Direct Aortic Access for Transcatheter Aortic Valve Replacement Using a Self-Expanding Device.

Background: Transcatheter aortic valve replacement (TAVR) using a self-expanding valve has been shown to be superior to an open operation in high-risk patients. Extensive iliofemoral peripheral vascular disease can prohibit femoral access. In these cases, direct aortic (DA) implantation may be a suitable option.

Impact of speed cameras on trauma centers.

Background: While studies, mostly from Europe and Australia, have examined the effect of speed cameras on motor vehicle collisions, limited data exist regarding their impact on charges and number of patients taken to Level 1 trauma centers (L1TCs). Because of conflicting perceptions and data on their value, speed cameras were implemented along select Arizona highways in 2008 but then removed in 2010. The hypotheses of our study were twofold.

Mycetism: a review of the recent literature.

Approximately 100 of the known species of mushrooms are poisonous to humans. New toxic mushroom species continue to be identified. Some species initially classified as edible are later reclassified as toxic.

Early results with the LARIAT device for left atrial appendage exclusion in patients with atrial fibrillation at high risk for stroke and anticoagulation.

Objectives: To evaluate early outcomes of left atrial appendage (LAA) closure via a percutaneous LAA ligation approach with the SentreHeart LARIAT(™) snare device.

Background: Atrial fibrillation increases the risk of stroke 4-5 fold, which can have devastating outcomes. Exclusion of the LAA is believed to decrease the risk of embolic stroke.

Two-year (mid-term) results for unprotected left main coronary artery percutaneous interventions with drug-eluting stents.

Objective: Bypass surgery remains the revascularization strategy of choice for left main trunk coronary artery disease in an unselected group of patients. Drug eluting stents have been proposed as a viable alternative to bypass surgery for left main trunk lesions but their intermediate and long term outcomes are still under scrutiny.

Methods: A series of 50 patients with significant unprotected left main trunk stenosis (>50%) underwent revascularization with drug eluting stents (sirolimus and paclitaxel stents) and were enrolled in a registry.

Insulin analogs or premixed insulin analogs in combination with oral agents for treatment of type 2 diabetes.

Context: Type 2 diabetes is a progressive disease that is reaching epidemic proportions. Whereas most patients are initially managed with oral antidiabetic agents (OADs), the majority eventually require insulin to maintain glycemic control. The availability of insulin analogs (rapid-acting, long-acting, and premixed), with more predictable time-action profiles than human insulin preparations and simple-to-use insulin delivery devices, can help ease the transition to insulin therapy, which is often delayed until glycemic control has been inadequate for several years.

Immediate- and short-term outcome following recanalization of long chronic total occlusions (> 50 mm) of native coronary arteries with the Frontrunner catheter.

Thirty percent of diagnostic angiograms have at least 1 chronic total occlusion (CTO). The 10-year survival of patients with a CTO is improved if they have the CTO successfully recanalized. The success of recanalization with conventional wires is 50% and the impact of new technology on recanalization is unknown.

Is peripartum hysterectomy more common in multiple gestations?

Objective: To compare the occurrence of peripartum hysterectomy between singleton and multiple gestations.

Methods: This was a historical cohort study comparing the occurrence of peripartum hysterectomy between singleton and multiple gestations at Banner Good Samaritan Regional Medical Center, Phoenix, Arizona, from January 1, 1996, to December 31, 2001.

Results: During the study years, 42,595 singleton, 1,131 twin, 164 triplet, 35 quadruplet, and 2 quintuplet deliveries occurred.

An automated algorithm for the computation of brain volume change from sequential MRIs using an iterative principal component analysis and its evaluation for the assessment of whole-brain atrophy rates in patients with probable Alzheimer's disease.

This article introduces an automated method for the computation of changes in brain volume from sequential magnetic resonance images (MRIs) using an iterative principal component analysis (IPCA) and demonstrates its ability to characterize whole-brain atrophy rates in patients with Alzheimer's disease (AD). The IPCA considers the voxel intensity pairs from coregistered MRIs and identifies those pairs a sufficiently large distance away from the iteratively determined PCA major axis. Analyses of simulated and real MRI data support the underlying assumption of a linear relationship in paired voxel intensities, identify an outlier distance threshold that optimizes the trade-off between sensitivity and specificity in the detection of small volume changes while accounting for global intensity changes, and demonstrate an ability to detect changes as small as 0.