Impact of abobotulinumtoxinA on the clinical features of cervical dystonia in routine practice.

Introduction: The efficacy and safety of abobotulinumtoxinA in the management of cervical dystonia has been established in randomized, controlled trials that use a selected trial population. In this meta-analysis of observational data, we evaluated the real-life effectiveness of abobotulinumtoxinA as delivered in routine clinical practice.

Methods: Meta-analysis of patient-level data for adult patients with cervical dystonia treated with abobotulinumtoxinA from three prospective, multicenter, observational studies (NCT01314365, NCT00833196 and NCT01753349).

Cumulative effects of long-term treatment with abobotulinumtoxinA in cervical dystonia: Findings from a prospective, observational study.

Objective: Patients with cervical dystonia (CD) require regular injections of botulinum neurotoxin type A (BoNT-A) to maintain treatment effectiveness. In this secondary analysis of a large routine-practice study, we assessed the response to abobotulinumtoxinA over repeated cycles and compared the responses of patients previously naïve to BoNT treatment to those already treated with BoNT-A.

Methods: INTEREST IN CD2 was a prospective, 3-year, observational study following CD patients treated with BoNT-A.

Correction to: How satisfied are cervical dystonia patients after 3 years of botulinum toxin type A treatment? Results from a prospective, long-term observational study.

The article How satisfied are cervical dystonia patients after 3 years of botulinum toxin type A treatment?

How satisfied are cervical dystonia patients after 3 years of botulinum toxin type A treatment? Results from a prospective, long-term observational study.

Background: Patients with cervical dystonia (CD) typically require regular injections of botulinum toxin to maintain symptomatic control. We aimed to document long-term patient satisfaction with CD symptom control in a large cohort of patients treated in routine practice.

Methods: This was a prospective, international, observational study (NCT01753349) following the course of adult CD treated with botulinum neurotoxin type A (BoNT-A) over 3 years.

Spectrum of practice in the routine management of cervical dystonia with abobotulinumtoxinA: findings from three prospective open-label observational studies.

Background: Cervical dystonia is a heterogeneous disorder with several possible presentations, for which first-line therapy is often botulinum toxin (BoNT). In routine clinical practice the success of each BoNT injection is dependent on several variables, including individual presentation and injection technique. Large multicenter, observational studies provide important information on individualized administration strategies that cannot be otherwise ascertained from controlled clinical trials.

INTEREST IN CD2, a global patient-centred study of long-term cervical dystonia treatment with botulinum toxin.

Background: Longitudinal cohort studies provide important information about the clinical effectiveness of an intervention in the routine clinical setting, and are an opportunity to understand how a population presents for treatment and is managed.

Methods: INTEREST IN CD2 (NCT01753349) is a prospective, international, 3-year, longitudinal, observational study following the course of adult idiopathic cervical dystonia (CD) treated with botulinum neurotoxin type A (BoNT-A). The primary objective is to document long-term patient satisfaction with BoNT-A treatment.

Histologic analysis of a covered stent implanted for pseudoaneurysm in a coronary artery.

Covered stents are the standard of care when coronary perforations complicate percutaneous coronary interventions and have also been utilized in the treatment of coronary aneurysms. We present the clinical and histologic features of a patient who developed a coronary perforation and pseudoaneurysm 4 years following deployment of intracoronary stents. Although the covered stent successfully sealed the perforation, subsequent thrombosis led to a fatal acute myocardial infarction.

Factors influencing response to Botulinum toxin type A in patients with idiopathic cervical dystonia: results from an international observational study.

Objectives: Real-life data on response to Botulinum toxin A (BoNT-A) in cervical dystonia (CD) are sparse. An expert group of neurologists was convened with the overall aim of developing a definition of treatment response, which could be applied in a non-interventional study of BoNT-A-treated subjects with CD.

Design: International, multicentre, prospective, observational study of a single injection cycle of BoNT-A as part of normal clinical practice.

Transcatheter closure of left ventricular pseudoaneurysm.

Left ventricular pseudoaneurysm is a rare complication of myocardial infarction, cardiovascular surgery, trauma, or infection. Untreated left ventricular pseudoaneurysm can have significant morbidity and mortality. Surgical treatment has generally been the standard of care.

Oral antiplatelet therapy in diabetes mellitus and the role of prasugrel: an overview.

Diabetics have a prothrombotic state that includes increased platelet reactivity. This contributes to the less favorable clinical outcomes observed in diabetics experiencing acute coronary syndromes as well as stable coronary artery disease. Many diabetics are relatively resistant to or have insufficient response to several antithrombotic agents.

Coronary artery spasm during angiography in a pediatric heart transplant recipient: subsequent prevention by intracoronary nitroglycerin administration.

Coronary artery spasm can occur during coronary angiography in pediatric heart transplant recipients. The angiographic appearance can suggest allograft vasculopathy. We report coronary artery spasm in a pediatric heart transplant recipient in whom intracoronary nitroglycerin administration prevented a repetition of spasm upon subsequent diagnostic coronary angiography.

Liver transplantation after radioembolization in a patient with unresectable HCC.

Background: A 58-year-old white man who was being followed by his hepatologist for nonalcoholic steatohepatitis-related liver cirrhosis and portal hypertension and who had been found to have a biopsy-proven hepatocellular carcinoma (HCC) on routine screening, self-referred to our center for a second opinion on the management of his HCC.

Investigations: Laboratory investigations, CT scan of the abdomen and chest, bone scan and technetium macroaggregated albumin scan.

Diagnosis: The patient had unresectable HCC.

Pretreatment with nitroprusside for microcirculatory protection in saphenous vein graft interventions.

Objectives: We hypothesized that the prophylactic administration of sodium nitroprusside (NTP) during saphenous vein graft (SVG) PCI would ameliorate the detrimental effects of distal embolization and reduce the frequency and magnitude of post-procedural myonecrosis.

Methods: Sixty-four consecutive patients with normal preprocedural cardiac enzymes underwent SVG PCI without embolic protection devices and received prophylactic intragraft NTP before initial device activation. For each case, 2 control patients were selected in reverse chronologic order and were matched for stent use, thromboatherectomy device use, clinical presentation, presence of thrombus and pre-PCI thrombolysis in myocardial infarction (TIMI) flow.

Nonalcoholic fatty liver disease and cardiovascular risk.

Nonalcoholic fatty liver disease (NAFLD) is a very common cause of chronic liver disease in the United States. A large proportion of patients with NAFLD have coexisting metabolic syndrome, a major risk factor for cardiovascular disease. A strong association between NAFLD and cardiovascular disease has been long suspected, and recent studies have confirmed that cardiovascular disease is the single most important cause of mortality in this patient population.

Rheolytic thrombectomy for dural venous sinus thrombosis.

Background And Purpose: Cerebral venous thrombosis is a rare condition. Its diagnosis and management can be difficult. Treatment options include systemically delivered anticoagulation or thrombolysis.

Vascular changes and black hole phenomenon after coronary brachytherapy: a pathologically distinct entity.

Restenosis remains an important issue even after coronary brachytherapy despite its efficacy in the treatment for in-stent restenosis. The acute and chronic changes in vascular wall are unique following brachytherapy. The restenotic tissue post coronary brachytherapy is relatively acellular and appears echolucent in intravascular ultrasound examination.

The safety of bivalirudin during elective percutaneous coronary interventions in heart transplant patients.

Background: Bivalirudin has been shown to be safe and effective during percutaneous coronary interventions (PCI) of native coronary arteries in the REPLACE 2 trial. The safety of bivalirudin during PCIs in heart transplant patients is not known.

Methods: Heart transplant patients who had undergone PCI of de novo lesions and received bivalirudin during the procedure were included in the study.

Saphenous vein graft-to-left atrium fistula treated with percutaneous transcatheter embolization with coils.

Coronary artery fistulae are rare anomalies that are most commonly congenital and rarely acquired. We present a first case of a vein graft to the left atrium fistula that occurred post coronary artery bypass grafting and was treated with percutaneous transcatheter embolization with coiling. The coil was initially lost in the left atrium, but was successfully retrieved and the fistula was closed.

Use of Tandem Heart as a temporary hemodynamic support option for severe pulmonary artery hypertension complicated by cardiogenic shock.

The TandemHeart is a recently-introduced percutaneous ventricular assist device that may be used for short-term hemodynamic support. Its utility has been shown for assisting the left ventricle in a variety of high-risk percutaneous interventions, in helping the left ventricle recover from myocarditis, in cardiomyopathies and in cardiogenic shock following acute coronary syndromes. Limited data exist on its applications in patients with right ventricular failure.