Objective: Transcarotid artery revascularization (TCAR) is a new surgical option for carotid artery stenosis. While this procedure is optimally performed in hybrid operating rooms (OR), it is currently unclear whether it could be safely performed using portable, C-arm fluoroscopy with equivalent results. The aim of this study is to determine whether there are differences in intraoperative and perioperative outcomes stratified by imaging modality.
Methods: A retrospective review of all TCAR procedures attempted within our health system was performed, capturing all cases between September 2017 and May 2022. Procedures were divided into 2 cohorts, based on whether they were performed in a hybrid OR or with portable, C-arm in a standard OR. Patient demographics, intraoperative results, and postoperative outcomes were compared using univariate strategies.
Results: A total of 503 patients were included for review, of which 422 were performed in a hybrid OR (84%) and 81 were performed using a portable C-arm (16%). Intraoperatively, an increased estimated blood loss (47.7 ± 54.7 vs 26.1 ± 26.9 mLs, < 0.01) and operative time was found in the cases performed in a hybrid OR. However, the fluoroscopy time was lower (4.0 ± 2.6 vs 5.2 ± 5.8 min, = 0.01) in the setting of advanced intraoperative imaging. Postoperatively, we found no differences with respect to myocardial infarction (0.2% vs. 0%, > 0.99), stroke (2.4% vs. 2.5%, = 0.96), or death (0.7% vs. 2.5%, = 0.15) between groups.
Conclusions: While there are some intraoperative variabilities between TCAR performed in hybrid versus standard ORs, postoperative outcomes are comparable. Therefore, the lack of a hybrid room should not be a deterrent to the adoption of TCAR.
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http://dx.doi.org/10.1177/17085381221135702 | DOI Listing |
J Nanobiotechnology
December 2024
Beijing Institute of Radiation Medicine, 27 Taiping Road, Beijing, 100850, China.
In the post-COVID-19 era, drug-resistant bacterial infections emerge as one of major death causes, where multidrug-resistant Acinetobacter baumannii (MRAB) and drug-resistant Pseudomonas aeruginosa (DRPA) represent primary pathogens. However, the classical antibiotic strategy currently faces the bottleneck of drug resistance. We develop an antimicrobial strategy that applies the selective delivery of CRISPR/Cas9 plasmids to pathogens with biomimetic cationic hybrid vesicles (BCVs), irrelevant to bacterial drug resistance.
View Article and Find Full Text PDFBiomed Tech (Berl)
December 2024
Department of Electrical Engineering, 577243 University of Science and Culture, Tehran, Iran.
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View Article and Find Full Text PDFClin Teach
February 2025
Office of Graduate Medical Education, Baylor College of Medicine, Houston, Texas, USA.
Introduction: Although Clinician Educator Tracks (CETs) have been developed for postgraduate trainees, more clarity is needed regarding which competencies are most relevant to resident and fellow physicians (housestaff) seeking to become Clinician Educators (CEs).
Methods: We used the Clinician Educator Milestones, an established framework for competencies at the faculty level, to perform a targeted needs assessment at a large academic institution from April-May 2023. Educational leaders in undergraduate (UME), graduate (GME) and senior medical education (SME) leadership roles were asked to prioritise the Clinician Educator Milestones subcompetencies for a 1-year track.
Eur J Pharm Sci
December 2024
Department of Infectious Diseases, LUCID, Leiden University Medical Center (LUMC), The Netherlands.
Tuberculosis (TB) remains a significant global health challenge, latently affecting around a quarter of the global population. The sole licensed TB vaccine, Mycobacterium bovis Bacillus Calmette-Guérin (BCG), shows variable efficacy, particularly among adolescents and adults, underscoring the pressing need for more effective vaccination strategies. The administration route is crucial for vaccine efficacy, and administration via the skin, being rich in immune cells, may offer advantages over conventional subcutaneous routes, which lack direct access to abundant antigen-presenting cells.
View Article and Find Full Text PDFBMC Med Educ
December 2024
School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
Background: Nursing staff need to be constantly exposed to information systems at work and encounter patients who share medical data obtained from the internet; this was widely observed during the coronavirus disease 2019 (COVID-19) pandemic. Hence, nursing staff should have the necessary skills and education that can help them develop nursing students' informatics competencies. However, research on assessing and improving nursing students' informatics competencies remains scarce.
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