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   Table of Contents - Current issue
July-September 2020
Volume 3 | Issue 3
Page Nos. 71-98

Online since Wednesday, August 26, 2020

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Clinical efficacy of AngioJet™ mechanical thrombectomy for the treatment of acute lower extremity arterial embolism and thrombosis p. 71
Qibing Niu, Quan Chen, Shiqi Wen, Anqiang Li, Fang Dong, Hao Shi, Wanli Sun
PURPOSE: This study aimed to evaluate the clinical efficacy of mechanical thrombectomy using the AngioJet™ System for the treatment of lower extremity acute arterial embolism and thrombosis. METHODS: A total of twenty patients who had acute arterial embolism and thrombosis of the lower extremity were recruited. All patients were treated using the AngioJet mechanical thrombectomy system. Clinical data of the patients were retrospectively collected. The clinical efficacy of thrombectomy was analyzed. RESULTS: Eighteen (90%) of the twenty patients successfully completed the mechanical thrombectomy using the AngioJet system. The mean time for hospital stay and operation was 4.2 ± 1.4 days and 1.31 ± 0.41 h, respectively. The average doses of urokinase and heparin during operation were 358,000 ± 123,000 U and 45.10 ± 8.30 mg, respectively. Two patients received a complementary treatment of incision for removing the thrombus. Two patients received catheter-directed thrombolysis (CDT) after the mechanical thrombectomy. Five patients received bare-metal stent implantation after balloon expansion. According to the Cooley standard, ten patients were in excellent conditions, six in good conditions, two in fair conditions, and two in poor conditions. No severe bleeding or renal function impairment was observed. CONCLUSION: The AngioJet mechanical thrombectomy system is safe and effective. Combined with the use of CDT and stent implantation, the AngioJet system could lead to quick recoveries of the perfusion of the lower extremity and improve the limb salvage rates, exhibiting excellent clinical values.
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Psychological effects of COVID-19 on the general population: A national cross-sectional survey of china mainland p. 76
Jianming Guo, Lianming Liao, Qinghua Guan, Lianrui Guo, Zhu Tong, Yingfeng Wu, Jian Zhang, Yongquan Gu
OBJECTIVE: We sought to determine the psychological impact of the COVID-2019 outbreak on general population in China. MATERIALS AND METHODS: In 20–22 February 2020, an online survey was implemented using an internet survey tool to collect the information and analyze the effects of the outbreak on the mental health of public population around China. RESULTS: A total of 6471 person responded the survey. About 3.46% of the respondents reported middle and high levels of anxiety while 0.62% of the respondents reported middle and high levels of depression since the COVID-19 outbreak. Respondents who were female younger or had middle-level education were more likely to have anxiety and depression than those who were male, older or had high-level education, respectively. CONCLUSIONS: The prevalence of COVID-19-related anxiety was higher among female and younger respondents, and those with low education. Preventing, detecting, and intervention to mental health conditions should be an important component of public health policy during COVID-19 outbreak.
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The value of outcome measures after endovenous iliofemoral thrombolysis in the big trials p. 82
Niels Bækgaard
Different outcome measures have been used in the last 10–15 years with the publications of some major randomized controlled trials which compared different methods of catheter-directed thrombolysis with anticoagulation in patients with iliofemoral deep-vein thrombosis (DVT). This review addresses the Villalta scale, the Venous Clinical Severity Score, Euro Quality of Life (QOL)-Five Dimensions, the 36-Item Short-Form Health Survey (SF-36), and VEnous INsufficiency Epidemiological and Economic Study on QOL (VEINES-QOL)/symptoms questionnaire as tools for assessing the postthrombotic syndrome (PTS). Patency has also been a part of the results in some trials, although it may be considered as a pseudo end point by some. The newly revised Clinical-Etiologic-Anatomic-Pathophysiologic classification is mentioned as well. It appears that none of the available outcome measures can answer all the questions. The Villalta scale is still the most used outcome measure for PTS after endovenous thrombolysis of iliofemoral DVT. It can be supplemented with the VSCC to differentiate the more severe cases. The generic part of QOL score seems to be useless in assessing changes in PTS, whereas the VEINES scores are useful. More attention should, however, be addressed to report on patency. The better the patency, the better the outcome in PTS. The reason for high rates of PTS can in many cases be the result of poor patency at baseline due to inadequate technical results. Future focus should be on improved patient selection and optimization of treatment strategies.
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Mesenchymal stem cell and hematopoietic stem cell transplantation for vasculitis p. 88
Lianming Liao
Vasculitis is a great therapeutic challenge. Currently, no effective treatments are available. Although biologics are emerging as new therapeutic alternatives, steroids remain the mainstay of the treatment. Similar to other immune-mediated diseases, refractory vasculitis seems to be a potential target of both bone marrow and mesenchymal stem cell transplantation. Preliminary data show stem cell-based therapies are effective for several types of vasculitis that are steroid-refractory. However, clinical data are sparse due to the limited number of patients. More studies are needed to confirm the preliminary results. In addition, optimization of the therapeutical regimens of stem cell transplantation is necessary in future.
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Acute limb ischemia due to tumor embolism p. 94
Thilina Gunawardena, Balasubramanium Saseekaran, Rezni Cassim, Mandika Wijeyaratne
Acute limb ischemia (ALI) is a surgical emergency that should be promptly recognized and treated. Tumor embolism is a rare cause for acute arterial occlusion and ALI. It has been reported with atrial myxomas and primary/secondary tumors of the lung. Here, we present a case report of bilateral lower limb ischemia due to acute occlusion of the aorta by a tumor embolus originating from a disseminated soft tissue sarcoma.
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Primary bilateral thalamic glioma with bipeduncle involvement of midbrain p. 97
Varun Aggarwal, Amit Narang, Chandani Maheshwari, Paramdeep Singh
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