The COAPT 5-year data demonstrate that compared with medical treatment transcatheter edge-to-edge repair (TEER) with the MitraClip in symptomatic patients with Grade 3+/Grade 4+ secondary mitral regurgitation (SMR) reduced by nearly half the annualized hospitalization risk (33 vs. 57%), by almost 30% the death rate (57 vs. 67%) and achieved significant and durable SMR reduction in 95% of patients. Control patients who crossed over to TEER at 2 years had better prognosis, but nearly half of them died before reaching crossover eligibility. Death or hospitalization for heart failure (HHF) occurred in 73.6% of TEER patients and 91.5% of controls within 5 years, pointing to a need for further study to address left ventricle (LV) dysfunction, the underlying cause of patient's disease. MTRA-FR targeted SMR using the same device and did not improve the composite endpoint of all-cause mortality or HHF at 12 months. Possible reasons for the discrepancy include enrolment of patients with more severe MR and less-advanced LV disease (dilation/dysfunction), less-procedural complications, and higher success in reducing MR in COAPT compared with MITRA-FR. Thus, the ideal patient for MitraClip treatment would be one with severe MR, but with no too severe LV dilation/dysfunction, which is what differentiates COAPT patients from those in MITRA-FR.
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http://dx.doi.org/10.1093/eurheartjsupp/suae003 | DOI Listing |
J Avian Med Surg
January 2025
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706, USA,
The antipsychotic medication haloperidol has been used for many years in avian medicine as a pharmacologic therapy for refractory feather destructive behavior in pet parrots. However, despite its common use, there are no published studies evaluating its efficacy and adverse effects in psittacine birds. The goal of this study was to report the signalment, clinical presentation, dosing regimen, response to therapy, and adverse effects of companion psittacine birds prescribed oral haloperidol therapy at a single veterinary referral hospital.
View Article and Find Full Text PDFJ Avian Med Surg
January 2025
Department of Small Animal Medicine and Surgery (Zoological Medicine), University of Georgia College of Veterinary Medicine, Athens, GA 30602, USA,
Weight loss and decreased appetite are commonly encountered sequela of disease and stress in avian patients. However, there is currently minimal information in the veterinary literature regarding appetite stimulation in birds. Capromorelin is a potent agonist of the growth hormone secretagogue receptor and increases food consumption via direct stimulation of the hunger centers of the hypothalamus.
View Article and Find Full Text PDFJ Avian Med Surg
January 2025
Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA.
Viscoelastic testing evaluates the formation and lysis of a clot over time, allowing more complete assessment of patient hemostasis in real time, whereas traditional tests, such as prothrombin time and partial thromboplastin time, only measure coagulation factor function. Patient-side viscoelastic coagulation monitors are easy to use, portable, and provide faster turnaround time than commercial laboratories. Viscoelastic testing requires only 0.
View Article and Find Full Text PDFOphthalmol Retina
January 2025
Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan; School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Population Health Data Center, National Cheng Kung University, Tainan, Taiwan. Electronic address:
J Perianesth Nurs
January 2025
Department of Nursing, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Purpose: This study aimed to explore the effect of an intelligent analgesia management system on postoperative pain management and the working mode of acute pain service.
Design: This is a retrospective cohort study.
Methods: A total of 584 patients who underwent laparoscopic abdominal surgery under general anesthesia and voluntarily received intravenous patient-controlled analgesia (PCA) between January 2018 and April 2020 at our hospital were selected.
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