BAPJ69-4A: a yeast two-hybrid strain for both positive and negative genetic selection.

Genetic selection systems, such as the yeast two-hybrid system, are efficient methods to detect protein-protein and protein-ligand interactions. These systems have been further developed to assess negative interactions, such as inhibition, using the URA3 genetic selection marker. Previously, chemical complementation was used to assess positive selection in Saccharomyces cerevisiae.

Effect of thoracic epidural analgesia on clinical outcomes following transapical transcatheter aortic valve implantation.

Objective: To determine the impact of perioperative thoracic epidural analgesia (TEA) on acute and late outcomes following transapical transcatheter aortic valve implantation (TA-TAVI).

Patients And Intervention: A total of 135 consecutive patients who underwent TA-TAVI were included. All patients received catheter-based pain control, either via TEA (TEA group, n=74) or intercostal local analgesia with a catheter placed at the surgical incision site (non-TEA group, n=61), depending on the preference of the anaesthesiologist responsible for the case.

International Association for Hospice and Palliative Care (IAHPC) List of Essential Practices in Palliative Care.

The objective of this study was to identify, through a consensus process, the essential practices in primary palliative care. A three-phase study was designed. Phase 1 methods included development of a working group; a literature review; development of a baseline list of practices; and identification of levels of intervention.

The use of dexmedetomidine in anesthesia and intensive care: a review.

The alpha-2 agonist dexmedetomidine is being increasingly used for sedation and as an adjunctive agent during general and regional anesthesia. It is used in a number of procedures and clinical settings including neuroanesthesia, vascular surgery, gastrointestinal endoscopy, fiberoptic intubation, and pediatric anesthesia. The drug is also considered a nearly ideal sedative agent in the intensive care setting.

Anesthesia for bronchoscopy.

Bronchoscopic procedures are at times intricate and the patients often very ill. These factors and an airway shared with the pulmonologist present a clear challenge to anesthesiologists. The key to success lies in the understanding of both the underlying pathology and procedure being performed combined with frequent two-way communication between the anesthesiologist and the pulmonologist.

Transcatheter aortic valve implantation using the slow balloon inflation technique: making balloon-expandable valves partially repositionable.

In transcatheter aortic valve implantation procedures using balloon-expandable valves, the valve is deployed by rapid balloon inflation within a short period of rapid ventricular pacing. This system and deployment technique is generally considered to be nonrepositionable. We illustrate with two cases (transapical and transfemoral) the possibility to partially reposition the valve during its deployment if a slow balloon inflation technique were employed-a technique that may minimize the risk of valve mal-positioning and its attendant complications.

The impact of complete revascularization on long-term survival is strongly dependent on age.

Background: Complete revascularization during coronary artery bypass grafting (CABG) has been reported to be associated with better short-term and long-term outcomes. We hypothesized that the survival benefit of complete revascularization would be less in old patients than in young patients.

Methods: We analyzed data from 6,539 consecutive patients who had undergone a first isolated on-pump CABG procedure between 2000 and 2008.

Need for permanent pacemaker as a complication of transcatheter aortic valve implantation and surgical aortic valve replacement in elderly patients with severe aortic stenosis and similar baseline electrocardiographic findings.

Objectives: The aim of this study was to compare the incidence and predictive factors of complete atrioventricular block (AVB) and permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR).

Background: No data exist on the need for PPI after TAVI versus SAVR in patients with similar baseline electrocardiographic (ECG) findings.

Methods: A total of 411 patients with severe aortic stenosis (AS) and no prior pacemaker who underwent TAVI with the balloon-expandable Edwards valve (Edwards Lifesciences, Irvine, California) were matched (1:1) with 411 elderly patients with severe AS who underwent isolated SAVR on the basis of baseline ECG findings.

Predictive factors, efficacy, and safety of balloon post-dilation after transcatheter aortic valve implantation with a balloon-expandable valve.

Objectives: This study sought to evaluate the predictive factors, effects, and safety of balloon post-dilation (BPD) for the treatment of significant paravalvular aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI).

Background: Very few data exist on BPD after TAVI with a balloon-expandable valve.

Methods: A total of 211 patients who underwent TAVI with a balloon-expandable valve were included.

Transaortic transcatheter aortic valve implantation: potential issues associated with the use of the ASCENDRA transapical delivery system.

Transaortic transcatheter aortic valve implantation (TAo-TAVI) has been recently proposed as an alternative to transapical (TA) and transfemoral (TF) approach. We now discuss a technical issue associated with TAo-TAVI related to the use of a delivery system dedicated to the antegrade TA approach. The potential solutions to this issue as well as the potential advantages of the TAo approach are discussed.

Use of the CTrach Laryngeal Mask Airway in adult patients: a retrospective review of 126 cases.

Study Objective: To evaluate the effectiveness of the CTrach Laryngeal Mask Airway (LMA) when used electively.

Design: Retrospective analysis.

Setting: Operating room of an academic hospital.

Out-of-hospital administration of intravenous glucose-insulin-potassium in patients with suspected acute coronary syndromes: the IMMEDIATE randomized controlled trial.

Context: Laboratory studies suggest that in the setting of cardiac ischemia, immediate intravenous glucose-insulin-potassium (GIK) reduces ischemia-related arrhythmias and myocardial injury. Clinical trials have not consistently shown these benefits, possibly due to delayed administration.

Objective: To test out-of hospital emergency medical service (EMS) administration of GIK in the first hours of suspected acute coronary syndromes (ACS).

Impact of residual regurgitation after aortic valve replacement.

Objectives: Mild-to-moderate aortic regurgitation (AR) is not infrequently encountered after standard aortic valve replacement, and reportedly more often following transcatheter aortic valve implantation. Patients are usually managed by observational follow-up, but the clinical significance and natural history of residual AR are unknown. The goal of this study was to determine its impact on the outcome of these patients.

The AFSP Standard - a lesson for law enforcement agencies.

Compliance with the AFSP (Association of Forensic Science Providers) Standard [1] which concerns the formulation of an evaluative opinion requires consideration of the defence case. This can be problematic for forensic scientists working with or for law enforcement agencies. Among the aims of law enforcement agencies is to secure a conviction while in many jurisdictions the forensic scientist owes an overriding duty to the Court.

Prominent septal hypertrophy: a contra-indication for transapical aortic valve implantation?

We report a case of transapical aortic valve implantation in a patient with severe left ventricular hypertrophy. The valve was deployed but failed to attain stable seating because of a hypertrophied septal ridge encroaching on the landing zone. Moderate perivalvar insufficiency was also noted.

Comparison of the Magill forceps and the Boedeker (curved) intubation forceps for removal of a foreign body in a Manikin.

Study Objective: To compare the straight Magill and the curved Boedeker Intubation Forceps in foreign body removal in a manikin with a difficult airway using the videolaryngoscope.

Design: Prospective comparative study.

Setting: University Medical Center.

Transcatheter aortic valve-in-valve-in-valve implantation for a failed xenograft.

A 78-year-old gentleman with a diagnosis of symptomatic severe xenograft aortic stenosis with multiple comorbidities was referred for transcatheter aortic valve implantation, that is, a "valve-in-valve" procedure. Transcatheter aortic valve implantation was performed by transapical approach using a balloon-expandable bioprosthesis. During valve deployment, the prosthesis moved toward the left ventricle and a second balloon-expandable valve was implanted within the first one-a "valve-in-valve-in-valve" to avoid further ventricular embolization of the first bioprosthesis.

Incidence, predictive factors, and prognostic value of new-onset atrial fibrillation following transcatheter aortic valve implantation.

Objectives: This study sought to evaluate the incidence, predictive factors, and prognostic value of new-onset atrial fibrillation (NOAF) following transcatheter aortic valve implantation (TAVI).

Background: Very few data exist on the occurrence of NOAF following TAVI.

Methods: A total of 138 consecutive patients with no prior history of atrial fibrillation (AF) underwent TAVI with a balloon-expandable valve.

Standard clinical risk factors for difficult laryngoscopy are not independent predictors of intubation success with the GlideScope.

Study Objectives: To determine whether the first-attempt tracheal intubation incidence using the GlideScope videolaryngoscope is higher in patients with predicted increased risk of difficult laryngoscopy, and to assess the ability of other a priori defined standard risk factors to predict first-attempt intubation success, in aggregate and by forming scores.

Design: Prospective study.

Setting: Operating room in a tertiary-care academic center.

Unexpected porcelain aorta after sternotomy for aortic valve replacement and coronary artery bypass surgery: aortic balloon valvuloplasty as a bail-out procedure.

We describe the case of a man requiring aortic valve replacement and coronary artery bypass grafting in whom a porcelain aorta was detected at surgery. Two coronary artery bypass grafts were done on a heart beating under cardiopulmonary bypass (CPB). Weaning from CPB was impossible owing to the untouched aortic stenosis.