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Robert Lederman

James E Gern, Agustin Calatroni, Katy F Jaffee, Henry Lynn, Amy Dresen, William W Cruikshank, Howard M Lederman, Hugh A Sampson, Wayne Shreffler, Leonard B Bacharier, Peter J Gergen, Diane R Gold, Meyer Kattan, George T O'Connor, Megan T Sandel, Robert A Wood, Gordon R Bloomberg
BACKGROUND: Disadvantaged urban children have high rates of allergic diseases and wheezing, which are diseases associated with Type 2-biased immunity. OBJECTIVE: To determine whether environmental exposures in early life influence cytokine responses which affect the development of recurrent wheezing illnesses and allergic sensitization. METHODS: A birth cohort of 560 urban families was recruited from neighborhoods with high rates of poverty, and 467 (83%) children were followed until 3 years of age...
January 13, 2017: Journal of Allergy and Clinical Immunology
Robert J Lederman, Adam B Greenbaum, Toby Rogers, Jaffar M Khan, Melissa Fusari, Marcus Y Chen
Transcaval access has been used successfully for over 200 transcatheter aortic valve replacements, large-bore percutaneous left ventricular assist devices, and thoracic endovascular aortic aneurysm repairs. This review teaches how to plan transcaval access and closure based on computed tomography. The main planning goals are to: 1) identify calcium-free crossing targets in the abdominal aorta along with optimal fluoroscopic projection angles and level with respect to lumbar vertebrae; 2) identify obstacles such as interposed bowel or pedunculated aortic atheroma; 3) plan covered stent bailout; and 4) identify jeopardized vascular branches such as renal arteries that might be obstructed by bailout covered stents if employed...
January 9, 2017: JACC. Cardiovascular Interventions
Adam B Greenbaum, Vasilis C Babaliaros, Marcus Y Chen, Annette M Stine, Toby Rogers, William W O'Neill, Gaetano Paone, Vinod H Thourani, Kamran I Muhammad, Robert A Leonardi, Stephen Ramee, James F Troendle, Robert J Lederman
BACKGROUND: Transcaval access may enable fully percutaneous transcatheter aortic valve replacement (TAVR) without the hazards and discomfort of transthoracic (transapical or transaortic) access. OBJECTIVES: The authors performed a prospective, independently adjudicated, multicenter, single-arm trial of transcaval access for TAVR in patients who were ineligible for femoral artery access and had high or prohibitive risk of complications from transthoracic access...
February 7, 2017: Journal of the American College of Cardiology
Jaffar Khan, Toby Rogers, Anthony Faranesh, Adam Greenbaum, Vasilis Babaliaros, Marcus Chen, Robert Lederman
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
Toby Rogers, Robert J Lederman
No abstract text is available yet for this article.
December 2016: Circulation. Cardiovascular Imaging
Toby Rogers, Kanishka Ratnayaka, Parag Karmarkar, Adrienne E Campbell-Washburn, William H Schenke, Jonathan R Mazal, Ozgur Kocaturk, Anthony Z Faranesh, Robert J Lederman
BACKGROUND: Diagnostic yield of endomyocardial biopsy is low, particularly in disease that affects the myocardium in a non-uniform distribution. We hypothesized that real-time MRI guidance could improve the yield through targeted biopsy of focal myocardial pathology. METHODS: An animal model of focal myocardial pathology was created by infusing 3mL of fluorescent microspheres (NuFlow Hydrocoat, 15μm diameter, 5 million spheres/mL) followed by 2mL of 100% ethanol to a branch coronary artery...
August 2016: JACC. Basic to Translational Science
Jaffar M Khan, Toby Rogers, William H Schenke, Jonathan R Mazal, Anthony Z Faranesh, Adam B Greenbaum, Vasilis C Babaliaros, Marcus Y Chen, Robert J Lederman
OBJECTIVES: The authors propose a novel transcatheter transection of the anterior mitral leaflet to prevent iatrogenic left ventricular outflow tract (LVOT) obstruction during transcatheter mitral valve replacement (TMVR). BACKGROUND: LVOT obstruction is a life-threatening complication of TMVR caused by septal displacement of the anterior mitral leaflet. METHODS: In vivo procedures in swine were guided by biplane x-ray fluoroscopy and intracardiac echocardiography...
September 12, 2016: JACC. Cardiovascular Interventions
Delaney McGuirt, Jonathan Mazal, Toby Rogers, Anthony Z Faranesh, William Schenke, Annette Stine, Laurie Grant, Robert J Lederman
BACKGROUND: A patient with a history of cancer in remission and congestive heart failure with no acute symptoms presented for a follow-up echocardiogram. The scan revealed a new echodense mass filling his right ventricular apex. An endomyocardial biopsy guided by x-ray fused with magnetic resonance (MR) imaging (XFM) was performed. This case report outlines the steps of XFM image preparation involving MR image acquisition, processing, and coregistration with x-ray fluoroscopy. DISCUSSION: In cases of focal pathology or cardiac masses, endomyocardial biopsy can be challenging because x-ray fluoroscopy guidance offers limited visualization of soft-tissue structures...
July 2016: Radiologic Technology
Souheil-Antoine Younes, Michael L Freeman, Joseph C Mudd, Carey L Shive, Arnold Reynaldi, Soumya Panigrahi, Jacob D Estes, Claire Deleage, Carissa Lucero, Jodi Anderson, Timothy W Schacker, Miles P Davenport, Joseph M McCune, Peter W Hunt, Sulggi A Lee, Sergio Serrano-Villar, Robert L Debernardo, Jeffrey M Jacobson, David H Canaday, Rafick-Pierre Sekaly, Benigno Rodriguez, Scott F Sieg, Michael M Lederman
In HIV-1-infected patients, increased numbers of circulating CD8+ T cells are linked to increased risk of morbidity and mortality. Here, we identified a bystander mechanism that promotes CD8 T cell activation and expansion in untreated HIV-1-infected patients. Compared with healthy controls, untreated HIV-1-infected patients have an increased population of proliferating, granzyme B+, CD8+ T cells in circulation. Vβ expression and deep sequencing of CDR3 revealed that in untreated HIV-1 infection, cycling memory CD8 T cells possess a broad T cell repertoire that reflects the repertoire of the resting population...
July 1, 2016: Journal of Clinical Investigation
Dee Dee Wang, Marvin Eng, Adam Greenbaum, Eric Myers, Michael Forbes, Milan Pantelic, Thomas Song, Christina Nelson, George Divine, Andrew Taylor, Janet Wyman, Mayra Guerrero, Robert J Lederman, Gaetano Paone, William O'Neill
No abstract text is available yet for this article.
November 2016: JACC. Cardiovascular Imaging
Thao P Nguyen, Supriya Shukla, Robert Asaad, Michael L Freeman, Michael M Lederman, Clifford V Harding, Scott F Sieg
OBJECTIVE: To assess CD4 T-cell responsiveness to IL-7 and IFN-α in HIV-infected patients who experience poor recovery of CD4 T-cell counts during therapy (immune failure patients). DESIGN: Responses to IL-7 and IFN-α were compared between HIV-infected immune failure (CD4 cell counts <379 cells/μl) patients and immune success (CD4 cell counts >500 cells/μl) as well as healthy control patients. METHODS: Flow cytometry was used to assess peripheral blood mononuclear cells for IL-7-induced proliferation, CD25 expression, and signaling (signal transducer and activator of transcription 5 phosphorylation and Akt phosphorylation) in CD4 T cells...
August 24, 2016: AIDS
Evan S Lederman, Alison P Toth, Gregory P Nicholson, Robert J Nowinski, George K Bal, Gerald R Williams, Joseph P Iannotti
BACKGROUND: Minimal information is currently available on the outcome of rotator cuff repair reinforced with an extracellular matrix (ECM) graft. Therefore, the purpose of this study was to determine the clinical and radiographic outcome of repair of large rotator cuff tears with ECM graft reinforcement. METHODS: This was a prospective study of 61 shoulders with large repairable rotator cuff tears (3 to 5 cm). The rotator cuff tears were surgically repaired and reinforced with a xenograft ECM graft...
December 2016: Journal of Shoulder and Elbow Surgery
Kanishka Ratnayaka, Toby Rogers, William H Schenke, Jonathan R Mazal, Marcus Y Chen, Merdim Sonmez, Michael S Hansen, Ozgur Kocaturk, Anthony Z Faranesh, Robert J Lederman
OBJECTIVES: The aim of this study was to test the hypothesis that real-time magnetic resonance imaging (MRI) would enable closed-chest percutaneous cavopulmonary anastomosis and shunt by facilitating needle guidance along a curvilinear trajectory, around critical structures, and between a superior vena cava "donor" vessel and a pulmonary artery "target." BACKGROUND: Children with single-ventricle physiology require multiple open heart operations for palliation, including sternotomies and cardiopulmonary bypass...
May 9, 2016: JACC. Cardiovascular Interventions
Toby Rogers, Srijoy Mahapatra, Steven Kim, Michael A Eckhaus, William H Schenke, Jonathan R Mazal, Adrienne Campbell-Washburn, Merdim Sonmez, Anthony Z Faranesh, Kanishka Ratnayaka, Robert J Lederman
BACKGROUND: Radiofrequency ablation for ventricular arrhythmias is limited by inability to visualize tissue destruction, by reversible conduction block resulting from edema surrounding lesions, and by insufficient lesion depth. We hypothesized that transcatheter needle injection of caustic agents doped with gadolinium contrast under real-time magnetic resonance imaging (MRI) could achieve deep, targeted, and irreversible myocardial ablation, which would be immediately visible. METHODS AND RESULTS: Under real-time MRI guidance, ethanol or acetic acid was injected into the myocardium of 8 swine using MRI-conspicuous needle catheters...
April 2016: Circulation. Arrhythmia and Electrophysiology
Oscar Lederman, Kristine Grainger, Robert Stanton, Angela Douglas, Kirrily Gould, Amy Perram, Rishi Baldeo, Theodora Fokas, Fiona Nauman, Amanda Semaan, Jude Hewavasam, Louise Pontin, Simon Rosenbaum
OBJECTIVE: The aim is to identify the role and scope of Accredited Exercise Physiologist (AEP) services in the mental health sector and to provide insight as to how AEPs can contribute to the multidisciplinary mental health team. METHODS: A modified Delphi approach was utilised. Thirteen AEPs with experience in mental health contributed to the iterative development of a national consensus statement. Six mental health professionals with expertise in psychiatry, mental health nursing, general practice and mental health research participated in the review process...
August 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Jonathan R Mazal, Toby Rogers, William H Schenke, Anthony Z Faranesh, Michael Hansen, Kendall O'Brien, Kanishka Ratnayaka, Robert J Lederman
Interventional-cardiovascular magnetic resonance (iCMR) is a promising clinical tool for adults and children who need a comprehensive hemodynamic catheterization of the heart. Magnetic resonance (MR) imaging-guided cardiac catheterization offers radiation-free examination with increased soft tissue contrast and unconstrained imaging planes for catheter guidance. The interventional MR technologist plays an important role in the care of patients undergoing such procedures. It is therefore helpful for technologists to understand the unique iCMR preprocedural preparation, procedural and imaging workflows, and management of emergencies...
January 2016: Radiologic Technology
Adrienne E Campbell-Washburn, Toby Rogers, Burcu Basar, Merdim Sonmez, Ozgur Kocaturk, Robert J Lederman, Michael S Hansen, Anthony Z Faranesh
BACKGROUND: CMR-guidance has the potential to improve tissue visualization during cardiovascular catheterization procedures and to reduce ionizing radiation exposure, but a lack of commercially available CMR guidewires limits widespread adoption. Standard metallic guidewires are considered to be unsafe in CMR due to risks of RF-induced heating. Here, we propose the use of RF-efficient gradient echo (GRE) spiral imaging for reduced guidewire heating (low flip angle, long readout), in combination with positive contrast for guidewire visualization...
December 22, 2015: Journal of Cardiovascular Magnetic Resonance
David A Zidar, Joseph C Mudd, Steven Juchnowski, Joao P Lopes, Sara Sparks, Samantha S Park, Masakazu Ishikawa, Robyn Osborne, Jeffrey B Washam, Cliburn Chan, Nicholas T Funderburg, Adeyinka Owoyele, Mohamad A Alaiti, Myttle Mayuga, Carl Orringer, Marco A Costa, Daniel I Simon, Curtis Tatsuoka, Robert M Califf, L Kristin Newby, Michael M Lederman, Kent J Weinhold
OBJECTIVE: Inflammation in response to oxidized lipoproteins is thought to play a key role in acute coronary syndromes (ACS), but the pattern of immune activation has not been fully characterized. We sought to perform detailed phenotypic and functional analysis of CD8 T lymphocytes from patients presenting with ACS to determine activation patterns and potential immunologic correlates of ACS. APPROACH AND RESULTS: We used polychromatic flow cytometry to analyze the cytokine production profiles of naïve, effector, and memory CD8 T cells in patients with ACS compared with control subjects with stable coronary artery disease...
February 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
Burcu Basar, Toby Rogers, Kanishka Ratnayaka, Adrienne E Campbell-Washburn, Jonathan R Mazal, William H Schenke, Merdim Sonmez, Anthony Z Faranesh, Robert J Lederman, Ozgur Kocaturk
BACKGROUND: Conventional guidewires are not suitable for use during cardiovascular magnetic resonance (CMR) catheterization. They employ metallic shafts for mechanical performance, but which are conductors subject to radiofrequency (RF) induced heating. To date, non-metallic CMR guidewire designs have provided inadequate mechanical support, trackability, and torquability. We propose a metallic guidewire for CMR that is by design intrinsically safe and that retains mechanical performance of commercial guidewires...
November 30, 2015: Journal of Cardiovascular Magnetic Resonance
Adam B Greenbaum, Toby Rogers, Gaetano Paone, Shawn E Flynn, Mayra E Guerrero, William W O'Neill, Robert J Lederman
OBJECTIVES: The purpose of this study was to test whether a microcatheter can safely be advanced across the right atrial appendage to access the pericardium and then withdrawn despite subsequent high-intensity anticoagulation. We also tested whether transatrial pericardial insufflation of carbon dioxide (CO2) would enhance the safety of subxiphoid needle access to the empty pericardium by separating the heart from the anterior pericardium. BACKGROUND: Subxiphoid needle access to the empty pericardium, required for left atrial suture ligation and epicardial ablation for rhythm disorders, risks myocardial or coronary laceration...
October 2015: JACC. Clinical Electrophysiology
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