralateral basal ganglia. Patient concerns: Here, we report the case of a patient diagnosed with hemichorea who had diabetes, cavernous angioma, and a small intracranial errhysis. Routine testing showed the patient's blood glucose level was slightly higher than the normal range. Interventions: The errhysis was too small to be tr...
Source: Medicine - October 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

MELAS and macroangiopathy: A case report and literature review
We reported a case of MELAS that presented right distal internal carotid arterial (ICA) stenosis and reviewed 12 similar previously reported cases involving intracranial large blood vessels. Patient concerns: A 38-year-old man suffered from recurrent stroke-like episodes (SE) such as alternating hemiparesis (right lesion 3 years ago and current left lesion), cortical blindness and seizure for 3 years, and was previously misdiagnosed as cerebral infarction. Magnetic Resonance Angiography (MRA) and Digital Subtraction Angiography (DSA) revealed right distal ICA stenosis and sparse cortex blood vessels, which were related ...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Cells to Society: Year of the Nurse / Global Impact
This study establishes baseline sociodemographic and clinical characteristics of hospitalized patients in Nepal who were experiencing heart failure.     Read more   Maternal Health ...
Source: Johns Hopkins University and Health Systems Archive - February 6, 2020 Category: Nursing Source Type: news

Practical challenges in the conduct of pragmatic trials embedded in health plans: Lessons of IMPACT-AFib, an FDA-Catalyst trial.
Abstract IMPACT-AFib was an 80,000-patient randomized clinical trial implemented by five US insurance companies (health plans) aimed at increasing the use of oral anticoagulants by individuals with atrial fibrillation who were at high risk of stroke and not on treatment. The underlying thesis was that patients could be change agents to initiate prescribing discussions with their providers. We tested the effect of mailing information to both patients and their providers. We used administrative medical claims and pharmacy dispensing data to identify eligible patients, to randomize them to an early or delayed interve...
Source: Clinical Trials - June 25, 2020 Category: Research Authors: Garcia CJ, Haynes K, Pokorney SD, Lin ND, McMahill-Walraven C, Nair V, Parlett L, Martin D, Al-Khalidi HR, McCall D, Granger CB, Platt R, Cocoros NM Tags: Clin Trials Source Type: research

Transdermal opioid patch in treatment of paroxysmal autonomic instability with dystonia with multiple cerebral insults: A case report
Rationale: Paroxysmal autonomic instability with dystonia (PAID) is an underdiagnosed syndrome that describes a collection of symptoms following diverse cerebral insults, such as traumatic brain injury, hydrocephalus, hemorrhagic stroke, or brain anoxia. It is manifested by systemic high blood pressure, hyperthermia, tachycardia, tachypnea, diaphoresis, intermittent agitation, and certain forms of dystonia. Patient concerns: A semi-comatose 46-year-old man was transferred from the regional rehabilitation hospital with various complaints involving fluctuating vital signs, including uncontrolled hyperthermia, hypertensi...
Source: Medicine - October 2, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Outcomes of extracorporeal membrane oxygenation in acute respiratory distress syndrome due to COVID ‐19: The lessons learned from the first wave of COVID‐19
ConclusionsBased on our experience, ECMO can improve refractory ARDS due to COVID ‐19 in select patients. Proper control of bacterial infections during COVID‐19 immunomodulation therapy may be critical to improving survival.
Source: Journal of Cardiac Surgery - March 19, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Cameron Blazoski, Michael Baram, Hitoshi Hirose Tags: ORIGINAL ARTICLE Source Type: research

The impact of basic atrial rhythm during catheter ablation of atrial fibrillation on clinical outcomes: Lessons from the German Ablation Registry
ConclusionBasic atrial rhythm at the time of AF ablation did not affect long ‐term rhythm outcome. For patients suffering from persistent AF a more favorable acute and long‐term safety profile was observed when ablated in SR.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - May 6, 2021 Category: Cardiology Authors: Laura Rottner, Johannes Brachmann, Thorsten Lewalter, Karl ‐Heinz Kuck, Stephan Willems, Lars Eckardt, Matthias Hochadel, Dietrich Andresen, Jochen Senges, Andreas Rillig, Andreas Metzner Tags: ORIGINAL ‐ ELECTROPHYSIOLOGY Source Type: research