Interv Cardiol Clin
January 2012
Calcific aortic stenosis (AS) is a common expression of aortic valve disease and increases in prevalence with advancing age. Recent studies have shown that calcific deposition in aortic valve leaflets is an actively regulated process with many pathophysiologic similarities to atherosclerosis. Surgical valve replacement is the definitive treatment of calcific AS, but many patients do not undergo surgery because of prohibitive comorbidities or other high-risk features.
View Article and Find Full Text PDFAims: Mounting data support a 'calcification paradox', whereby reduced bone mineral density is associated with increased vascular calcification. Furthermore, reduced bone mineral density is prevalent in older persons with lower body mass index (BMI). Therefore, although BMI and coronary artery calcification (CAC) exhibit a positive relationship in younger persons, it is predicted that in older persons and/or those at risk for osteoporosis, an inverse relationship between BMI and CAC may apply.
View Article and Find Full Text PDFBackground: Minimally invasive plate osteosynthesis (MIPO) technique is reported as a satisfactory procedure for the treatment of humeral shaft fractures by the anterior approach by several authors. However, none of the published reports had a significant follow-up nor have they reported patient outcomes. We evaluated the clinical, radiographic, and functional outcome over a minimum follow-up of 2 years using the same MIPO technique to humeral shaft fracture.
View Article and Find Full Text PDFBackground: The posterior superior alveolar (PSA) nerve block is commonly used in dentistry for treatment of the maxillary molars. Although this procedure is associated with many complications, ocular complications have been rarely reported.
Case Report: This report details an iatrogenic paresis of the abducent nerve and partial palsy of the oculomotor nerve leading to diplopia, strabismus and ptosis following a PSA nerve block and extraction of maxillary right second molar.
Background: Anemia in burn patients is due to surgical blood loss and anemia of critical illness. Because the commitment paradigm of common bone marrow progenitors dictates the production of erythroid, myeloid, and lymphoid cells, we hypothesized that skewed bone marrow lineage commitment decreases red cell production and causes anemia after a burn injury.
Methods: After anesthesia, B(6)D(2)F(1) mice received a 15% total body surface area dorsal scald burn.
Catheter Cardiovasc Interv
October 2012
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.
Spinocerebellar ataxia type 1 (SCA1) is an adult-onset, dominantly inherited neurodegenerative disease caused by expansion of a glutamine repeat tract in ataxin-1 (ATXN1). Although the precise function of ATXN1 remains elusive, it seems to be involved in transcriptional repression. We find that mutant ATXN1 represses transcription of the neurotrophic and angiogenic factor vascular endothelial growth factor (VEGF).
View Article and Find Full Text PDFBackground: Percutaneous coronary intervention (PCI) is associated with periprocedural myocardial infarction (MI) in 3% to 15% of cases (depending on the definition used). In many cases, these MIs result from distal embolization of lipid-core plaque (LCP) constituents. Prospective identification of LCP with catheter-based near-infrared spectroscopy (NIRS) may predict an increased risk of periprocedural MI and facilitate development of preventive measures.
View Article and Find Full Text PDFObjectives: 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.
Recent studies have highlighted the critical importance of bleeding complications on prognosis in patients with acute coronary syndromes (ACS). In fact, the hazard for an adverse cardiovascular event associated with bleeding is similar to that of a myocardial infarction. Several bleeding risk scores are now available that reliably quantify the probability of an ACS patient experiencing a bleeding complication.
View Article and Find Full Text PDFPiroxicam, an anti-inflammatory drug, exhibits poor water solubility and flow properties, poor dissolution and poor wetting. Consequently, the aim of this study was to improve the dissolution of piroxicam. Microparticles containing piroxicam were produced by spray drying, using isopropyl alcohol and water in the ratio of 40:60 v/v as solvent system, and spray chilling technology by melting the drug and chilling it with a pneumatic nozzle to enhance dissolution rate.
View Article and Find Full Text PDFBackground: Global fusion is recommended in sub-axial cervical spine injuries with retrolisthesis, translation rotation injuries associated with end plate or tear drop fractures. We propose a modification of Stellerman's algorithm which we have used where in patients are primarily treated via anterior decompression and fixation. Global fusion was done only in cases where post-decompression traction does not achieve reduction in cases with locked facets.
View Article and Find Full Text PDFDespite surgical advances, the Bentall procedure still carries a 2-6% rate of acute complications involving the coronary vessels, including ostial stenoses, kinking or pseudoaneurysm formation. We report an unusual case of a patient who developed acute cardiogenic shock within hours following a Bentall procedure, requiring urgent mechanical assist device support. Coronary angiography revealed significant bilateral coronary ostial stenoses; suggesting global cardiac hypoperfusion as the cause for this acute hemodynamic collapse.
View Article and Find Full Text PDFPurpose: Computer navigation has the potential to provide precise intraoperative knowledge to the surgeon. Previous studies with navigation have confirmed its function for improved component position but few studies have reported the accuracy and precision of navigation system in clinical use. With this study we propose to evaluate the efficacy of navigation in guiding cup placement.
View Article and Find Full Text PDFBackground: Restoration of wrist function to close to preinjury levels of patients with intra-articular distal end radius fractures is of concern. Open reduction and internal fixation with angular stable screw fixation implants is coming in vogue but little literature evidence supports it. The objectives of this study are to assess the ability of volar locking plates to maintain fracture reduction when used to treat dorsally displaced intra-articular distal radial fractures and to assess the patient-related outcome after this procedure.
View Article and Find Full Text PDFAlthough current literature demonstrates metabolic abnormalities are associated with mortality, obese patients who tend to have more metabolic abnormalities paradoxically have lower overall mortality rates compared to their normal-weight counterparts. In this study, we examined the prevalence of metabolic abnormality clustering and its relation to mortality in obese and normal-weight patients after percutaneous coronary intervention (PCI). Patients (n = 9,673) undergoing elective PCI from October 2003 through December 2006 at a single urban hospital were categorized by body mass index (BMI) levels of 18.
View Article and Find Full Text PDFObjectives: We seek to identify predictors of 30-day mortality after balloon aortic valvuloplasty (BAV).
Background: To date, there is no validated method of predicting patient outcomes after percutaneous aortic valve interventions.
Methods: Data for consecutive patients with severe aortic stenosis who underwent BAV at the Mount Sinai Medical Center from January 2001 to July 2007 were retrospectively reviewed.
Objectives: To compare the practical use, safety, and clinical outcomes associated with the TandemHeart (TH) versus Impella Recover 2.5 (IR2.5) devices when used for circulatory support during high-risk percutaneous coronary intervention (PCI).
View Article and Find Full Text PDFJACC Cardiovasc Interv
December 2010
Background: There is great variability among individual patients in platelet inhibition after aspirin intake. Aspirin resistance has been associated with a higher incidence of ischemic events after percutaneous coronary intervention (PCI). The optimal antiplatelet therapy in aspirin-resistant patients undergoing PCI is unknown.
View Article and Find Full Text PDFBackground: Transcoronary septal ablation is efficacious for patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) and outflow-tract gradient (OTG). However, while patients with symptomatic concentric left ventricular hypertrophy (CLVH) may develop OTG, the safety and efficacy of septal ablation in these patients is unknown.
Objectives: To determine the potential safety and efficacy of transcoronary alcohol septal ablation in refractory, symptomatic patients with CLVH and significant OTG.
Background: Crohn's disease (CD) can often present initially with extraintestinal manifestations and/or perianal disease. Cytology of such a lesion helps arrive at the diagnosis.
Case: A 27-year-old woman presented with recurrent, painful, discharging perianal lesions.
Contemporary management of coronary artery disease relies increasingly on percutaneous techniques combined with medical therapy. Although percutaneous coronary intervention (PCI) can be performed successfully in most lesions, several difficult lesion subsets continue to present unique technical challenges. These complex lesions may be classified according to anatomic criteria, including extensive calcification, thrombus, and chronic occlusions, or by location, such as bifurcations, saphenous vein grafts and unprotected left main.
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