Accessory veins related hand ischemia: A case series.
Ontology highlight
ABSTRACT: Introduction
Arteriovenous fistula is considered as a lifeline for chronic kidney patients undergoing maintenance hemodialysis.Objective
To study the outcome of ligation of the accessory vein causing hyperperfusion and ischemia of the ipsilateral limb.Method
ology: A single institution, single surgeon, in-hospital, retrospective case series of patients presented with alarm symptoms in postoperative period following arteriovenous fistula.Results
A total of 800 AVF were created between 2016 and 2019, out of which 6/800 (0.75 %) patients presented with alarm symptoms related to venous hypertension and underwent accessory vein ligation. All showed normal recovery with complete resolution of symptoms postoperatively.Conclusion
Timely ligation of the accessory vein in patients with arteriovenous fistula with accessory vein related alarm symptoms showed salvage of lifeline and limb with no residual complications during follow-up.
SUBMITTER: Shelar A
PROVIDER: S-EPMC8347829 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BackgroundHand knob infarction is a well-known stroke entity. Based on very limited data, embolic stroke mechanism has been considered the most frequent cause; however, prognosis is considered good. We wanted to shed more light on this phenomenon by assessing a cohort of patients referred to a general hospital stroke unit.MethodsEvery subject admitted to our stroke unit with an acute isolated hand paresis in the period from 2007 to 2012 was identified prospectively. Patients who had suffered from a stroke in the hand motor cortex or an adjacent area explaining the acute loss of hand function were included in the study. The Trial of Org 10172 in Acute Stroke Treatment criteria were used to classify subtypes of stroke according to etiology. The patients were followed up during autumn 2012.ResultsSeventeen subjects were admitted, but in 2 of them symptoms were transitory and magnetic resonance imaging was negative. Two patients were excluded due to persisting sensory deficits. The remaining 13 (11 males and 2 females) patients with an average age of 62.9 (± 13.4) years were included, representing 1.5% of all ischemic strokes diagnosed at the stroke unit in the given period. All patients were right-handed, and the dominant hand was affected only in 4 (31%). The average Medical Research Council's scale score was 3.1 (± 1.4) on admission, and classified as bad. On follow-up, which occurred on average 29.8 (± 19.8) months after the stroke, the score was 4.6 (± 0.4) and was classified as fair to good. No patient experienced a new stroke. The outcome was good to excellent in 10 patients (77%). Two patients died (15%), 1 of probable cardiac arrest and 1 of unknown cause. One patient did not participate in the follow-up. The majority of patients had evidence of both small artery (77%) and large artery (85%) disease. On average, there were 1.6 (± 0.4) new ischemic lesions per patient. Six patients had a solitary lesion (46%). In 5 of them, small artery occlusion was considered the probable stroke mechanism. In 4 cases, the stroke was of undetermined etiology. Three patients had atrial fibrillation, and in 2 of them cardioembolism was the probable stroke mechanism. Two patients with definite large artery atherosclerosis underwent carotid endarterectomy, and 1 of them had comorbid atrial fibrillation.ConclusionStrokes causing isolated hand paresis seem to have a heterogeneous etiology. Prognosis regarding hand function is good, but long-term outcome depends on stroke etiology and secondary prophylaxis.
| S-EPMC3656697 | biostudies-literature
Project description:Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a rare, fatal, developmental lung disorder, which usually presents as persistent pulmonary hypertension of the newborn (PPHN) unresponsive to treatment. The authors present their own experience with three cases admitted during the last 15 years.
| S-EPMC4009999 | biostudies-literature
Project description:Background: With the progress of modernization, treadmill hand injury in pediatric population is taking on a global trend in recent years. The purpose of this study was to investigate the epidemiology and clinical features in a developing country, thereby providing some experience in the treatment and prevention of this particular type of injury. Methods: A 5-year retrospective review of patients with treadmill hand injury in Burn and Plastic Surgery ward at Children' Hospital of Chongqing Medical University was conducted. Demographics, injury details, therapy performed, length of hospital stay, complications, and outcome were analyzed. Results: Forty-six patients were surveyed, with a mean age of 3.5 ± 2.0 years old, including 24 males and 22 females. Injuries (77.8%) occurred between dinner to bedtime, and 95.7% happened indoors. Fingers were the most vulnerable part, of which the middle finger, ring finger, and index finger were the top three ones. The mean body surface area (BSA%) was 0.3 ± 0.2, but at least in deep dermal. Dressing changes, full-thickness skin grafts (FTSG), and Negative Pleasure Wound Therapy (NPWT) assisted FTSG were performed. The scar contracture, as the most severe complication, occurred in 26 patients, of which 22 originally received dressing changes at the time of injury. Conclusion: Treadmill hand injury in children should be highly regarded. Compared with conservative dressing changes, surgical intervention from a professional team may achieve more satisfactory prognosis and fewer complications. A prevention strategy based on "Time-Space-Person" was summarized according to its epidemiological characteristics, may help to decrease the incidence of this specific type of injury theoretically.
| S-EPMC7928388 | biostudies-literature
Project description:To evaluate the Radial Reload Stapler during laparoscopic low anterior resection (LAR) or anterior proctosigmoidectomy for rectal cancer by assessing the primary and secondary endpoints.
| 2133579 | ecrin-mdr-crc
Project description:BACKGROUND:The experience of upper limb loss involves loss of both functional capabilities and the sensory connection of a hand. Research studies to restore sensation to persons with upper limb loss with neural interfaces typically measure outcomes through standardized functional tests or quantitative surveys. However, these types of metrics cannot fully capture the personal experience of living with limb loss or the impact of sensory restoration on this experience. Qualitative studies can demonstrate the viewpoints and priorities of specific persons or groups and reveal the underlying conceptual structure of various aspects of their experiences. METHODS AND FINDINGS:Following a home use trial of a neural-connected, sensory-enabled prosthesis, two persons with upper limb loss were interviewed about their experiences using the sensory restoration system in unsupervised, unconstrained settings. We used grounded theory methodology to examine their experiences, perspectives, and opinions about the sensory restoration system. We then developed a model to describe the impact of sensation on the experience of a hand for persons with upper limb loss. CONCLUSIONS:The experience of sensation was complex and included concepts such as the naturalness of the experience, sensation modality, and the usefulness of the sensory information. Sensation was critical for outcome acceptance, and contributed to prosthesis embodiment, confidence, reduced focus and attention for using the prosthesis, and social interactions. Embodiment, confidence, and social interactions were also key determinants of outcome acceptance. This model provides a unified framework to study and understand the impact of sensation on the experience of limb loss and to understand outcome acceptance following upper limb loss more broadly.
| S-EPMC6355013 | biostudies-literature
Project description:Pathogenic MAGEL2 variants result in the phenotypes of Chitayat-Hall syndrome (CHS), Schaaf-Yang syndrome (SYS) and Prader-Willi syndrome (PWS). We present five patients with mutations in MAGEL2, including the first patient reported with a missense variant, adding to the limited literature. Further, we performed a systematic review of the CHS and SYS literature, assess the overlap between CHS, SYS and PWS, and analyze genotype-phenotype correlations among them. We conclude that there is neither a clinical nor etiological difference between CHS and SYS, and propose that the two syndromes simply be referred to as MAGEL2-related disorders.
| S-EPMC6864226 | biostudies-literature
Project description:Objectives:Long-term paired associative stimulation (PAS) is a non-invasive combination of transcranial magnetic stimulation and peripheral nerve stimulation and leads to improved hand motor function in individuals with incomplete traumatic tetraplegia. Spinal cord injuries (SCIs) can also be induced by neurological diseases. We tested a similar long-term PAS approach in patients with non-traumatic neurological SCI. Methods:In this case series, five patients with non-traumatic tetraplegia received PAS to the weaker upper limb 3 to 5 times per week for 6?weeks. Patients were evaluated by manual muscle testing (MMT) before and immediately after the therapy and at the 1- and 6-month follow-ups. Patients were also evaluated for spasticity, hand mechanical and digital dynamometry, pinch test and Box and Block test. Results:MMT values of all patients improved at all post-PAS evaluations. The mean?±?standard error MMT increase was 1.44?±?0.37 points (p?=?0.043) immediately after PAS, 1.57?±?0.4 points (p?=?0.043) at the 1-month follow-up and 1.71?±?0.47 points (p?=?0.043) at the 6-month follow-up. The pinch test, digital dynamometry and Box and Block test results also improved in all patients. Conclusions:Long-term PAS may be a safe and effective treatment for improving hand function in patients with non-traumatic tetraplegia. Significance:This is the first report demonstrating the therapeutic potential of PAS for neurological SCI.
| S-EPMC6921158 | biostudies-literature
Project description:Clinically isolated syndrome (CIS) refers to the earliest clinical manifestation of multiple sclerosis (MS). Currently there are no prognostic biological markers that accurately predict conversion of CIS to clinically definite MS (CDMS). Furthermore, the earliest molecular events in MS are still unknown. We used microarrays to study gene expression in naïve CD4+ T cells from 37 CIS patients at time of diagnosis and after one year. Supervised machine-learning methods were used to build predictive models of disease conversion. We identified 975 genes whose expression segregated CIS patients into 4 distinct subgroups. A subset of 108 genes further discriminated patients from one of these (group#1) from other CIS patients. Remarkably, 92% of patients from group #1 converted to CDMS within 9 months. Consistent downregulation of TOB1, a critical regulator of cell proliferation, was characteristic of group #1 patients. Decreased TOB1 expression at the RNA and protein levels was also confirmed in experimental autoimmune encephalomyelitis (EAE). Finally, a genetic association was observed between TOB1 variation and MS progression in an independent cohort. These results indicate that CIS patients at high risk of conversion have impaired regulation of T cell quiescence resulting in earlier activation of pathogenic CD4+ cells. Keywords: Disease state: CIS (Clinically Isolated Syndrome - Multiple Sclerosis) versus control. Time series: some patients and controls were resampled approximately one year later
2008-11-26 | GSE13732 | GEO
Project description:We repurposed the antifibrotic drug pirfenidone-which is approved for treatment of idiopathic lung fibrosis-in a series of patients with nonalcoholic steatohepatitis-related cirrhosis. Our report demonstrates the observed improvements in necroinflammation and regression of cirrhosis with pirfenidone use for 12-weeks, associated with classical hepatic repair complex features on follow-up liver biopsies. This novel work could help stimulate further randomized trials of pirfenidone in patients with nonalcoholic steatohepatitis-related liver fibrosis or cirrhosis, for whom no recommended drug treatments exists currently.
| S-EPMC7132022 | biostudies-literature
Project description:Persistent Thebesian veins with the appearance of multiple coronary artery microfistulas are a rare finding and little is known about their physiologic and clinical features. In addition, few reports have demonstrated the perfusion status of patients with Thebesian veins. We report a 75-year-old woman referred for non-ST-elevation myocardial infarction due to prominent Thebesian veins who displayed a perfusion defect in cardiac magnetic resonance imaging. <Learning objective: This case emphasizes that non-obstructive coronary arterial anomaly can lead to myocardial ischemia with angina symptoms and cardiac enzyme rise. Moreover, it provided the typical angiographic appearance of Thebesian vein network and image of myocardial perfusion defect induced by coronary steal.>.
| S-EPMC7125364 | biostudies-literature