Cardiac reverse remodelling by imaging parameters with recent changes to guideline medical therapy in heart failure.

Recently established heart failure therapies, including sodium glucose co-transporter 2 inhibitors, angiotensin-neprilysin inhibitors, and cardiac resynchronization therapy, have led to both clinical and structural improvements. Reverse remodelling describes the structural and functional responses to therapy and has been shown to correlate with patients' clinical response, acting as a biomarker for treatment success. The introduction of these new therapeutic agents in addition to advances in non-invasive cardiac imaging has led to an expansion in the evaluation and the validation of cardiac reverse remodelling.

Temporal trends in cardiovascular care: Insights from the COVID-19 pandemic.

In response to the ongoing COVID-19 pandemic, public health care measures have been implemented to limit spread of the contagion and ensure adequate healthcare resource allocation. Correlating with these measures are observed changes in the incidence and outcomes of cardiovascular conditions in the absence of COVID-19 infection. The pandemic has resulted in a reduction in acute coronary syndrome, heart failure and arrhythmia admissions but with worsened outcomes in those diagnosed with these conditions.

Thrombotic Thrombocytopenic Purpura associated with Pembrolizumab.

Introduction: Thrombotic thrombocytopenic purpura (TTP) is a life threatening type of thrombotic microangiopathy (TMA) caused by a deficiency in ADAMTS13. Here, we describe a case of TTP in association with pembrolizumab treatment for metastatic urothelial carcinoma.

Case Report: Our patient was a 68-year-old male who received three cycles of pembrolizumab.

Incidence and treatment of arrhythmias secondary to coronavirus infection in humans: A systematic review.

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide resulting in significant morbidity and mortality. Arrhythmias are prevalent and reportedly, the second most common complication. Several mechanistic pathways are proposed to explain the pro-arrhythmic effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Inpatient rehabilitation facilities: The 3-hour rule.

The aim of this study was to determine whether patients whose treatment is consistent with the 3-hour rule have better outcomes than patients whose treatment is not consistent with the 3-hour rule.This is a retrospective review of the records of 581 patients. The authors compared the outcomes of 397 patients whose therapy was consistent with the 3-hour rule to the outcomes of 184 patients whose therapy was not consistent with the rule for at least one 7-day period during the stay on an inpatient rehabilitation facility.

The contribution of an avoidance response to contralateral neglect.

Displacement of line bisection to the right of midline in a patient with a right hemisphere lesion has been attributed to either contralesional attentional or intentional hemispatial neglect. However, it has been suggested that patients with hemispheric lesions might also have an avoidance response, and the ipsilesional eye and hand deviation attributed to neglect might, at least in part, be related to this response. The authors report a patient with a net contralateral neglect produced by the combination of intention and avoidance factors.

Reduced prepulse inhibition after electrolytic lesions of nucleus accumbens subregions in the rat.

A variety of neurochemical and anatomical studies have shown that the ventral striatal nucleus accumbens (NAcc) can be divided into a predominantly medial 'shell' and a predominantly lateral 'core'. These accumbens subdivisions are innervated by different cortical regions and project to different anatomical targets. Additionally, recent behavioral observations suggest functional differences between the accumbens shell and core.

Mitochondrial toxin 3-nitropropionic acid produces startle reflex abnormalities and striatal damage in rats that model some features of Huntington's disease.

Systemic administration of the mitochondrial toxin 3-nitropropionic acid (3NP) to rats produces striatal lesions that mimic some aspects of pathology in Huntington's disease (HD). To evaluate whether 3NP-induced lesions cause sensorimotor gating deficits observed in HD, we measured prepulse inhibition (PPI) of the acoustic startle reflex after systemic administration of 3NP (10, 15, or 20 mg/kg) to 5-month-old rats. PPI, the reduction of startle magnitude by a weak auditory prestimulus, is significantly reduced in patients with HD.

Regulation of prepulse inhibition by ventral pallidal projections.

The acoustic startle reflex is inhibited by the presentation of a weak auditory prestimulus 30-500 ma prior to the starting stimulus. Previous studies have demonstrated that prepulse inhibition (PPI) of acoustic startle is regulated by GABAergic activity in the ventral pallidum. Ventral pallidal efferents include major projections to the pedunculopontine tegmental nucleus (PPTg), subthalamic nucleus (STN), and mediodorsal thalamus (MD).

Prepulse inhibition in the rat is regulated by ventral and caudodorsal striato-pallidal circuitry.

It has been shown that the acoustic startle reflex is inhibited by weak auditory prepulses presented 30-500 ms prior to the startling stimulus and that this prepulse inhibition (PPI) is modulated by ventral striato-pallidal circuitry. However, dorsal striatal modulation of PPI has not been examined. Cell-specific lesions and intracerebral drug infusions were used to elucidate striatal modulation of PPI.

Ventral pallidal GABA-A receptors regulate prepulse inhibition of acoustic startle.

Prepulse inhibition (PPI) of the acoustic startle reflex occurs when a weak auditory stimulus is presented 30-500 ms before the startling stimulus. Previous studies have shown that PPI is modulated by GABAergic projections from the ventral striatum to the ventral pallidum (VP). To evaluate the anatomical and pharmacological substrates of pallidal modulation of PPI, we measured PPI after intrapallidal infusion of GABA-B and GABA-A antagonists.

Quinolinic acid lesions of the ventral striatum reduce sensorimotor gating of acoustic startle in rats.

The startle reflex is inhibited when the startling stimulus is preceded 30-500 ms by a weak noise or 'prepulse'. While the primary startle circuit is organized at or below the pons, the amount of 'prepulse inhibition' (PPI) is modulated by forebrain activity and is reduced in certain neuropsychiatric disorders. The reduction of PPI in these disorders is thought to reflect disturbances in sensorimotor inhibition which underlie an inability to 'gate' irrelevant sensory, motor or cognitive information.

Markers for biogenic amines in the aged rat brain: relationship to decline in spatial learning ability.

The major goal of the study was to evaluate the relationship of brain aging to individual differences in functional decline in rats. Forebrain choline-acetyltransferase (ChAT) and monoamines, including their metabolites, were examined in young and aged male Long-Evans rats in relation to their spatial learning ability. Aged rats that were unimpaired on a spatial learning task exhibited few changes in neurochemistry relative to the young group: each change in this subgroup was also evident in the remaining aged animals that were behaviorally impaired.

Facial resurfacing with the Limberg flap.

The Limberg flap is a valuable tool in teaching the art of local flap design. It is a very versatile addition to the armamentarium of any surgeon which provides a precise mathematical design for closure of both the primary and the secondary (donor) defect. The lines of maximum extensibility of the skin are crucial in the design of the rhomboid and the flap.