Detection and tracking of a novel genetically tagged biological simulant in the environment.

A variant of Bacillus thuringiensis subsp. kurstaki containing a single, stable copy of a uniquely amplifiable DNA oligomer integrated into the genome for tracking the fate of biological agents in the environment was developed. The use of genetically tagged spores overcomes the ambiguity of discerning the test material from pre-existing environmental microflora or from previously released background material.

Genetic barcodes for improved environmental tracking of an anthrax simulant.

The development of realistic risk models that predict the dissemination, dispersion and persistence of potential biothreat agents have utilized nonpathogenic surrogate organisms such as Bacillus atrophaeus subsp. globigii or commercial products such as Bacillus thuringiensis subsp. kurstaki.

Management of Persistent Cerebrospinal Fluid Leakage Following Thoraco-lumbar Surgery.

Study Design: This was a retrospective study of patients who had developed a dural tear after thoracic and lumbar spine surgery that was not recognized during the surgery, and was treated either by lumbar drainage or over-sewing of the wounds.

Purpose: To revisit the treatment strategies in postoperative dural leaks and present our experience with over-sewing of the wound and lumbar drainage.

Overview Of Literature: Unintended durotomy is a frequent complication of spinal surgery.

The case of the entitled resident: a composite case study of a resident performance problem syndrome with interdisciplinary commentary.

Background: Residents with performance problems create substantial burden on programs and institutions. Understanding the nature and quality of performance problems can help in learning to address performance problems.

Aim: We sought to illuminate the effects of resident performance problems and the potential solutions for those problems from the perspectives of people with various roles in health care.

Excessive TV watching in patients with frontotemporal dementia.

The "environmental dependency syndrome" refers to a loss of personal autonomy such that a person's environment almost entirely controls their actions. The goal of this study is to learn if patients with frontotemporal degeneration (FTD) exhibit prolonged TV watching, a behavior which may be a symptom of environmental dependency. We recruited 40 patients with FTD and 48 patients with Alzheimer's disease (AD), and asked these participants' caregivers about TV watching behaviors including total viewing time and channel/show preference, along with other behaviors indicative of environmental dependency.

Synthesis of enantiopure, trisubstituted cryptophane-A derivatives.

The efficient synthesis of enantiopure, trisubstituted cryptophane-A derivatives, organic host molecules with unusually high xenon affinity, is reported. Synthesis and chromatographic separation of (±) tri-Mosher's acid substituted cryptophane diastereomers gave ready access to the enantiopure cryptophanes, which are critical components in the design of enantiomerically pure (129)Xe biosensors. Hyperpolarized (129)Xe NMR spectroscopy identified single resonances for both trisubstituted cryptophane diastereomers that were separated by 9.

Failed repeated thrombolysis requiring left ventricular assist device pump exchange.

A 51-year-old male with untreated hepatitis C infection, cirrhosis, and dilated cardiomyopathy with a HeartMate II LVAD presented with right heart failure and cardiogenic shock, INR of 7, hemolysis, and renal failure. Acute LVAD thrombosis was suspected. Alteplase was injected into the inflow cannula of the LVAD with little effect.

Prevalence and predictors of cable extrusion and loss of electrical integrity with the Riata defibrillator lead.

Introduction: Recently, a medical advisory was issued regarding the Riata and Riata ST silicone endocardial defibrillator leads (St. Jude Medical, Sylmar, CA, USA) addressing the issue of conductor cables extruding in an "inside-out" fashion from the main body of the lead. However, little data exist to guide our management of patients with these leads.

Radial artery perforation during transradial catheterization managed with a coronary polytetrafluoroethylene-covered stent graft.

A 69-year-old man underwent transradial catheterization (TRC) with successful percutaneous coronary intervention (PCI), but developed a radial artery perforation. Guiding catheter re-positioning and prolonged balloon inflation were unable to provide hemostasis. Successful reconstruction of the perforated vessel required the unconventional and novel use of a coronary polytetrafluoroethylene-covered stent graft.

Angiographic investigation of the pathophysiology of perioperative myocardial infarction.

Background: The study of the pathophysiologic mechanism of perioperative myocardial infarctions is limited to two small autopsy studies suggesting a major role for plaque rupture and thrombosis. However, the perioperative period is characterized by increased cardiac metabolic demand that may lead to infarction in patients with otherwise stable obstructive coronary artery disease. The purpose of this study is to investigate the pathophysiology of perioperative myocardial infarctions.

Do the benefits of anti-arrhythmic drugs outweigh the associated risks? A tale of treatment goals in atrial fibrillation.

Atrial fibrillation (AF) is the most common cardiac rhythm disorder and places a substantial burden on the US healthcare system. Unfortunately, there is no consensus as to whether patients should be treated with a primary rate- or rhythm-control strategy. The use of anti-arrhythmic drugs in the treatment of AF is discussed in the broader context of AF disease-management strategies with a focus on rhythm control.

Intravenous immunoglobulin prevents murine antibody-mediated acute lung injury at the level of neutrophil reactive oxygen species (ROS) production.

Transfusion-related acute lung injury (TRALI) is a leading cause of transfusion-associated mortality that can occur with any type of transfusion and is thought to be primarily due to donor antibodies activating pulmonary neutrophils in recipients. Recently, a large prospective case controlled clinical study of cardiac surgery patients demonstrated that despite implementation of male donors, a high incidence of TRALI still occurred and suggested a need for additional interventions in susceptible patient populations. To examine if intravenous immunoglobulin (IVIg) may be effective, a murine model of antibody-mediated acute lung injury that approximates human TRALI was examined.

Congenital pancreatoblastoma: report of an atypical case and review of the literature.

Pancreatoblastoma is a rare malignant tumor of the pancreas mostly diagnosed in childhood. The clinical presentation and outcome of infantile and congenital pancreatoblastoma have not been clearly elucidated. This report describes our recent institutional experience with an unusual case of congenital pancreatoblastoma.

Motor neuron morphology estimation for its classification in the Drosophila brain.

Type-specific dendritic arborization patterns dictate synaptic connectivity and are fundamental determinants of neuronal function. We exploit the morphological stereotypy and relative simplicity of the Drosophila nervous system to model the diverse dendritic morphologies of individual motor neurons (MNs) to understand underlying principles of synaptic connectivity in a motor circuit. The genetic tractability of Drosophila allows us to label single MNs with green fluorescent protein (GFP) and serially reconstruct identifiable MNs in 3D with confocal microscopy.

Capturing the teachable moment: a grounded theory study of verbal teaching interactions in the operating room.

Background: Teaching in the operating room is one of the major cornerstones of surgical education. As time available for intraoperative resident teaching diminishes, such teaching time becomes increasingly precious. We studied how surgeons communicate with residents during an operation, with the goal of enhancing intraoperative teaching opportunities.

Three-dimensional motor neuron morphology estimation in the Drosophila ventral nerve cord.

Type-specific dendritic arborization patterns dictate synaptic connectivity and are fundamental determinants of neuronal function. We exploit the morphological stereotypy and relative simplicity of the Drosophila nervous system to model the diverse neuronal morphologies of individual motor neurons (MNs) and understand underlying principles of synaptic connectivity in a motor circuit. Our computational approach aims at the reconstruction of the neuron morphology, namely the robust segmentation of the neuron volumes from their surroundings with the simultaneous partitioning into their compartments, namely the soma, axon, and dendrites.

Very late stent thrombosis approximately 7 years after deployment and one-week cessation of dual antiplatelet therapy.

This work describes the longest reported interval between drug-eluting stent (DES) placement and very late stent thrombosis (VLST). A 69-year-old male presented with substernal chest pain associated with ST-segment myocardial infarction (STEMI) after having a DES deployed 6.9 years (2506 days) prior.

One-year treatment persistence and potential adverse events among patients with atrial fibrillation treated with amiodarone or sotalol: a retrospective claims database analysis.

Background: The risk-benefit profile of antiarrhythmic drugs (AADs) affects the choice of pharmacotherapy for maintenance of sinus rhythm. Adverse events (AEs) associated with AADs may influence patient compliance and compromise the management of atrial fibrillation (AF). There are limited data on the incidence of AEs or persistence with AADs outside the clinical trial environment.

Female gender and mortality after percutaneous coronary intervention: results from a large registry.

Objectives: To investigate if previously reported gender-based outcome disparities following percutaneous coronary intervention (PCI) are applicable in a large and racially-diverse cohort in the drug eluting stent (DES) era.

Background: It is generally believed that women suffer inferior outcomes compared to men after PCI. However, various strategies have evolved that may have mitigated this imbalance, including improved medical therapy, attention to risk-factors, and procedural advances of PCI including DES.

Impact of the everolimus-eluting stent on stent thrombosis: a meta-analysis of 13 randomized trials.

Objectives: We evaluated the impact of the everolimus-eluting stent (EES) on the frequency of stent thrombosis (ST), target vessel revascularization (TVR), myocardial infarction (MI), and cardiac death in randomized controlled trials comparing the EES to non-everolimus-eluting drug-eluting stents (EE-DES).

Background: Whether or not the unique properties of the EES translate into reductions in ST remains unknown.

Methods: We searched MEDLINE, Scopus, the Cochrane Library, and Internet sources for articles comparing outcomes between EES and non-EE-DES without language or date restriction.

Predictors of low clopidogrel adherence following percutaneous coronary intervention.

Few data are available on factors associated with low adherence or early clopidogrel discontinuation after percutaneous coronary intervention (PCI). Patients (n = 284) were evaluated before hospital discharge after PCI to identify factors associated with low adherence to clopidogrel 30 days later. Adherence to daily medications before PCI was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) and categorized as low (score <6), medium (score 6 to <8), or high (score 8).