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At least 793 records · Page 44Linked to original sources
PubMed1999

Surgical treatment of patent ductus arteriosus (PDA) through mini subaxillary extrapleural approach.

In this study, a new surgical technique for the surgical treatment of patent ductus arteriosus (PDA) is evaluated. The subaxillary extrapleural approach was performed on 836 patients with patent ductus arteriosus. And 20 of these patients were evaluated for postoperative outcomes compared with the routine technique. The results indicated that the new method is safe, less traumatic and has better cosmetic effects. It is concluded in this article that the subaxillary extrapleural approach for PDA is a good modification to the routine surgical technique, that is surgery through the posterolateral approach.

Cardiac Surgical Procedures↗
PubMed1999

Determination of regulatory review period for purposes of patent extension; Therma Choice Uterine Ballon Therapy System. Food and Drug Administration, HHS. Notice.

The Food and Drug Administration (FDA) has determined the regulatory review period for Therma Choice5 Uterine Ballon Therapy System and is publishing this notice of that determination as required by law. FDA has made the determination because of the submission of an application to the Commissioner of Patents and Trademarks, Department of Commerce, for the extension of a patent which claims that medical device.

Catheter Ablation↗
PubMedDate not supplied

[An analysis of surgical treatment methods in femoral neck fractures based on a patent information search].

Patent inventive discoveries in the USSR over the period 1949-1989 are analyzed together with the world patent discoveries, inventions, designs (Ukraine since 1989 included) over the period 1978-1998, which are divided into several groups different in principle, criteria of analysis are singled out, new notions of "cruel", dosage, dynamic compression are determined. By making use of principles of biological low-invasive metallo-osteosynthesis and new notions of "cruel", dosage, and dynamic compression optimal options were found for fixation of fractures of the femoral neck: low-traumatic nail set in the neck at an angle of 130 degrees fit with a small-sized diaphyseal put-in lamina and a local stimulation of union or spongiosa for the neck of the femur screw with an attachment preventing caput femoris rotation, and a springy element combined with a small-sized diaphyseal put-in lamina (that is, a modified system of the dynamic screw for the neck of the femur).

Bone Nails↗
PubMed2000

[Percutaneous closure of patent ductus arteriosus with the Amplatzer duct occluder].

BACKGROUND AND METHODS: Percutaneous closure of a moderate-to-large sized patent ductus arteriosus using multiple coils or a Rashkind double-umbrella may be technically demanding and raises a significant rate of embolization and residual shunting. This is why we tried a new self-expandable device called Amplatzer Duct Occluder to close transvenously large ductuses in eighteen patients at a median age of 2.8 years (range: 0.7 to 34). They had a patent ductus arteriosus with a minimal diameter > 3 mm (mean: 5 +/- 2 mm). The device had a mean diameter of 9 +/- 2 mm and was delivered through a 6F venous sheath. Aortography was done 5 to 10 minutes after the release and follow-up evaluation was performed with color Doppler echocardiography within 24 h, 1 and 3 to 6 months after the procedure. RESULTS: Placement was successful in all but the first patient (95%). Complete closure was achieved immediately in 4/17 patients (24%) and in 13/17 (76%) 24 h later. Two patients were lost for follow-up. Complete closure was confirmed in 14 of the 15 (93%) reviewed patients at 1 and 3 months. In all patients with a ductal diameter < or = 7.5 mm the closure was complete at 1 month. Embolization occurred in one patient with a 9.7 mm duct and surgery was undertaken. A mild and transient hematuria was observed in one patient. No pulmonary artery stenosis nor aortic obstruction were observed on follow-up. CONCLUSION: The Amplatzer Duct Occluder device offers a safe and effective option to treat patients with a ductus arteriosus which minimal diameter is up to 7.5 mm.

Adolescent↗
PubMed2000

[Acute intravascular hemolysis after complete occlusion of a patent ductus arteriosus by detachable coils].

A case of acute intravascular haemolysis after complete occlusion of a patent ductus arteriosus by detachable coils in a 10 months old child is reported. The child had a patent ductus arteriosus, a small secundum atrial defect, mild valvular pulmonary stenosis, and stenosis of branches of the pulmonary artery not diagnosed before closure of the ductus. Haemolysis developed several hours after complete occlusion of the ductus by two detachable coils. The mechanism of the haemolysis was thought to be the presence of metallic spirals in the left pulmonary artery, just beyond stenosis situated at the origin of this artery. Simple balloon dilatation of the left pulmonary artery stenosis resulted in the complete regression of haemolysis.

Arterial Occlusive Diseases↗
PubMed1999

[Percutaneous closure of patent arterial ducts with occluding spring coils].

In recent years percutaneous closure of small and medium-sized patent arterial ducts has been achieved using occluding spring coils. We describe our experience in 93 patients with this technique, using a snare to facilitate the procedure in most. All patients had a clinically apparent patent arterial duct and had undergone attempts at transcatheter closure at a mean age of 6.8 years. In 1, the duct was a residual lesion following surgical ligation, and in 5 it was a residual following attempted closure with the Rashkind double-umbrella. The mean narrowest diameter of the ducts was 2.1 mm. In our 93 patients implantation was successful in 92 (99%), using 1 coil (82 patients), or 2 (10 patients), and in 1 by a combination of a double-umbrella device and an occluding spring coil. The mean fluoroscopic screening time for the whole group was 22.8 minutes, which decreased to 16.8 minutes in the last 50 patients. The coil embolized in 7 patients, but was retrieved in 6 and the ducts were subsequently occluded with another coil. In 1 patient the coil was left in a distal small branch of the left pulmonary artery and the duct was successfully occluded with a double-umbrella. Color-Doppler echocardiogram performed the morning after placement of the coils showed residual leaks in 18%. At mean follow-up of 24.6 months repeat imaging showed residual leaks in only 3 of these patients (3%). We conclude that occlusion of small to medium-sized ducts using coils appears to be effective and is the treatment of choice. The use of a snare to hold and manipulate the coil as it is delivered improves control of the coil, the accuracy of its placement, as well as giving complete occlusion of the ducts.

Child↗
PubMedDate not supplied

[Occlusion of patent ductus arteriosus with a Gianturco-Grifka device. First case at the Instituo Mexicano del Seguro Social (IMSS)].

We present the initial experience of closing of patent ductus arteriosus (PDA) with a new device; Gianturco-Grifka, at the General Hospital of The Medical Center "La Raza". The patient was a 4 year's old girl, in whom we detected continuous murmur in the second intercostal space, echocardiography showed a long conical patent ductus arteriosus 4.9 mm of diameter, systolic pressure of the pulmonary artery was 35 mm Hg with QP/QS 1.6:1. Hemodynamic study revealed a long conical ductus arteriosus 5 mm of diameter, type A1 from Krichenko classification. We proceeded to occlude the PDA with a Gianturco-Grifka device of 7 mm. Immediately after the PDA occlusion the shunt disappeared, there were no complications during the procedure. More cases are needed to determine long term benefits and limitations, of this procedure. However we conclude that technically it is easy to use. There is greater decrease of residual shunt that the one reported with other devices.

Cardiac Catheterization↗
PubMed2000

Transcatheter closure of patent ductus arteriosus.

OBJECTIVE: To present short and intermediate results of catheter closure of patent ductus artereiosus using spring coils and Amplatzer duct occluder. SETTING: Tertiary care referral hospital in New Delhi. METHOD: 121 patients were diagnosed to be having patency of the arterial duct between October 1996 and December 1999. Their ages ranged between 4 mo and 480 mo (mean 80.5 mo). Before August 1998 only spring coils were used as an alternative to surgical closure of the duct, whereas between August 1998 and December 1999 both coils and device were used. RESULTS: Spring coils were attempted in 48, Amplatzer duct occluder in 44 and 29 patients were referred for surgery. Coils were successfully deployed in 42/48 (87.5%) and device in 42/44 (95.5%) patients. Complete closure of the arterial duct was seen in 96% patients in the coil closure group at the end of one year and 100% closure was achieved in the device closure group at the end of 3 months in all the patients followed. Coil embolised in 11 patients, significant stenosis of left pulmonary occurred in one patient and severe hemolysis requiring blood transfusion occurred in one patient after coil closure. Six patients required a second procedure to close the residual shunt within 6 months of the initial coil deployment. One patient had loss of femoral artery pulses in right leg after device closure and required heparin infusion for 48 hours. There were 8 failed attempts. All these patients have been operated successfully. CONCLUSION: Percutaneous closure of the patent ductus arteriosus using Coils or the Amplatzer device is an acceptable method. Small residual shunts are common after the initial procedure especially after coil deployment but most close spontaneously.

Adolescent↗
PubMed2001

Left vocal cord paralysis associated with long-standing patent ductus arteriosus.

SUMMARY: Left vocal cord paralysis in association with patent ductus arteriosus is unusual. We report a patient with long-standing patent ductus arteriosus (PDA) in whom CT studies obtained before and after paralysis developed showed an interval increase in size of the pulmonary trunk. The pathogenesis of left vocal cord paralysis in association with long-standing PDA is discussed.

Aged↗
PubMed2000

Patent protection of pharmaceuticals.

Patenting of biologically active compounds by academic institutions is discussed, with emphasis on patents for already known compounds.

Patents as Topic↗
PubMed2001

Patent ductus arteriosus and cystic periventricular leucomalacia in preterm infants.

AIM: To test the association between early disturbances in hemodynamics induced by left-to-right shunting through the duct and cystic periventricular leucomalacia. PATIENTS: Forty-six preterm infants (27-32 wk) admitted to the neonatal intensive care unit with risk criteria. METHODS: Patent ductus arteriosus was evaluated on days 1 and 4, and was significant (sPDA) in cases of absent or reversed end diastolic flow in the subductal aorta. Resistance index was measured in the anterior cerebral artery and in the subductal aorta. MAIN OUTCOME: Diagnosis of cystic periventricular leucomalacia between day 10 and day 50. RESULTS: The 12 infants who developed cystic periventricular leucomalacia were compared with those who did not. On day 1, sPDA was more frequent (64% vs 26%; p = 0.03) in the cystic periventricular leucomalacia group, left ventricular output was higher (median = 341 vs 279 ml kg-1.min-1; p = 0.005), and rescue surfactant was more frequently used (83% vs 47%; p = 0.03). This latter association was confirmed by multivariate analysis. Resistance index in the anterior cerebral artery was increased in cases of significant patent ductus arteriosus (p < 0.01) and was correlated with resistance index in the subductal aorta. CONCLUSION: On day 1 in this selected population, sPDA has an effect on blood flow velocity waveform in cerebral arteries and is associated with an increase in the emergence of cystic periventricular leucomalacia. This association could be casual rather than causal.

Cerebral Hemorrhage↗
PubMed2001

[Percutaneous closure of patent ductus arteriosus with the Amplatzer duct occluder. Results of 29 patients].

The authors report their experience of percutaneous closure of large patent ductus arteriosus with the Amplatzer duct occluder. The age of the patients ranged from 3 months to 72 years (average 24 months) with body weights of 3.9 to 74 Kg (average 16 Kg). The smallest angiographic diameter of the ductus was 4.0 +/- 1.3 mm at angiography (range 1.8 to 6 mm). The occluder was inserted under local anaesthetic with control aortography in all but one case who required general anaesthesia. In two small babies, the implantation was performed after venous puncture alone with transthoracic echocardiographic monitoring. The implantation was successful in all but one case in which there was a distensible duct. Early angiographic control showed suppression of the shunt in 61% of patients. Secondary haemolysis was observed in one case and was corrected by a second catheterisation 4 days later, with occlusion of the duct with a balloon catheter. The patients were followed up clinically, radiologically and echocardiographically. Doppler echocardiography showed absence of a residual shunt in 24 patients (86%) one month after the procedure, in 25 patients (89%) 3 months after the procedure and in 26 patients (93%) one year after the procedure. Two patients were left with mild or moderate shunts 12 and 16 months after the attempted occlusion. No cases of aortic or pulmonary obstruction were observed. The authors conclude that the Amplatzer duct occluder is a reliable device for closing large patent ductus arteriosus. It may be proposed in young symptomatic children over 4 Kg in body weight. A high rate of occlusion is obtained with a minimal risk of complications.

Adolescent↗
PubMed2001

Antibacterial agents (oxazolidinones, quinolones, macrolides and new agents): patent highlights June to December 2000.

Several patent disclosures were made on oxazolidinone, quinolone, macrolide and new antimicrobial agents between June and December 2000; 26 of these patents are discussed in this review. The exciting report on new oxazolidinone derivatives with potent activity against fastidious Gram-negative organisms is highlighted. Most of the new quinolones are structurally dissimilar to the traditional fluoroquinolones and demonstrate activity against Helicobacter pylori (MIC=0.013 microg/ml). New 14-membered macrolides with broad-spectrum activity including against Mycobacterium avium are also presented. A novel peptidic antibiotic with potent antimicrobial activity against Streptococcus pneumoniae (MIC<0.0005 microg/ml) is also highlighted.

Animals↗
PubMed2000

Canada loses appeal of WTO panel ruling on minimum patent terms.

In the last issue, we reported on a ruling of a Panel of the World Trade Organization (WTO) that Canada was in breach of the international Agreement on Trade-Related Aspects of Intellectual Property Rights (the TRIPS Agreement). The Panel found that Canada's Patent Act does not provide the minimum patent terms required by the trade agreement. Canada appealed that decision, but on 18 September 2000 the WTO Appellate Body upheld the Panel ruling.

Anti-HIV Agents↗
PubMed2001

Canadian court upholds Glaxo's patent on AZT.

In October 2000, the Federal Court of Appeal issued the latest ruling in the ongoing dispute over the validity of Glaxo's Canadian patent for AZT, upholding Glaxo's patent but narrowing the scope of the claims it could validly make. The decision is now on appeal to the Supreme Court of Canada.

Canada↗
PubMed2002

Safety and efficacy of using 0.052-inch Gianturco coil for closure of large ( > or = 4mm) patent ductus arteriosus.

Transcatheter closure of patent ductus arteriosus (PDA) is now a well-established treatment alternative to surgery in many cardiology centers. Of all the methods used, transcatheter coil occlusion is the preferred therapy. For small PDA, the method using 0.038" Gianturco coils has proven safe and effective. However, this therapeutic strategy has encountered some difficulties with large PDA. This study provides an alternative strategy, using 0.052" Gianturco coil and complete closure of residual shunt with multiple coils to close large PDA. Fifteen patients underwent transcatheter coil occlusion of large ( > or = 4mm) patent ductus arteriosus. The intermediate success rate was 86.7%. There were four complications and only two patients had to be referred for surgery.

Adolescent↗
PubMed2002

Transcatheter closure of the patent ductus arteriosus with new-generation devices: comparative data and follow-up results.

BACKGROUND: Many devices currently used for the closure of the patent ductus arteriosus are claimed to be safe and cost-effective, but only few data exist with respect to the gold standard of the Rashkind occluder. The aim of this study was to assess the efficacy and safety of three new different devices and to compare the results to those of a control group of patients carrying a Rashkind occluder. This should provide the basis for further cost-analysis studies. METHODS: The records of all patients who underwent closure of the patent ductus at our Institution from April 1989 to May 2001 were reviewed. Eighty patients (median age 10.3 years, median weight 27.6 kg) were treated (25 with a Rashkind device, 11 with Duct-Occlud coils, 35 with Cook detachable coils, 9 with the Amplatzer system). RESULTS: Kaplan-Meyer estimates of long-term complete occlusion of the ductus showed, compared to the Rashkind device, a significant improvement for the Cook and Amplatzer (p = 0.025 and p = 0.003, respectively) devices but not for the Duct-Occlud coils (p = 0.165). One patient of the Duct-Occlud group (9%) and 3 with the Rashkind device (12%) featured a significant residual shunt and needed a second intervention. The complication rate was 4% for the Rashkind occluder, 5% for the Cook coils, 9% for the Duct-Occlud system, and 11% for the Amplatzer device (p > 0.05). CONCLUSIONS: The new devices are as safe as the Rashkind occluder and provide effective treatment. The Cook coils and the Amplatzer occluder offer better results compared to the Rashkind and Duct-Occlud devices.

Adolescent↗