Urological complications caused by inferior vena cava filters: a systematic review.

INTRODUCTION: Inferior vena cava (IVC) filters act in preventing pulmonary embolisms (PE). Various complications have been reported with their use. However, a credible urological complication rate, filter characteristics, and clinical presentation has yet to be summarized. Thus, we reported these complications in the form of a systematic review. EVIDENCE ACQUISITION: A search strategy was designed using PubMed, MEDLINE, and EMBASE on February 10th, 2022. The design of this search strategy did not include any language restrictions. The key words (and wildcard terms) used in the search strategy were urolog*, ureter*, bladder, kidney coupled with filter, inferior vena cava, and cava*. Inclusion criteria were: patients older than 18, with previous IVC filter placement, and urologic complication reported. Exclusion criteria were: patients younger than 18, no IVC filter placement, and no urologic complication reported. Other case series and reviews were excluded to avoid patient duplication. EVIDENCE SYNTHESIS: Thirty-five articles were selected for full-text screening. Thirty-seven patient cases were reviewed, and the median age was 53 (range: 21-92 years old). Abdominal and or flank pain was reported in 16 (43%) patients, hematuria was seen in eight (22%) and two (5%) patients died due to acute renal failure resulting from the urologic complications of the IVC filter. Indications for IVC filter placement were recurrent pulmonary embolism (PE), contraindication to or noncompliance with anticoagulant therapy. The IVC filters were infrarenal in 29 (78.4%) patients, suprarenal in five (13.5%) patients, not reported in two patients, and misplaced into the right ovarian vein in one patient. Three or more imaging modalities were obtained in 19 patients (51%) for planning. IVC filter removal was not performed in 17 (45.9%) patients, endovascular retrieval occurred in nine (24.3%) patients, and open removal was performed in seven (18.9%) patients, and tissue interposition was performed in two (5.4%) patients. One patient did not have the management reported. CONCLUSIONS: Urological complications caused by IVC filters although rare, are likely underreported, require extensive workup, and pose surgical challenges. Due to their complex management, filter retrieval should be planned for as soon as feasible, and plans should be made as early as during the IVC filter implant. For those that do develop complications, clinical judgement must be exercised in management, and open surgical, endovascular or even conservative management strategies can be viable options and should be discussed in a multidisciplinary setting.

Atherectomy to treat femoropopliteal atherosclerotic disease.

Atherectomy as an endovascular modality to treat peripheral arterial disease has gained traction over the past 10 years. Unlike most other available technologies, atherectomy works by physically debulking atherosclerotic plaque via a variety of mechanisms being the femoropopliteal segment the most targeted one. The aims of this review were to detail the types of atherectomy available, existing evidence available for atherectomy use in the femoropopliteal segment as compared to other interventions, critical appraisal of its current use and the possible influences on its indication. Future steps regarding atherectomy usage and data presentation are also described.

Selection of Beauveria bassiana (Bals.) Vuill. and Metarhizium anisopliae (Metsch.) Sorok. strains for control of Cornitermes cumulans (Kollar)

Fifty strains of the entomopathogenic fungi Beauveria bassiana (Bals.) Vuill. and Metarhizium anisopliae (Metsch.) Sorok. were tested against the termite Cornitermes cumulans. In the first phase of the experiments, several bioassays were conducted and the five best strains were selected. The criterion for strain selection during this phase was the confirmed mortality above 50 percent five days after application of the fungus. Three M. anisopliae and two B. bassiana strains were the most virulent. The second phase of the experiments consisted of a bioassay and a conidial production test using a rice medium. The best M. anisopliae and B. bassiana strains were selected using both the confirmed insect mortality nine days after application of the fungus and the yield of conidia. Considering results from the bioassay, M. anisopliae 1037 showed the highest confirmed (57.8 percent) and total (89.2 percent) mortalities after nine days. Among the B. bassiana strains, 447 was the most virulent with confirmed and total mortalities of 45.9 percent and 89.8 percent, respectively. M. anisopliae 1037 had the highest conidial yield with mean of 3.37 x 10(12) conidia/kg of rice, followed by B. bassiana strain 447 with 2.66 x 10(12) conidia/kg of rice. The M. anisopliae strain 1037 was the highest virulent followed by B. bassiana strain 447. This strains showed the greatest potential as agents to be used in biological control programs against C. cumulans.

Nesta pesquisa foram testados cinqüenta isolados dos fungos entomopatogênicos Beauveria bassiana (Bals.) Vuill. e Metarhizium anisopliae (Metsch.) Sorok. sobre Cornitermes cumulans. Na primeira fase foram realizados vários bioensaios, selecionando-se os 5 melhores isolados. O critério usado para a seleção foi a mortalidade confirmada acima de 50 por cento, no quinto dia após a aplicação. Três isolados de M. anisopliae e dois de B. bassiana foram os mais virulentos. A segunda fase de seleção constou de um bioensaio e um teste de produção de conídios em meio de arroz, selecionando-se o melhor isolado de M. anisopliae e de B. bassiana. Os critérios adotados foram: mortalidade confirmada até ao nono dia após a inoculação e quantidade de conídios produzidos. Considerando os resultados do bioensaio, o isolado 1037 M. anisopliae foi o que apresentou maior média de mortalidade confirmada (57,8 por cento) e mortalidade total (89,2 por cento), decorridos nove dias da inoculação. Dos isolados de B. bassiana, o 447 foi o mais virulento, causando mortalidade confirmada média de 50,5 por cento e total de 89,8 por cento. O isolado 1037 de M. anisopliae foi o mais produtivo, com produções médias de 3,37 x 10(12) conídios/kg de arroz, seguido do 447 com 2,66 x 10(12) conídios/kg de arroz. Estes isolados possuem grande potencial para utilização em programas de controle biológico de C. cumulans.