Comparison of Clinical Effectiveness and Safety of Drug-Coated Balloons versus Percutaneous Transluminal Angioplasty in Arteriovenous Fistulae: A Review of Systematic Reviews and Updated Meta-Analysis.

PURPOSE: To evaluate the clinical effectiveness and safety of drug-coated balloons (DCBs) compared with those of percutaneous transluminal angioplasty (PTA) for arteriovenous fistula (AVF) stenosis via a review of systematic reviews (SRs) and an update of the current meta-analysis. MATERIALS AND METHODS: Literature was searched to retrieve SRs comparing DCBs and PTA for AVFs. A narrative review of SRs and pooled analysis were performed. RESULTS: Eleven SRs were included. DCBs demonstrated favorable outcomes at 6 and 12 months compared with PTA, with improved patency in 7 SRs and a trend toward favorable outcomes without statistical significance in 3 SRs. Target lesion revascularization (TLR) was reported in 3 SRs; 2 reviews reported a significantly lower incidence in the DCB group than in the PTA group, whereas 1 review reported no significant differences at 12 months. Four studies reporting all-cause mortality revealed no significant difference between the 2 treatments. In the updated meta-analysis including 23 studies, DCBs demonstrated improved primary patency at 6 months (risk ratio [RR], 1.27; 95% CI, 1.07-1.50) and 12 months (RR, 1.36; 95% CI, 1.19-1.55) and were associated with a lower incidence of TLR at 6 months (RR, 0.54; 95% CI, 0.41-0.73) and 12 months (RR, 0.78; 95% CI, 0.62-0.99). There was no difference in mortality between the 2 groups for 24 months. CONCLUSIONS: A review of SRs and meta-analysis update revealed the consistent benefits of DCBs over PTA in treating AVFs in terms of primary patency and TLR. Compared with PTA, DCBs do not increase mortality risk.

One-pot preparation of 3D nano- and microaggregates via in situ nanoparticlization of polyacetylene diblock copolymers produced by ROMP.

Zero-dimensional (0D) nanospheres, 1D nanocaterpillars, and 3D aggregates are produced from simple diblock copolymers containing polyacetylene (PA) via in situ nanoparticlization of conjugated polymers. The diblock copolymers are prepared by ring-opening metathesis polymerization via one-pot sequential addition of an endo-tricyclo[4.2.2.0]deca-3,9-diene (TD) and cyclooctatetraene. Initially, they spontaneously form nanospheres consisting of a PA core and PTD shell, and increasing the length of the PA block leads to the direct nanoparticlization of the higher-dimensional structures such as 1D and 3D aggregates because of the decreased effective volume ratio of the rigid PTD shell to the solvophobic PA core.

Anti-Alzheimer's Materials Isolated from Marine Bio-resources: A Review.

The most common type of dementia found in the elderly population is Alzheimer's disease. The disease not only impacts the patients and their families but also the society therefore, the main focus of researchers is to search new bioactive materials for treating AD. The marine environment is a rich source of functional ingredients and to date, we can find sufficient research relating to anti- Alzheimer's compounds isolated from marine environment. Therefore, this review focuses on the anti- Alzheimer's material from marine bio-resources and then expounds on the anti-Alzheimer's compounds from marine seaweed, marine animal and marine microorganisms. Moreover, because of the complexity of the disease, different hypothesizes have been elaborated and active compounds have been isolated to inhibit different stages of pathophysiological mechanisms. Sulfated polysaccharides, glycoprotein, and enzymatic hydrolysates from marine seaweeds, peptides, dietary omega-3 polyunsaturated fatty acids and skeletal polysaccharide from marine animals and secondary metabolites from marine microorganism are summarized in this review under the anti-Alzheimer's compounds from the marine.

Mixture of three amino acids as stabilizers replacing albumin in lyophilization of new third generation recombinant factor VIII GreenGene F.

A formulation with stabilizers replacing albumin was developed for lyophilization of recombinant factor VIII (FVIII), GreenGene F (WHO INN: beroctocog alfa), to achieve stability and eliminate safety issues of blood-derived albumin. L-Arginine (hydrophilic amino acid, positively charged side chain), L-glutamic acid (hydrophilic amino acid, negatively charged side chain), and L-isoleucine (hydrophobic amino acid, nonpolar) were selected as stabilizers, and the mixture of the three amino acids were optimized. The mixture had results comparative with albumin and other commonly used stabilizers showing good preservation of recombinant FVIII during lyophilization, robust stability with consistently high recovery of FVIIII, very low aggregate formation, and good storage stability without alterations in protein characteristics. In vivo test results showed that the efficacy was maintained and had no signs of toxicity. The study demonstrated that the three amino acid mixture acts as a good stabilizer for lyophilization of recombinant FVIII and as a safe excipient.

Successful management of staple line leak after laparoscopic sleeve gastrectomy with vascular plug and covered stent.

PURPOSE: Laparoscopic sleeve gastrectomy (LSG) is a feasible option for morbid obesity. But gastric leak is one of the most dreadful complications. We report our experience of staple line leak, which was managed successfully with vascular plug and covered stent. METHODS: A staple line leak occurred after LSG. Followed attempts of reoperation, drainage procedures of abscess cavity, and repeated endoscopic treatments were all unavailing. Finally, vascular plug was placed at fistula tract and consequent endoscopic covered stent placement could propose the solution. RESULTS: Granulation tissue, which occluded the fistula tract was identified by computed tomographic scan 2 weeks after stent placement. Leak healed successfully, and the patient discharged safely a week after stent removal. CONCLUSIONS: We consider inducing granulation tissue by applying vascular plug at fistula tract in combination with covered stent placement, which is a safe and effective therapeutic option for management of intractable staple line leak after LSG.

Treatment of tracheobronchial obstruction with a polytetrafluoroethylene-covered retrievable expandable nitinol stent.

PURPOSE: To evaluate the clinical effectiveness of polytetrafluoroethylene (PTFE)-covered retrievable expandable nitinol stents in tracheobronchial strictures. MATERIALS AND METHODS: With fluoroscopic guidance, PTFE-covered retrievable expandable nitinol stents were placed in 15 symptomatic patients with benign (n = 6) or malignant (n = 9) tracheobronchial strictures. Complications and improvement in respiratory status were evaluated. Stents were removed electively 6 months after placement in benign strictures or if complications occurred. Membrane degradation or separation from the wire mesh was evaluated in removed stents. RESULTS: A total of 17 stents were successfully placed and were well tolerated in all patients. Sputum retention, stent migration, and tissue hyperplasia occurred in 23.5% (n = 4), 17.6% (n = 3), and 17.6% (n = 3) of stents, respectively. A total of 11 stents were successfully removed electively 6 months after placement (n = 4) or when complications occurred (n = 7). All 11 such stents were removed without difficulty with use of standard techniques, antecedent balloon dilation being necessary in two cases as a result of tissue hyperplasia. No removed stent showed signs of membrane degradation, and two removed stents showed signs of membrane separation from the mesh. CONCLUSIONS: PTFE-covered retrievable expandable nitinol stents were effective in the treatment of tracheobronchial strictures. Stent removal was easy with use of standard techniques, and no removed stent showed evidence of membrane degradation.