Stent grafting for aneurysmal degeneration of chronic descending thoracic aortic dissections.

Objective: The objective of this study was to examine the results of thoracic endovascular aneurysm repair (TEVAR) for chronic descending thoracic aortic (DTA) dissections with aneurysmal degeneration.

Methods: Over 70 months at a single institution, 27 patients underwent TEVAR for aneurysms related to chronic (>6 weeks) DTA dissections.

Results: Mean patient age was 67.

A genome-wide association search for type 2 diabetes genes in African Americans.

African Americans are disproportionately affected by type 2 diabetes (T2DM) yet few studies have examined T2DM using genome-wide association approaches in this ethnicity. The aim of this study was to identify genes associated with T2DM in the African American population. We performed a Genome Wide Association Study (GWAS) using the Affymetrix 6.

Understanding neuromotor strategy during functional upper extremity tasks using symbolic dynamics.

The ability to model and quantify brain activation patterns that pertain to natural neuromotor strategy of the upper extremities during functional task performance is critical to the development of therapeutic interventions such as neuroprosthetic devices. The mechanisms of information flow, activation sequence and patterns, and the interaction between anatomical regions of the brain that are specific to movement planning, intention and execution of voluntary upper extremity motor tasks were investigated here. This paper presents a novel method using symbolic dynamics (orbital decomposition) and nonlinear dynamic tools of entropy, self-organization and chaos to describe the underlying structure of activation shifts in regions of the brain that are involved with the cognitive aspects of functional upper extremity task performance.

B-cell depletion and remissions of malignancy along with cytokine-associated toxicity in a clinical trial of anti-CD19 chimeric-antigen-receptor-transduced T cells.

We conducted a clinical trial to assess adoptive transfer of T cells genetically modified to express an anti-CD19 chimeric Ag receptor (CAR). Our clinical protocol consisted of chemotherapy followed by an infusion of anti-CD19-CAR-transduced T cells and a course of IL-2. Six of the 8 patients treated on our protocol obtained remissions of their advanced, progressive B-cell malignancies.

Presentation, complications, and natural history of penetrating atherosclerotic ulcer disease.

Objectives: Increased utilization of computed tomography angiography (CTA) has increased the radiologic diagnosis of penetrating atherosclerotic ulcers (PAUs), which are defined as the ulceration of atherosclerotic plaque through the internal elastic lamina into the aortic media. However, the presentation, treatment indications, and natural history of this disease process remain unclear.

Methods: The radiology database at a single university hospital was searched retrospectively for the CTA diagnosis of PAU from January 2003 to June 2009.

Evaluating the effectiveness of a schools-based programme to promote exercise self-efficacy in children and young people with risk factors for obesity: steps to active kids (STAK).

Background: Low levels of physical activity in children have been linked to an increased risk of obesity, but many children lack confidence in relation to exercise (exercise self-efficacy). Factors which can impact on confidence include a chronic health condition such as asthma, poor motor skills and being overweight. Increasing levels of physical activity have obvious benefits for children with asthma and children who are overweight, but few activity interventions with children specifically target children with low exercise self-efficacy (ESE).

Increased wall stress of saccular versus fusiform aneurysms of the descending thoracic aorta.

Background: Repair of fusiform descending thoracic aortic aneurysms (DTAs) is indicated when aneurysmal diameter exceeds a certain threshold; however, diameter-related indications for repair of saccular DTA are less well established.

Methods: Human subjects with fusiform (n = 17) and saccular (n = 17) DTAs who underwent computed tomographic angiography were identified. Patients with aneurysms related to connective tissue disease were excluded.

Adaptive multi-cluster fuzzy C-means segmentation of breast parenchymal tissue in digital mammography.

The relative fibroglandular tissue content in the breast, commonly referred to as breast density, has been shown to be the most significant risk factor for breast cancer after age. Currently, the most common approaches to quantify density are based on either semi-automated methods or visual assessment, both of which are highly subjective. This work presents a novel multi-class fuzzy c-means (FCM) algorithm for fully-automated identification and quantification of breast density, optimized for the imaging characteristics of digital mammography.

Myocardial structure, function, and scar in patients with type 1 diabetes mellitus.

Background: We report relationships between cardiovascular disease risk factors and myocardial structure, function, and scar in patients with type 1 diabetes mellitus in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study.

Methods And Results: Cardiac magnetic resonance was obtained in 1017 patients with type 1 diabetes mellitus. Gadolinium cardiac magnetic resonance was also obtained in 741 patients.

Using focused missed-case conferences to reduce discrepancies in musculoskeletal studies interpreted by residents on call.

Objective: The purpose of this study is to determine whether focused missed-case conferences can significantly reduce the number of major discrepancies in musculoskeletal imaging studies interpreted by residents on call.

Materials And Methods: A review of major discrepancies in musculoskeletal conventional radiography imaging studies interpreted by radiology residents and fellows on call from July 2008 to July 2009 revealed 31 common and important musculoskeletal injuries missed or misinterpreted at our institution. These missed cases were presented during focused missed-case conferences from July through October 2009.

Increased ascending aortic wall stress in patients with bicuspid aortic valves.

Background: Patients with bicuspid aortic valves (BAV) are at increased risk of ascending aortic dilatation, dissection, and rupture. We hypothesized that ascending aortic wall stress may be increased in patients with BAV compared with patients with tricuspid aortic valves (TAV).

Methods: Twenty patients with BAV and 20 patients with TAV underwent electrocardiogram-gated computed tomographic angiography.

Predictors of decreased short- and long-term survival following open abdominal aortic aneurysm repair.

Objectives: The purpose of this study was to identify predictors of decreased survival after open abdominal aortic aneurysm (AAA) repair at a single university hospital.

Methods: Patients undergoing open AAA repair from June 2003 to June 2009 were identified. Primary outcomes were 30-day and 5-year survival.

Low rehospitalization rate for vascular surgery patients.

Objectives: Reducing rehospitalization rates has been proposed to improve care, reduce costs, and as a pay-for-performance criterion. Recent review of Medicare claims data indicates that vascular surgery patients have among the highest rates of 30-day rehospitalization at 23.9%.

ANGPTL4 variants E40K and T266M are associated with lower fasting triglyceride levels in Non-Hispanic White Americans from the Look AHEAD Clinical Trial.

Background: Elevated triglyceride levels are a risk factor for cardiovascular disease. Angiopoietin-like protein 4 (Angptl4) is a metabolic factor that raises plasma triglyceride levels by inhibiting lipoprotein lipase (LPL). In non-diabetic individuals, the ANGPTL4 coding variant E40K has been associated with lower plasma triglyceride levels while the T266M variant has been associated with more modest effects on triglyceride metabolism.

Does glucose variability influence the relationship between mean plasma glucose and HbA1c levels in type 1 and type 2 diabetic patients?

Objective: The A1C-Derived Average Glucose (ADAG) study demonstrated a linear relationship between HbA(1c) and mean plasma glucose (MPG). As glucose variability (GV) may contribute to glycation, we examined the association of several glucose variability indices and the MPG-HbA(1c) relationship.

Research Design And Methods: Analyses included 268 patients with type 1 diabetes and 159 with type 2 diabetes.

Preventing childhood obesity during infancy in UK primary care: a mixed-methods study of HCPs' knowledge, beliefs and practice.

Background: There is a strong rationale for intervening in early childhood to prevent obesity. Over a quarter of infants gain weight more rapidly than desirable during the first six months of life putting them at greater risk of obesity in childhood. However, little is known about UK healthcare professionals' (HCPs) approach to primary prevention.

Executive summary: guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.

Background: Multiple laboratory tests are used in the diagnosis and management of patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these assays varies substantially.

Approach: An expert committee compiled evidence-based recommendations for the use of laboratory analysis in patients with diabetes.

Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.

Background: Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially.

Approach: An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes.

Position statement executive summary: guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.

Background: Multiple laboratory tests are used in the diagnosis and management of patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these assays varies substantially.

Approach: An expert committee compiled evidence-based recommendations for the use of laboratory analysis in patients with diabetes.

Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.

Background: Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially.

Approach: An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes.

Obesity and type 2 diabetes: what can be unified and what needs to be individualized?

Objective: This report examines what is known about the relationship between obesity and type 2 diabetes and how future research in these areas might be directed to benefit prevention, interventions, and overall patient care.

Research Design And Methods: An international working group of 32 experts in the pathophysiology, genetics, clinical trials, and clinical care of obesity and/or type 2 diabetes participated in a conference held on 6-7 January 2011 and cosponsored by The Endocrine Society, the American Diabetes Association, and the European Association for the Study of Diabetes. A writing group comprising eight participants subsequently prepared this summary and recommendations.

Obesity and type 2 diabetes: what can be unified and what needs to be individualized?

Objective: This report examines what is known about the relationship between obesity and type 2 diabetes and how future research in these areas might be directed to benefit prevention, interventions, and overall patient care.

Research Design And Methods: An international working group of 32 experts in the pathophysiology, genetics, clinical trials, and clinical care of obesity and/or type 2 diabetes participated in a conference held on 6-7 January 2011 and cosponsored by The Endocrine Society, the American Diabetes Association, and the European Association for the Study of Diabetes. A writing group comprising eight participants subsequently prepared this summary and recommendations.

Open and endovascular repair of hepatic artery aneurysm: two case reports and review of the literature.

Hepatic artery aneurysms (HAAs) represent a complex and often lethal condition. An 80-year-old woman with polyarteritis nodosa and a right hepatic lobe HAA underwent endovascular repair with coils. Her case was complicated by intraoperative HAA rupture requiring exploratory laparotomy.