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Atsuo Nakamura, Takushi Ooga, Mitsuharu Matsumoto
The intestinal microbiome produces various metabolites that may harm or benefit the host. However, the production pathways of these metabolites have not been well characterised. The polyamines putrescine and spermidine required for physiological process are also produced by intestinal microbiome. The production and release of these polyamines by microbiome are poorly understood, though we have confirmed that intestinal bacteria produced putrescine from arginine. In this study, we characterised polyamine synthesis by analysing the collective metabolic functions of the intestinal microbiome...
September 5, 2018: Gut Microbes
Piera Capranzano, Nicolas M Van Mieghem, Corrado Tamburino
Aortic stenosis and mitral regurgitation are increasingly treated by percutaneous interventions including transcatheter aortic valve implantation (TAVI) and several mitral valve repair techniques, changing the landscape of valvular therapies in which surgery was predominant. Several randomised studies on TAVI have led to the use of this procedure in patients at intermediate or higher operative risk and have set strong foundations for future trials aiming to expand indications or to overcome several residual issues with TAVI...
August 31, 2018: EuroIntervention
David Heinzmann, Stefan Fuß, Saskia V Ungern-Sternberg, Jürgen Schreieck, Meinrad Gawaz, Michael Gramlich, Peter Seizer
BACKGROUND/AIMS: Fibrotic remodeling of the atria plays a key role in the pathogenesis of atrial fibrillation (AF). As little is known about the contribution of circulating monocytes in atrial remodeling and the pathophysiology of AF, we investigated profibrotic factors in different subsets of circulating monocytes obtained from patients with atrial fibrillation undergoing catheter ablation. METHODS: A 3D high density voltage mapping was performed in sinus rhythm to evaluate the extent of low-voltage areas (LVAs) in the atria of 71 patients with persistent AF...
2018: Cellular Physiology and Biochemistry
Andrew J Schissler, Robert J Gylnn, Piotr S Sobieszczyk, Aaron B Waxman
It is unclear if ultrasound-assisted catheter-directed thrombolysis (UACDT) confers benefit over anticoagulation (AC) alone in the management of intermediate-risk ("submassive") pulmonary embolism (PE), defined by evidence of right ventricular (RV) dysfunction in hemodynamically stable patients. This study sought to evaluate any lasting advantage of UACDT on mortality and resolution of RV dysfunction in intermediate-risk PE at a large academic medical center. Adults aged ≤ 86 years admitted with intermediate-risk PE from 2011 to 2016 were retrospectively identified...
October 2018: Pulmonary Circulation
Peter S Ginn, Serina B Tart, Stephen M Sharkady, Dorothea K Thompson
Cedecea neteri , a member of the Enterobacteriaceae family, has only been identified as a human pathogen in a few previous clinical cases, thus complicating assessment of this organism's pathogenicity and medical relevance. Documented infections attributed to C. neteri primarily involved bacteremia in severely immunocompromised patients. We report a rare case of urinary catheter colonization by a multidrug-resistant C. neteri strain in a patient of advanced age with benign prostatic hyperplasia and other chronic comorbidities...
2018: Case Reports in Infectious Diseases
Cihangir Kaymaz, Ozgur Yasar Akbal, Aykun Hakgor, H Ceren Tokgoz, Ali Karagoz, Ibrahim Halil Tanboga, Seda Tanyeri, Berhan Keskin, Sevim Turkday, Durmus Demir, Cem Dogan, Zubeyde Bayram, Rezzan Deniz Acar, Busra Guvendi, Nihal Ozdemir, Victor F Tapson, Stavros Konstantinides
AIMS: In this single-centre study, we evaluated short- and long-term efficacy and safety outcomes of ultrasound-assisted thrombolysis (USAT) performed in patients with acute pulmonary embolism (PE) at intermediate-high- and high-risk (IHR,HR). METHODS AND RESULTS: Study group comprised retrospectively evaluated 141 patients with PE who underwent USAT. Tissue-type plasminogen activator (t-PA) dosage was 36.1±15.3 mg, and infusion duration was 24.5±8.1 hours. The USAT was associated with improvements in echocardiographic measures of right-ventricle systolic function, pulmonary-arterial (PA) obstruction score, right to left ventricle diameter ratio (RV/LV), right to left atrial diameter ratio and PA pressures, irrespective of the risk (p<0...
August 7, 2018: EuroIntervention
Takeshi Hatanaka, Hirotaka Arai, Satoru Kakizaki
Transcatheter arterial chemoembolization (TACE) is widely accepted as a treatment for patients with hepatocellular carcinoma (HCC) in the intermediate stage according to the Barcelona Clinic Liver Cancer (BCLC) guidelines. Recently, balloon-occluded TACE (B-TACE) was developed in Japan. Despite the lack of a clear definition, B-TACE is generally defined as the infusion of emulsion of chemotherapeutic agents with lipiodol followed by gelatin particles under the occlusion of feeding arteries by a microballoon catheter, which leads to the dense lipiodol emulsion (LE) accumulation in HCC nodules...
July 27, 2018: World Journal of Hepatology
Xiuhua Hu, Minglei Yang, Lu Han, Yujiao Du
To explore the diagnostic performance of a machine-learning-based (ML-based) computed fractional flow reserve (cFFR) derived from coronary computed tomography angiography (CCTA) in identifying ischemia-causing lesions verified by invasive FFR in catheter coronary angiography (ICA). We retrospectively studied 117 intermediate coronary artery lesions [40-80% diameter stenosis (DS)] from 105 patients (mean age 62 years, 32 female) who had undergone invasive FFR. CCTA images were used to compute cFFR values on the workstation...
July 30, 2018: International Journal of Cardiovascular Imaging
Leonardo Rangel-Castilla, Adnan H Siddiqui
We present a case of a patient with pseudotumor cerebri (PC) and transverse/sigmoid junction sinus (TSJS) stenosis treated with stenting venoplasty. A 54-yr-old man with a history of hypertension, hyperlipidemia, and chronic obstructive pulmonary disease presented with subacute onset of progressive headaches, blurred vision, and papilledema. He was clinically diagnosed with PC. Left TSJS stenosis was suspected on magnetic resonance venography and confirmed with digital subtraction angiography and venography...
July 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Yunxia Li, Zhiru Tang, Tiejun Li, C Chen, Feiruo Huang, Jing Yang, Qingqing Xu, Jifu Zhen, Zhaoliang Wu, Mao Li, Jiajing Sun, Jinchao Chen, Xiangxin Zhang, Liuting Wu, Rui An, Shengjun Zhao, Qingyan Jiang, Weiyun Zhu, Yulong Yin, Zhihong Sun
This study was performed to determine if pyruvate, which acts as a critical intermediate in energy metabolism, can substitute the role of glutamate as a metabolic fuel and effectively reduce nitrogen excretion in pigs. First, the experiment in vitro was carried out to investigate the effects of culturing porcine small intestinal epithelial cell line with pyruvate on the oxidation. Then, barrows weighing 40 kg were used in the experiment investigating the changes of nitrogen balance in response to addition of pyruvate to low-protein diets...
July 27, 2018: Journal of Animal Science
Kyle Wang, Ronald C Chen, Brent L Kane, Clinton A Medbery, Kelly J Underhill, James R Gray, Anuj V Peddada, Donald B Fuller
PURPOSE: SBRT is an emerging option for localized prostate cancer. However, there are no standard dosimetric guidelines and normal tissue tolerances for extreme hypofractionation are not well defined. We analyzed dosimetric correlations with patient-reported urinary and bowel quality of life (QOL) on a prospective trial. METHODS: Patients with low/intermediate-risk prostate cancer from 18 institutions were enrolled on a Phase II trial from 2007-2012 and treated using robotic SBRT to 38 Gy in 4 fractions on consecutive days...
July 26, 2018: International Journal of Radiation Oncology, Biology, Physics
Pedro J Prada, María Ferri, Juan Cardenal, Ana García Blanco, Javier Anchuelo, Iván Díaz de Cerio, Andrés Vázquez, Maite Pacheco, Ignacio Raba, Samuel Ruiz
PURPOSE: To evaluate acute and late genitourinary toxicity, the gastrointestinal toxicity, and the long-term biochemical control after high-dose-rate (HDR) monotherapy in one fraction (20.5 Gy). MATERIALS AND METHODS: Between May 2011 and October 2014, 60 consecutive patients with low- and intermediate-risk prostate cancer were treated; the median followup was 51 months (range 30-79). All patients received one implant and one fraction of 20.5 Gy HDR real-time U/S planned with transperineal hyaluronic acid injection into the perirectal...
July 18, 2018: Brachytherapy
Victor F Tapson, Keith Sterling, Noah Jones, Mahir Elder, Uttam Tripathy, Jayson Brower, Robert L Maholic, Charles B Ross, Kannan Natarajan, Pete Fong, Lee Greenspon, Houman Tamaddon, Amir R Piracha, Tod Engelhardt, John Katopodis, Vasco Marques, Andrew S P Sharp, Gregory Piazza, Samuel Z Goldhaber
OBJECTIVES: The aim of this study was to determine the lowest optimal tissue plasminogen activator (tPA) dose and delivery duration using ultrasound-facilitated catheter-directed thrombolysis (USCDT) for the treatment of acute intermediate-risk (submassive) pulmonary embolism. BACKGROUND: Previous trials of USCDT used tPA over 12 to 24 h at doses of 20 to 24 mg for acute pulmonary embolism. METHODS: Hemodynamically stable adults with acute intermediate-risk pulmonary embolism documented by computed tomographic angiography were randomized into this prospective multicenter, parallel-group trial...
July 23, 2018: JACC. Cardiovascular Interventions
Peter Korsten, Eirini Mavropoulou, Susanne Wienbeck, David Ellenberger, Daniel Patschan, Michael Zeisberg, Radovan Vasko, Björn Tampe, Gerhard A Müller
RATIONALE: Central venous catheter (CVC) placement is a standard procedure in critical care. Ultrasound guidance during placement is recommended by current guidelines, but there is no consensus on the best method for evaluating the correct CVC tip position. Recently, the "rapid atrial swirl sign" (RASS) has been investigated in a limited number of studies. OBJECTIVES: We performed a prospective diagnostic accuracy study of focused echocardiography for the evaluation of CVC tip position in our medical ICU and IMC units...
2018: PloS One
Reto Andreas Wildhaber, Dominik Bruegger, Nour Zalmai, Hampus Malmberg, Josef Goette, Marcel Jacomet, Hildegard Tanner, Andreas Haeberlin, Hans-Andrea Loeliger
The rapid progress of invasive therapeutic options for cardiac arrhythmias increases the need for accurate diagnostics. The surface electrocardiogram (ECG) is still the standard of noninvasive diagnostics but lacks atrial signal resolution. By contrast, esophageal electrocardiography (EECG) yields atrial signals of high amplitude and with a high signal-to-noise ratio. Esophageal electrocardiography has become fast and safe, but the mechanical constraints of esophageal measuring catheters and the "random" motion of the catheter inside the subject's esophagus limit the spatial resolution of EECG signals...
August 2018: IEEE Transactions on Biomedical Circuits and Systems
Andres Enriquez, Javad Hashemi, Kevin Michael, Hoshiar Abdollah, Christopher Simpson, Adrian Baranchuk, Damian Redfearn
Purpose: Catheter ablation is an effective therapy for symptomatic atrial fibrillation (AF). The aim of this study was to assess the effect of ibutilide administration in patients with long standing persistent AF undergoing catheter ablation. Methods: We included 25 patients undergoing stepwise catheter ablation with ibutilide 1.0 mg infused prior to mapping and ablation as first step. Procedural and long-term outcomes were compared to a matched cohort of 25 patients in which ibutilide was not used but all other steps remained the same...
April 2018: Journal of Atrial Fibrillation
William Kanipe, Kellie Shobe, Yin Li, Mary Kime, Cheryl A Smith-Miller
This study compared traditional short peripheral catheter (SPC) insertion methods with 2 vein visualization equipment models among a general patient population on a surgical step-down unit based on first-attempt success rates and the time required to achieve catheter insertion. The experiences of clinical nurses using the ultrasound and vein visualization equipment were also explored. No significant statistical differences were found between the insertion methods, based on 90 unique SPC insertion attempts. However, nurses reported that using the vein visualization equipment informed patient care, facilitated communication among members of the health care team, and facilitated second SPC insertion attempts...
July 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Srikanth R Boddu, Pierre Gobin, Cristiano Oliveria, Marc Dinkin, Athos Patsalides
Purpose: To evaluate the alteration of pressure characteristics in the cerebral venous sinuses before and after venous sinus stenting (VSS) using mean sinus pressures (MSPs), sinus pressure gradient (SPG), and sinus pressure pulsatility (SPP) parameters among the idiopathic intracranial hypertension (IIH) patients. Materials and Methods: Prospective evaluation of 45 consecutive IIH patients who underwent VSS at our institution. A written informed consent approved by the Weill Cornell Institutional Review Board was signed by the study participants...
June 2018: Journal of Vascular and Interventional Neurology
N C Burdick Sanchez, J A Carroll, P R Broadway, B E Bass, J W Frank
Lactobacillus acidophilus fermentation products have been used to improve the performance of nursery pigs. However, research on the influence of this supplement on health is lacking. This study was designed to determine if feeding a Lactobacillus acidophilus fermentation product to weaned pigs would reduce stress and acute phase responses (APR) following a lipopolysaccharide (LPS) challenge. Pigs (n=30; 6.4±0.1 kg) were individually housed in stainless steel pens with ad libitum access to feed and water. Pigs were weighed upon arrival, assigned to one of three groups (n=10/treatment), and fed for 18 days: (1) Control, fed a non-medicated starter diet; (2) Control diet with the inclusion of a Lactobacillus acidophilus fermentation product at 1 kg/metric ton (SGX1) and (3) Control diet with the inclusion of a Lactobacillus acidophilus fermentation product at 2 kg/metric ton (SGX2)...
June 20, 2018: Animal: An International Journal of Animal Bioscience
Efthymios D Avgerinos, Zein Saadeddin, Adham N Abou Ali, Larry Fish, Catalin Toma, Maria Chaer, Belinda N Rivera-Lebron, Rabih A Chaer
OBJECTIVE: During the past few years, there has been a surge in the use of catheter-directed thrombolysis (CDT) for acute pulmonary embolism (PE), in the form of either standard CDT or ultrasound-assisted CDT (usCDT). This is a systematic review and meta-analysis of all published series on contemporary CDT for acute PE seeking to determine their clinical efficacy, stratifying by PE severity and CDT modality. METHODS: A comprehensive MEDLINE and Embase search was performed to identify studies that reported outcomes of CDT for acute PE published from 2009 to July 2017...
July 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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