Bicuspid valve CT registry of balloon-expandable TAVR: BETTER TAVR registry.

Background: The anatomic substrate of bicuspid valves may lead to suboptimal TAVR stent expansion and geometry.

Aim: We evaluated determinants of stent geometry in bicuspid valves treated with Sapien transcatheter aortic valve replacement (TAVR) valves.

Methods: A multicenter retrospective registry of patients (February 2019 to August 2022) who underwent post-TAVR computed tomography to determine stent area (vs.

Bespoke valve sizing avoids annular rupture in patients treated with a balloon-expandable transcatheter heart valve.

Background: Annular and left ventricular outflow tract (LVOT) calcification increase the risk of annular rupture following transcatheter aortic valve replacement (TAVR). The outcomes of a strategy of routine use of a balloon-expandable valve (BEV) for all patients irrespective of annular or LVOT calcium is unknown.

Objectives: We evaluated the impact of bespoke sizing on annular rupture in patients treated with a BEV.

One-Year Clinical Outcome of Inspiron Stent in All-Comers Population (Analysis from 790 Consecutive Patients).

Aims: The goal of this study was to evaluate the performance of the Inspiron coronary stent (Scitech Medical™, Goiás, Brazil). The Inspiron sirolimus-eluting stent uses an ultrathin L-605 cobalt-chromium alloy with a 75 m strut thickness platform coated with an abluminal biodegradable polymer. The polymer is eliminated from the body through the tricarboxylic acid cycle in 6-9 months, releasing 80% of the drug within 30 days after its deployment.

Carbohydrate antigen 125 for mortality risk prediction following acute myocardial infarction.

Carbohydrate antigen 125 (CA125) is a congestion and inflammation biomarker and has been proved to be related to a worse prognosis in heart diseases. However, the precise relationship between elevated CA125 in patients with ST-segment elevation myocardial infarction (STEMI) has not yet been sufficiently studied. We set out to determine the association of CA125 with all-cause mortality at 6 months in STEMI.

Predictors of coronary stent thrombosis: a case-control study.

To verify the frequency and predictors associated with stent thrombosis (ST) in a developing country. Observational, case-control study including 2535 consecutive patients undergoing percutaneous coronary intervention (PCI) in two reference hospitals in Brazil, from October 2013 to December 2015. ST patients were matched to controls in a 1:3 ratio for gender, age, procedure indication, and performing hospital.

Carbohydrate antigen 125: a promising tool for risk stratification in heart diseases.

All patients with heart diseases should undergo risk stratification to predict those who are at high risk for short- and long-term adverse outcomes. Carbohydrate antigen 125 (CA125) is a glycoprotein produced by mesothelium that has clinical role in ovarian cancer monitoring. However, as it is not specific for ovarian cells, CA125 could also be used in heart diseases to monitor congestion and inflammation.

P2Y receptor inhibition with prasugrel and ticagrelor in STEMI patients after fibrinolytic therapy: Analysis from the SAMPA randomized trial.

Background: A pharmacodynamic comparison between ticagrelor and prasugrel after fibrinolytic therapy has not yet been performed.

Methods: In the single-center SAMPA trial, 50 consecutive STEMI patients previously treated with clopidogrel and undergoing a pharmacoinvasive strategy were randomized to either a ticagrelor (n=25) 180mg loading dose followed by 90mg bid, or a prasugrel (n=25) 60mg loading dose followed by 10mg/day, initiated after fibrinolytic therapy but before angiography. Platelet reactivity was assessed with the VerifyNow P2Y assay at 0, 2, 6, and 24h after randomization.

Acute kidney injury in a tropical country: a cohort study of 253 patients in an infectious diseases intensive care unit.

Introduction: Acute kidney injury (AKI) is a frequent and potentially fatal complication in infectious diseases. The aim of this study was to investigate the clinical aspects of AKI associated with infectious diseases and the factors associated with mortality.

Methods: This retrospective study was conducted in patients with AKI who were admitted to the intensive care unit (ICU) of a tertiary infectious diseases hospital from January 2003 to January 2012.

Factors associated with thrombocytopenia in severe leptospirosis (Weil's disease).

Objective: This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area.

Methods: This retrospective study included 374 consecutive patients with leptospirosis who were admitted to tertiary hospitals in Fortaleza, Brazil. All patients had a diagnosis of severe leptospirosis (Weil's disease).

Predictors of in-hospital mortality in patients with ST-segment elevation myocardial infarction undergoing pharmacoinvasive treatment.

Objectives: To identify predictors of in-hospital mortality in patients with acute myocardial infarction undergoing pharmacoinvasive treatment.

Methods: This was an observational, prospective study that included 398 patients admitted to a tertiary center for percutaneous coronary intervention within 3 to 24 hours after thrombolysis with tenecteplase. ClinicalTrials.

Relation between the ankle-brachial index and the complexity of coronary artery disease in older patients.

Background: In the elderly, the ankle-brachial index (ABI) has greater than 90% sensitivity and specificity for peripheral artery disease identification. A well-known relation exists between peripheral artery disease and the number of diseased coronary vessels. Yet, other anatomical characteristics have important impacts on the type of treatment and prognosis.

P2Y12 platelet receptors: importance in percutaneous coronary intervention.

Apart from their role in hemostasis and thrombosis, platelets are involved in many other biological processes such as wound healing and angiogenesis. Percutaneous coronary intervention is a highly thrombogenic procedure inducing platelets and monocytes activation through endothelial trauma and contact activation by intravascular devices. Platelet P2Y12 receptor activation by adenosine diphosphate facilitates non-ADP agonist-mediated platelet aggregation, dense granule secretion, procoagulant activity, and the phosphorylation of several intraplatelet proteins, making it an ideal drug target.

Is a drill-less dental filling possible?

Dental caries, a bacterial process that results in the acidic destruction of tooth structure, has historically been managed by the mechanical excavation of diseased tooth structure and then restoration with a synthetic material. The mechanical excavation of the infected site is most commonly achieved by a dental handpiece, or "drill"; this handpiece may induce stress and anxiety in many patients. Alternatively, a drill-less filling will involve the utilization of silver diamine fluoride (38%) to arrest and prevent dental caries, followed by restoration with a bonded filling material to achieve adequate seal at the lesion margins.

Evaluation of a novel basic life support method in simulated microgravity.

Background: If a cardiac arrest occurs in microgravity, current emergency protocols aim to treat patients via a medical restraint system within 2-4 min. It is vital that crewmembers have the ability to perform single-person cardiopulmonary resuscitation (CPR) during this period, allowing time for advanced life support to be deployed. The efficacy of the Evetts-Russomano (ER) method has been tested in 22 s of microgravity in a parabolic flight and has shown that external chest compressions (ECC) and mouth-to-mouth ventilation are possible.

Evaluation of external cardiac massage performance during hypogravity simulation.

Preservation of astronaut crew health during an exploration mission to the Moon or Mars will be crucial to mission success. The likelyhood of a life threatening medical condition occurring during a mission to Mars has been estimated by NASA to be 1% per year. Since basic life support is a vital skill in critical care medicine, plans must be in place for cardiopulmonary resuscitation in both microgravity and hypogravity (i.