Impaired balance between coronary blood flow and myocardial metabolism in postpartum swine.

Understanding of the mechanisms contributing to the increased maternal susceptibility for major adverse cardiovascular events in the postpartum period remains poor. Accordingly, this study tested the hypothesis that the balance between coronary blood flow and myocardial metabolism is compromised during the puerperium period (35-45 days post-delivery) in swine. Systemic and coronary hemodynamic responses were assessed in anesthetized, open-chest control (nonpregnant) and puerperium/postpartum swine at baseline and in response to intravenous infusion of dobutamine (1-30 μg/kg/min).

Outbreak of pertussis among healthcare workers in a hospital maternity unit.

In December 2015, an outbreak of pertussis was detected among staff working in the Maternity Unit of a district general hospital in Hampshire. This occurred in the background of increased pertussis activity in the community. The outbreak occurred over the Christmas holiday period causing staff shortages at a time when the departments were already overstretched.

New developments in the treatment of hypoactive sexual desire disorder - a focus on Flibanserin.

The objective of the authors is to highlight the historical complexities for the diagnosis and treatment of hypoactive sexual desire disorder (HSDD) with a focus on Flibanserin. A systematic review of the medical literature published in PubMed using the search terms HSDD and Flibanserin was conducted. Each author reviewed the results of the systematic review for articles to include in this study.

Feasibility of Transseptal Puncture Using a Nonfluoroscopic Catheter Tracking System.

Background: Radiation exposure in the electrophysiology lab is a major occupational hazard to the electrophysiologists. A catheter localization system (MediGuide Technology, St. Jude Medical Inc.

Impact of nonfluoroscopic MediGuide™ tracking system on radiation exposure in radiofrequency ablation procedures (LESS-RADS registry)-an initial experience.

Background: Radiation exposure in the electrophysiology (EP) lab is a major concern to most electrophysiologists. A new technology, MediGuide™ nonfluoroscopic catheter tracking system, has been used for the first time in the USA recently. We intended to evaluate the efficacy of this novel catheter tracking system in reducing radiation exposure.

Atrial Flutter Ablation Using MediGuide Non-fluoroscopic Catheter Tracking System: A Novel Technology to Reduce Radiation Exposure.

We describe the first case of cardiac arrhythmia ablation with the novel MediGuide non-fluoroscopic catheter tracking system in North America. This new technology uses electromagnetic field to track sensor integrated intracardiac electrophysiology catheters which are projected on pre-recorded fluoroscopy cine loops. This new technology permits catheter tracking in virtual biplane fluoroscopy and enhances spatial resolution of conventional 3D mapping systems while drastically reducing radiation exposure.

Epidemiology of antimicrobial resistance among gram-negative organisms recovered from patients in a multistate network of long-term care facilities.

We identified 1,805 gram-negative organisms in cultures of urine samples obtained over a 10-month period from residents of 63 long-term care facilities. The prevalence of fluoroquinolone resistance in Escherichia coli was 51% (446 of 874 isolates), whereas the prevalences of ceftazidime and imipenem resistance in Klebsiella species were 26% and 6% (84 and 19 of 323 isolates), respectively. The prevalence of resistance varied significantly by facility type, size, and geographic location.

Extracorporeal life support for support of children with malignancy and respiratory or cardiac failure: The extracorporeal life support experience.

Background: Extracorporeal life support (ECLS) is a means of respiratory and hemodynamic support for patients failing conventional therapies. Children with cancer who develop complications during therapy may require ECLS.

Methods: The extracorporeal life support organization (ELSO) registry was queried for all patients younger than 21 years with an International Classification of Diseases, Ninth Revision diagnosis of neoplasm.

Enhanced fluid management with continuous venovenous hemofiltration in pediatric respiratory failure patients receiving extracorporeal membrane oxygenation support.

Background/purpose: Children receiving extracorporeal membrane oxygenation (ECMO) for respiratory failure can have significant fluid overload and renal insufficiency. Addition of inline continuous venovenous hemofiltration (CVVH) could provide additional benefits in fluid management compared to use of standard medical therapies with ECMO.

Methods: Patients with pediatric respiratory failure receiving ECMO with CVVH were case-matched to similar patients receiving ECMO without CVVH to compare fluid balance, medication use, and clinical outcomes.

Oocyte-specific G-protein-coupled receptor 3 (GPR3): no perturbations found in 82 women with premature ovarian failure (first report).

The oocyte-specific G-protein-coupled receptor 3 (GPR3) gene is essential in maintaining meiotic arrest in mouse oocytes. Disruption of GPR3 results in early depletion of oocytes and thus premature ovarian aging. To determine if mutations of the GPR3 gene were present in 82 predominantly North American caucasian women with premature ovarian failure (POF), we used denaturing high-performance liquid chromatography and DNA sequencing to detect sequence variants.

Growth differentiating factor-9 mutations may be associated with premature ovarian failure.

Objective: To determine whether perturbations of the growth differentiating factor-9 (GDF9) gene are associated with premature ovarian failure (POF).

Design: Mutational analysis of the GDF9 gene in 61 women with POF.

Setting: Academic institution.

Gadolinium radiologic contrast is a useful alternative for hysterosalpingography in patients with iodine allergy.

Objective: To report the successful use of gadolinium radiologic contrast for hysterosalpingography.

Design: Case report.

Setting: Outpatient care in a private practice setting.

Uteroovarian ligament torsion of the due to a paratubal cyst.

Paratubal cysts rarely undergo torsion. When they do, typically they involve the infundibulopelvic ligament and affect the ovary and fallopian tube. We present a case and discussion of torsion of the uteroovarian ligament secondary to a large paratubal cyst with preservation of the ovary and fallopian tube.

Characterizing ectopic pregnancies that rupture despite treatment with methotrexate.

Objective: To identify risk factors for tubal rupture among ectopic pregnancies treated with methotrexate (MTX).

Design: Retrospective case-control analysis.

Setting: An urban medical center.

Extracorporeal life support for posttraumatic acute respiratory distress syndrome at a children's medical center.

Background: Primary traumatic injury was considered previously a contraindication for institution of extracorporeal life support because of high risk for persistent or new bleeding. Published experience in adults suggests that extracorporeal membrane oxygenation (ECMO) can successfully support trauma victims with pulmonary failure. The authors reviewed their experience with the use of ECMO in pediatric and adult trauma patients with acute respiratory distress syndrome (ARDS) at a children's medical center.

Somatic DNA alterations in endometriosis: high frequency of chromosome 17 and p53 loss in late-stage endometriosis.

Problem: Genetic predisposition to endometriosis is well established, but the gene(s) involved largely remain unknown. Although endometriosis is considered a benign disease, it displays several features similar to malignancy: altered morphology, disregulated growth, invasion. We hypothesize endometriosis arises as result of somatic DNA alterations occurring in a multi-step process, analogous to origin of neoplasia.

Pregnancies following use of metformin for ovulation induction in patients with polycystic ovary syndrome.

Objective: To assess pregnancy outcome in anovulatory infertility patients diagnosed with polycystic ovary syndrome (PCOS) who were treated with metformin.

Design: Case series.

Setting: Outpatient.