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Satoshi Tobe - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary arteriovenous Fistula ruptured in an adolescent girl 1 week after her mother’s rupture: a report of a case
General Thoracic and Cardiovascular Surgery, 2020Co-Authors: Suguru Mitsui, Shunsuke Tauchi, Yugo Tanaka, Satoshi TobeAbstract:A 14-year-old girl was diagnosed with hemothorax associated with pulmonary arteriovenous Fistula rupture, and emergency surgery was performed. One week before her surgery, her mother at 32 weeks of gestation underwent emergency surgery for hemothorax caused by pulmonary arteriovenous Fistula rupture. Both were diagnosed with hereditary hemorrhagic telangiectasia. The indications for treatment of pulmonary arteriovenous Fistulas in young patients remain controversial because the risk of complications concerning pulmonary arteriovenous Fistula is lower in young patients than in adult patients. We recommend that aggressive treatment should be performed for pulmonary arteriovenous Fistulas in patients with hereditary hemorrhagic telangiectasis with a family history of pulmonary arteriovenous Fistula rupture even if the patient is asymptomatic and young, because such patients may have a high risk of pulmonary arteriovenous Fistula rupture.
Mauno Harkonen - One of the best experts on this subject based on the ideXlab platform.
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hereditary hemorrhagic telangiectasia osler weber rendu disease complicated by pulmonary arteriovenous Fistula and brain abscess
Acta Medica Scandinavica, 2009Co-Authors: Mauno HarkonenAbstract:. A man who developed two brain abscesses was later found to have hereditary hemorrhagic telangiectasia with a pulmonary arteriovenous Fistula. Brain abscess is a known complication of pulmonary arteriovenous Fistulas. About 15 % of patients with hereditary hemorrhagic telangiectasia develop such a Fistula during their lives. Surgical resection of pulmonary arteriovenous Fistulas is recommended because of the risk of severe neurological sequelae.
Suguru Mitsui - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary arteriovenous Fistula ruptured in an adolescent girl 1 week after her mother’s rupture: a report of a case
General Thoracic and Cardiovascular Surgery, 2020Co-Authors: Suguru Mitsui, Shunsuke Tauchi, Yugo Tanaka, Satoshi TobeAbstract:A 14-year-old girl was diagnosed with hemothorax associated with pulmonary arteriovenous Fistula rupture, and emergency surgery was performed. One week before her surgery, her mother at 32 weeks of gestation underwent emergency surgery for hemothorax caused by pulmonary arteriovenous Fistula rupture. Both were diagnosed with hereditary hemorrhagic telangiectasia. The indications for treatment of pulmonary arteriovenous Fistulas in young patients remain controversial because the risk of complications concerning pulmonary arteriovenous Fistula is lower in young patients than in adult patients. We recommend that aggressive treatment should be performed for pulmonary arteriovenous Fistulas in patients with hereditary hemorrhagic telangiectasis with a family history of pulmonary arteriovenous Fistula rupture even if the patient is asymptomatic and young, because such patients may have a high risk of pulmonary arteriovenous Fistula rupture.
Robert M Merion - One of the best experts on this subject based on the ideXlab platform.
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enhanced training in vascular access creation predicts arteriovenous Fistula placement and patency in hemodialysis patients results from the dialysis outcomes and practice patterns study
Annals of Surgery, 2008Co-Authors: Rajiv Saran, Stacey J Elder, David A Goodkin, Takashi Akiba, Jean Ethier, Hugh C Rayner, Akira Saito, Eric W Young, Brenda W Gillespie, Robert M MerionAbstract:OBJECTIVE: To investigate whether intensity of surgical training influences type of vascular access placed and Fistula survival. SUMMARY BACKGROUND DATA: Wide variations in Fistula placement and survival occur internationally. Underlying explanations are not well understood. METHODS: Prospective data from 12 countries in the Dialysis Outcomes and Practice Patterns Study were analyzed; outcomes of interest were type of vascular access in use (Fistula vs. graft) in hemodialysis patients at study entry and time from placement until primary and secondary access failures, as predicted by surgical training. Logistic and Cox regression models were adjusted for patient characteristics and time on hemodialysis. RESULTS: During training, US surgeons created fewer Fistulae (US mean = 16 vs. 39-426 in other countries) and noted less emphasis on vascular access placement compared with surgeons elsewhere. Significant predictors of Fistula versus graft placement in hemodialysis patients included number of Fistulae placed during training (adjusted odds ratio [AOR] = 2.2 for Fistula placement, per 2 times greater number of Fistulae placed during training, P or = 25 (vs. < 25) Fistulae during training. CONCLUSIONS: Surgical training is key to both Fistula placement and survival, yet US surgical programs seem to place less emphasis on Fistula creation than those in other countries. Enhancing surgical training in Fistula creation would help meet targets of the Fistula First Initiative.
Ailsa Hart - One of the best experts on this subject based on the ideXlab platform.
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the rectal mucosa in patients with crohn s anal Fistulae harbours lower numbers of bifidobacteria and the Fistula tracts are devoid of a microbial ecosystem
Gut, 2011Co-Authors: P. Tozer, R. K. S. Phillips, Neil B Rayment, O H Alhassi, A Murguranathan, N Daulatzai, Stella C Knight, Kevin Whelan, Ailsa HartAbstract:Introduction The aetiology of Crohn9s perianal Fistulae remains obscure but genetic, microbial and immune factors play a role. For example, faecal diversion and antimicrobial treatment are partially efficacious in some Crohn9s anal Fistulae. There is evidence of reduced mucosal clostridia and Faecalibacterium prausnitzii and increased enterobacteria (eg, Escherichia coli ) in active Crohn9s disease but the relationship between rectal microbiota and anal Fistulae has not been well documented. Aim To characterise the Fistula tract and rectal microbiota in patients with Crohn9s and idiopathic anal Fistulae using fluorescent in situ hybridisation (FISH). Methods Fistula and/or rectal biopsies were taken from patients with Crohn9s or idiopathic anal Fistulae and isolated luminal Crohn9s disease by a standardised technique, washed in sterile phosphate buffered saline and snap frozen in liquid nitrogen. Frozen sections were hybridised with oligonucleotide probes targeting the microbial 16S rRNA. The hybridised mucosa associated microbiota were identified and quantified. Results 36 patients with anal Fistulae (18 Crohn9s (CPD), 18 idiopathic (IPD)) had rectal and Fistula tract biopsies taken. 12 patients with only luminal Crohn9s disease (no perianal disease (CD)) had rectal samples taken. None of the Fistula tract biopsies from either CPD or IPD patients contained any mucosa-associated bacteria, with the exception of one patient (IPD). This finding was identified using FISH, and confirmed using gram staining and scanning electron microscopy. There were more rectal bifidobacteria in patients with IPD than CPD and CD (p=0.02). Rectal microbiota were otherwise similar across the three groups. In all Crohn9s patients (CPD and CD), a longer duration of disease was associated with a higher number of Bacteroides (p=0.02). Conclusion The study findings suggest that there is altered rectal microbiota (decreased bifidobacteria) in patients with Crohn9s anal Fistulae, but that the Fistula tracts themselves lack mucosa-associated microbiota which may have relevance for the presumed microbial-immune interaction thought to drive inflammation.
