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Cardiac surgery
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
ECMO is another circulatory support device that is similar to CPB; however ECMO can be established using venous access only (called VV-ECMO) or venous and arterial access (VA-ECMO). This mechanical support is mainly used for neonates and adults with potentially reversible respiratory failure, postcardiac surgery or as a temporary stabilisation method for patient who may need VAD (bridge therapy) as it can be easy to establish in unstable patients.
Cicatricial alopecias: Pathogenesis, classification, clinical features, diagnosis, and management
Published in Jerry Shapiro, Nina Otberg, Hair Loss and Restoration, 2015
First-line treatment for moderately active classic LPP lesions is intralesional triamcinolone acetonide at a concentration of 10 mg/cc every 4–6 weeks or in combination with topical class I or II corticosteroids [10,26]. Literature on the efficacy of oral medication is limited. Options for systemic treatment include anti-inflammatory agents such as hydroxychloroquine, tetracyclines, pioglitazones, retinoids, griseofulvine, and immunosuppressive medications such as cyclosporine, mycophenolate mofetil, and systemic corticosteroids [5,6,56–61]. Oral corticosteroids in the first week of treatment as bridge therapy might be considered in very active cases. Systemic therapy should always be considered in the management of Graham-Little–Piccardi–Lassueur syndrome since the lesions are not limited to the scalp and local, topical, and intralesional therapy is less practicable.
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
A VAD is a mechanical pump that does the work of the left or right ventricle or both to restore normal hemodynamic parameters and perfusion for the body in advanced HF. Early VADs were transcutaneous, or extracorporeal, but most modern devices are now surgically implanted, or intracorporeal, aside from the power source. The pump mechanism may generate a pulsatile or continuous flow depending on the device model. Left ventricular assist devices (LVADs) pull blood from the left ventricle into the ascending aorta via two surgical conduits and the pumping device that sits within the abdominal wall. A third conduit, the driveline, attaches the LVAD to an external power source through a person's abdominal wall (see Figure 123.3). In 1994, the U.S. FDA approved an LVAD as bridge therapy to heart transplantation, and the first wearable device was used. Â 141
Does the addition of dexmedetomidine to morphine have any clinical benefit on the treatment of pain in patients with metastatic cancer? A pilot study
Published in Progress in Palliative Care, 2021
Rana Yamout, Marcel-Louis Viallard, Samer Hoteit, Hicham Abou-Zeid, Fadia Shebbo, Nicole Naccache
Dexmedetomidine is an alpha 2 adrenergic receptor agonist, known for its sedative effect without causing respiratory depression.6–8 A case report demonstrated that the addition of dexmedetomidine treatment to methadone and hydromorphone was safe with analgesic and opioid-sparing effects.9 Thus, it has been recommended to be used as a ‘bridge therapy’ in patients with refractory cancer pain.9 Dexmedetomidine infusion also showed good pain control in end-stage patients while keeping the patient awake and alert.10,11
“Tailored” antiplatelet bridging therapy with cangrelor: moving toward personalized medicine
Published in Platelets, 2022
Renato Valenti, Iacopo Muraca, Rossella Marcucci, Francesca Ciatti, Martina Berteotti, Anna Maria Gori, Nazario Carrabba, Angela Migliorini, Niccolò Marchionni, Marco Valgimigli
Recently, in our institution we started a program in order to individualize the management of bridging therapy with the support of platelet reactivity test (Figure 1). So far, we have dealt with four different cases of bridge therapy in high-risk patients (Table I).