Three-dimensional electroanatomically guided slow pathway elimination is associated with procedural improvements and clinical benefit in atrioventricular node reentrant tachycardia patients.

Background: Slow pathway (SP) ablation, in the context of atrioventricular node reentrant tachycardia (AVNRT) treatment could result in either complete elimination or only modification of the SP with ambiguity regarding associated benefits. Three-dimensional electroanatomical mapping (3D-EAM) may be used adjunctively aiming to complete SP elimination. Our purpose was to compare a 3D-EAM-based strategy targeting SP elimination to the conventional fluoroscopic approach with respect to clinical outcomes.

Global Leadership Initiative on Malnutrition Criteria Predict Pulmonary Complications and 90-Day Mortality after Major Abdominal Surgery in Cancer Patients.

Although several studies have reported an association between malnutrition and the risk of severe complications after abdominal surgery, there have been no studies evaluating the use of Global Leadership Initiative on Malnutrition (GLIM) criteria for predicting postoperative pulmonary complications (PPCs) following major abdominal surgery in cancer patients. This study aimed to investigate the association among the diagnosis of malnutrition by GLIM criteria, PPCs risk and 90-day all-cause mortality rate following major abdominal surgery in cancer patients. We prospectively analyzed 218 patients (45% male, mean age 70.

Low phospholipid-associated cholelithiasis syndrome: A rare cause of acute pancreatitis that should not be neglected.

Background: Low phospholipid-associated cholelithiasis (LPAC) syndrome is a very particular form of biliary lithiasis with no excess of cholesterol secretion into bile, but a decrease in phosphatidylcholine secretion, which is responsible for stones forming not only in the gallbladder, but also in the liver. LPAC syndrome may be underreported due to a lack of testing resulting from insufficient awareness among clinicians.

Aim: To describe the clinical and radiological characteristics of patients with LPAC syndrome to better identify and diagnose the disease.

The effect of level of injury and physical activity on heart rate variability following spinal cord injury.

Objective/background: To assess frequency domain heart rate variability (HRV) parameters at rest and in response to postural autonomic provocations in individuals with spinal cord injury (SCI) and investigate the autonomic influences on the heart of different physical activities.

Design: Cross-sectional study.

Methods: Ten subjects with complete cervical SCI and fourteen subjects with complete low thoracic SCI were prospectively recruited from the community and further divided in sedentary and physically active groups, the latter defined as regular weekly 4 hour physical activity for the preceding 3 months.

Institutional (local) diagnostic reference levels in fluoroscopically guided spine surgery.

In this study, institutional (local) diagnostic reference levels (LDRLs) and action levels (ALs) for spine interventional procedures are reported. Fluoroscopy time (FT), kerma area product (KAP), cumulative dose (CD), as well as anatomical, clinical and technical factors affecting procedure complexity were recorded for 156 patients who underwent cervical and thoraco-lumbar interventions. Patient entrance surface dose (ESD), effective dose (ED), thyroid absorbed dose and gonadal dose were also estimated, based on KAP measurements.

, a cause of cystitis with malodorous urine in a child: clinical and microbiological challenges.

An infection of the lower urinary tract associated with an extremely unpleasant odour due to in an otherwise healthy 5-year-old boy is described herein. Interestingly, imaging examination revealed the presence of a bladder diverticulum. Routine microbiological examination based on Gram staining, colony morphology and catalase reactivity suggested that the responsible pathogen could belong either to staphylococci, α-haemolytic streptococci or enterococci, which are more common urine isolates.

The role of catheter ablation in the management of patients with implantable cardioverter defibrillators presenting with electrical storm.

Objective: Electrical storm (ES) is not uncommon among patients with an implantable cardioverter defibrillator (ICD) in situ. Catheter ablation (CA) may suppress the arrhythmia in the acute setting and prevent ES recurrence.

Methods: Nineteen consecutive patients with an ICD in situ presenting with ES underwent electrophysiologic studies followed by CA.

The melding of nanomedicine in thrombosis imaging and treatment: a review.

Thromboembolic diseases constitute a plague in our century, wherein an imbalance of hemostasis leads to thrombus formation and vessels constriction reducing blood flow. Hence, the recent rise of nanomedicine gives birth to advanced diagnostic modalities and therapeutic agents for the early diagnosis and treatment of such diseases. Multimodal nanoagents for the detection of intravascular thrombi and nanovehicles for thrombus-targeted fibrinolytic therapy are few paradigms of nanomedicine approaches to overcome current diagnostic treatment roadblocks and persistent clinical needs.

Quantification of Operational Learning in Minimal Invasive Extracorporeal Circulation.

Minimal invasive extracorporeal circulation (MiECC) has initiated important new efforts within science and technology towards a more physiologic perfusion. In this study, we aim to investigate the learning curve of our center regarding MiECC. We studied a series of 150 consecutive patients who underwent elective coronary artery bypass grafting by the same surgical team during the initial phase of MiECC application.

Digoxin in Heart Failure with a Reduced Ejection Fraction: A Risk Factor or a Risk Marker.

Digoxin is one of the oldest compounds used in cardiovascular medicine. Nevertheless, its mechanism of action and most importantly its clinical utility have been the subject of an endless dispute. Positive inotropic and neurohormonal modulation properties are attributed to digoxin, and it was the mainstay of heart failure therapeutics for decades.

Implantable cardioverter defibrillators for primary prevention of sudden death in hypertrophic cardiomyopathy.

Aims: Sudden cardiac death (SCD) may complicate hypertrophic cardiomyopathy (HCM) natural course. Patient selection for implantable cardioverter defibrillator (ICD) therapy in the primary prevention setting is still a challenge.

Methods: Thirty-seven HCM patients with a primary prevention ICD were included.

P wave analysis with wavelets identifies hypertensive patients at risk of recurrence of atrial fibrillation: A case-control study and 1year follow-up.

Aims: Hypertension is a major risk factor for atrial fibrillation (AF); however, reliable non-invasive tools to assess AF risk in hypertensive patients are lacking. We sought to evaluate the efficacy of P wave wavelet analysis in predicting AF risk recurrence in a hypertensive cohort.

Methods: We studied 37 hypertensive patients who presented with an AF episode for the first time and 37 age- and sex-matched hypertensive controls without AF.

Therapeutic management of intraventricular cavernoma: case series and review of the literature.

Intraventricular cavernoma (IVC) is a rare intracranial vascular malformation and only 100 cases of IVC have been described in the literature. Although IVCs share some common characteristics with intraparenchymal cavernomas, they also have some distinct features involving structure, clinical symptoms, radiologic appearance, and onset of symptoms. This review presents our experience, consisting of five IVC cases over a period of 11 years.

Growth factors mediated differentiation of mesenchymal stem cells to cardiac polymicrotissue using hanging drop and bioreactor.

Heart disease is the major leading cause of death worldwide and the use of stem cells promises new ways for its treatment. The relatively easy and quick acquisition of human umbilical cord matrix mesenchymal stem cells (HUMSCs) and their properties make them useful for the treatment of cardiac diseases. Therefore, the main aim of this investigation was to create cardiac polymicrotissue from HUMSCs using a combination of growth factors [sphingosine-1-phosphate (S1P) and suramin] and techniques (hanging drop and bioreactor).

Percutaneous extraction of transvenous permanent pacemaker/defibrillator leads.

Background: Widespread use of cardiovascular implantable electronic devices has inevitably increased the need for lead revision/replacement. We report our experience in percutaneous extraction of transvenous permanent pacemaker/defibrillator leads.

Methods: Thirty-six patients admitted to our centre from September 2005 through October 2012 for percutaneous lead extraction were included.

Gross motor development in full-term Greek infants assessed by the Alberta Infant Motor Scale: reference values and socioeconomic impact.

Objective: The aims of this study were to investigate gross motor development in Greek infants and establish AIMS percentile curves and to examine possible association of AIMS scores with socioeconomic parameters.

Methods: Mean AIMS scores of 1068 healthy Greek full-term infants were compared at monthly age level with the respective mean scores of the Canadian normative sample. In a subgroup of 345 study participants, parents provided, via interview, information about family socioeconomic status.

Significance of the C-caffeine breath test for patients with cirrhosis.

Background: The 13C-caffeine breath test (CBT) is a non-invasive, quantitative test of liver function which has been shown to correlate inversely to the Child-Pugh score. The aim of the study was to determine the utility of CBT in the assessment of cirrhosis and its correlation to the model for end-stage liver disease (MELD) score.

Methods: Thirty-nine patients, 29 with cirrhosis and 10 with chronic liver disease without cirrhosis, and 8 healthy volunteers were included.

Determinants of functional mitral regurgitation severity in patients with ischemic cardiomyopathy versus nonischemic dilated cardiomyopathy.

Aims: Functional mitral regurgitation (MR) is prevalent among patients with left ventricular (LV) dysfunction and is associated with a poorer prognosis. Our aim was to assess the primary determinants of MR severity in patients with ischemic cardiomyopathy (ICM) and nonischemic dilated cardiomyopathy (DCM).

Methods And Results: Patients with functional MR secondary to ICM (n = 55) and DCM (n = 48) were prospectively enrolled.

Pathophysiology-based novel pharmacotherapy for heart failure with preserved ejection fraction.

Heart failure has become increasingly prevalent and poses a significant socioeconomic burden in the developed world. Approximately half of heart failure patients have preserved ejection fraction (HFpEF) and experience an increased morbidity and mortality attributed to the lack of effective therapies and to the presence of comorbidities. Suppression of neurohormonal activation by beta-blockers and renin-angiotensin-aldosterone system inhibitors is the cornerstone in the pharmacotherapy of heart failure with reduced ejection fraction (HFrEF).