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Dexmedetomidine Protects Against Septic Liver Injury by Enhancing Autophagy Through Activation of the AMPK/SIRT1 Signaling Pathway.

Front Pharmacol 2021 26;12:658677. Epub 2021 Apr 26.

Department of Intensive Care Unit, Children's Hospital of Chongqing Medical University, Chongqing, China.

Liver injury is one of the serious complications of sepsis. Previous studies suggested that dexmedetomidine (DEX) could alleviate cecal ligation and puncture (CLP)-induced liver injury. However, it is unclear whether the protective effect of DEX on sepsis-induced liver injury is related to autophagy. Read More

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Comparison between radiofrequency ablation combined with mifepristone and radiofrequency ablation for large uterine fibroids.

Int J Hyperthermia 2021 ;38(1):777-780

Department of Ultrasound, Beijing Chaoyang Hospital Capital Medical University, Beijing, PR China.

Objective: To evaluate the clinical outcomes of transvaginal ultrasound-guided (US-guided) radiofrequency ablation (RFA) combined with mifepristone for the treatment of large uterine fibroids.

Methods: Between June 2016 and December 2018, a total of 30 patients with symptomatic uterine fibroids (≥5cm) who underwent transvaginal US-guided RFA combined with mifepristone were included in this retrospective study. A matching cohort of 30 patients underwent transvaginal US-guided RFA without mifepristone as controls. Read More

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January 2021

Pyogenic Lumbar Facet Joint Infection with Foot Drop.

Case Rep Orthop 2021 22;2021:5544126. Epub 2021 Apr 22.

Department of Orthopaedic Surgery, Kochi Prefectural Hata Kenmin Hospital, 3-1 Yoshina, Yamana-cho, Sukumo, Kochi 788-0785, Japan.

Pyogenic facet joint infection (PFJI) is a relatively rare spinal infection. Clinical suspicion of this condition is a key for diagnosis. We report a case of PFJI which required decompression surgery for severe neurological dysfunction. Read More

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Usefulness of ultrasound-guided tibio-pedal access in patients with critical limb ischemia.

Cir Esp 2021 May 7. Epub 2021 May 7.

Servicio de angiología y cirugía vascular, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Llobregat, España.

Introduction: Retrograde access performed guided by fluoroscopy or ultrasound. We aimed to analyze the usefulness of ultrasound in retrograde access in patients with critical limb ischemia.

Methods: Observational analytical study. Read More

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Red dichromatic imaging reduces endoscopic treatment time of esophageal varices by increasing bleeding point visibility (with video).

Dig Endosc 2021 May 10. Epub 2021 May 10.

Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.

Background: Red dichromatic imaging (RDI) is a novel image-enhanced endoscopy released in 2020, which increases the visibility of deeper vessels. In this study, we retrospectively investigated whether RDI can shorten treatment times of endoscopic injection sclerotherapy (EIS), and which operational procedure times are affected compared with white light imaging (WLI).

Methods: A total of 155 patients (RDI: 70; WLI: 85) with risky esophageal varices (EV), who were treated with EIS were analyzed. Read More

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Endobronchial Seeding of Squamous Lung Carcinoma with Mediastinal Lymph Involvement Node after EBUS: A Case Report.

Ann Thorac Cardiovasc Surg 2021 May 8. Epub 2021 May 8.

Department of Pathology, Avicenne University Hospital, Paris 13 University, Bobigny, France.

In locally advanced non-small-cell lung cancer (NSCLC), mediastinal staging is the cornerstone of the therapeutic decision and echoendoscopy is the most practiced exam to assess the lymph node involvement. We describe a rare case of endobronchial involvement by cells originating from a metastatic lymph node after endobronchial ultrasound (EBUS). A 64-year-old man was diagnosed with a squamous cell lung cancer with mediastinal nodal involvement proven by EBUS. Read More

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Complications associated with intrathecal drug delivery in a paediatric patient with Niemann-Pick type C.

BMJ Case Rep 2021 May 7;14(5). Epub 2021 May 7.

Neurosurgery, Great Ormond Street Hospital for Children, London, UK.

We report on a male subject with a diagnosis of Niemann-Pick type C (NPC). He received an experimental medicinal product intrathecally initially via lumbar puncture (LP) and eventually via intrathecal drug delivery device. Shortly after implantation, the device catheter migrated outside of the intrathecal space and coiled subcutaneously. Read More

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Rapid Neurocognitive Deterioration and Mortality in a Healthcare Professional With Spongiform Encephalopathy: Implications for Neurologic and End-of-Life Care.

Cureus 2021 Apr 3;13(4):e14277. Epub 2021 Apr 3.

Neurology, College of Osteopathic Medicine, Kansas City University, Kansas City, USA.

Spongiform encephalopathy (SE) is a rare prion disorder characterized by progressive cognitive dysfunction and mortality. Affected patients can observe a wide variety of neurological symptoms, such as myoclonus, dementia, cerebellar signs, and others. We present a case of laboratory-confirmed SE in an otherwise healthy 57-year-old medical professional who initially presented with nonspecific and unique "head in a fish-bowl" dissociation and cognitive decline. Read More

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The Efficacy of Intraoperative Fluorescent Imaging Using Indocyanine Green for Cholangiography During Cholecystectomy and Hepatectomy.

Clin Exp Gastroenterol 2021 30;14:145-154. Epub 2021 Apr 30.

Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan.

Purpose: Bile duct injury is one of the most serious complications of laparoscopic cholecystectomy. Intraoperative indocyanine green (ICG) cholangiography is a safe and useful navigation modality for confirming the biliary anatomy. ICG cholangiography is expected to be a routine method for helping avoid bile duct injuries. Read More

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How does puncture modality affect the risk of intraoperative bleeding during percutaneous nephrolithotomy? A prospective randomized trial.

Actas Urol Esp 2021 May 3. Epub 2021 May 3.

Department of Urology, Biruni University Faculty of Medicine, Estambul, Turquía.

Introduction And Objectives: To evaluate the possible effects of two different renal puncture techniques (ultrasound-assisted [US-assisted], fluoroscopic-guided [FG]) on the intraoperative hemorrhage risk during percutaneous nephrolithotomy (PCNL).

Material And Methods: A total of 130 patients with Guy stone scores of 1-2 were prospectively allocated to US-assisted and FG puncture groups by simple randomization. Patients with intraoperative pelvicalyceal rupture and the ones requiring multiple accesses were excluded from the study. Read More

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Serial Tap Test of patients with idiopathic normal pressure hydrocephalus: impact on cognitive function and its meaning.

Fluids Barriers CNS 2021 May 6;18(1):22. Epub 2021 May 6.

Neurology Service, Internal Medicine Department, Hospital Clinics, Federal University of Paraná, Curitiba, Paraná, Brazil.

Background: Idiopathic normal pressure hydrocephalus (INPH) is characterized by gait disturbance, urinary incontinence and cognitive decline. Symptoms are potentially reversible and treatment is based on cerebrospinal fluid shunting. The tap test (TT) is used to identify patients that will benefit from surgery. Read More

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Optical Coherence Tomography and Microdialysis for Microneedle-Mediated Penetration Enhancement Study of Paeoniflorin-Loaded Ethosomes.

Skin Pharmacol Physiol 2021 May 6:1-11. Epub 2021 May 6.

School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China.

Background: To understand the cumulative effect of topical formulations after medication, evaluate the therapeutic effect of microneedle-assisted (MN-assisted) paeoniflorin-loaded ethosomes (TGP-E), and explore the potential for deep penetration of drugs, this paper uses microdialysis to systematically study the percutaneous pharmacokinetics of TGP-E.

Methods: First, optical coherence tomography (OCT) was used to study the effectiveness of microneedle puncture. Second, a microdialysis method and a UPLC-MS method for determining the amount of paeoniflorin (Pae) in dialysate were established. Read More

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Trehalose/sodium hyaluronate eye drops in post-cataract ocular surface disorders.

Int Ophthalmol 2021 May 6. Epub 2021 May 6.

Ophthalmology Unit, Misericordia Hospital, USL Toscana Sud Est, Grosseto, Italy.

Purpose: Prospective, randomised, open-label, comparative study to evaluate efficacy of trehalose/sodium hyaluronate eye drops for post-operative discomfort and tear film stability in patients undergoing cataract surgery.

Methods: Patients with healthy ocular surface, subclinical, or mild dry eye were enrolled. Tear breakup time (TBUT), Schirmer test, dry eye symptoms, corneal fluorescein staining (CFS), and ocular surface disease (OSDI) evaluation were performed pre-operatively and at two and four weeks after surgery. Read More

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A new method for facilitating ultrasound-guided in-plane cannulation of the subclavian vein: a randomized clinical trial.

Sci Rep 2021 May 5;11(1):9605. Epub 2021 May 5.

Department of Anesthesiology, Daping Hospital, Army Medical University, 10 ChangjiangZhilu, Yuzhong District, Chongqing, 400042, China.

The objective of this study was to propose a new method for facilitating needle-beam alignment ultrasound-guided in-plane catheterization of the subclavian vein (SCV). Three hundred patients were recruited, and ultrasound examination of the SCV was performed. Then, the patients were divided into two groups and SCV catheterization was performed: ultrasound-guided catheterization with the aiming method (group A) and ultrasound-guided catheterization with needle guide (group NG). Read More

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CircPTK2-miR-181c-5p-HMGB1: a new regulatory pathway for microglia activation and hippocampal neuronal apoptosis induced by sepsis.

Mol Med 2021 05 5;27(1):45. Epub 2021 May 5.

Neuroscience Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88, Jiefang Road, Hangzhou, 310009, Zhejiang Province, China.

Background: Circular RNA hsa_circ_0008305 (circPTK2), miR-181c-5p and High mobility group box-1 (HMGB1) had a targeted regulatory relationship through bioinformatics analysis. This study explained the effects of these genes in microglia and sepsis mice.

Methods: Lipopolysaccharide (LPS) or Cecal Ligation and Puncture (CLP) was used to induce inflammation cell model or sepsis mouse model, as needed. Read More

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Ultrasound-guided pediatric vascular cannulation by inexperienced operators: outcomes in a training model.

J Ultrasound 2021 May 4. Epub 2021 May 4.

Department of Clinical Sciences, Fernando Pessoa Canarias University, Las Palmas de Gran Canaria, Spain.

Objective: To present the results of an ultrasound vascular cannulation (UGVC) training program for inexperienced operators using a training model.

Method: This was a descriptive observational study developed in the paediatric intensive care unit (PICU) of a third-level hospital. Operators received basic theoretical training in the USVC technique, followed by practical training with a model designed for USVC-inexperienced healthcare professionals. Read More

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Application of Spinal Robotic Navigation Technology to Minimally Invasive Percutaneous Treatment of Spinal Fractures: A Clinical, Non-Randomized, Controlled Study.

Orthop Surg 2021 May 4. Epub 2021 May 4.

Department of Orthopedics, Chinese PLA General Hospital, Beijing, China.

Objective: To introduce a new robotic navigation system that assists pedicle screw implantation and verify the accuracy and stability of the system.

Methods: Pedicle screw placements were performed on the thoracic vertebrae (T)9-Lumbar vertebrae (L)5 thoracolumbar vertebrae of cadavers using robotic guidance. The operative duration, puncture success, correction, and correction time were assessed. Read More

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Healthy Life-Year Costs of Treatment Speed From Arrival to Endovascular Thrombectomy in Patients With Ischemic Stroke: A Meta-analysis of Individual Patient Data From 7 Randomized Clinical Trials.

JAMA Neurol 2021 May 3. Epub 2021 May 3.

Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles.

Importance: The benefits of endovascular thrombectomy (EVT) are time dependent. Prior studies may have underestimated the time-benefit association because time of onset is imprecisely known.

Objective: To assess the lifetime outcomes associated with speed of endovascular thrombectomy in patients with acute ischemic stroke due to large-vessel occlusion (LVO). Read More

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Acute Hemispheric Stroke: Full Remission Following Surgical Thrombectomy.

EJVES Vasc Forum 2020 8;47:31-34. Epub 2020 Apr 8.

Department for Vascular Medicine, Vascular Surgery, Angiology and Endovascular Therapy, University Heart and Vascular Centre, Hamburg-Eppendorf, Hamburg, Germany.

Introduction: Carotid occlusion because of embolisation or as a distal extension of thrombus formation in an ulcerated plaque can be the cause of a devastating stroke, caused by sudden occlusion of the internal carotid artery (ICA). Often, invasive treatments are not an option because of the limited time frame. In rare situations of acute stroke onset and admission to therapy within six hours however, aggressive recanalisation may be considered. Read More

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Follistatin-Like 1 Attenuation Suppresses Intervertebral Disc Degeneration in Mice through Interacting with TNF- and Smad Signaling Pathway.

Oxid Med Cell Longev 2021 10;2021:6640751. Epub 2021 Apr 10.

Department of Orthopedic, Qilu Hospital, Cheeloo College of Medicine of Shandong University, Jinan, China.

Background: Inflammation plays an important role in intervertebral disc degeneration (IDD). The protein follistatin-like 1 (FSTL1) plays a proinflammatory role in a variety of inflammatory diseases.

Objectives: The purpose of this study was to investigate whether IDD could be delayed by inhibiting FSTL-1 expression. Read More

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Mechanical thrombectomy in patients with cervical artery dissection and stroke in the anterior or posterior circulation - a multicenter analysis from the German Stroke Registry.

Neurol Res Pract 2021 May 3;3(1):20. Epub 2021 May 3.

Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.

Background: Cervical artery dissection (CAD) is a rare cause of acute ischemic stroke (AIS) with large vessel occlusion (LVO) and may constitute a challenge for mechanical thrombectomy (MT). We compared procedural characteristics, reperfusion rates, and clinical outcome in AIS patients undergoing MT with and without CAD.

Methods: We performed a pre-specified analysis of patients registered within the German Stroke Registry, a prospectively maintained multicenter registry of consecutive patients with AIS patients treated by MT. Read More

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"Interventional Pain Training using Phantom Model during COVID-19 Pandemic".

Pain Pract 2021 May 2. Epub 2021 May 2.

Pain Management Department, Hospital Zambrano Hellion, TecSalud. San Pedro Garza García, Nuevo León, México.

Background: Fluoroscopic-guided lumbar procedures have increased in daily pain practice since the lumbar spine is one of the most common sources of pain. Interventional pain fellows must develop a minimum number of skills during their training in order to achieve the competences without neglecting radiological safety. However, medical training in fluoroscopic-guided interventions is being affected by the current COVID-19 situation. Read More

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Has the introduction of an advanced practitioner led service had an impact on radiation dose for fluoroscopy guided lumbar punctures? A service review.

P Crosthwaite

Radiography (Lond) 2021 Apr 28. Epub 2021 Apr 28.

The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, L9 7LJ, UK. Electronic address:

Introduction: Historically, procedures requiring fluoroscopic guidance such as myelography; barium and video swallows; and fluoroscopy guided lumbar punctures (LP) have been performed by radiologists with the assistance of radiographers. As the National Health Service (NHS) evolves, more responsibilities are being disseminated to specifically trained radiographers to relieve workload due to a national shortage of radiologists. One step taken by the trust was to train an Advanced Practitioner (AP) in fluoroscopy to perform fluoroscopy guided LPs. Read More

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[Effect of blood-letting puncture of "Well-points" on hippocampal mitophagy-related protein expression in rats with acute brain injury due to hypobaric hypoxia].

Zhen Ci Yan Jiu 2021 Apr;46(4):301-5

Department of Chinese Medicine, Medical College of Qinghai University, Xining 810001, China.

Objective: To study the effect of blood-letting puncture at "Well-points" of the twelve meridians on hippocampal mitophagy of hypobaric hypoxia-induced brain injury (HHIBI) rats, so as to explore its biological mechanisms underlying improvement of high altitude hypoxia-induced brain injury.

Methods: Male SD rats were randomly divided into normal control group (=9), and model and blood-letting groups which were further divided into 6, 12, 24, 48 and 72 h subgroups (=9 in each subgroup). The HHIBI model was established by putting the rats into a hypobaric hypoxia chamber (equivalent to 5 000 m above sea level). Read More

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Long-Term Results of a Standard Algorithm for Intravenous Port Implantation.

J Pers Med 2021 Apr 24;11(5). Epub 2021 Apr 24.

Department of Surgery, Thoracic and Cardiovascular Surgery Division, Chang Gung Memorial Hospital, Linkou 333423, Taiwan.

Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. Read More

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Histomorphometric Comparison between Two Types of Acellular Dermal Matrix Grafts: A Mini Pig Animal Model Study.

Int J Environ Res Public Health 2021 Apr 7;18(8). Epub 2021 Apr 7.

Faculty of Dentistry, Universidad Alfonso X El Sabio, 28961 Villanueva de la Cañada, Spain.

Acellular dermal matrix grafts (ADMG) have been used as soft tissue graft substitutes for autografts in periodontal plastic surgical procedures. They have benefits like avoiding a second surgical site and patient morbidity that have been associated with autografts, but there is limited evidence available on their tissue response and wound healing process. This histomorphometric animal model study was carried out in mini pigs and it aimed to compare the two types of ADMG materials of porcine derivative with a control group through observation of parameters like epithelial and Keratinized layer thickness, angiogenesis, cellularity, matrix resorption, and inflammatory infiltrate. Read More

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Protective action of N-acetyl-L-cysteine associated with a polyvalent antivenom on the envenomation induced by Lachesis muta muta (South American bushmaster) in rats.

Toxicon 2021 Apr 27;198:36-47. Epub 2021 Apr 27.

Laboratory of Toxinology and Cardiovascular Research, Graduate Program in Health Sciences, University of Western São Paulo (UNOESTE), Rodovia Raposo Tavares Km 572, B2-205, 19067-175, Presidente Prudente, SP, Brazil. Electronic address:

In this study, we examined the potential use of N-acetyl-L-cysteine (NAC) in association with a polyvalent antivenom and as stand-alone therapy to reduce the acute local and systemic effects induced by Lachesis muta muta venom in rats. Male Wistar rats (300-350 g) were exposed to L. m. Read More

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Endovascular therapy with or without intravenous thrombolysis in acute stroke with tandem occlusion.

J Neurointerv Surg 2021 Apr 28. Epub 2021 Apr 28.

Department of Diagnostic and Therapeutic Neuroradiology, Université de Lorraine, CHRU-Nancy, Nancy, France

Background: Endovascular therapy (EVT) is effective and safe in patients with tandem occlusion. The benefit of intravenous thrombolysis (IVT) prior to EVT in acute tandem occlusion is debatable.

Objective: To compare EVT alone with EVT plus IVT in patients with acute ischemic stroke due to anterior circulation tandem occlusions. Read More

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Safety assessment of multiple repeated percutaneous punctures for the collection of cerebrospinal fluid in rats.

Braz J Med Biol Res 2021 26;54(6):e10032. Epub 2021 Apr 26.

College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China.

The objective of this study was to examine the safety of multiple repeated percutaneous punctures of cisterna magna for collecting cerebrospinal fluid (CSF) and preliminarily determine the optimal time interval and volume at each collection. Sixty Wistar rats were randomly assigned to six groups: 10 d-0 μL, 10 d-100 μL (100 μL CSF collected at an interval of 10 days), 10 d-150 μL, 15 d-0 μL, 15 d-100 μL, and 15 d-150 μL. CSF was collected by percutaneous puncture of the cisterna magna at four time-points. Read More

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Marmoset angiography just by percutaneous puncture of the caudal ventral artery.

PLoS One 2021 28;16(4):e0250576. Epub 2021 Apr 28.

Division of Regenerative Medicine, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan.

Surgery in humans is continuously evolving and promoted minimally invasive treatment. On the other hand, despite the importance of the 3Rs principles for experimental animals is well documented, no reports describe specific methodologies for implementing "refinement" in practice. Here, we describe a new technique, the "Ohta Method" for caudal arthrocentesis in the pursuit of the 3Rs for animal experiments and the development of innovative methods for investigating systemic organ arteries through minimally invasive procedures. Read More

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