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https://www.readbyqxmd.com/read/29240566/a-practical-clinical-approach-to-utilize-cardiopulmonary-exercise-testing-in-the-evaluation-and-management-of-coronary-artery-disease-a-primer-for-cardiologists
#1
Sundeep Chaudhry, Ross Arena, Deepak L Bhatt, Subodh Verma, Naresh Kumar
PURPOSE OF REVIEW: There is growing clinical interest for the use of cardiopulmonary exercise testing (CPET) to evaluate patients with or suspected coronary artery disease (CAD). With mounting evidence, this concise review with relevant teaching cases helps to illustrate how to integrate CPET data into real world patient care. RECENT FINDINGS: CPET provides a novel and purely physiological basis to identify cardiac dysfunction in symptomatic patients with both obstructive-CAD and nonobstructive-CAD (NO-CAD)...
December 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29240265/bone-mineral-density-and-its-serial-changes-are-associated-with-pth-levels-in-pseudohypoparathyroidism-type-1b-patients
#2
Xueying Chu, Yan Zhu, Ou Wang, Min Nie, Tingting Quan, Yu Xue, Wenbo Wang, Yan Jiang, Mei Li, Weibo Xia, Xiaoping Xing
BACKGROUND: Bone responsiveness to serum PTH in pseudohypoparathyroidism 1B (PHP1B) is controversial. OBJECTIVE: Forty-eight PHP1B patients diagnosed by molecular analysis were recruited from 2000 to 2016 from the Peking Union Medical College Hospital. Fifty-five gender-matched non-surgical hypoparathyroidism (NS-HP) patients were selected and included for comparison. METHODS: Basic information, laboratory test and dual-energy X-ray absorptiometry results were collected...
December 14, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29240235/three-dimensional-digital-reconstruction-of-skin-epidermis-and-dermis
#3
P Liu, J-Y Zhu, B Tang, Z-C Hu
This study describes how three-dimensional (3D) human skin tissue is reconstructed, and provides digital anatomical data for the physiological structure of human skin tissue based on large-scale thin serial sections. Human skin samples embedded in paraffin were cut serially into thin sections and then stained with hematoxylin-eosin. Images of serial sections obtained from lighting microscopy were scanned and aligned by the scale-invariant feature transform algorithm. 3D reconstruction of the skin tissue was generated using Mimics software...
December 14, 2017: Journal of Microscopy
https://www.readbyqxmd.com/read/29240109/carry-free-full-symbol-one-step-modified-signed-digit-addition
#4
Shuai Kong, Junjie Peng, Youyi Fu, Xinyu Wei
Optical computing has advantages over electronic computing because it can carry much more information and process more data bits. Providing that carry-look-ahead is applied in optical computing in the same way electronic computing accomplishes addition calculation, it will be more inefficient because of the delay caused by a large number of serial carries. On the basis of the research on relations among the augend, addend, results, and the redundancy of modified signed-digit (MSD) number, the implementation method of carry-free one-step MSD addition is presented...
December 10, 2017: Applied Optics
https://www.readbyqxmd.com/read/29240037/fetal-anemia-causing-hydrops-fetalis-from-an-alpha-globin-variant-homozygous-hemoglobin-constant-spring
#5
Patcharee Komvilaisak, Ratana Komvilaisak, Arunee Jetsrisuparb, Surapon Wiangnon, Junya Jirapradittha, Pakaphan Kiatchoosakun, Goonapa Fucharoen
BACKGROUND: Fetal anemia is often assumed to be due to red cell alloimmunization and Parvovirus infection, and can lead to hydrops fetalis and death in utero. Other causes, such as mutations of hemoglobin alpha, are less commonly considered. METHODS: We report 7 cases with fetal anemia causing hydrops fetalis. Serial Doppler ultrasound for measurement peak systolic velocity (PSV) of middle cerebral artery (MCA) was used for evaluation of fetal anemia. Fetal anemia is suggested if the MCA/PSV ratio is >1...
December 12, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29239689/an-enhanced-mixture-method-for-constructing-gatekeeping-procedures-in-clinical-trials
#6
George Kordzakhia, Thomas Brechenmacher, Eiji Ishida, Alex Dmitrienko, Winston Wenxiang Zheng, David Fuyuan Li
It is increasingly common to encounter complex multiplicity problems with several multiplicity components in confirmatory Phase III clinical trials. These components are often based on several endpoints (primary and secondary endpoints) and several dose-control comparisons. When constructing a multiplicity adjustment in these settings, it is important to control the Type I error rate over all multiplicity components. An important class of multiple testing procedures, known as gatekeeping procedures, was derived using the mixture method that enables clinical trial sponsors to set up efficient multiplicity adjustments that account for clinically relevant logical relationships among the hypotheses of interest...
December 14, 2017: Journal of Biopharmaceutical Statistics
https://www.readbyqxmd.com/read/29239645/keeping-future-rivals-down-temporal-social-comparison-predicts-coworker-social-undermining-via-future-status-threat-and-envy
#7
Susan Reh, Christian Tröster, Niels Van Quaquebeke
The extant social undermining literature suggests that employees envy and, consequently, undermine coworkers when they feel that these coworkers are better off and thus pose a threat to their own current status. With the present research, we draw on the sociofunctional approach to emotions to propose that an anticipated future status threat can similarly incline employees to feel envy toward, and subsequently undermine, their coworkers. We argue that employees pay special attention to coworkers' past development in relation to their own, because faster-rising coworkers may pose a future status threat even if they are still performing worse in absolute terms in the present...
December 14, 2017: Journal of Applied Psychology
https://www.readbyqxmd.com/read/29239210/serum-neuron-specific-enolase-levels-at-presentation-and-long-term-neurological-sequelae-after-acute-charcoal-burning-induced-carbon-monoxide-poisoning
#8
J M Moon, B J Chun, S D Lee, E J Jung
OBJECTIVE: This study aimed to investigate whether clinical parameters and serum neuron-specific enolase (NSE) levels measured at emergency department (ED) presentation help stratify the risk of acute or delayed persistent severe neurological sequelae after acute carbon monoxide (CO) poisoning induced by charcoal burning. METHODS: This retrospective study included 236 patients who suffered from CO poisoning. Demographic information, serum NSE levels measured in the ED, treatment, clinical course, and long-term neurological outcomes were recorded...
December 14, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29239196/clinical-experience-of-positron-emission-tomography-in-infective-aortic-disease
#9
Julian S Tsang, Yiu Che Chan, Yuk Law, Stephen W Cheng
Background Fluorine-18-fluorodeoxyglucose positron-emission tomography with computed tomography has revolutionized medical diagnosis by adding functional activity to anatomic imaging. We report our experience with this technique in patients with mycotic aortic pathology and aortic vascular graft infection. Methods We conducted a retrospective review of a prospective database of patients who underwent 18F-fluorodeoxyglucose positron-emission tomography with computed tomography for suspected infective aortic disease...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29239068/estimating-chronic-hepatitis-c-prognosis-using-transient-elastography-based-liver-stiffness-a-systematic-review-and-meta-analysis
#10
Aysegul Erman, Abhinay Sathya, Austin Nam, Joanna M Bielecki, Jordan J Feld, Hla-Hla Thein, William W L Wong, Paul Grootendorst, Murray D Krahn
Chronic hepatitis C (CHC) is a leading cause of hepatic fibrosis and cirrhosis. The level of fibrosis is traditionally established by histology and prognosis is estimated using fibrosis progression rates (FPRs; annual probability of progressing across histological stages). However, newer non-invasive alternatives are quickly replacing biopsy. One alternative, transient elastography (TE), quantifies fibrosis by measuring liver stiffness (LSM). Given these developments, the purpose of this study was (1) to estimate prognosis in treatment-naïve CHC patients using TE-based liver stiffness progression rates (LSPR) as an alternative to FPRs and (2) to compare consistency between LSPRs and FPRs...
December 14, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29238995/test-dose-pharmacokinetics-in-pediatric-patients-receiving-once-daily-iv-busulfan-conditioning-for-hematopoietic-stem-cell-transplant-a-reliable-approach
#11
Kristina M Brooks, Paul Jarosinski, Thomas Hughes, Elizabeth Kang, Nirali N Shah, John B Le Gall, Dennis D Hickstein, Suk See De Ravin, Jomy M George, Parag Kumar
Intravenous (IV) busulfan test dose pharmacokinetics (PK) has been shown to accurately predict once-daily dose requirements and improve outcomes in adult transplant patients, but there are limited data to support this approach in children. Test doses of busulfan ∼0.8 mg/kg were infused over 2 to 3 hours, followed by serial sampling to 4-6 hours postinfusion in pediatric hematopoietic stem cell transplant recipients (n = 5). Once-daily busulfan doses were calculated based on a myelosuppressive area under the concentration-time curve (AUC) target of ∼3700 to 4000 μmol·min/L and assumed dose-proportionality to the test dose...
December 14, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29238962/population-pharmacokinetics-of-polymyxin-b
#12
Pooja Manchandani, Visanu Thamlikitkul, Yanina Dubrovskaya, Jessica T Babic, David C Lye, Lawrence S Lee, Vincent H Tam
Polymyxin B is used as a last treatment resort for multidrug-resistant Gram-negative bacterial infections. The objectives of this study were to examine the population pharmacokinetics of polymyxin B and investigate factor(s) influencing pharmacokinetic variability. Four serial blood samples each were collected from 35 adult patients at steady state. The concentrations of individual polymyxin B components were analyzed using a validated LCMS/MS assay and combined to derive total concentrations. A maximum likelihood expectation maximization approach was used to fit the data...
December 14, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29238960/is-inpatient-ictal-video-electroencephalographic-monitoring-mandatory-in-mesial-temporal-lobe-epilepsy-with-unilateral-hippocampal-sclerosis-a-prospective-study
#13
Marina K M Alvim, Marcia E Morita, Clarissa L Yasuda, Benito P Damasceno, Tátila M Lopes, Ana Carolina Coan, Enrico Ghizoni, Helder Tedeschi, Fernando Cendes
OBJECTIVE: To compare surgical outcome in mesial temporal lobe epilepsy (MTLE) patients with unilateral hippocampal sclerosis (MTLE-HS) who had or did not have preoperative video-electroencephalographic monitoring (VEEG). METHODS: A prospective study was undertaken with 166 consecutive pharmacoresistant unilateral MTLE-HS patients. All patients were investigated with detailed seizure semiology, serial routine outpatient EEG, magnetic resonance imaging, neuropsychological evaluation, and if necessary, other examinations...
December 13, 2017: Epilepsia
https://www.readbyqxmd.com/read/29238951/pharmacologic-targeting-of-red-blood-cells-to-improve-tissue-oxygenation
#14
James D Reynolds, Trevor Jenkins, Faisal Matto, Ryan Nazemian, Obada Farhan, Nathan Morris, John M Longphre, Douglas T Hess, Richard E Moon, Claude A Piantadosi, Jonathan S Stamler
Disruption of microvascular blood flow is a common cause of tissue hypoxia in disease, yet no therapies are available that directly target the microvasculature to improve tissue oxygenation. Red blood cells (RBCs) auto-regulate blood flow through S-nitroso-hemoglobin (SNO-Hb)-mediated export of nitric oxide (NO) bioactivity. We therefore tested the idea that pharmacological enhancement of RBCs using the S-nitrosylating agent ethyl nitrite (ENO) may provide a novel approach to improve tissue oxygenation. Serial ENO dosing was carried out in sheep (1-400 ppm) and humans (1-100 ppm) at normoxia and at reduced FiO2 ...
December 14, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29238879/the-small-vesicular-culprits-the-investigation-of-extracellular-vesicles-as-new-targets-for-cancer-treatment
#15
REVIEW
Fumihiko Urabe, Nobuyoshi Kosaka, Yusuke Yoshioka, Shin Egawa, Takahiro Ochiya
Extracellular vesicles (EVs) are membranous vesicles released from almost all type of cells including cancer cells. EVs transfer their components, such as microRNAs (miRNAs), messenger RNAs, lipids and proteins, from one cell to another, affecting the target cells. Emerging evidence suggests that reciprocal interactions between cancer cells and the cells in their microenvironment via EVs drive disease progression and therapy resistance. Therefore, understanding the roles of EVs in cancer biology will provide us with new opportunities to treat patients...
December 13, 2017: Clinical and Translational Medicine
https://www.readbyqxmd.com/read/29238804/efficacy-of-high-sensitivity-troponin-t-in-identifying-very-low-risk-patients-with-possible-acute-coronary-syndrome
#16
W Frank Peacock, Brigette M Baumann, Deborah Bruton, Thomas E Davis, Beverly Handy, Christopher W Jones, Judd E Hollander, Alexander T Limkakeng, Abhi Mehrotra, Martin Than, Andre Ziegler, Carina Dinkel
Importance: Physicians need information on how to use the first available high-sensitivity troponin (hsTnT) assay in the United States to identify patients at very low risk for 30-day adverse cardiac events (ACE). Objective: To determine whether a negative hsTnT assay at 0 and 3 hours following emergency department presentation could identify patients at less than 1% risk of a 30-day ACE. Design, Setting, and Participants: A prospective, observational study at 15 emergency departments in the United States between 2011 and 2015 that included individuals 21 years and older, presenting to the emergency department with suspected acute coronary syndrome...
December 13, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29237797/endothelial-progenitor-cells-enhance-blood-brain-barrier-permeability-in-subacute-stroke
#17
João Sargento-Freitas, Sezin Aday, César Nunes, Miguel Cordeiro, Ana Gouveia, Fernando Silva, Cristina Machado, Bruno Rodrigues, Gustavo Cordeiro Santo, Carlos Ferreira, André Amorim, Susana Sousa, Ana Catarina Gomes, Miguel Castelo-Branco, Lino Ferreira, Luís Cunha
OBJECTIVE: To study the association among endothelial progenitor cells (EPCs), subacute blood-brain barrier (BBB) permeability, and clinical outcome after ischemic stroke, determining the micro RNAs of EPCs responsible for good clinical outcome. METHODS: We included consecutive patients with nonlacunar acute ischemic strokes in the territory of a middle cerebral artery and ages between 18 and 80 years. Clinical outcome was defined as modified Rankin Scale score at 3 months...
December 13, 2017: Neurology
https://www.readbyqxmd.com/read/29237474/dimethylarginines-in-patients-with-intracerebral-hemorrhage-association-with-outcome-hematoma-enlargement-and-edema
#18
Hans Worthmann, Na Li, Jens Martens-Lobenhoffer, Meike Dirks, Ramona Schuppner, Ralf Lichtinghagen, Jan T Kielstein, Peter Raab, Heinrich Lanfermann, Stefanie M Bode-Böger, Karin Weissenborn
BACKGROUND: Asymmetric dimethylarginine (ADMA)--the most potent endogenous NO-synthase inhibitor, has been regarded as mediator of endothelial dysfunction and oxidative stress. Considering experimental data, levels of ADMA and its structural isomer symmetric dimethylarginine (SDMA) might be elevated after intracerebral hemorrhage (ICH) and associated with clinical outcome and secondary brain injury. METHODS: Blood samples from 20 patients with acute ICH were taken at ≤ 24 h and 3 and 7 days after the event...
December 13, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29237466/rapid-detection-of-infectious-bovine-rhinotracheitis-virus-using-recombinase-polymerase-amplification-assays
#19
Peili Hou, Hongmei Wang, Guimin Zhao, Chengqiang He, Hongbin He
BACKGROUND: Infectious bovine rhinotracheitis virus (IBRV) is a major pathogen in cattle and has led to significant economic losses to the dairy industry worldwide, and therefore a more optimal method for the rapid diagnosis of IBRV infection is highly needed. In this study, we described the development of a lateral flow dipstrip (LFD) of isothermal recombinase polymerase amplification (RPA) method for rapid detection of IBRV. METHODS: Distinct regions were selected as a candidate target for designing the LFD-RPA primers and probes...
December 13, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29236642/noninvasive-cardiac-radiation-for-ablation-of-ventricular-tachycardia
#20
Phillip S Cuculich, Matthew R Schill, Rojano Kashani, Sasa Mutic, Adam Lang, Daniel Cooper, Mitchell Faddis, Marye Gleva, Amit Noheria, Timothy W Smith, Dennis Hallahan, Yoram Rudy, Clifford G Robinson
BACKGROUND: Recent advances have enabled noninvasive mapping of cardiac arrhythmias with electrocardiographic imaging and noninvasive delivery of precise ablative radiation with stereotactic body radiation therapy (SBRT). We combined these techniques to perform catheter-free, electrophysiology-guided, noninvasive cardiac radioablation for ventricular tachycardia. METHODS: We targeted arrhythmogenic scar regions by combining anatomical imaging with noninvasive electrocardiographic imaging during ventricular tachycardia that was induced by means of an implantable cardioverter-defibrillator (ICD)...
December 14, 2017: New England Journal of Medicine
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