Comparison of two transcatheter device strategies for occlusion of the patent ductus arteriosus.

Objectives: The present study evaluates two transcatheter closure strategies utilized at a single center and makes recommendations for device selection when occluding the patent ductus arteriosus.

Background: A variety of devices are available for transcatheter closure of the patent ductus arteriosus (PDA) but no guidelines exist to guide operator device choice.

Methods: A total of 132 patients underwent attempted transcatheter PDA closure utilizing one of two consecutive closure strategies between January 2000 and June 2005.

Lung function and cardiopulmonary exercise capacity in patients with corrected tetralogy of Fallot.

Background: Since surgical repair of tetralogy of Fallot was introduced, follow-up studies have shown that the majority of patients lead active lives and have no subjective exercise limitation.

Objectives: To examine lung function, cardiopulmonary functional capacity and echo-Doppler assessment of pulmonary pressure in adult patients 20 years after repair of TOF.

Methods: Unselected consecutive patients performed full lung function testing, progressive cardiopulmonary exercise, and echo-Doppler assessments of pulmonary pressure.

Exercise capacity improves after transcatheter closure of the Fontan fenestration in children.

Objectives: This study evaluated the aerobic capacity, exercise capacity, and arterial oxygen saturation (O(2)Sat) in children before and after transcatheter Fontan fenestration closure.

Design: Observational study comparing exercise parameters and hemodynamics before and after transcatheter fenestration closure in Fontan patients.

Outcome Measures: Working capacity, exercise duration, oxygen consumption (VO(2)), and arterial O(2)Sat were evaluated during aerobic exercise.

Phase separation and crystallization of hemoglobin C in transgenic mouse and human erythrocytes.

Individuals expressing hemoglobin C (beta6 Glu-->Lys) present red blood cells (RBC) with intraerythrocytic crystals that form when hemoglobin (Hb) is oxygenated. Our earlier in vitro liquid-liquid (L-L) phase separation studies demonstrated that liganded HbC exhibits a stronger net intermolecular attraction with a longer range than liganded HbS or HbA, and that L-L phase separation preceded and enhanced crystallization. We now present evidence for the role of phase separation in HbC crystallization in the RBC, and the role of the RBC membrane as a nucleation center.

[Persons with dementia caught between medicine, care and politics].

When there is a suggestion of dementia, a thorough diagnostic work up including a comprehensive assessment is needed for the benefit of the old person, his family and society. This provides the basis for needed interventions, including prevention and rehabilitation, in addition to treatment and care. A comprehensive approach is in order since dementia is the single most important cause for care-dependency.

Computed tomography angiography with three-dimensional reconstruction for pulmony venous definition in high-risk infants with congenital heart disease.

Background: Pulmonary venous anomalies may be difficult to define in small, critically ill infants using standard echocardiography. In many centers, invasive cardiac catheterization is used if the diagnosis remains inconclusive. We evaluated computed tomography angiography (CTA) as a low-risk alternative to cardiac catheterization in these infants.

Human embryonic stem cells in culture possess primary cilia with hedgehog signaling machinery.

Human embryonic stem cells (hESCs) are potential therapeutic tools and models of human development. With a growing interest in primary cilia in signal transduction pathways that are crucial for embryological development and tissue differentiation and interest in mechanisms regulating human hESC differentiation, demonstrating the existence of primary cilia and the localization of signaling components in undifferentiated hESCs establishes a mechanistic basis for the regulation of hESC differentiation. Using electron microscopy (EM), immunofluorescence, and confocal microscopies, we show that primary cilia are present in three undifferentiated hESC lines.

Three-dimensional and thermal surface imaging produces reliable measures of joint shape and temperature: a potential tool for quantifying arthritis.

Introduction: The assessment of joints with active arthritis is a core component of widely used outcome measures. However, substantial variability exists within and across examiners in assessment of these active joint counts. Swelling and temperature changes, two qualities estimated during active joint counts, are amenable to quantification using noncontact digital imaging technologies.

Gene therapy for arthritis.

Arthritis is among the leading causes of disability in the developed world. There remains no cure for this disease and the current treatments are only modestly effective at slowing the disease's progression and providing symptomatic relief. The clinical effectiveness of current treatment regimens has been limited by short half-lives of the drugs and the requirement for repeated systemic administration.

Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II.

Objective: To provide a single source for the best available estimates of the US prevalence of and number of individuals affected by osteoarthritis, polymyalgia rheumatica and giant cell arteritis, gout, fibromyalgia, and carpal tunnel syndrome, as well as the symptoms of neck and back pain. A companion article (part I) addresses additional conditions.

Methods: The National Arthritis Data Workgroup reviewed published analyses from available national surveys, such as the National Health and Nutrition Examination Survey and the National Health Interview Survey.

Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I.

Objective: To provide a single source for the best available estimates of the US prevalence of and number of individuals affected by arthritis overall, rheumatoid arthritis, juvenile arthritis, the spondylarthritides, systemic lupus erythematosus, systemic sclerosis, and Sjögren's syndrome. A companion article (part II) addresses additional conditions.

Methods: The National Arthritis Data Workgroup reviewed published analyses from available national surveys, such as the National Health and Nutrition Examination Survey and the National Health Interview Survey (NHIS).

Laser treatment of pediatric vascular lesions: Port wine stains and hemangiomas.

Pediatric vascular lesions can be medically threatening and psychologically distressing to patients. This article reviews literature on the laser treatment of two common pediatric vascular lesions, port wine stains and hemangiomas. The purpose of this report was to distinguish the lesions from one another and to present the advantages, disadvantages, complications, and limitations of laser treatment for each lesion type.

High serum total cholesterol--an indicator for monitoring cholesterol lowering efforts: U.S. adults, 2005-2006.

Elevated serum total cholesterol is a major and modifiable risk factor for heart disease, the lead-ing cause of death in the United States (1,2). Reducing mean total serum cholesterol levels among adults to less than 200 mg/dL and reducing the proportion who have levels of 240 mg/dL or higher to less than 17% are national Healthy People 2010 objectives (3). Age-adjusted mean serum cholesterol levels among adults aged 20-74 years declined from 222 mg/dL in 1960-1962 to 203 mg/dL in 1999-2002 (4).

The hybrid cardiac catheterization laboratory for congenital heart disease: From conception to completion.

There has been a recent trend toward hybrid cardiac catheterization procedures for the treatment of patients with various forms of congenital heart disease. Hybrid procedures offer the combined advantages of outstanding imaging in a full operating room environment, allowing direct access onto the heart or the great vessels for access or procedure completion, or complementary imaging before, during, or after surgical correction when necessary. With the increase in frequency of hybrid procedures, more medical centers are contemplating the conversion of standard cardiac catheterization rooms to hybrid facilities, or de novo construction.

NGAL is an early predictive biomarker of contrast-induced nephropathy in children.

We hypothesized that neutrophil gelatinase-associated lipocalin (NGAL) is an early predictive biomarker of contrast-induced nephropathy (CIN). We prospectively enrolled 91 children (age 0-18 years) with congenital heart disease undergoing elective cardiac catheterization and angiography with contrast administration (CC; Ioversol). Serial urine and plasma samples were analyzed in a double-blind fashion by NGAL enzyme-linked immunosorbent assay (ELISA).

Hyaluronidase in the office: a necessity for every dermasurgeon that injects hyaluronic acid.

Soft tissue augmentation plays an increasingly important role in the management of the aging face. The recent explosion of dermal filler use in aesthetic dermatology has brought with it the expected reporting of rare but significant side effects. These include the too-superficial placement of product which can yield an undesirable bluish discoloration due to the Tyndall effect, the use of excessive product, persistent granulomatous foreign-body reactions and, most significantly, the risk of injection necrosis.

Coxiella burnetii infection of an aortic graft: surgical view and a word of caution.

A 30-year-old-man presented with an aortic graft infection. Polymerase chain reaction study identified the infectious organism as Coxiella burnetii, a strictly intracellular pathogen that causes Q fever in humans. The patient was successfully treated by removal of the infected graft, implantation of homograft aortic tube, and specific antibiotic therapy.

Drug use and sexual behaviors reported by adults: United States, 1999-2002.

This report presents prevalence estimates for self-reported adult drug use and sexual behaviors in the United States. Data are from the National Health and Nutrition Examination Survey (NHANES) collected from 1999 to 2002. NHANES surveys a stratified multistage probability sample of the civilian noninstitutionalized population of the United States.

Implementation of an objective testing system in noninvasive cardiac imaging for evaluation of pediatric cardiology fellows.

Introduction: Current evaluation of pediatric cardiology fellow performance is subjective and qualitative. More objective tools are recommended by credentialing boards and may provide more effective evaluation and education.

Objective: A series of training level-specific multiple-choice tests were developed and evaluated for their effectiveness as evaluation and educational tools for pediatric cardiology fellows.