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Characterization along with adaptation involving Caldicellulosiruptor stresses to improve sugar amounts, targeting increased hydrogen production via lignocellulosic hydrolysates.
Introduction Intermittent claudication (IC) and chronic limb-threatening ischemia (CLTI) are both associated with a decreased health status (HS), and possibly quality of life (QOL). A better understanding of the differences in QOL between patients with IC and CLTI could be of additional value in shared decision making. The aim of this study was to compare the QOL at baseline between patients with IC and patients with CLTI. Material and methods The study population was based on two study cohorts, one cohort consisted of patients with IC (ELECT registry), the other cohort of patients with CLTI (KOP-study). Patients with an age of ≥70 years were included. QOL at baseline was measured by the WHOQOL-BREF questionnaire. Non-responders were excluded from data analyses. Student's T-tests and Analysis of Covariance (ANCOVA) analyses were used to compare QOL between the two groups. Outcomes of the ANCOVA analyses were expressed as estimated marginal means. Results In total 308 patients were included, 115 patients with e in QOL.Background The absence of recommendations for the systematic collection of microbiological specimens to help determine the management of infective native aortic aneurysms (INAAs) may lead to diagnostic difficulty and sub-optimal antibiotic treatment. In this review, we attempt to establish recommendations in the field by identifying current strategies for the diagnosis and management of INAA and comparing them with those for infective endocarditis (IE). Methods A systematic literature review of Medline and ScienceDirect databases was performed using PRISMA methodology to identify guidelines for the management of INAA. These guidelines were scrutinised for recommendations concerning the procurement of microbiological specimens according to a defined protocol and involvement of specialists in infectious diseases, and compared with current practice for IE. Results Three guidelines were found to have sections dedicated to INAA. Of these, none provided any recommendations concerning the procurement of microbiological specimens for diagnostic and therapeutic purposes. The guidelines from the American Heart Association recommend that patients with INAA should be managed by a team of specialists (including representation from the fields of infectious diseases and/or microbiology). Current guidelines for the investigation and management of IE provide detailed recommendations concerning the procurement of microbiological specimens for diagnostic and therapeutic purposes, as well as the involvement of specialists in infectious medicine in multidisciplinary management. Conclusion This article emphasises the absence of recommendations for the optimal diagnosis and management of patients with INAAs. Whilst specific research is required to create evidence-based recommendations, application of strategies to identify microorganisms and multidisciplinary team management derived from the management of IE may be both safe and appropriate for the clinical management of this highly complex and heterogeneous group.Objective The comorbidity-polypharmacy score (CPPS) was developed to quantify the severity of comorbidities of geriatric trauma patients. CPPS is the sum of the number of medications and comorbidities, and is thus objective, user-friendly, and potentially adaptable to many clinical situations. We sought to understand if CPPS associates with outcomes and mortality after common vascular surgery procedures. Methods This is a retrospective single center study. A total of 466 patients who underwent carotid endarterectomy, infrainguinal bypass, percutaneous lower extremity revascularization, or endovascular abdominal aortic aneurysm repair at a single medical center were included. CPPS were classified as mild, moderate, severe, and morbid based on scores of 0-7, 8-15, 15-21, and ≥ 21, respectively. Endpoints were reinterventions, 30-day readmission, and mortality. We used Chi-squared tests to analyze differences in categorical variables; Kruskal-Wallis tests to analyze differences in continuous variables; Kaplan-Me existing predictors of patient outcomes and in serving as an adjunctive tool for determining resource allocation and discharge planning in vascular surgery patients.Background Structural heart defects, secondary to congenital malformations, have been commonly repaired by open cardiac surgery. Endovascular technology enables these repairs to be performed with fewer complications and better recovery. However, endovascular therapy can be associated with major complications as device dislocation or embolization. We present the case of migration of an amplatzer occluder device into the abdominal aorta and its surgical retrieval. Clinical case A 10-year-old child with ostium secundum-type interatrial communication underwent endovascular repair in our centre. Cardiologists sorted out the atrial communication by endovascular deployment of an amplatzer device. The 24-hour ultrasound control study showed the loss of the occluder. An angio-CT scan showed the migration of the amplatzer into the juxtarenal abdominal aorta. Initially, an endovascular rescue was attempted, but was not effective. Our vascular team performed a median laparotomy, control of the abdominal aorta proximal to the renal arteries, control of the renal arteries and the infrarenal aorta. We performed a transverse arteriotomy and the material was removed. Subsequently, the arteriotomy was closed directly without any patch. Postoperative evolution was uneventful. Comments Most of the migrations and embolizations of the devices to close interatrial communications remain intracardiac. Although embolization of the abdominal aorta is only reported sporadically, it could cause a major vascular complication. Percutaneous retrieval of the device is currently recommended, with conventional surgery being the efficient treatment in case of endovascular failure or severe damage to the aorta.Objectives This study aims to assess primary bare stenting for iliac Chronic Total Occlusions (CTO) with mid-term follow-up. Methods From April 2013 to May 2016, all patients presenting with symptomatic iliac CTO were treated endovascularly and included in a prospective single-center cohort. Common iliac CTO were treated with balloon-expandable bare metal stents. External iliac lesions were treated with bare self-expandable nitinol stents. Primary endpoint was primary sustained clinical improvement. 49 iliac CTO were treated in 46 patients. Results 22 lesions were located at the level of the common iliac artery (45%), 20 at the external iliac artery (41%), 7 extending to both (14%). Mean stenting length was 114.4±49.8mm. Technical success was 98%. Primary sustained clinical improvement was achieved for 93.4±3.7% of patients at 12 months and 87.7±5.2% at 24 months. 3 in-stent thrombosis were observed with no restenosis in the remaining patients at 24 months. PTC028 Freedom from target lesion revascularization was 93.
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