Temporal trend and potential impact of angiotensin receptor neprilysin inhibitors on transcatheter edge-to-edge mitral valve repair.

Introduction And Objectives: Transcatheter edge-to-edge repair (TEER) should be considered in patients with heart failure and secondary mitral regurgitation (MR). Angiotensin receptor-neprilysin inhibitors (ARNIs) have been demonstrated to improve prognosis in heart failure. We aimed to evaluate the impact ARNIs on patient selection and outcomes.

Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device.

Background And Aim: Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve not only for procedural outcomes but also for patient selection. The aim of the study was to compare a contemporary series of patients undergoing PMVR using a second-generation Mitraclip device (Mitraclip NT) with previous cohorts treated with a first-generation system.

Methods: This multicenter study collected individual data from 18 centers between 2012 and 2017.

Maintenance Therapy with 3-monthly Bacillus Calmette-Guérin for 3 Years is Not Superior to Standard Induction Therapy in High-risk Non-muscle-invasive Urothelial Bladder Carcinoma: Final Results of Randomised CUETO Study 98013.

Background: Bacillus Calmette-Guérin (BCG) maintenance therapy for 3 yr following BCG induction can reduce the progression of urothelial bladder carcinoma versus BCG induction alone, but is associated with high toxicity.

Objective: To investigate whether a modified 3-yr BCG maintenance regimen following induction therapy is more effective than standard BCG induction therapy alone and exhibits a low toxicity profile.

Design, Setting, And Participants: Patients from the outpatient clinics of the participating centres with high-risk non-muscle-invasive bladder carcinoma (NMIBC) were randomised between October 1999 and April 2007.

[Diagnostic criteria and therapy of malignant external otitis].

The development of quinolone derivatives has completely changed the treatment and prognosis of malignant external otitis. Two cases are reported and the current diagnostic criteria are reviewed.

[Relative humidity and acari. An intervention study].

In this work we collect the results of the variation of the variable "rechange of the wind with the exterior" in the three possibilities of a bedroom: --close window, semi close and totally open. And we unite the relation that we already know between the prevail of acariens (Dermatophagoides) and the relative humidity of the wind in a Bilbao city's house.

Microvascular angina pectoris in hypertensive patients with left ventricular hypertrophy and diagnostic value of exercise thallium-201 scintigraphy.

In a series of 120 hypertensive patients, 60 were found to have echocardiographic left ventricular (LV) hypertrophy (Devereux's method). Of these, 18 (30%) had typical stress-induced angina and underwent coronary angiography, which showed that 11 (61%) had normal coronary arteries, and 7 (39%) (p < 0.05) had coronary stenosis of the epicardial arteries.

[Bladder leiomyoma: report of a case].

We report a case of leiomyoma of the bladder in a male patient who presented with cystitic syndrome and hematuria. The literature is briefly reviewed and the benign nature of this condition is underscored. The prognosis is excellent with correct treatment.

[Lateral cysts of the prostate].

Description and differential diagnosis of lateral cysts of the prostate gland which during their growth may invade its central section. Most cases, sized below 0.8 cm, are diagnosed by accident.

Classification of hypertensive cardiomyopathy.

A clinical pathophysiological classification of hypertensive cardiomyopathy has been established on the basis of the degree to which the heart is affected by chronic, systemic arterial hypertension: Degree I: Asymptomatic patients without left ventricular hypertrophy but with left ventricular diastolic dysfunction according to Doppler mitral inversion relation (E/A < 0.9) or to gamma scintigraphy (peak filling rate reduction < or = 2.7 EDC.

Prognostic significance of ventricular arrhythmias in the presence of pathological left ventricular hypertrophy.

It is well known that pathological left ventricular hypertrophy, either primary or secondary to cardiac overload, is associated with a high incidence of ventricular arrhythmias and sudden death, and that asymptomatic ventricular arrhythmias seem to be related to a high incidence of sudden death in patients with hypertrophic cardiomyopathy and ischaemic heart disease. However, this association has not been prospectively evaluated in patients with hypertensive LVH, where other factors, such as myocardial ischaemia, can play an important role. More studies are needed in this respect before establishing therapeutic implications.

Segmentary coronary reserve in hypertensive patients with echocardiographic left ventricular hypertrophy, gamma-graphic ischaemia and normal coronary angiography.

Stress thallium scintigraphies are frequently positive in patients with systemic hypertension (SHT), especially in the presence of left ventricular hypertrophy (LVH). In order to determine whether positive thallium perfusion scans in patients with LVH secondary to SHT and normal coronary angiographies are due to segmentary reduction of coronary reserve (CR), we have studied 10 out of 60 consecutive cases of SHT with echocardiographic LVH, using intracoronary Doppler. We compared coronary blood flow velocity at rest and post-papaverine (PP), and CR in at least two major coronary vessels, always including the one corresponding to the ischaemic segment.

Functional and organic components of diastolic dysfunction in hypertensive heart disease: therapeutic implications.

The major structural and functional determinants of impaired left ventricular diastolic function in the hypertensive patient are reviewed, together with the indices normally used to detect this failure. The alteration of functional determinants can be quickly modified, while structural determinants are modified only over the long term. Drug therapy first affects the functional determinants, bringing about their attenuation and initiating the modification of the structural factors, thus accounting for the improvement in diastolic function over the long term.

[Bladder hernia. Report of 4 cases].

Four cases of vesicoscrotal herniation are described. The different etiology and forms of presentation (from an incidental finding to one requiring emergency treatment) of this condition are discussed. Surgical treatment is based on its size, location and coexisting pathology (prostatic hyperplasia, calculus, bladder tumor, etc.

Comparative study of gallopamil versus nifedipine in patients with ischemic heart disease.

In order to compare the anti-ischemic activity of gallopamil and nifedipine, a cross-over, double-blind, randomised trial was carried out in 30 male out-patients with a history of stable exertional angina, proven coronary disease and a positive stress test (ST-segment depression > or = 1 mm). After a first 1-week wash-out period on placebo, the patients were randomised to gallopamil, 150 mg/day (50, 50 and 50) or nifedipine, 30 mg/day (10, 10 and 10) for 28 days. After a second 1-week wash-out period active treatments were crossed for another 28 days.

Usefulness of exercise testing performed with vasodilators for predicting the severity of myocardial ischaemia during daily activities and treatment.

Fifty patients (aged 53 +/- 7 years) with confirmed coronary disease performed two stress tests (baseline and following treatment with vasodilators) and were divided into two groups: (A) fixed ischaemic threshold (n = 27), and (B) variable ischaemic threshold (n = 23). All patients underwent 24-h baseline Holter monitoring and monitoring following treatment with nifedipine, placebo, propranolol and nifedipine + propranolol. In Group A, 92% of ischaemic episodes occurred at heart rates similar to those found during exercise testing.

Congestive heart failure from left ventricular diastolic dysfunction in systemic hypertension.

Previous studies have pointed out that congestive heart failure (CHF) with normal ejection fraction presents a uniform clinical profile that is indistinguishable from heart failure with low ejection fraction. Thirty-six patients with systemic hypertension who had recently experienced CHF with normal ejection fraction (> or = 50%) and no clinical history of ischemic cardiomyopathy were studied. The patients were divided into 2 groups according to degree of echocardiographic hypertrophy: group A (19 patients) with a ventricular mass/volume ratio > 1.

[Trigeminal neuralgia. First manifestation of adenocarcinoma of the prostate].

We report a case of adenocarcinoma of the prostate that had been incidentally discovered during patient evaluation for trigeminal nerve neuralgia refractory to treatment. Analysis revealed the underlying cause of neuralgia was tumor metastasis to the mandible, which had caused irritation of the fifth nerve. The patient was treated with complete androgenic block and his symptoms improved simultaneously with partial remission of metastasis.

[Diagnostic value of auditory brainstem evoked potentials (ABP) in high risk premature and newborn infants].

In this work we have studied 37 children, both preterm and term, belonging ti high risk group of contracting hearing loss, in order to confirm the predictability of ABR in the diagnostic of the congenital hearing losses during the prenatal period and so make possible their immediate and proper rehabilitation. With this purpose we have studied parameters such as threshold, latency of waves and intervals. We have discovered that in preterm children, owing to reasons such as answers of little amplitude, movements of the children and difficulty to determine the gestational age, the parameters of normality are only the existence or not of waves, discarding the value of the threshold and the latency of waves.

Treatment of transient myocardial ischemia in patients with stable angina: a comparative study of verapamil slow-release and nifedipine plus propranolol.

We compared the effect of verapamil slow-release (VSR) and the combination of nifedipine plus propranolol on transient myocardial ischemia in a double-blind study comprising 20 patients with proven coronary artery disease and chronic stable angina. According to the results of 24-h Holter-monitoring recording, patients were divided into two groups: 10 patients with fixed coronary reserve and 10 patients with variable coronary reserve. The number of ischemic events was reduced with both therapies: from 12 +/- 10 at baseline to 3.