Antegrade common femoral artery access site closure using the MANTA vascular closure device.

In antegrade peripheral endovascular procedures, the use of covered stents may require a large sheath size, which precludes the use of regular closure devices. The MANTA vascular closure device is a collagen plug-based vascular closure device for large bore percutaneous arterial interventions, which is normally used to close retrograde vascular access sites. We describe successful antegrade common femoral access site closure with the MANTA vascular closure device in 2 patients, a 68-year-old male and an 89-year-old male, both with a popliteal artery aneurysm which was treated by percutaneous endovascular stentgraft placement. Use of the MANTA vascular closure device simplifies large-bore antegrade common femoral artery access and avoids the need for surgical artery cutdown.

Diagnostic yield of computed tomography-guided biopsy and aspiration for vertebral osteomyelitis.

INTRODUCTION: The diagnostic yield of and best approaches for imaging-guided percutaneous biopsy for vertebral osteomyelitis is controversial. Early studies suggest yields of up to 90%; however, recent evidence shows lower yields of 30-40%. We aim to determine yield and predictors of yield in percutaneous CT-guided biopsies in vertebral osteomyelitis. METHODS: We conducted a retrospective observational single-centre study cohort study of all patients presenting for vertebral biopsy or aspiration between 2014 and 2018. Only patients undergoing biopsy for suspected infection were included. Patients with malignant indications were excluded. Comprehensive review of medical records was performed for clinical presentation, comorbidities, imaging, biomarkers, microbiology and treatment. RESULTS: Overall, 40 out of 88 biopsies were performed for suspected infection, in 36 patients. Mean age was 59 ± 18 years; 29 (81%) were male. Of the 40 samples, an organism was identified in 14 samples (35%). Gram-positive organisms were most commonly identified; Staphylococcus aureus was cultured in 7 (50%) of samples. Mean admission CRP was significantly higher in patients with identified organisms compared to those without (137 ± 106 vs 54 ± 78, P = 0.008). Aspiration was a strong independent predictor of positive microbiological growth on multivariate analysis (OR 6.52 [1.25-34.02], P = 0.026). Biopsy or aspiration aided clinical decision-making in half of cases. CONCLUSIONS: Percutaneous CT-guided biopsy has a modest yield for identifying the culprit organism in suspected cases of vertebral osteomyelitis. Elevated CRP and aspiration of fluid collections are associated with improved microbiological yield and should be considered in deciding when and where to biopsy.

Aortic Aneurysm Rupture After Urokinase Treatment for Acute Limb Ischemia in Two Patients After EVAR.

Endovascular aneurysm repair (EVAR) is first-choice treatment for many patients with abdominal aortic aneurysms. Complications unique to endovascular treatment include endoleak and endotension, which can eventually lead to rupture. We present two cases of late aortic rupture after EVAR, where both patients had recent preceding catheter-directed thrombolysis with urokinase for acute limb ischemia. These cases suggest a relation between thrombolytic therapy and aortic rupture after EVAR, and we should therefore be aware of this possible complication.

Acute Abdominal Pain Caused by an Infected Mesenteric Cyst in a 24-Year-Old Female.

A mesenteric cyst is a rare cause for abdominal pain. This umbrella term includes cystic entities which reside in the mesentery. We present a case of an infected false mesenteric cyst in a 24-year-old female patient without prior surgery or known trauma. Mainstay of treatment involves surgical resection, although less invasive treatments have been described. Prognosis depends on the origin of the cyst.

Mars water-ice clouds and precipitation.

The light detection and ranging instrument on the Phoenix mission observed water-ice clouds in the atmosphere of Mars that were similar to cirrus clouds on Earth. Fall streaks in the cloud structure traced the precipitation of ice crystals toward the ground. Measurements of atmospheric dust indicated that the planetary boundary layer (PBL) on Mars was well mixed, up to heights of around 4 kilometers, by the summer daytime turbulence and convection. The water-ice clouds were detected at the top of the PBL and near the ground each night in late summer after the air temperature started decreasing. The interpretation is that water vapor mixed upward by daytime turbulence and convection forms ice crystal clouds at night that precipitate back toward the surface.

TCDD residues in fish and shellfish from U.S. waterways.

TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin) in the edible portion of fish and shellfish from various U.S. waterways has been monitored since 1979. Analytical results for the period 1979-1994 are reported. Extracts obtained after column chromatographic and liquid chromatographic cleanup were examined by electron capture detection-gas chromatography (GC), and final quantitation and confirmation were performed by GC/mass spectrometry with multiple ion detection. Analyses of 1623 test samples indicated that TCDD residues in fish and shellfish were not widespread but rather were localized in areas near waste sites, chlorophenol manufacturers, and pulp and paper mills. Analytical results indicated that levels in aquatic species from these sites have been declining steadily. No TCDD (limit of detection and confirmation, 1-2 ppt) has been found in recent years in aquatic species from most Atlantic, Pacific, and Gulf of Mexico sites and Great Lakes other than Lake Ontario and Saginaw Bay (Lake Huron).

[Immunologic survey on leptospirosis in the Marquesas Islands]. / Enquête immunologique sur les leptospiroses aux Iles Marquises.

Marquesas Islands, within the French Polynesian territory, are situated in the south hemisphere, near the Equator. They are volcanic islands, with a humid and hot climate, and high hygrometry . These islands are relatively isolated. Our sera were collected at the occasion of a blood test campaign: in Taiohae , 104 people, and Atuona , 149 people; they were between 17 and 57 years old. The results show that 45 people have antibodies against L. biflexa Patoc (17,8%). Among them, 24 have antibodies against icterohaemorrhagiae (9,5%). This is the evidence of the presence of leptospires in these islands.