Irish journal of medical science
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Endovascular repair (EVAR) for large abdominal aortic aneurysm (AAA) in anatomically suitable patients is associated with low early mortality and morbidity. However, EVAR is associated with a significant risk of late complication and a high cumulative re-intervention rate. Many large experienced centres have offered complex EVAR to challenging aortic anatomies such as abdominal aorto-iliac aneurysm (AAIA). We hypothesised that complex EVAR, for AAIA, would be associated with an increased risk of late graft-related complications. ⋯ EVAR can be carried out with low early mortality but has a significant risk of late complication, the commonest of which is endoleak. Complex EVAR for abdominal aorto-iliac aneurysm can be carried out with comparable results to conventional EVAR. However, high rates of persistent endoleak and inferior mesenteric artery patency, and lack of aneurysm sac shrinkage, would suggest they may be at increased risk of late complications and may benefit from enhanced and extended radiological surveillance.
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Sentinel lymph node (SLN) positivity is an important prognostic factor in cutaneous melanoma. A nomogram has been developed at Memorial Sloan-Kettering Cancer Centre (MSKCC) to predict SLN positivity and this may be useful to select patients for SLN biopsy. ⋯ This nomogram is valid and accurate at predicting SLN positivity in an Irish population. This may facilitate the clinical decision to perform a SLN biopsy in malignant melanoma.
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The survival benefit of postoperative adjuvant transcatheter arterial chemoembolization (TACE) remains controversial. ⋯ Postoperative adjuvant TACE improves the survival of patients with HBV-related HCC (stage B) after curative resection compared to surgery only.
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Influence of age and gender on Doppler index of diastolic function in Chinese hypertensive patients.
This paper explores age- and gender-specific changes in Doppler echocardiographic index-E' of left ventricular diastolic function. ⋯ Age-related changes in diastolic indices correlated with gender among hypertensive patients. Diastolic function deteriorated more significantly among elderly women compared with elderly men. The study may explain the increased incidence of diastolic heart failure in elderly women with hypertension.