Management of isolated native tricuspid valve infective endocarditis by a multidisciplinary program: a single-center retrospective cohort study.

Background: Isolated native tricuspid valve infective endocarditis remains a challenging disease to treat given the large number of patients with substance use disorder. There is limited data on the optimal treatment strategy and the impact of a multidisciplinary endocarditis program on outcomes for this population.

Objectives: To assess the clinical outcomes associated with management of native tricuspid valve infective endocarditis by a multidisciplinary team.

Percutaneous Correction of a Large Left Superior Vena Cava to Left Atrium Fistula.

• Fistula between the PLSVC and the LA is a rare congenital condition. • Patients can present as adults with cerebrovascular accidents and dyspnea. • Percutaneous correction using a covered stent is feasible.

Beyond a team: The comprehensive interdisciplinary endocarditis program in the United States.

Although multidisciplinary teams have been shown to decrease in-hospital mortality for patient with infectious endocarditis, most studies have focused on the inpatient role of these teams, and are primarily based at European tertiary care centers. There is limited literature available on the optimal longitudinal care of this patient population. Here we outline our experience developing an interdisciplinary endocarditis program at the University of Kentucky, which cares for patients from their index hospitalization into the outpatient setting, while also coordinating transfers from regional hospitals and offering education to regional providers.

Caveolin-1 in Müller Glia Exists as Heat-Resistant, High Molecular Weight Complexes.

Caveolin-1 (Cav1), the core structural and scaffolding protein of caveolae membrane domains, is highly expressed in many retinal cells and is associated with ocular diseases. Cav1 regulates innate immune responses and is implicated in neuroinflammatory and neuroprotective signaling in the retina. We have shown that Cav1 expression in Müller glia accounts for over 70% of all retinal Cav1 expression.

Diffuse Coronary Vasospasm After Mitral Valve Replacement, Maze Procedure, and Tricuspid Valve Repair.

Coronary vasospasm is a known complication after coronary artery bypass grafting surgery but has rarely been described in non-coronary cardiac operations. We report the case of a 51-year-old male with nonischemic cardiomyopathy and paroxysmal atrial fibrillation. He presented with severe mitral and tricuspid regurgitation and was taken for mitral valve replacement, tricuspid valve repair, and Maze procedure.

Translatomic response of retinal Müller glia to acute and chronic stress.

Analysis of retina cell type-specific epigenetic and transcriptomic signatures is crucial to understanding the pathophysiology of retinal degenerations such as age-related macular degeneration (AMD) and delineating cell autonomous and cell-non-autonomous mechanisms. We have discovered that Aldh1l1 is specifically expressed in the major macroglia of the retina, Müller glia, and, unlike the brain, is not expressed in retinal astrocytes. This allows use of Aldh1l1 cre drivers and Nuclear Tagging and Translating Ribosome Affinity Purification (NuTRAP) constructs for temporally controlled labeling and paired analysis of Müller glia epigenomes and translatomes.

Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation Case Series: A Single-Center Experience.

Introduction: We aimed to review the characteristics and outcomes of left atrial veno-arterial extra corporeal membrane oxygenation (LAVA ECMO) at our institution over a 4-y period from 2017 to 2020.

Methods: Among 227 adult patients who received VA ECMO support from January 2017 to December 2020, we reviewed 33 of these who underwent transseptal cannulation and were converted to LAVA ECMO. The timing of transseptal cannulation, either at initiation of VA ECMO (n = 25) or with a later transseptal cannulation to treat complications of left ventricular (LV) distention while on VA ECMO (n = 8), was reviewed.

Relevance of the Activities-Specific Balance Confidence (ABC) Scale to Urban Community-Dwelling Adults With Diagnosed Vestibular Dysfunction.

Objective: To determine how relevant the items on the activities-specific balance confidence (ABC) scale are to patients living in an urban setting and to evaluate additional items relevant to urban populations but not included in the current version of the scale.

Design: Cross-sectional clinical survey.

Setting: Urban, tertiary vestibular rehabilitation clinic.

Chronic granulomatous disease and McLeod syndrome: Stem cell transplant and transfusion support in a 2-year-old patient-a case report.

Chronic granulomatous disease (CGD) with McLeod neuroacanthocytosis syndrome (MLS) is a contiguous gene deletion disorder characterized by defective phagocytic function and decreased Kell antigen expression. CGD cure is achieved through hematopoietic stem cell transplant (HSCT) usually in the peri-pubescent years. The presence of MLS makes peri-transfusion support complex, however.

Immediate Improvement in Subjective Visual Vertical and Disequilibrium Predicts Resolution of Benign Paroxysmal Positional Vertigo Following Single Canalith Repositioning Maneuver.

Objective: To evaluate whether immediate post-canalith repositioning maneuver (CRM) vestibular changes are predictive of benign paroxysmal positional vertigo (BPPV) resolution.

Study Design: Retrospective cohort study.

Setting: Tertiary referral center.

Caveolar and non-Caveolar Caveolin-1 in ocular homeostasis and disease.

Caveolae, specialized plasma membrane invaginations present in most cell types, play important roles in multiple cellular processes including cell signaling, lipid uptake and metabolism, endocytosis and mechanotransduction. They are found in almost all cell types but most abundant in endothelial cells, adipocytes and fibroblasts. Caveolin-1 (Cav1), the signature structural protein of caveolae was the first protein associated with caveolae, and in association with Cavin1/PTRF is required for caveolae formation.

The inside-out technique is safe and effective for thoracic central venous obstruction.

Background: Thoracic central venous obstruction (TCVO) presents a challenging scenario for patients requiring central venous access. The inside-out technique for crossing occluded veins has been described; however, to date, case series have reported on a limited number of patients. The purpose of the present study was to evaluate the indications for, efficacy of, and outcomes with the inside-out technique at a single tertiary academic center, with close attention to the severity of TCVO using the Society of Interventional Radiology (SIR) TCVO classification.

Cryopreservation of rare pediatric red blood cells for support following bone marrow transplant.

Background: A 2-year-old, 10.8 kg male pediatric patient with X-linked chronic granulomatous disease (CGD) with McLeod syndrome (MLS) was scheduled for a hematopoietic stem cell transplant (HSCT). Identification of allogenic red blood cells (RBC) for post-transplant support was unsuccessful prompting the development of a customized method to collect and freeze rare autologous pediatric cells.

Ratio of Mixed Venous Oxygen Saturation-to-Pulmonary Capillary Wedge Pressure: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program.

Background: Hemodynamic values from right heart catheterization aid diagnosis and clinical decision-making but may not predict outcomes. Mixed venous oxygen saturation percentage and pulmonary capillary wedge pressure relate to cardiac output and congestion, respectively. We theorized that a novel, simple ratio of these measurements could estimate cardiovascular prognosis.

The Chx10-Traf3 Knockout Mouse as a Viable Model to Study Neuronal Immune Regulation.

Uncontrolled inflammation is associated with neurodegenerative conditions in central nervous system tissues, including the retina and brain. We previously found that the neural retina (NR) plays an important role in retinal immunity. Tumor necrosis factor Receptor-Associated Factor 3 (TRAF3) is a known immune regulator expressed in the retina; however, whether TRAF3 regulates retinal immunity is unknown.

Extracorporeal Life Support and Mechanical Circulatory Support in Out-of-Hospital Cardiac Arrest and Refractory Cardiogenic Shock.

The prevalence of extracorporeal cardiopulmonary resuscitation is increasing worldwide as more health care centers develop the necessary infrastructure, protocols, and technical expertise required to provide mobile extracorporeal life support with short notice. Strict adherence to patient selection guidelines in the setting of out-of-hospital cardiac arrest, as well as in-hospital cardiac arrest, allows for improved survival with neurologically favorable outcomes in a larger patient population. This review discusses the preferred approaches, cannulation techniques, and available support devices ideal for the various clinical situations encountered during the treatment of cardiac arrest and refractory cardiogenic shock.

Neuroretinal-Derived Caveolin-1 Promotes Endotoxin-Induced Inflammation in the Murine Retina.

Purpose: The immune-privileged environment and complex organization of retinal tissue support the retina's essential role in visual function, yet confound inquiries into cell-specific inflammatory effects that lead to dysfunction and degeneration. Caveolin-1 (Cav1) is an integral membrane protein expressed in several retinal cell types and is implicated in immune regulation. However, whether Cav1 promotes or inhibits inflammatory processes in the retina (as well as in other tissues) remains unclear.

An inhibitor of endothelial ETS transcription factors promotes physiologic and therapeutic vessel regression.

During the progression of ocular diseases such as retinopathy of prematurity and diabetic retinopathy, overgrowth of retinal blood vessels results in the formation of pathological neovascular tufts that impair vision. Current therapeutic options for treating these diseases include antiangiogenic strategies that can lead to the undesirable inhibition of normal vascular development. Therefore, strategies that eliminate pathological neovascular tufts while sparing normal blood vessels are needed.