scholarly journals Standardized Protocol for Hemodialysis Vascular Access Assessment: The Role of Ultrasound and ColorDoppler

2018 ◽  
Vol 45 (1-3) ◽  
pp. 260-269 ◽  
Author(s):  
Federico Nalesso ◽  
Francesco Garzotto ◽  
Ilaria Petrucci ◽  
Sara Samoni ◽  
Grazia Maria Virzì ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Vascular Access ◽  
Hemodynamic Parameters ◽  
Non Invasive ◽  
Standardized Protocol ◽  
Hemodialysis Vascular Access ◽  
Simple Step ◽  
Artery Flow

Introduction: Ultrasound and colorDoppler technique, which is relatively inexpensive, rapid, non-invasive and repeatable is a powerful tool used for early diagnosis of vascular access (VA) complications in hemodialysis patients. To date a standard and widely comprehensible echocolorDoppler (ECD) protocol is not available. Materials and Methods: A simple step-by-step protocol based on anatomical and hemodynamic parameters of VA has been developed during a 3-years VA ECD follow-up. It consists of an ECD study scheme. The algorithm created involves the calculation of brachial artery flow, description of artero-venous and/or graft-vascular anastomosis and efferent vessel and/or graft. Results: The algorithm allows to formulate a medical report that takes into account both anatomic and hemodynamic parameters of the VA. Reduction of complications and the prevention of chronic complications as well as the early detection of acute problems were achieved. Discussion and Conclusion: The creation of a step-by-step protocol may simplify the multidisciplinary management of VA, its monitoring and the early diagnosis of its complications.

scholarly journals Reduced Flow-Mediated Dilatation Is Not Related to COVID-19 Severity Three Months after Hospitalization for SARS-CoV-2 Infection

2021 ◽  
Vol 10 (6) ◽  
pp. 1318
Author(s):  
Marianne Riou ◽  
Walid Oulehri ◽  
Cedric Momas ◽  
Olivier Rouyer ◽  
Fabienne Lebourg ◽  
...  
Keyword(s):  
Vascular Endothelium ◽  
Matched Control ◽  
Acute Infection ◽  
Critical Role ◽  
Lung Damage ◽  
Vascular Effect ◽  
Flow Mediated Dilatation ◽  
Artery Flow

The coronavirus disease 2019 (COVID-19) pandemic has spread rapidly worldwide, with more than two million deaths. Evidence indicates the critical role of the vascular endothelium in its pathophysiology but, like potential changes in functional vasodilation, the vascular effect of SARS-CoV-2 at a given distance from the acute infection is largely unknown. We assessed brachial artery flow-mediated dilatation (FMD) in 27 COVID-19 patients needing conventional or intensive care unit hospitalization, three months after SARS-CoV-2 infection diagnosis and in nine age- and sex- matched control subjects. Interestingly, the FMD was lower in COVID-19 patients as compared to controls (8.2 (7.2–8.9) vs. 10.3 (9.1–11.7)); p = 0.002, and half of the hospitalized COVID-19 survivors presented with a reduced FMD < 8% at three months of COVID-19 onset. Impaired FMD was not associated with severe or critical SARS-CoV-2 infection, reflected by ICU hospitalization, total hospitalization duration, or severity of lung damage. In conclusion, reduced FMD is often observed even three months after hospitalization for SARS-CoV-2 infection, but such alteration predominantly appears to not be related to COVID-19 severity. Longer and larger follow-up studies will help to clarify the potential prognosis value of FMD among COVID-19 patients, as well as to further determine the mechanisms involved.

Whole Tumor Capsule is Prognostic of a Very Good Outcome in the Classical Variant of Papillary Thyroid Cancer

2021 ◽  
Author(s):  
Carlotta Giani ◽  
Liborio Torregrossa ◽  
Ramone Teresa ◽  
Romei Cristina ◽  
Antonio Matrone ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Braf V600e ◽  
Braf Mutations ◽  
Biological Behaviour ◽  
Non Invasive ◽  
Good Outcome ◽  
Predictive Role ◽  
Pathological Behavior

Abstract Context Tumour capsule integrity is becoming a relevant issue to predict the biological behaviour of human tumours, including thyroid cancer. Aim To verify if a whole tumour capsule in the classical variant of PTC (CVPTC) could have a predictive role of a good outcome as for follicular variant (FVPTC). Methods FVPTC (n=600) and CVPTC (n=554) cases, were analysed. We distinguished encapsulated-FVPTC (E-FVPTC) and encapsulated-CVPTC (E-CVPTC) and, thereafter, invasive (Ei-FVPTC and Ei-CVPTC) and non-invasive (En-FVPTC and En-CVPTC) tumours, according to the invasion or integrity of tumour capsule, respectively. Cases without tumour capsule were indicated as invasive-FVPTC (I-FVPTC) and invasive-CVPTC (I-CVPTC). Sub-group of each variant was evaluated for BRAF mutations. Results E-FVPTC was more frequent than E-CVPTC (p&lt;0.0001). No differences were found between En-FVPTC and En-CVPTC or between Ei-FVPTC and Ei-CVPTC. After 18 years of follow-up, a greater number of not-cured cases were observed in Ei-CVPTC with respect to Ei-FVPTC, but not in En-CVPTC to En-FVPTC. Multivariate clustering analysis showed that En-FVPTC, En-CVPTC, and Ei-FVPTC have similar features but different from I-FVPTC and I-CVPTC and, to a lesser extent, from Ei-CVPTC. 177/614 (28.8%) cases were BRAF  V600E-mutated and 10/614(1.6%) carried BRAF-rare alterations. Significantly higher rate of En-CVPTC (22/49,44.9%) than En-FVPTC (15/195,7.7%) (p&lt;0.0001) were BRAF  V600E-mutated. Conclusions En-CVPTC is less prevalent than En-FVPTC. However, they have a good clinical/ pathological behavior comparable to En-FVPTC. This finding confirms the good prognostic role of a whole tumour capsule also in CVPTC. New nomenclature for En-CVPTC, similar to that introduced for En-FVPTC (i.e, NIFTP) could be envisaged.

scholarly journals Diffusion-Weighted Imaging in Oncology: An Update

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1493 ◽  
Author(s):  
Carmelo Messina ◽  
Rodolfo Bignone ◽  
Alberto Bruno ◽  
Antonio Bruno ◽  
Federico Bruno ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Water Molecules ◽  
Non Invasive ◽  
Diffusion Weighted ◽  
Routine Magnetic Resonance Imaging ◽  
Treatment Responses ◽  
Magnetic Resonance Imaging Mri ◽  
Almost All

To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the “functional” information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations. In this review, we provide an up-to-date overview on the application of DWI in oncology.

scholarly journals P299 The Role Of A Multidisciplinary Respiratory Hub In Improving Post-discharge Follow Up Of Patients Receiving Acute Non-invasive Ventilation (niv)

Thorax ◽  
2014 ◽  
Vol 69 (Suppl 2) ◽  
pp. A205-A205
Author(s):  
F. Rauf ◽  
A. Oakes ◽  
Y. Khan ◽  
T. Stuart ◽  
B. Chakraborty ◽  
...  
Keyword(s):  
Invasive Ventilation ◽  
Post Discharge ◽  
Non Invasive ◽  
Non Invasive Ventilation

Role of active follow-up for early diagnosis of relapse after elective end of therapies

2005 ◽  
Vol 45 (6) ◽  
pp. 781-786 ◽  
Author(s):  
Simona Biasotti ◽  
Alberto Garaventa ◽  
Paola Padovani ◽  
Maura Faraci ◽  
Francesca Fioredda ◽  
...  
Keyword(s):  
Early Diagnosis

scholarly journals Role of IGF2 in the Study of Development and Evolution of Prostate Cancer

2022 ◽  
Vol 12 ◽  
Author(s):  
P. Porras-Quesada ◽  
JM. González-Cabezuelo ◽  
V. Sánchez-Conde ◽  
I. Puche-Sanz ◽  
V. Arenas-Rodríguez ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Biomedical Research ◽  
Current Medical ◽  
Significant Problem ◽  
Non Invasive ◽  
Relevant Role ◽  
Development And Evolution

Prostate Cancer (PC) is commonly known as one of the most frequent tumors among males. A significant problem of this tumor is that in early stages most of the cases course as indolent forms, so an active surveillance will anticipate the appearance of aggressive stages. One of the main strategies in medical and biomedical research is to find non-invasive biomarkers for improving monitoring and performing a more precise follow-up of diseases like PC. Here we report the relevant role of IGF2 and miR-93-5p as non-invasive biomarker for PC. This event could improve current medical strategies in PC.

scholarly journals Urine Phenylacetylglutamine Determination in Patients with Hyperphenylalaninemia

2021 ◽  
Vol 10 (16) ◽  
pp. 3674
Author(s):  
Fernando Andrade ◽  
Ainara Cano ◽  
María Unceta Suarez ◽  
Arantza Arza ◽  
Ana Vinuesa ◽  
...  
Keyword(s):  
Potential Role ◽  
Venous Blood ◽  
Phenyl Group ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Non Invasive ◽  
Frequent Monitoring ◽  
Healthy Control

Phenylketonuria (PKU), an autosomal-recessive inborn error of phenylalanine (Phe) metabolism is the most prevalent disorder of amino acid metabolism. Currently, clinical follow-up relies on frequent monitoring of Phe levels in blood. We hypothesize that the urine level of phenylacetylglutamine (PAG), a phenyl-group marker, could be used as a non-invasive biomarker. In this cross-sectional study, a validated liquid chromatography coupled to tandem mass spectrometry (LC-MS) method was used for urinary PAG quantification in 35 participants with hyperphenylalaninemia (HPA) and 33 age- and sex-matched healthy controls. We have found that (a) PKU patients present higher urine PAG levels than healthy control subjects, and that (b) there is a significant correlation between urine PAG and circulating Phe levels in patients with HPA. In addition, we show a significant strong correlation between Phe levels from venous blood samples and from capillary finger-prick dried blood spot (DBS) samples collected at the same time in patients with HPA. Further research in order to assess the potential role of urine PAG as a non-invasive biomarker in PKU is warranted.

Hemodialysis vascular accesses in patients on chronic hemodialysis at the Kenyatta National Hospital in Kenya

2019 ◽  
Vol 20 (6) ◽  
pp. 697-700
Author(s):  
Samuel K Kabinga ◽  
Joshua K Kayima ◽  
Seth O McLigeyo ◽  
John N Ndungu
Keyword(s):  
Vascular Access ◽  
Chronic Hemodialysis ◽  
P Value ◽  
National Hospital ◽  
Diabetes Clinic ◽  
Kenyatta National Hospital ◽  
Hemodialysis Vascular Access ◽  
The Mean ◽  
Real Danger

Introduction:The objective of our study was to document the level of preparedness for renal replacement therapy assessed by incident hemodialysis vascular access and the access at least 3 months after initiation of hemodialysis at Kenyatta National Hospital, Nairobi.Methods:Between June and July 2018, we carried out a cross-sectional descriptive study on the preparedness for hemodialysis by patients who were on chronic hemodialysis in the Kenyatta National Hospital Renal Department. Sociodemographic, medical history, duration of follow-up, and state of preparedness parameters were obtained through interview and entered into the questionnaire. The data were entered in preprogrammed format in the Statistical Package for the Social Sciences (SPSS) version 20.0 for analyses.Results:Eighty-two patients were enrolled. Males were 50% (41). The mean age was 45.39 ± 15.96 years but females were 5 years younger than their male counterparts. About 85.4% of the patients were drawn from the hypertension and diabetes clinics, and the mean, mode, and median of the duration of follow-up were 41, 0, and 0 months, respectively, in these clinics. Almost three in every four patients (74.4%) were initiated on hemodialysis as emergency (p value < 0.001). About 80% were initiated hemodialysis via acute catheters placed in the jugular and subclavian veins (p value < 0.001). At least 3 months later, 40% still had acute catheters on the same veins (p value < 0.001). Acute venous catheters in the femoral veins were in 9.2% at initiation and 6.6% of the patients at least 3 months later. Less than 2% of the patients had arteriovenous fistulae at initiation, which rose to 14.5% in 3 months. Tunneled catheters were placed in 11.8% initially and at least 3 months, were almost in 40% of the patients.Conclusion:In conclusion, our young hemodialysis population mainly drawn from hypertension and diabetes clinic requires more input in hemodialysis vascular access planning. Focused individualized follow-up and early referrals to nephrologists are required. Uptake of arteriovenous grafts for hemodialysis might reduce the prevalence of hemodialysis catheters. As it is, this population is threatened with iterative vascular accesses complications as well as real danger of exhaustion of their vascular capital. There is real danger of increase in mortality from access complications.

scholarly journals New Horizons in Early Dementia Diagnosis: Can Cerebellar Stimulation Untangle the Knot?

2019 ◽  
Vol 8 (9) ◽  
pp. 1470
Author(s):  
Antonino Naro ◽  
Angela Marra ◽  
Luana Billeri ◽  
Simona Portaro ◽  
Rosaria De Luca ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
New Horizons ◽  
Diagnosis And Prognosis ◽  
Challenging Tasks ◽  
Early Dementia ◽  
Diagnosis Of Dementia ◽  
Theta Burst ◽  
Cerebellar Stimulation

Differentiating Mild Cognitive Impairment (MCI) from dementia and estimating the risk of MCI-to-dementia conversion (MDC) are challenging tasks. Thus, objective tools are mandatory to get early diagnosis and prognosis. About that, there is a growing interest on the role of cerebellum-cerebrum connectivity (CCC). The aim of this study was to differentiate patients with an early diagnosis of dementia and MCI depending on the effects of a transcranial magnetic stimulation protocol (intermittent theta-burst stimulation -iTBS) delivered on the cerebellum able to modify cortico-cortical connectivity. Indeed, the risk of MDC is related to the response to iTBS, being higher in non-responder individuals. All patients with MCI, but eight (labelled as MCI-), showed preserved iTBS aftereffect. Contrariwise, none of the patients with dementia showed iTBS aftereffects. None of the patients showed EEG aftereffects following a sham TBS protocol. Five among the MCI- patients converted to dementia at 6-month follow-up. Our data suggest that cerebellar stimulation by means of iTBS may support the differential diagnosis between MCI and dementia and potentially identify the individuals with MCI who may be at risk of MDC. These findings may help clinicians to adopt a better prevention/follow-up strategy in such patients.

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