Coronary intravascular lithotripsy for severe coronary artery calcification: The Disrupt CAD I-IV trials.

Coronary artery calcification (CAC) severity is associated with increased vessel inflammation, atherosclerosis, stent failure, and risk of percutaneous coronary intervention-related complications. Current modalities for CAC modification include atherectomy techniques (rotational, orbital, and laser) and balloon modification (cutting and scoring). However, these methods are limited by their risk of slow flow/no reflow, coronary dissection, perforation, and myocardial infarction.

Can ROTEM thromboelastometry predict postoperative bleeding after cardiac surgery?

Objective: To evaluate the predictive ability of ROTEM thromboelastometry (Pentapharm, Basel, Switzerland) to identify patients bleeding more than 200 mL/h in the early postoperative period after cardiac surgery.

Design: A prospective observational study.

Setting: A single university hospital.

Severe small airways disease resistant to medical treatment in a child with cystic fibrosis.

At the age of 12, a child with cystic fibrosis developed severe small airways obstruction of unknown aetiology, in the absence of significant bronchiectasis. He remained resistant to medical treatment until, following an exacerbation of allergic bronchopulmonary aspergillosis 18 months later, he responded to high dose oral steroids. He now remains steroid-dependent, and suffering from multiple side-effects.

The role of neurotransmitters in bronchial asthma.

Neural control of airway caliber is far from simple and it is likely to contribute to the airway narrowing in asthma and chronic obstructive airway disease (COAD). Complex interactions may occur between the different components of autonomic control and inflammatory mediators released from cells in the inflamed airway may profoundly alter the balance of neural control. Further elucidation of these interactions should shed light on the mechanisms of airway disease and may lead to therapeutic advances.

Endobronchial stenting for anastomotic stenosis after sleeve resection.

Bronchial anastomotic stenosis is a potentially serious complication of sleeve resection. A Silastic endobronchial stent that prevents progressive narrowing at the anastomotic site is described. Insertion of the stent offers a simple and effective treatment that allows improved pulmonary performance, clearing of infection, and good quality of life.

Sputum induction for diagnosis of Pneumocystis carinii pneumonia.

51 patients infected with the human immunodeficiency virus (HIV) and with suspected Pneumocystis carinii pneumonia underwent sputum induction. Sputum specimens from 18 patients were positive for P carinii and patients were treated appropriately 25 of the 33 patients with negative specimens underwent bronchoscopy and bronchoalveolar lavage within 4 days of sputum induction, only 1 of whom had evidence of Pneumocystis infection. For diagnosis of Pneumocystis carinii pneumonia, sputum induction according to a strict protocol had a sensitivity of 94.

Partial characterization of a rapidly released antigenic/allergenic component (Ag 5) of Aspergillus fumigatus.

An antigenic component of Aspergillus fumigatus, which was responsible for inducing an initial early antibody response in rabbits immunized with A. fumigatus germlings, has been identified and partially characterized. By immunofluorescent antibody and ELISA techniques, this antigen was demonstrated to be present on the germling surface, although it was also detected in supernatants of conidia/germlings within 1 hour and was present in all shake and stationary culture-filtrate extracts.

Neutrophil chemotactic activity in acute severe asthma (status asthmaticus).

Serum neutrophil chemotactic activity (NCA) was measured in patients with acute severe asthma (status asthmaticus) and compared with that in control subjects (mild asthma, stable chronic irreversible air-flow obstruction, allergic rhinitis, noninfective lung conditions, or asymptomatic). There were 9 subjects in each group. Statistically significant elevations (p less than 0.