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Quarterly published in print and online "Inventi Impact: Pathology (Formerly Inventi Impact: Medical Devices)" publishes high quality unpublished as well as high impact pre-published research and reviews catering to the needs of researchers and professionals. The journal focuses on medical devices that improve diagnostic, interventional and therapeutic treatments. It provides special coverage to novel devices that allow new surgical strategies, new methods of drug delivery, or possible reductions in the complexity, cost, or adverse effects of healthcare.
For patients receiving chemotherapy, drugs represent the largest cost. Clinical
chemotherapy Pathways have become a critical strategy to identify unnecessary
drug costs and to implement mechanisms to deliver lower cost alternatives
without sacrificing outcomes or quality of care. This paper describes the
steps of development of a functioning pathways program beginning in an environment
of full-risk capitation, including drugs. The next steps involved
quantitating the potential impact of such a program and then collaborating
with a payer to test the concept. When these studies showed promise, the
practices adopting pathways used them as a backbone for drug management
in the Oncology Care Model. These experiences very likely represent steps in
a continuum towards placing more of the drug delivery costs at risk. The potential
for again considering capitated payments is discussed....
Retinitis pigmentosa (RP) represents a clinically and genetically heterogeneous disease characterized by progressive photoreceptor\nloss. In recent years, research has been rarely made in blood flow affected in RP. The specific mechanism of blood flow affected in\nRP is not completely clear. A number of studies indicated that the decreased blood flow was related to RP. According to clinical\nobservation and treatment experience, Chinese medicine considered that blood stasis runs throughout the RP disease\nprogression, and the blood stasis corresponding to Chinese herbal medicine has a positive effect on the clinical treatment of RP.\nTherefore, we proposed that the decreased blood flow may participate in the lesion. In this article, we will review the findings on\nthe decreased blood flow affected in RP from the perspective of modern medicine and Chinese medicine...
The oncocytic variant of chromophobe renal cell carcinoma (oChRCC) and low-grade oncocytic tumor (LOT) is introduced as new
renal disease entity. Both of these tumors are low-grade malignancies consisting of cells with eosinophilic cytoplasm. Distinguishing
between eosinophilic variant of chromophobe renal cell carcinoma (eCRCC) and oncocytoma is often a diagnostic challenge in
routine surgical pathology. However, oChRCC and LOT might be independent disease entities that might not fit completely into
any of these categories. Histologically, these tumors have greater morphological similarity with oncocytoma than with ChRCC.
However, immunohistochemically, they exhibit diffuse and dense positivity for CK7 and are negative for CD117. In the present
case, we initially had difficulty distinguishing among oncocytoma, eCRCC, and type 2 papillary renal cell carcinoma (2-pRCC).
However, after learning about new disease entities such as oChRCC and LOT, we were able to diagnose this tumor....
Background: Sudden unexpected death of epilepsy (SUDEP) is a severe outcome of epilepsy. This study aimed to\nreport the clinical and pathological findings in patients with SUDEP.\nMethods: The record of patients with sudden death was screened. When the reason of death matched with the\ndefinition of SUDEP, the clinical and pathological data were analyzed. Eleven patients with SUDEP were included in\nthe study.\nResults: Eight patients died after a generalized tonic-clonic seizure, seizures were induced by emotional changes in\nfive patients, four cases were found dead in bed. Carbamazepine was prescribed in six patients. The autopsy\nshowed brain edema and pulmonary edema in all eleven patients. Loss of neurons and gliosis were presented in\nsome brains of SUDEP subjects. The main pathological changes in SUDEP include brain edema, pulmonary edema,\nloss of neurons and gliosis.\nConclusions: Risk factors for SUDEP in the study are generalized tonic-clonic seizure, emotional disturbance and\ncarbamazepine treatment....
Hypertrophic gastropathy is a rare idiopathic hyperproliferative disorder which may present as Menetrierâ??s disease (MD)\ncharacterized by foveolar hyperplasia in the gastric fundus and body. It is often accompanied by a severe loss of plasma proteins\n(including albumin) from the altered gastric mucosa. The disease occurs in two forms, a childhood form due to cytomegalovirus\ninfection and an adult form\n....................
Introduction: We evaluate an innovative device consisting of an enteral feeding tube equipped with a\nphotoplethysmography (PPG) sensor in contact with the duodenal mucosa. This study aims to determine if the\nPPG signal, composed of a continuous (PDC) and a pulsatile part (PAC), is a reliable method to assess gut\nperfusion in a porcine model of septic shock.\nMethod: Fourteen piglets were anesthetized and mechanically ventilated. They were randomly assigned to two\ngroups: the nonseptic (NS) group received an infusion of RingerÃ¢â?¬â?¢s lactate solution (RL) alone, the septic (S) group\nreceived in addition a suspension of live Pseudomonas aeruginosa. Heart rate (HR), pulse oximetry (SpO2), mean\narterial pressure (MAP), cardiac index (CI) and serum lactates were recorded and gut microcirculation (GM) was\nmonitored with a laser Doppler probe applied on the duodenal serosa. PDC and PAC were given by the PPG\nprobe inserted in the duodenum. Data was collected every 15 minutes (t0, t15Ã¢â?¬Â¦) during 150 minutes (t150).\nAfter administration of the bacteria suspension (t0), resuscitation maneuvers were performed following a defined\nalgorithm. GM PAC, and PDC were expressed as variation from baseline (GMvar, PACvar, PDCvar). Analysis of variance\n(ANOVA) with repeated measures was performed to compare hemodynamic variables, with Bonferroni correction\nas post hoc analysis on t0, t60 and t150.\nResults: One piglet was withdrawn from analysis due to a defective probe. S group (six piglets) received\nresuscitation therapy while NS group (seven piglets) did not. A significant group effect was found for the all\nparameters except HR. Post hoc analysis found a significant decrease for GM and PAC at t60. The correlation between\nPAC, PDC and microcirculatory parameters were as follows: rPACvar-GMvar = 0.496, P <0.001, rPDCvar-GMvar = 0.244; P = 0.002.\nIn the septic group, correlations were as follows: rPAC-lactate = ?0.772, P <0.001; rPDC-lactate = ?0.681, P <0.01). At the\nonset of shock, a decrease of PAC, PDC and GM occurred before the alteration of MAP.\nConclusions: PAC and PDC decreased at the onset of shock and were correlated with GM and lactate. These results\nconfirm that PPG signal reliably reflects the early perfusion alteration of the gut. Further studies should assess the\nclinical use of this device....
Purpose: Urinary pH is an important factor linked to renal stone disease and a useful marker in the treatment of\nurolithiasis. Although the gold standard for measuring urinary pH utilizes a glass electrode and a pH meter, at\npresent dipstick testing is largely used to estimate urinary pH. However, the accuracy and precision of this method\nmay be insufficient for making clinical decisions in patients with lithiasis. The aim of this study is to describe a new\ndevice for urinary pH testing.\nMethods: The device includes a pH sensor based on differential measurement of an ISFET-REFET pair. The drawbacks\nassociated with this type of configuration, namely short lifetime and manual fabrication, have been overcome in\nthe prototype. An automatic one point calibration is performed when turning on the system. Two buffer solutions\nwere utilized to determine the intra- and inter-day precision of the device. The pH of 30 fresh human urine\nsamples was measured using a pH-meter, a dipstick and the new electronic device.\nResults: In some cases, dipstick measurements differed from those of the pH meter by more than 0.40 units, a\nclinically relevant discrepancy, whereas none of the measurements made with the new electronic device differed\nfrom the results of the pH-meter by more than 0.1 pH units.\nConclusions: This new electronic device has the possibility to be used by stone-formers to control their urinary\npH at home, increasing the tools available for stone prevention and prophylaxis...
The paper demonstrates the feasibility of the gel-clot method for the analysis of bacterial endotoxins in water extracts of ultrapure\nparaffin oil which is a water insoluble oily medical device. Because ultrapure paraffin oil is water insoluble oily liquid, the ultrapure\nparaffin oil (10 mL) was shaken with 10mL water for 15 minutes at 2000 rpm, the endotoxin present was extracted to the aqueous\nphase without interference inhibition/enhancement of the product, the recovery of the endotoxin added to the ultrapure paraffin\noil was determined. A validation study confirmed that endotoxins present in ultrapure paraffin oil which is water insoluble liquid\nmedical device pass over into the aqueous phase at concentrations of 20, 10, and 5 EU/mL with recoveries of 94.2% to 111%. So the\nconclusion is that the gel-clot test is suitable for detecting bacterial endotoxins in ultrapure paraffin oil which is a water insoluble\noily medical device....
Silver is used widely in wound dressings and medical devices as a broad-spectrum antibiotic. Metallic silver and most inorganic\r\nsilver compounds ionise in moisture, body fluids, and secretions to release biologically active Ag+. The ion is absorbed into the\r\nsystemic circulation from the diet and drinking water, by inhalation and through intraparenteral administration. Percutaneous\r\nabsorption of Ag+ through intact or damaged skin is low. Ag+ binds strongly to metallothionein, albumins, and macroglobulins\r\nand is metabolised to all tissues other than the brain and the central nervous system. Silver sulphide or silver selenide precipitates,\r\nbound lysosomally in soft tissues, are inert and not associated with an irreversible toxic change. Argyria and argyrosis are the\r\nprinciple effects associated with heavy deposition of insoluble silver precipitates in the dermis and cornea/conjunctiva.Whilst these\r\nchanges may be profoundly disfiguring and persistent, they are not associated with pathological damage in any tissue. The present\r\npaper discusses the mechanisms of absorption and metabolism of silver in the human body, presumed mechanisms of argyria and\r\nargyrosis, and the elimination of silver-protein complexes in the bile and urine. Minimum blood silver levels consistent with early\r\nsigns of argyria or argyrosis are not known. Silver allergy does occur but the extent of the problem is not known. Reference values\r\nfor silver exposure are discussed....
The knowledge and compliance with regulatory requirement is a key to success in development and marketing of medical devices. High quality and well-designed medical devices are necessary to provide safe and effective clinical care for patients as well as to ensure the health and safety of professional and lay device users. For this purpose one have to review the regulations in different countries for assuring safety and efficacy of medical devices.The primary goal is to protect public health and safety. A regulatory system should ensure that valuable new technologies are made available to the clinical community and to patients and consumers expeditiously while preventing unsafe or ineffective devices from reaching the market.. Regulatory decisions must be based on strong and clear science, free of external influences and consistent with the directives of law. As the guarantor of public health, enforcement of the law must be vigorously, fairly and uniformly carried out and appropriate regulatory and legal actions taken against violators. Government-prescribed rules and procedures must be clearly articulated for those who must comply with them....
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