Transradial versus transfemoral arterial access in the uterine artery embolization of fibroids

Purpose: Transradial arterial access has become more popular in body interventional procedures but has not been ubiquitously adapted. This retrospective study assesses the efficacy of this approach in uterine artery embolization. Aim of the study was to compare transradial to transfemoral arterial access in patients undergoing uterine artery embolization for the treatment of fibroids. Material and methods: A total of 172 patients underwent uterine artery embolization procedures at our institute from October 2014 to June 2020. Of these, 76 patients had their operations performed via transfemoral access while 96 underwent transradial access. The peak radiation dose, fluoroscopy time, procedure time, total contrast volume, and equipment cost for each procedure were all reviewed to evaluate for statistical differences between the 2 groups. Results: All cases were technically successful without major complications. The average peak skin dose was 2281 mGy, with no statistical difference between the transradial or transfemoral cohorts. Average fluoroscopy time was 25 minutes, also with no statistical difference between the subsets. Mean procedure time was 100 min, and mean contrast volume usage was 138 mL with no statistical differences. Similarly, the average equipment cost was $2204, with no significant differences found between transradial and transfemoral access. Conclusions: With respect to many pertinent radiation parameters, transradial access was evaluated as being an equally efficacious alternative to transfemoral access in uterine artery embolization procedures. The results of this study suggest that transradial access should be considered more often, whenever viable, as an option in the uterine artery embolization treatment of fibroids

Use of the gun-sight technique to create a parallel transjugular intrahepatic portosystemic shunt

A parallel shunt (PS) is often necessary to regain portal decompression in a dysfunctional transjugular intrahepatic portosystemic shunt (TIPS). Here, we successfully utilized the gun-sight technique to create a PS. An 81-year-old male with decompensated NASH cirrhosis and recent TIPS placement presents with recurrent ascites and pleural effusions in the setting of a persistent portosystemic gradient. Due to a lack of access to endovascular ultrasound and complex patient anatomy, a gun-site technique was approached to create a PS (left portal vein [PV] to left hepatic vein [HV]). After the right HV and existing TIPS were accessed via the right internal jugular vein access, the left HV was accessed. Following a left portal venogram, 10 mm snares were placed into the left HV and the left PV. An 18-gauge needle was then fluoroscopically placed through and through both snares. A 0.035 Glidewire was snared with the help of both snares, establishing access from the left HV via the left PV to the right PV. After serial dilation, a roadrunner wire and catheter were placed into the main PV and superior mesenteric vein, followed by stent dilation. Post-TIPS portal venogram showed prompt flow of contrast from the main PV to the right atrium without any stenosis through both TIPS stents in the left and right PVs. Initial and postprocedural TIPS gradients were 24 mm Hg and 6 mm Hg, respectively. Gun-site technique is a valuable technique in creating a parallel TIPS shunt

Synthesis, Structure–Activity Relationships, and Biological Studies of Chromenochalcones as Potential Antileishmanial Agents

Antileishmanial activities of a library of synthetic chalcone analogues have been examined. Among them, five compounds (<b>11</b>, <b>14</b>, <b>16</b>, <b>17</b>, <b>22</b>, and <b>24</b>) exhibited better activity than the marketed drug miltefosine in in vitro studies against the intracellular amastigotes form of Leishmania donovani. Three promising compounds, <b>16</b>, <b>17</b>, and <b>22</b>, were tested in a L. donovani/hamster model. Oral administration of chalcone <b>16</b>, at a concentration of 100 mg/kg of body weight per day for 5 consecutive days, resulted in >84% parasite inhibition at day 7 post-treatment and it retained the activity until day 28. The molecular and immunological studies revealed that compound <b>16</b> has a dual nature to act as a direct parasite killing agent and as a host immunostimulant. Pharmacokinetics and serum albumin binding studies also suggest that compound <b>16</b> has the potential to be a candidate for the treatment of the nonhealing form of leishmaniasis

Nanosilver at the interface of biomedical applications, toxicology, and synthetic strategies

In recent years, the applications of metal in health and industry have been increased due to the possibility that metal nanocolloids can be engineered for desirable surface properties in order to redefine their interaction with biological or environmental components. Metal nanoparticles have always been interesting for the scientist due to their unique surface and size-dependent biomedical properties; however, there are safety concerns for their clinical applications. Among such nanomaterials, an interesting example is of silver nanoparticles (AgNPs). Despite of their remarkable antibacterial and anticancer potential, the AgNPs are still locked out for any possible clinical or biomedical application. Even in current scenario where multidrug-resistant bacterial infections are emerging as a global threat and continuously evolving to resist all upcoming medicinal strategies. This chapter will review those barriers that are deterring the biomedical explorations of AgNPs in context of their synthesis, biomedical applications, toxicology, and future possibilities to address these barriers and improve the biocompatibility and clinical potential

Fundamentals and Applications of Chitosan

International audienceChitosan is a biopolymer obtained from chitin, one of the most abundant and renewable material on Earth. Chitin is a primary component of cell walls in fungi, the exoskeletons of arthropods, such as crustaceans, e.g. crabs, lobsters and shrimps, and insects, the radulae of molluscs, cephalopod beaks, and the scales of fish and lissamphibians. The discovery of chitin in 1811 is attributed to Henri Braconnot while the history of chitosan dates back to 1859 with the work of Charles Rouget. The name of chitosan was, however, introduced in 1894 by Felix Hoppe-Seyler. Because of its particular macromolecular structure, biocompatibility, biode-gradability and other intrinsic functional properties, chitosan has attracted major scientific and industrial interests from the late 1970s. Chitosan and its derivatives have practical applications in food industry, agriculture, pharmacy, medicine, cos-metology, textile and paper industries, and chemistry. In the last two decades, chito-san has also received much attention in numerous other fields such as dentistry, ophthalmology, biomedicine and bio-imaging, hygiene and personal care, veterinary medicine, packaging industry, agrochemistry, aquaculture, functional textiles and cosmetotextiles, catalysis, chromatography, beverage industry, photography, wastewater treatment and sludge dewatering, and biotechnology. Nutraceuticals and cosmeceuticals are actually growing markets, and therapeutic and biomedical products should be the next markets in the development of chitosan. Chitosan is also the N. Morin-Crini (*) · Laboratoire Chrono-environnement, UMR 6249, UFR Sciences et Techniques