The Seventh Prevention of Syncope Trial (POST VII)-A randomized clinical trial of atomoxetine for the prevention of vasovagal syncope: Rationale and study design.

Background: Vasovagal syncope (VVS) is common, recurs, and is associated with markedly reduced quality of life, anxiety, and frequent injuries. The few pharmacological therapies for VVS proven to have a moderate benefit in reducing recurrences are limited to patients without coexisting conditions such as hypertension or heart failure. Although there is some data to suggest Atomoxetine, a norepinephrine reuptake transport inhibitor (NET), may be a promising treatment option, an adequately powered randomized placebo-controlled trial is needed.

Atomoxetine for suppression of vasovagal syncope.

Objective: Vasovagal syncope (VVS) is a common clinical condition with few effective medical therapies. The study aimed to evaluate the effectiveness of atomoxetine in suppressing syncope in patients with recurrent VVS.

Methods: This was a retrospective, open-label, observational case series of 12 patients taking atomoxetine for suppression of recurrent vasovagal syncope.

Variations in IgG antibody subclass responses to oral bacteria: Effects of periodontal disease and modifying factors.

Background And Objective: Local and systemic IgG antibodies or oral bacteria have been described with periodontitis. We extended these observations by assessing the impact of a range of intrinsic factors on serum IgG subclass antibodies to both commensal and pathogenic oral bacteria that would contribute to variations in immune protection or disease susceptibility in periodontitis have not been described.

Methods: Subjects (n = 278) were classified as healthy, gingivitis, or periodontitis and categorized as mild, moderate, and severe periodontitis.

Successful use of calcium channel blocker for management of arterio-venous malformations following Fontan procedure.

In diffuse forms of arteriovenous malformation following Fontan procedure, "classical" medical therapy, inhaled nitric oxide and sildenafil, may play a role, until re-direction of hepatic flow to pulmonary circulation cures it. However, in refractory cases, as reported in our 2-year-old patient, unusual medications such as calcium channel blockers can be tried and continued if patients respond adequately.

Modified Senning Procedure for Correction of Atrioventricular Discordance With Total Anomalous Pulmonary Venous Return, Atrial Situs Inversus, Dextrocardia, and Bilateral Superior Venae Cavae.

The Senning and Mustard baffles remain important techniques for the treatment of congenitally corrected transposition (cc-TGA), isolated ventricular inversion, and D-transposition of the great arteries with delayed presentation. We describe the treatment of an 8-month old infant with atrioventricular discordance, ventriculoarterial concordance, and dextrocardia with atrial situs inversus. A modified Senning procedure was performed through the "left-sided" atrium.

Myocardial Performance Index in Childhood Onset Essential Hypertension and White Coat Hypertension.

Background: As a global measure of ventricular systolic and diastolic function, the myocardial performance index (MPI) can be an early indicator of hypertensive cardiomyopathy in children with essential hypertension (EH).

Methods: Children with untreated newly diagnosed EH and white coat hypertension (WCH) by a 24-hour ambulatory blood pressure monitoring (ABPM), both groups without any identifiable etiology for the hypertension, were enrolled for the study. Echocardiograms and vascular ultrasounds for carotid artery intimal medial thickness were performed on all children prior to therapy.

Impact of stent implantation on pulmonary artery growth.

Background: Goals of stent implantation (SI) in children with pulmonary artery (PA) stenosis are to relieve obstruction and improve flow to the distal vasculature. We evaluated stent impact on distal PA growth.

Methods: We compared data of children who underwent unilateral SI using the nonstenotic contralateral PA (CPA) as a control (1998-2005; f/u data through 2009).

Timing of human chorionic gonadotrophin (hCG) hormone administration in IVF protocols using GnRH antagonists: a randomized controlled trial.

This randomized controlled trial investigated whether delaying human chorionic gonadotrophin hormone (hCG) administration within an IVF cycle impacts upon clinical outcomes. Participants included 125 women undergoing IVF/ICSI cycles at Leeds Centre for Reproductive Medicine. Subjects were aged 20-36 years, body mass index (BMI) 20-30 kg/m(2) with a normal FSH level (<8 IU/l).

Catheter balloon adjustment of the pulmonary artery band: feasibility and safety.

The study aimed to assess the feasibility and safety of increasing pulmonary artery band (PAB) diameter by catheter-based PAB balloon dilation (PABBD). Eight dilations were performed between October 2006 and December 2008. Hemoclips were used to fix PABs surgically in a procedure designed to permit progressive clip dislodgment in a controlled manner.

"Wire-target" technique for precise vascular access.

Herein, we describe a technique that facilitates percutaneous vascular access when the traditional method of achieving access is unsuccessful. For multiple reasons, gaining access to small vessels in pediatric patients is sometimes difficult. In instances of atrial, ventricular, or great arterial communications, a wire can be positioned from a vein or artery across the communications into an artery or vein to which access needs to be gained.

Deletion of JAM-C, a candidate gene for heart defects in Jacobsen syndrome, results in a normal cardiac phenotype in mice.

The 11q terminal deletion disorder (11q-) is a rare chromosomal disorder caused by a deletion in distal 11q. Fifty-six percent of patients have clinically significant congenital heart defects. A cardiac "critical region" has been identified in distal 11q that contains over 40 annotated genes.

Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries: Initial results and long-term follow up.

Background: Balloon angioplasty of bifurcating pulmonary artery (PA) stenoses is often inadequate, and stent treatment often requires simultaneous implantation of two stents. This study evaluates initial results and long-term follow up of transcatheter stent placement in bifurcating PAs.

Methods: This is a retrospective review of patients (pts) who had bifurcating PA stents placed in main and lobar branches from 1993 to 2007.

Adverse impact of vascular stent "mass effect" on airways.

Objectives: To report our experience with bronchial compression secondary to vascular stent implantation within the mediastinum of patients with congenital heart disease.

Background: Stents are routinely used to correct native and postsurgical vessel stenoses. However, the "mass effect" of stents on adjacent structures within the chest has not been consistently appreciated nor evaluated.

Left main coronary artery compression from right pulmonary artery stenting.

Complications related to pulmonary artery stenting include stent migration, jailing of vessels, vessel rupture, and compression of surrounding structures. Compression of the left main coronary artery (LMCA) as a result of stent placement in the right pulmonary artery (RPA) is extremely rare. We present two patients post repair of congenital heart disease who suffered LMCA compression following RPA stenting.