Adoption and patterns of use of invasive physiological assessment of coronary artery disease in a large cohort of 40821 real-world procedures over a 12-year period.

Introduction And Objectives: Use of invasive physiological assessment in patients with coronary artery disease varies widely and is perceived to be low. We aimed to examine adoption rates as well as patterns and determinants of use in an unselected population undergoing invasive coronary angiography over a long time frame.

Methods: We retrospectively determined the per-procedure prevalence of physiological assessment in 40821 coronary cases performed between 2007 and 2018 in two large-volume centers.

Adoption and patterns of use of invasive physiological assessment of coronary artery disease in a large cohort of 40821 real-world procedures over a 12-year period.

Introduction And Objectives: Use of invasive physiological assessment in patients with coronary artery disease varies widely and is perceived to be low. We aimed to examine adoption rates as well as patterns and determinants of use in an unselected population undergoing invasive coronary angiography over a long time frame.

Methods: We retrospectively determined the per-procedure prevalence of physiological assessment in 40821 coronary cases performed between 2007 and 2018 in two large-volume centers.

A reversible cause of left ventricular dysfunction: Case report and brief review.

The authors describe a case of a patient admitted to the emergency department with diabetic ketoacidosis. Although there were no symptoms attributable to the cardiovascular system, lab tests revealed elevated troponin I and natriuretic peptides, coupled with repolarization abnormalities on the ECG. The transthoracic echocardiogram (TTE) showed a non-dilated left ventricle with severe left ventricular systolic dysfunction due to diffuse hypokinesia, and a concomitant diagnosis of profile L heart failure was proposed.

Maternal ingestion of cocoa causes constriction of fetal ductus arteriosus in rats.

Maternal consumption of polyphenol-rich foods has been associated with fetal ductus arteriosus constriction (DAC), but safety of chocolate exposure in fetal life has not been studied. This experimental study tested the hypothesis that maternal cocoa consumption in late pregnancy causes fetal DAC, with possible associated antioxidant effects. Pregnant Wistar rats, at the 21st gestational day, received by orogastric tube cocoa (720 mg/Kg) for 12 h, indomethacin (10 mg/Kg), for 8 h, or only water, before cesaren section.

A reversible cause of left ventricular dysfunction: Case report and brief review.

The authors describe a case of a patient admitted to the emergency department with diabetic ketoacidosis. Although there were no symptoms attributable to the cardiovascular system, lab tests revealed elevated troponin I and natriuretic peptides, coupled with repolarization abnormalities on the ECG. The transthoracic echocardiogram (TTE) showed a non-dilated left ventricle with severe left ventricular systolic dysfunction due to diffuse hypokinesia, and a concomitant diagnosis of profile L heart failure was proposed.

Pancreatic Cancer Incidence, Mortality, and Survival in Puerto Rico, 2001-2015.

Objective: To perform an epidemiologic profile of pancreatic cancer (PC) in Puerto Rico (PR) with data gathered from 2001 to 2015.

Methods: Using data from the PR Central Cancer Registry we estimated incidence and mortality rates and trends of PC in PR, and performed survival analyses. We also compared the age-standardized incidence and mortality rates of PC in people in PR with those of Hispanics, non-Hispanic whites, and non Hispanic blacks in the United States (US).

Anterior and Posterior Mediastinum Leiomyomas Arising From the Parietal Pleura.

A 72-year-old male patient was found with enlarged nodes in the anterior and posterior mediastinum on screening imaging studies of the chest. The anterior node appeared as a single cystic lesion without significant metabolic activity on scintigraphy images. The posterior node was a single solid lesion in the lower left periesophageal space above the diaphragmatic crura with moderate metabolic uptake.

Concomitant pulmonary embolism and aortic dissection: approach to anticoagulation.

The authors describe a case of a patient admitted with a pre-syncopal episode and precordial discomfort, and whose cardiac ultrasound performed in the Emergency Room was suggestive of Pulmonary Embolism. The patient was submitted to fibrinolytic therapy after cardiac arrest. The computerized tomography done after this episode not only confirmed the presence of pulmonary embolism but had also shown a Stanford Type B Aortic Dissection.

Use of adjuvant chemotherapy in patients with stage III colon cancer in Puerto Rico: A population-based study.

Objective: This study aims to examine factors associated with the use of adjuvant chemotherapy and the use of oxaliplatin after curative resection in stage III colon cancer patients and assesses the effect of their use in three-year survival.

Methods: This retrospective cohort study was conducted using Puerto Rico Central Cancer Registry-Health Insurance Linkage Database. The study cohort consisted of stage III colon cancer patients with a curative surgery in the period 2008-2012.

The prevalence of Barrett's-esophagus-associated dysplasia in Puerto Rico.

Objective: Barrett's esophagus (BE) is the strongest risk factor of esophageal adenocarcinoma (EAC). A previous study found a lower incidence of EAC in Puerto Rico (PR) as compared to other racial/ethnic groups in the United States (US). Notwithstanding, BE epidemiology in PR is unknown.

Complement protein C1q promotes macrophage anti-inflammatory M2-like polarization during the clearance of atherogenic lipoproteins.

Objective: Innate immune protein C1q plays a dual role in the chronic inflammatory disease of atherosclerosis. Complement activation via C1q exacerbates pathology in the atherosclerotic lesion in later stages of the disease. However, in early stages of disease C1q is protective.

Aldehyde dehydrogenase 2 activation in heart failure restores mitochondrial function and improves ventricular function and remodelling.

Aims: We previously demonstrated that pharmacological activation of mitochondrial aldehyde dehydrogenase 2 (ALDH2) protects the heart against acute ischaemia/reperfusion injury. Here, we determined the benefits of chronic activation of ALDH2 on the progression of heart failure (HF) using a post-myocardial infarction model.

Methods And Results: We showed that a 6-week treatment of myocardial infarction-induced HF rats with a selective ALDH2 activator (Alda-1), starting 4 weeks after myocardial infarction at a time when ventricular remodelling and cardiac dysfunction were present, improved cardiomyocyte shortening, cardiac function, left ventricular compliance and diastolic function under basal conditions, and after isoproterenol stimulation.

Acute coronary syndrome of paradoxical origin.

We describe a rare case of acute myocardial infarction secondary to paradoxical embolism complicating acute pulmonary embolism. A 44-year-old woman presented to the emergency department with chest pain. The physical examination was unremarkable except for oxygen saturation of 75%, and the electrocardiogram showed ST-segment elevation in the inferior leads.

Esophageal cancer incidence rates by histological type and overall: Puerto Rico versus the United States Surveillance, Epidemiology, and End Results population, 1992-2005.

Objective: The aim of our study was to compare the age-standardized incidence of esophageal cancer (EC) in Puerto Ricans (PRs) with that for non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic (USH), groups in the United States (US) as reported by the Surveillance, Epidemiology, and End Results program for the 1992-2005 period.

Methods: We computed the age-standardized and age-specific incidence (per 100,000 individuals) of EC during 1992-2005 using the World Standard Population as reference. The percent changes for age-standardized rates (ASR), from 1992-1996 to 2001-2005, were calculated.

Natural orifice translumenal endoscopic surgery for anterior spinal procedures.

Background. NOTES techniques allow transesophageal access to the mediastinum. The aim of this study was to assess the feasibility of transesophageal biopsy of thoracic vertebrae.

[A rare form of acute pulmonary edema: case report].

We report the case of a 21-year-old man who underwent appendectomy under general anesthesia and developed acute pulmonary edema immediately after extubation. We then review the literature, focusing on the pathophysiology and the most important aspects of diagnosis and treatment of post-extubation pulmonary edema.

A 2-microm continuous-wave laser system for safe and high-precision dissection during NOTES procedures.

Introduction: Lasers 2-microm in wavelength offer efficient tissue cutting with limited thermal damage in biological tissue.

Objective: To evaluate the dissection capabilities of a 2-microm continuous-wave laser for NOTES procedures.

Methods And Procedures: We conducted 18 acute animal experiments.

Infection during natural orifice transluminal endoscopic surgery: a randomized, controlled study in a live porcine model.

Background: Currently reported natural orifice transluminal endoscopic surgery (NOTES) procedures in animals have been done in heterogeneous milieus ranging from nonsterile to sterile procedures, with mixed results, including no infection in those performed in nonsterile settings.

Objective: To establish the potential frequency of infection during NOTES, comparing sterile to nonsterile approaches.

Setting: Survival experiments on sixteen 50-kg pigs.

Recombinant human granulocyte-macrophage colony stimulating factor (sargramostim) as an alternative therapy for fistulizing Crohn's disease.

Background: Impaired neutrophil function has been proposed in the pathogenesis of Inflammatory Bowel Disease. Failure to control the response to bacteria and bacterial products triggers the inflammatory cascade. Genetic disorders of neutrophil dysfunction exhibit gastrointestinal manifestations similar to Crohn's disease.

Effects of fluid resuscitation on cardiovascular performance after posttraumatic pneumonectomy.

Background: : Several factors have been implicated in the high-mortality rate of posttraumatic pneumonectomy. In this study, we evaluated the hemodynamic and echocardiographic changes induced by pneumonectomy and fluid resuscitation after hemorrhagic shock.

Methods: : Fourteen dogs were bled to a target mean arterial pressure of 40 mmHg.

Patient- and cyst-related factors for improved prediction of malignancy within cystic lesions of the pancreas.

Background And Aims: Early diagnosis of cancer in pancreatic cysts is important for timely referral to surgery. The aim of this study was to develop a predictive model for pancreatic cyst malignancy to improve patient selection for surgical resection.

Methods: We performed retrospective analyses of endoscopic ultrasound (EUS) and pathology databases identifying pancreatic cysts with available final pathological diagnoses.

Successful diagnostic and therapeutic intrauterine fetal interventions by natural orifice transluminal endoscopic surgery (with videos).

Background: Despite advances in the development of fetal surgery, morbidity and mortality are substantial. A natural orifice transluminal endoscopic surgery (NOTES)-guided approach to the gravid uterus may offer a less-invasive technique.

Objective: To assess the feasibility of NOTES for diagnostic and therapeutic intrauterine fetal interventions.