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The Editors of Medical Science Monitor wish to inform you that the above manuscript has been retracted from publication due to concerns with the credibility and originality of the study, the manuscript content, and the Figure images. Reference: Jun Xia, Ni Xie, Yuning Feng, Anyu Yin, Pinni Liu, Ruming Zhou, Fan Lin, Guozhao Teng, Yi Lei. Brain Susceptibility Weighted Imaging Signal Changes in Acute Hemorrhagic Anemia: An Experimental Study Using a Rabbit Model. Med Sci Monit, 2014; 20: 1291-1297. DOI: 10.12659/MSM.890641.
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Background: To evaluate the diagnostic performance of split-bolus single-phase dual-energy computed tomography (DECT) with virtual non-contrast computed tomography (VNCT) compared to three-phase computed tomography (CT) urography in patients with urinary calculi, and to examine the performance of split-bolus single-phase DECT when reducing the effective dose. Methods: A total of 48 patients with abdominal pain or hematuria suggestive of unilateral urinary calculi were enrolled and randomly divided into the experimental and control groups, with 24 cases in each group. Patients in the experimental group underwent split-bolus single-phase DECT to obtain a mixed nephrographic excretory phase. Patients in the control group accepted a single-bolus three-phase CT urography scan (non-contrast, nephrographic phase, and excretory phase). The CT values and the contrast-to-noise ratio (CNR) of 7 segments of the urinary tract were measured and compared between the two groups by using the Mann-Whitney U test. The dose-length product (DLP) and effective dose of each patient were compared between the two groups using an independent t-test. Results: Among all 48 patients, 35 calculi were detected in the experimental group (n=24), and 47 calculi were detected in the control group (n=24). There was no significant difference between the two groups in both CT value measurements and the CNR. The mean DLP and mean effective dose of the experimental group were significantly lower than those of the control group, and the effective dose in the experimental group was decreased by 40% compared with the control group. Conclusions: The application of DECT combined with split-bolus nephrographic excretory phase CT urography can reveal the urinary calculi covered by a contrast medium and also reduce the effective dose exposure to patients.
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PURPOSE: We report a case of revascularization for an occluded renal artery using endovascular renal thrombus aspiration followed by catheter-directed thrombolysis. CASE REPORT: A 56-year-old man presented with sudden onset severe left-sided abdominal and loin pain for 6 hours. Urgent computed tomography (CT) angiogram showed occlusion of left renal artery. Emergency selective left renal angiogram and thrombus aspiration using a 5-French Cobra catheter was performed. Catheter-directed thrombolysis with urokinase was initiated after aspiration thrombectomy. Angiogram 24 hours after thrombolysis showed the left renal artery and its segmental branches were successfully revascularized. Patient was put on anticoagulation after operation and his renal function recovered well. CONCLUSION: Percutaneous aspiration thrombectomy with conventional catheters combined with intra-arterial local fibrinolysis could be used to salvage the renal function in case of complete renal artery thromboembolic occlusion.
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Doença Arterial Periférica , Tromboembolia , Trombose , Catéteres , Fibrinólise , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Renal/diagnóstico por imagem , Trombectomia/métodos , Terapia Trombolítica/métodos , Trombose/diagnóstico por imagem , Trombose/tratamento farmacológico , Trombose/etiologia , Resultado do TratamentoRESUMO
To investigate the effect analysis and preventive effects of nucleic acid testing combined with enzyme-linked immunosorbent assay (ELISA) on blood-borne diseases. This study included 72335 blood samples that were collected in our hospital from March 2019 to March 2020. All the samples were tested for anti HIV (AIDS antibody), anti HCV (hepatitis C antibody), HBsAg (hepatitis B surface antigen) and anti TP (syphilis antibody) in blood respectively with two manufacturers' reagents. The results of anti HIV, anti HCV, HBsAg and anti TP of all samples were analyzed, and blood samples with 0.7< sample test value / critical value (s / CO) < 3.0 were tested by ELISA and negative blood samples were tested by ELISA and nucleic acid testing. Then we analyzed the results of nucleic acid testing. 610 blood samples failed to pass the test of anti HIV, anti HCV, HBsAg and anti TP ELISA, accounting for 0.84% of the total numbers, including 100 blood samples with 1.0 3.0, 338 blood samples with 0.7< s/CO <1.0 and 71725 blood samples were qualified. We used nucleic acid testing to test 71725 qualified samples tested by ELISA and then there were 50 samples with positive HBV-DNA , accounting for 0.07% (50 / 71725), no one with positive HIV-RNA and positive HCV-RNA, accounting for 0.00% (0/71725). The positive rate of blood samples with HBsAg 0.7
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Infecções Transmitidas por Sangue/diagnóstico
, Ensaio de Imunoadsorção Enzimática/métodos
, Ácidos Nucleicos/sangue
, Adulto
, Feminino
, Humanos
, Técnicas de Imunoadsorção
, Masculino
, Pessoa de Meia-Idade
, Adulto Jovem
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OBJECTIVE/HYPOTHESIS: To investigate the endovascular intervention or extracranial/intracranial (EC/IC) vascular bypass in the management of patients with head and neck cancer-related carotid blowout syndrome (CBS). STUDY DESIGN: Retrospective case series. METHODS: Retrospective analysis of clinical data of patients with head and neck cancer-related CBS treated by endovascular intervention and/or EC/IC vascular bypass, analysis of its bleeding control, neurological complications, and survival results. RESULTS: Thrity-seven patients were included. Twenty-five were associated with external carotid artery (ECA); twelve were associated with internal or common carotid artery (ICA/CCA). All patients with ECA hemorrhage were treated with endovascular embolization. Of the 12 patients with ICA/CCA hemorrhage, 9 underwent EC/IC bypass, 1 underwent endovascular embolization, and 3 underwent endovascular stenting. For patients with ECA-related CBS, the median survival was 6 months, and the 90-day, 1-year, and 2-year survival rates were 67.1%, 44.7%, and 33.6%, respectively; the estimated rebleeding risk at 1-month, 6-month, and 2-year was 7.1%, 20.0%, and 31.6%, respectively. For patients with ICA/CCA-related CBS, the median survival was 22.5 months, and the 90-day, 1-year, and 2-year survival rates were 92.3%, 71.8%, and 41.0%, respectively; the estimated rebleeding risk at 1 month, 6 months, and 2 years is 7.7%,15.4%, and 15.4%, respectively. ICA/CCA-related CBS patients have significantly longer survival time and lower risk of rebleeding, which may be related to the more use of EC/IC vascular bypass as a definite treatment. CONCLUSIONS: For patients with ICA/CCA-related CBS, if there is more stable hemodynamics, longer expected survival, EC/IC vascular bypass is preferred. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:1548-1556, 2021.
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Doenças das Artérias Carótidas/cirurgia , Revascularização Cerebral/métodos , Procedimentos Endovasculares/métodos , Neoplasias de Cabeça e Pescoço/complicações , Hemorragia/cirurgia , Adulto , Idoso , Doenças das Artérias Carótidas/etiologia , Doenças das Artérias Carótidas/mortalidade , Artéria Carótida Externa/cirurgia , Artéria Carótida Interna/cirurgia , Revascularização Cerebral/instrumentação , Revascularização Cerebral/estatística & dados numéricos , Embolização Terapêutica/estatística & dados numéricos , Procedimentos Endovasculares/instrumentação , Procedimentos Endovasculares/estatística & dados numéricos , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/mortalidade , Hemorragia/etiologia , Hemorragia/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Medição de Risco/estatística & dados numéricos , Ruptura Espontânea/etiologia , Ruptura Espontânea/mortalidade , Ruptura Espontânea/cirurgia , Prevenção Secundária/instrumentação , Prevenção Secundária/métodos , Prevenção Secundária/estatística & dados numéricos , Stents , Taxa de Sobrevida , Resultado do TratamentoRESUMO
BACKGROUND: Central venous catheter (CVC) is commonly used to provide access for hemodialysis (HD) when arteriovenous access is not available. The misplacement of CVC into azygos vein (AV) is a rare but a potential serious complication. Previous reports communicated the opinion that left-sided catheterization predisposed to AV misplacement, but these reports concentrated on peripherally inserted CVCs, placed for indications rather than HD. Unintended AV misplacement of HD catheters (HDCs) has not been well studied. We seek to investigate factors associated with inadvertent AV miscannulation during HDC placement. METHODS: We are to present a case of unintentional misplacement of a tunneled HD catheter (tHDC) into the azygos arch from right internal jugular vein (RIJV) despite real-time fluoroscopy guidance. Additionally, we have undertaken a systematic literature search in Pubmed to study the anatomical and other factors related to unintended AV misposition in HD setting. RESULTS: From 2005 to August 31, 2018, a total of 11 articles containing 16 cases of misplacement of HDCs into AV were identified. Of the 17 cases of unintentional AV misposition including ours, the majority of the misguided HDCs (94.1%, 16/17) were tHDCs and only 1 case was related to a temporary (non-tunneled) catheter. Most catheter misplacements (88.2%, 15/17) were performed without real-time radiological guidance. The reported incidence of inadvertent AV cannulation from different institutions varied between 0.6% and 3.8%. Among the 16 misplaced tHDCs, the rates of AV misposition that arose from RIJV and left internal jugular vein (LIJV) insertion are even at 50%. CONCLUSIONS: Based upon anatomical and case studies, we have found that AV may join posterior aspect of superior vena cava at different directions and levels. Hence, this might explain why AV misplacement might occur whether an HDC is inserted from the LIJV or RIJV approach. By raising the awareness of this potential complication and how we may minimize it, we hope to reduce the future complication of AV misposition.
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Veia Ázigos , Cateterismo Venoso Central , Cateteres Venosos Centrais , Erros Médicos , Diálise Renal , Idoso , Veia Ázigos/cirurgia , Cateterismo Venoso Central/métodos , Cateterismo Venoso Central/normas , Cateteres Venosos Centrais/normas , Humanos , Veias Jugulares/cirurgia , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Masculino , Radiografia Torácica , Diálise Renal/normasRESUMO
BACKGROUND: The aim of this study was to investigate susceptibility-weighted imaging (SWI) signal changes in different brain regions in a rabbit model of acute hemorrhagic anemia. MATERIAL/METHODS: Ten New Zealand white rabbits were used for construction of the model of acute hemorrhagic anemia. Signal intensities of SWI images of the bilateral frontal cortex, frontal white matter, temporal lobe, and thalamic nuclei were measured. In addition, the cerebral gray-white contrast and venous structures of the SWI images were evaluated by an experienced physician. RESULTS: Repeated bloodletting was associated with significant reductions in red blood cell count, hemoglobin concentration, hematocrit, pH, and PaCO2, and elevations of blood lactate and PaO2. In normal status, the SWI signal intensity was significantly higher in the frontal cortex than in the frontal white matter (63.10±22.82 vs. 52.50±20.29; P<0.05). Repeated bloodletting (5 occasions) caused significant (P<0.05) decreases in the SWI signals of the frontal cortex (from 63.10±22.82 to 37.70±4.32), temporal lobe (from 52.50±20.29 to 42.60±5.54), and thalamus (from 60.40±20.29 to 39.40±3.47), but was without effect in the frontal white matter. The cerebral white-gray contrast and venous structures were clearer after bloodletting than before bloodletting. CONCLUSIONS: The effect of hemorrhage on the brain is reflected by SWI signal changes in the cerebral cortex and gray matter nuclei.
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Anemia/diagnóstico , Anemia/patologia , Encéfalo/patologia , Modelos Animais de Doenças , Hemorragia/complicações , Imageamento por Ressonância Magnética/métodos , Anemia/etiologia , Animais , Sangria/métodos , Contagem de Eritrócitos , Hematócrito , Hemoglobinas/metabolismo , Ácido Láctico/sangue , CoelhosRESUMO
BACKGROUND: The aim of the study was to evaluate the clinical efficacy of superselective intra-arterial targeted neo-adjuvant chemotherapy in the treatment of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and human epidermal growth factor receptor 2 (HER2)-negative (triple-negative) breast cancer. PATIENTS AND METHODS.: A total of 47 triple-negative breast cancer patients (29 at stage II, 13 at stage III and 5 at stage IV) were randomly assigned to two groups: targeted chemotherapy group (n=24) and control group (n=23). Patients in the targeted chemotherapy group received preoperative superselective intra-arterial chemotherapy with CEF regimen (C: cyclophosphamide [600 mg/m(2)]; E: epirubicin [90 mg/m(2)]; F: 5-fluorouracil [600 mg/m(2)]), and those in the control group received routine neoadjuvant chemotherapy with CEF. The duration of the treatment, changes in lesions and the prognosis were determined. RESULTS: The average course of the treatment was 15 days in the targeted chemotherapy group which was significantly shorter than that in the control group (31 days) (P<0.01). The remission rate of lesions was 91.6% in the targeted chemotherapy group and 60.9% in the control group, respectively. Among these patients, 9 died within two years, including 2 (both at IV stage) in the targeted chemotherapy group and 7 (2 at stage II, 4 at stage III and 1 at stage IV) in the control group. CONCLUSIONS: As an neoadjuvant therapy, the superselective intra-arterial chemotherapy is effective for triple-negative breast cancer, with advantages of the short treatment course and favourable remission rates as well as prognoses.