Expert review of medical devices
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Expert Rev Med Devices · Nov 2013
ReviewFloTrac/Vigileo system monitoring in acute-care surgery: current and future trends.
As acute critical-care surgery evolves, it is imperative to introduce reliable devices that can intraoperatively assess a patient's cardiovascular functions. Owing to the fact that traditional methods are usually invasive, non- or less-invasive innovations have attracted the attention of clinicians in recent decades. The FloTrac system monitors cardiovascular performance by analyzing peripheral arterial waveforms and a preset database, and it decreases the invasiveness by using a pulmonary arterial catheter. ⋯ The accuracy of the latest third-generation algorithm is controversial in septic conditions, and its use is still unacceptable in liver transplantation. Due to vasoactive challenges, especially in the administration of norepinephrine, a conclusion could not be reached. Clinicians should recognize the appropriate uses and limitations when using the algorithm during acute critical surgeries.
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Expert Rev Med Devices · Sep 2013
ReviewLinear and radial endobronchial ultrasound in diagnosis and staging of lung cancer.
Endobronchial ultrasound (EBUS) in recent years has become a routine diagnostic procedure in bronchology. Linear EBUS shows high diagnostic yield in evaluation of mediastinal lymph nodes. It is mainly used for nodal evaluation in lung cancer, but has also proven to be efficient in diagnostic evaluation of mediastinal masses. ⋯ The application of miniature radial EBUS probes, together with guiding sheaths and other guiding accessories, allow the access to smaller and more peripheral lung lesions. In addition, EBUS bronchoscopy can be utilized for the placement of brachytherapy catheters, or evaluation of the distal bronchi in order to chose between different therapeutic bronchoscopic techniques for desobstruction. An experienced bronchoscopist, availability of ROSE and additional guiding devices might be necessary to accomplish the best possible results of EBUS bronchoscopy.
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Expert Rev Med Devices · May 2013
ReviewTherapeutic time window of noninvasive brain stimulation for pain treatment: inhibition of maladaptive plasticity with early intervention.
Neuromodulatory effects of noninvasive brain stimulation (NIBS) have been extensively studied in chronic disorders such as major depression, chronic pain and stroke. However, few studies have explored the use of these techniques in acute conditions. ⋯ In this review, the authors discuss the potential role of NIBS in blocking maladaptive plasticity using the transition of acute to chronic pain in conditions such as postsurgical pain, central poststroke pain, pain after spinal cord injury and pain after traumatic brain injury as a model. The authors also present suggestions for clinical trial design using NIBS in the acute stage of illnesses.
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The GORE(®) TAG(®) (W. L. ⋯ The Conformable GORE TAG has recently become commercially available and underwent several changes from the original design to help increase compression resistance, expand treatment ranges and oversizing windows, and improve conformability. This article describes the GORE TAG and Conformable GORE TAG devices, their potential uses and the outcomes in treating various aortic pathologies.