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Complications of endovascular management of aortoiliac occlusive disease
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Karem C. Harth, Saideep Bose, Vikram S. Kashyap
For patients who have had symptoms/thrombosis for longer periods of time, lysis is less successful. The Surgery versus Thrombolysis for Ischemia of the Lower Extremity (STILE) trial randomized 237 patients to thrombolysis or surgical revascularization and enrolled patients if they had symptoms for less than 6 months. After 1 year of follow-up, 43.8% of lysis patients experienced ongoing ischemia requiring intervention while only 20% of surgical patients did, and 28% experienced significant morbidity while only 5% of surgical patients did.19 One additional explanation for the poor lysis outcomes in this trial is that only 21.8% of patients had AIOD, whereas more recent analysis demonstrate a higher success rate with endovascular interventions for AIOD when compared to femoropopliteal or tibial lesions.20
Antibiotics: The Need for Innovation
Published in Nathan Keighley, Miraculous Medicines and the Chemistry of Drug Design, 2020
One very important difference between bacterial cells and those of animals is the presence of a cell wall that encapsulates the bacterial cell. This is in addition to a plasma membrane and serves to protect the cell, give it structure and stability, and, most crucially, to balance osmotic pressure; otherwise, if bacteria without a cell membrane entered an aqueous environment containing a low concentration of salts, water would freely enter the cell due to osmotic pressure, which would cause the cell to swell and eventually burst. This is known as lysis. While the cell wall does not prevent water from entering the cell, it does stop the cell from swelling, and, therefore, indirectly prevents excessive amounts of water entering the cell, which would be catastrophic for the bacterium.
Non-Hodgkin Lymphoma
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Piers Blombery, David C. Linch
There are three forms of BL: endemic, sporadic, and immunodeficiency-associated. BL typically presents as rapidly progressive extra-nodal disease with frequent bone marrow, intestinal tract, and leptomeningeal disease. Nodal disease is more common in adults than in children and is often bulky.63 Both spontaneous tumor lysis syndrome (i.e., preceding treatment) and treatment-induced tumor lysis syndrome are common in BL and are important contributors to early morbidity and mortality. Rigorous hydration and recombinant urate oxidase are now routinely used in patients with BL.64
Dihydropyrimidine dehydrogenase (DPD) genotype and phenotype among Danish cancer patients: prevalence and correlation between DPYD-genotype variants and P-uracil concentrations
Published in Acta Oncologica, 2022
Niels Herluf Paulsen, Camilla Qvortrup, Fie Juhl Vojdeman, Peter Plomgaard, Stig Ejdrup Andersen, Anne Ramlov, Birgitte Bertelsen, Maria Rossing, Claus Gyrup Nielsen, Elke Hoffmann-Lücke, Eva Greibe, Hanne Spangsberg Holm, Heidi Hvid Nielsen, Ihab Bishara Yousef Lolas, Jonna Skov Madsen, Marianne Lerbaek Bergmann, Morten Mørk, Palle B. Nielsen Fruekilde, Pernille Bøttger, Peter Clausager Petersen, Peter Henrik Nissen, Søren Feddersen, Troels K. Bergmann, Per Pfeiffer, Per Damkier
The DPD-phenotype can be measured using different methods, including dihydrouracil/uracil ratio, uracil measurements in saliva, or uracil in plasma. The latter method was implemented into clinical practice in Denmark because it is commonly used in Europe and is recommended by the EMA [6,7,9,12]. The physiological role of the DPD-enzyme is to metabolize the two endogenous pyrimidines, thymine, and uracil, leading to an elevated plasma-uracil concentration ([U]) in patients with DPD-deficiency. [U] is affected by food intake and circadian rhythm [13,14] and is significantly increased in patients with end-stage renal disease [15]. The [U] concentration may also be affected in patients with tumor lysis syndrome, where a pronounced increase in [U] has been reported [16]. Furthermore, [U] is not stable in whole blood, so plasma must be isolated immediately after blood sampling and stored at −20 °C or analyzed. Incorrect or prolonged handling of samples could lead to falsely elevated [U] values [17]. Recently, De With et al. found significant between-center variance in pretreatment [U], underlining that measurement of [U] can be susceptible to preanalytical errors as well as the difference between unstandardized methods [18]. Patients with [U] ≥ 16 ng/mL and >150 ng/mL are categorized as having partial DPD deficiency and complete DPD deficiency, respectively [19].
Phase Transition Microemulsion of Brimonidine Tartrate for Glaucoma Therapy: Preparation, Characterization and Pharmacodynamic Study
Published in Current Eye Research, 2021
Nivedita Gautam, Karthikeyan Kesavan
Estimation of irritancy levels of the developed PMEs is done by HET-CAM test.20 Briefly, fertilized chicken eggs weighing 40–50 grams were collected from commercial sources and candled to remove the nonviable or defective ones. The eggs were incubated at 37 ± 0.5°C and 40 ± 5% humidity for 9 days. The eggs were rotated 180° manually in a gentle manner thrice a day to ensure proper development and embryo viability. The eggs were placed at equatorial position so that chorioallantoic membrane should develop away from the egg shell. On 9th day, the eggs were candled to confirm fertility and identify the airspace, marking was done. After complete incubation of 10 days, egg shell of each egg of three groups was opened at that marked portion. The inner membrane is cautiously removed with the help of forceps without disrupting the blood vessels to expose the chorioallantoic membrane underneath. The 300 µl volume of 0.9% saline solution (negative control), 0.1 M NaOH (positive control) and test solution (PMEs) was added onto the CAM by a pipette directly, and a timer started. Any effects like hemorrhage, lysis, and coagulation were assessed. After the treatment, semi-quantitatively grade using the method developed by Gupta et al. (2010)21 was performed. Each test solution is allotted a grade on the basis of haemorrhaging visibility. Images were taken to record qualitative data. The scores were recorded as per the scoring schemes.
Catheter-directed thrombolysis and mechanical intervention in deep venous thrombosis: what is the status after the ATTRACT trial?
Published in Postgraduate Medicine, 2021
Savannah E. Fletcher, Sonia Jasuja, Leo P. Lawler, John M. Moriarty
For maximal PTS risk reduction, CDT should occur during the acute or early subacute phase of DVT before chronic transformation of the thrombus has occurred [25]. The duration of thrombotic occlusion likely contributes to valve destruction and influences the success of venous recanalization [35]. A study by Mewissen et al. demonstrated that the achievement of complete lysis was more likely in acute DVT (symptoms < 10 days in duration) compared to chronic DVT (symptoms > 10 days in duration) and similarly less than 50% lysis was more common in cases of chronic DVT [37]. In this same study, no patients with chronic femoral-popliteal DVT had complete lysis, but patients with acute on chronic DVT symptoms had outcomes similar to the patients presenting with acute DVT [37]. Several studies performed CDT within 14 days of symptom onset while the CaVenT study allowed 21 days of symptoms before treatment, possibly playing a role in the higher rates of PTS seen in that study [35,38,39].