Impact of aortic valve replacement in symptomatic low-risk patients with less than severe aortic stenosis.

Objective: To evaluate whether transcatheter or surgical aortic valve replacement (TAVR or SAVR) affects clinical and haemodynamic outcomes in symptomatic patients with moderately-severe aortic stenosis (AS).

Methods: Echocardiographic evidence of severe AS for enrolment in the Evolut Low Risk trial was based on site-reported measurements. For this post hoc analysis, core laboratory measurements identified patients with symptomatic moderately-severe AS (1.

3-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis.

Background: Randomized data comparing outcomes of transcatheter aortic valve replacement (TAVR) with surgery in low-surgical risk patients at time points beyond 2 years is limited. This presents an unknown for physicians striving to educate patients as part of a shared decision-making process.

Objectives: The authors evaluated 3-year clinical and echocardiographic outcomes from the Evolut Low Risk trial.

Association between prior peripherally inserted central catheters and lack of functioning arteriovenous fistulas: a case-control study in hemodialysis patients.

Background: Although an arteriovenous fistula (AVF) is the hemodialysis access of choice, its prevalence continues to be lower than recommended in the United States. We assessed the association between past peripherally inserted central catheters (PICCs) and lack of functioning AVFs.

Study Design: Case-control study.

Outcomes of arteriovenous fistula creation after the Fistula First Initiative.

Background And Objectives: The arteriovenous fistula (AVF) is the preferred hemodialysis access, but AVF-failure rate is high, and complications from AVF placement are rarely reported. There is no clear consensus on predictors of AVF patency. This study determined AVF outcomes and patency predictors at Mayo Clinic Rochester following the Fistula First Initiative.

An epidermotropic canine papillomavirus with malignant potential contains an E5 gene and establishes a unique genus.

A novel canine papillomavirus, CfPV-2, was cloned from a footpad lesion of a golden retriever. Unlike the known canine oral papillomavirus (COPV), which has a double-stranded DNA genome size of 8607 bps, the genome of CfPV-2 is 8101 bps. Some of this size difference is due to an abbreviated early-late region (ELR), which is 1200 bps shorter than that of COPV.

Prospective, randomized evaluation of a cuffed expanded polytetrafluoroethylene graft for hemodialysis vascular access.

Background: A cuffed expanded polytetrafluoroethylene (ePTFE) hemodialysis graft was developed to address the problem of recurrent stenosis at the graft-vein anastomosis. The purpose of this study was to compare graft patency and blood flow rates of cuffed and noncuffed (standard) ePTFE grafts placed for hemodialysis access.

Methods: Forty-eight patients were prospectively randomized and followed for up to 24 months after placement of a cuffed or standard ePTFE graft for hemodialysis access.

Avian papillomaviruses: the parrot Psittacus erithacus papillomavirus (PePV) genome has a unique organization of the early protein region and is phylogenetically related to the chaffinch papillomavirus.

Background: An avian papillomavirus genome has been cloned from a cutaneous exophytic papilloma from an African grey parrot (Psittacus erithacus). The nucleotide sequence, genome organization, and phylogenetic position of the Psittacus erithacus papillomavirus (PePV) were determined. This PePV sequence represents the first complete avian papillomavirus genome defined.

Preliminary experience with a cuffed ePTFE graft for hemodialysis vascular access.

The purpose of this study was to determine graft patency and blood flow rates in recipients of a new cuffed ePTFE graft (Venaflo graft) used for hemodialysis access. A pilot study was conducted with 12 (7 men, 5 women) consecutive patients (age range, 36-76 yr; mean, 65 yr). All patients were recipients of a new cuffed PTFE graft placed for hemodialysis access.

Improved preservation of residual renal function in chronic hemodialysis patients using polysulfone dialyzers.

Our objective was to determine whether patients with chronic renal failure requiring maintenance hemodialysis retain intrinsic renal function longer when using reprocessed polysulfone (PS) membrane hemodialyzers or single-use cellulose acetate (CA) membrane hemodialyzers. Fifty consecutive patients with residual renal function (urea clearance > 2.0 mL/min) using PS dialyzers were compared with a retrospective, disease- and time-matched population of patients using CA dialyzers.

Role of poloxamer 188 during recovery from ischemic spinal cord injury: a preliminary study.

Paraplegia following aortic surgery is not a common event. When it does occur it significantly alters the patient's outcome. Poloxamer 188 (P188) has been shown in the experimental animal to increase regional blood flow to ischemic areas.

Gangliosides and spinal cord ischemia secondary to aortic cross-clamping in the rat model.

Gangliosides, complex glycolipids of the nervous system cell membranes, have been found effective both in reducing the degree of ischemic injury and in stimulating neuronal regeneration during the recovery period. In order to investigate their neuroprotective effect during spinal cord ischemia, 60 male Sprague-Dawley rats underwent occlusion of the thoracic aorta and both subclavian arteries for 13 min. In the postoperative period, function of hindlimbs was appraised, daily for 30 days, by a deficit score (0-15).

The importance of bone biopsy in managing renal osteodystrophy.

A case is presented in which bone biopsy results helped to resolve not only difficult issues in the clinical management of the patient's renal osteodystrophy but also disruptive psychosocial problems surrounding her clinical course. The outcome was a satisfactory resolution based on rational medical treatment and directed supportive care. The presentation highlights important principles in the procurement, processing, and interpretation of the bone biopsy, while also addressing the importance of accurate diagnosis in facilitating the overall long-term management by the entire renal team.

Clinical benefits of high and variable sodium concentration dialysate in hemodialysis patients.

Twenty-one hemodialysis patients were studied during 25 dialysis sessions with a dialysate sodium of 140 mEq/L and during 25 sessions with a high and variable sodium dialysate (145 mEq/L decreased to 140 mEq/L). Bicarbonate dialysate and ultrafiltration-controlled dialysis equipment were used. Neither the average interdialytic weight gain nor the predialysis and postdialysis blood pressures changed.

Surgical repair of atrial septal rupture due to blunt trauma.

We report a case of atrial septal rupture and surgical cure after blunt chest trauma. Review of the literature indicates that this rare lesion results from severe forces applied to the chest and is often associated with other serious and life-threatening injuries. The defect may not be recognized for several months or even years in patients who survive concomitant initial trauma.

Repair of atrial septal defect due to penetrating trauma.

We report a case of stab wound to the heart resulting in an atrial septal defect and perforation of the anterior leaflet of the mitral valve, which we repaired successfully 7 years after the injury. To our knowledge, repair of an atrial septal defect due to penetrating trauma has never before been reported. Investigation of possible valvular heart disease in a patient with a history of chest trauma should be aimed at identifying both intracardiac shunts and valvular abnormalities, so that a complete repair can be performed.

Identification of human papillomavirus type 16 in primary and recurrent cervical cancer following radiation therapy.

Formalin-fixed, paraffin-embedded tissue blocks from 13 women with cervical carcinoma that recurred following radiation therapy were evaluated for the presence of human papillomavirus (HPV) by in situ hybridization using ribonucleic acid 35S-labeled probes for HPV types 6, 11, 16, and 18. Ten of thirteen patients also had pretreatment biopsies from their primary tumors available for analysis. HPV 16 was detected in both primary and recurrent lesions in 4 women.

Effects of recombinant human erythropoietin on cerebral and cutaneous blood flow and on blood coagulability.

Seizures, hypertensive encephalopathy, transient ischemic attacks, and thrombosis of hemodialysis accesses occurred in early clinical trials with recombinant human erythropoietin. To determine if these events may be caused by the increased hematocrit value or some direct effect of the recombinant human hormone, 10 transfusion-dependent hemodialysis patients were divided into two groups of five according to their serum ferritin concentration: group A. less than 800 microgram/liter, and group B.

Transfusional iron overload in patients undergoing dialysis: treatment with erythropoietin and phlebotomy.

Five patients undergoing long-term hemodialysis with transfusional iron overload received treatment for 18 weeks with a regimen of recombinant human erythropoietin (150 U/kg) and regular phlebotomy to maintain the hematocrit value at 25% and reduce the total body iron burden. In the 149 phlebotomy sessions performed in these patients, a mean of 228 +/- 8 ml (mean +/- SEM) of whole blood was removed; it had a hematocrit value of 27.7% +/- 0.

Detection of antigens associated with Epstein-Barr virus replication in extracts from biopsy specimens of nasopharyngeal carcinomas.

By using monoclonal antibodies to different Epstein-Barr virus (EBV) polypeptides in combination with immunoblotting, we detected antigens associated with EBV replication in extracts from nasopharyngeal carcinoma (NPC) biopsy specimens. Major polypeptides associated with both the diffuse and the restricted components of the early antigen (EA) complex were found in extracts from nine of nine NPC biopsy specimens. Cells from an additional NPC biopsy specimen, passaged repeatedly in nude mice, were found to be positive for the major EA (restricted) polypeptide.

Partial characterization of a renotropic factor.

In 70 experiments, the existence of a circulating renal growth factor was confirmed by 9.3% stimulation of 3H-thymidine into the DNA of renal fragments incubating for 90 min in the presence of sera from 20-hour unilaterally nephrectomized rats compared to sera from 20-hour sham-operated rats (p less than 0.001).