Updates on Radiation Therapy for Pituitary Tumors: Techniques and Prognosis.

Radiation therapy for the treatment of both functional and nonfunctional pituitary tumors for dogs and cats has been described in veterinary medicine with a recent shift in focus toward stereotactic techniques. While the technology required and normal tissue constraints for stereotactic procedures are more stringent, recent publications indicate that, while it helps alleviate clinical signs, the survival response may not be as durable as with conventionally fractionated radiation therapy in dogs, despite being seen in cats. Regardless of the protocol recommendation, potential benefit to the patient is excellent with manageable side effect profiles.

Phenotypic spectrum of the first Belgian founder: a large multi-exon deletion with a varying phenotype.

Background: Variants in the gene are a frequent cause of hypertrophic cardiomyopathy (HCM) but display a large phenotypic heterogeneity. Founder mutations are often believed to be more benign as they prevailed despite potential negative selection pressure. We detected a pathogenic variant in (del exon 23-26) in several probands.

A systematic algorithm for large-bore arterial access closure after TAVI: the TAVI-MultiCLOSE study.

Background: Despite transcatheter aortic valve implantation (TAVI) having become a routine procedure, access site bleeding and vascular complications are still a concern which contribute to procedure-related morbidity and mortality.

Aims: The TAVI-MultiCLOSE study aimed to assess the safety and efficacy of a new vascular closure algorithm for percutaneous large-bore arterial access closure following transfemoral (TF)-TAVI.

Methods: All consecutive TF-TAVI cases in which the MultiCLOSE vascular closure algorithm was used were prospectively included in a multicentre, observational study.

The Place of Transaxillary Access in Transcatheter Aortic Valve Implantation (TAVI) Compared to Alternative Routes-A Systematic Review Article.

Background: Transfemoral transcatheter aortic valve implantation (TAVI) has proven non-inferior or superior against surgical aortic valve replacement (SAVR) for patients at high, intermediate or low surgical risk. However, transfemoral access is not always feasible in patients with severely atherosclerotic or tortuous iliofemoral arteries. For these cases, alternative access techniques have been developed, such as transcarotid, transcaval, direct aortic or transaxillary access.

Chimney Stenting During Transcatheter Aortic Valve Implantation.

Acute coronary artery obstruction is a rare but life-threatening complication of transcatheter aortic valve implantation. In patients at risk of coronary artery obstruction, pre-emptive coronary artery protection with a coronary wire, balloon or stent provides a bailout treatment option. The authors describe the steps involved in performing chimney stenting and summarise the short- and long-term outcome data associated with this technique.

Compromised Cardiopulmonary Exercise Capacity in Patients Early After Endoscopic Atraumatic Coronary Artery Bypass Graft: Implications for Rehabilitation.

Objective: The purpose of this work was to test the hypothesis that cardiopulmonary exercise tolerance is better preserved early after endoscopic atraumatic coronary artery bypass graft (endo-ACAB) surgery versus coronary artery bypass graft (CABG) surgery.

Design: Twenty endo-ACAB surgery patients, 20 CABG surgery patients, and 15 healthy subjects executed a maximal cardiopulmonary exercise test, with assessment and comparison of cycling power output, O2 uptake, CO2 output, respiratory gas exchange ratio, end-tidal O2 and CO2 pressures, equivalents for O2 uptake and CO2 output, heart rate, O2 pulse, expiratory volume, tidal volume, respiratory rate, at peak exercise and ventilatory threshold. In patients, forced expiratory volume and forced vital capacity were measured.

ENT one day surgery: critical analysis with the HFMEA method.

Objectives: Research shows that 51.4% of adverse events in hospitals occur in surgery and that 3-22% of surgical patients experience adverse events. The risk may be even higher when turnover is high and when patients are children, as is often the case in ear, nose and throat surgery.

Liquid chromatographic determination of the plasma concentrations of cefotaxime and desacetylcefotaxime in plasma of critically ill patients.

A method for the simultaneous determination of cefotaxime (CTX) and desacetylcefotaxime (DES) in plasma was developed, using acetonitrile protein precipitation and high-performance liquid chromatography (HPLC) with UV-detection at 285 nm. Desacetylcefotaxime was also analysed after conversion in highly acidic medium to its lactone form (DES-lactone). The chromatographic separation was performed on a C18 Aqua column.

Relationship between gamma-hydroxybutyrate plasma concentrations and its electroencephalographic effects in the rat.

In view of the potential interest in an objective parameter for the depth of coma in intoxications with the recreational drug gamma-hydroxybutyrate (GHB), we have studied the relationship between the plasma concentrations and the electroencephalographic (EEG) changes induced by GHB in the rat. Fifteen rats randomly received either 150 (n = 3), 200 (n = 6) or 300 mg kg(-1) (n = 6) GHB over 5 min, followed by a supramaximal dose of 450 mg kg(-1) over 5 min at the end of the experiment. Plasma concentrations were determined with HPLC.

Development and validation of a high-performance liquid chromatographic method for the determination of gamma-hydroxybutyric acid in rat plasma.

A method for the determination of gamma-hydroxybutyric acid (GHB) in rat plasma was developed using solid-phase extraction (SPE) and high-performance liquid chromatography (HPLC) with UV detection. GHB was isolated from plasma using strong anion-exchange SPE columns. The chromatographic separation was performed on a C18 Aqua column.

Influence of hypovolemia on the pharmacokinetics and the electroencephalographic effect of propofol in the rat.

Background: Hypovolemia decreases the dose requirement for anesthetics, but no data are available for propofol. As it is impossible to study this in patients, a rat model was used in which the influence of hypovolemia on the pharmacokinetics and pharmacodynamics of propofol was investigated.

Methods: Animals were randomly allocated to either a control (n = 9) or a hypovolemia (n = 9) group, and propofol was infused (150 mg x kg(-1) x h(-1)) until isoelectric periods of 5 s or longer were observed in the electroencephalogram.

Trovafloxacin concentrations in airway fluids of patients with severe community-acquired pneumonia.

The penetration of trovafloxacin (TVA), 200 mg once daily, into the airways of 17 patients with severe pneumonia was studied. The mean (standard deviations are given in parentheses) steady-state TVA concentrations, 2 h after the last intake, were 3.1 (0.

Effects of smoking, CYP2D6 genotype, and concomitant drug intake on the steady state plasma concentrations of haloperidol and reduced haloperidol in schizophrenic inpatients.

The effects of smoking, CYP2D6 genotype, and concomitant use of enzyme inducers or inhibitors on the steady state plasma concentrations of haloperidol (HAL) and reduced haloperidol (RHAL) were evaluated in 92 schizophrenic inpatients. All but three of these patients received concomitant medication, in many cases with drugs potentially interacting with HAL. Of the 92 patients, 63 were treated orally with HAL in a daily dose of 0.

Relationship between etomidate plasma concentration and EEG effect in the rat.

Purpose: The effect-plasma concentration relationship of etomidate was studied in the rat using electroencephalographic changes as a pharmacodynamic parameter.

Methods: Etomidate was infused (50 mg/kg/h) in chronically instrumented rats (n=6) until isoelectric periods of 5 s or longer were observed in the electroencephalogram (EEG). The EEG was continuously recorded during the experiment and frequent arterial blood samples were taken for determination of etomidate plasma concentrations.

The influence of hemorrhagic shock on the pharmacokinetics and the analgesic effect of morphine in the rat.

The influence of hemorrhagic shock (removal of 30% of the blood volume) on the pharmacokinetics and the analgesic effect of morphine was investigated in conscious rats. Plasma concentrations of morphine after a bolus injection (5 mg/kg) are higher in the shock animals, which is attributed to a small decrease in clearance (-22%; P > 0.05) and a significant decrease in distribution volume (-33%; P < 0.

Comparison of two high-performance liquid chromatographic methods for monitoring plasma concentrations of haloperidol and reduced haloperidol.

Two high-performance liquid chromatographic methods for monitoring haloperidol (HAL) and reduced haloperidol (RHAL) plasma concentrations were compared. In one method ultraviolet detection and a C18 column were used (UV method); in the other method electrochemical detection and a CN-column were used (EC method). Both methods are accurate and precise.

Variability of morphine disposition during long-term subcutaneous infusion in terminally ill cancer patients.

Objective: To study the plasma concentrations of morphine and its glucuronides to assess the intra- and interindividual variability of the disposition of morphine administered by subcutaneous infusion in cancer patients.

Methods: Blood samples were taken repeatedly in eight patients with severe cancer pain who were being treated with morphine (60-3000 mg per day) via chronic (8-160 days) subcutaneous infusion. Venous blood samples were collected at least weekly and, when possible, on 3 consecutive days after dose adaptation or any other major change in the patients' treatment.

Characterization of the cytochrome P450 isoenzymes involved in the in vitro N-dealkylation of haloperidol.

Aims: The present study was carried out to identify the cytochrome P450 isoenzyme(s) involved in the N-dealkylation of haloperidol (HAL).

Methods: In vitro studies were performed using human liver microsomes and c-DNA-expressed human P450 isoforms. N-dealkylation of HAL was assessed by measuring the formation of 4-(4-chlorophenyl)-4-hydroxypiperidine (CPHP).

Are there differences in late outcome after PTCA for angina pectoris after non-Q wave vs Q wave myocardial infarction?

Aims: Revascularization is thought to improve prognosis better if ischaemia persists after so-called non-Q wave myocardial infarction, than after Q-wave myocardial infarction, because it is assumed that prognosis is better where there is less left ventricular function loss. This study evaluates the differences in clinical outcome between patients with Q wave and those with non-Q wave myocardial infarction who underwent percutaneous transluminal coronary angioplasty because of recurrent ischaemia.

Methods: We retrospectively analysed two consecutive groups of patients who underwent percutaneous transluminal coronary angioplasty for ischaemia after either a non-Q wave (n = 175) or a Q wave (n = 175) myocardial infarction, and who were followed for 4 years.

Dipyridamole-induced angina pectoris during sestamibi stress test in patients with significant coronary artery disease: clinical, angiographic, and nuclear determinants.

Intravenous dipyridamole induces angina pectoris (AP) in some patients with significant coronary artery disease (CAD). The aim of this prospective study was to identify the angiographic, nuclear, and clinical determinants. The authors examined 50 patients consecutively with significant CAD on coronary angiography.

Measurement of cefuroxime in human bronchoalveolar lavage fluid by high-performance liquid chromatography after solid-phase extraction.

A sensitive and selective method for the determination of cefuroxime in bronchoalveolar lavage (BAL) fluid using high-performance liquid chromatography (HPLC) with UV detection at 280 nm after solid-phase extraction with C18 cartridges was developed. A Waters symmetry C18 column was used and the mobile phase was acetonitrile-0.05 M ammonium phosphate buffer (pH 3.

High performance liquid chromatography determination of dextromethorphan and its metabolites in urine using solid-phase extraction.

A high performance liquid chromatography assay coupled with fluorescence detection was developed for the determination of dextromethorphan and its metabolites in urine. The products and the internal standard, pholcodine, were separated on an Alltima C18, 5 microns column (250 x 4.6 mm), using a mobile phase containing sodium dodecyl sulphate (1 mM) in a mixture of acetonitrile-sodium dihydrogen phosphate (0.

Severe diltiazem poisoning with intestinal pseudo-obstruction: case report and toxicological data.

This case report concerns a 30-year-old man who survived a 4.2 g diltiazem overdose. He sustained vasoplegic shock with a junctional escape rhythm which required high doses of norepinephrine and epinephrine.