New oral anticoagulants in patients with nonvalvular atrial fibrillation: a review of pharmacokinetics, safety, efficacy, quality of life, and cost effectiveness.

Atrial fibrillation (AF) continues to be a leading cause of cerebrovascular morbidity and mortality resulting from cardioembolic stroke. Oral anticoagulation therapy has been shown to decrease the incidence of cardioembolic stroke in patients with AF by more than 50%. Appropriate use of anticoagulation with vitamin K antagonists requires precise adherence and monitoring.

Is contrast medium osmolality a causal factor for contrast-induced nephropathy?

The exact pathophysiology of contrast-induced nephropathy (CIN) is not fully clarified, yet the osmotic characteristics of contrast media (CM) have been a significant focus in many investigations of CIN. Osmotic effects of CM specific to the kidney include transient decreases in blood flow, filtration fraction, and glomerular filtration rate. Potentially significant secondary effects include an osmotically induced diuresis with a concomitant dehydrating effect.

Interpretation of coagulation test results under direct oral anticoagulants.

Diagnostic of global coagulation parameters is part of the daily clinical routine practice in conservative as well in operative disciplines. The correct interpretation of in vitro test results in context to the ex vivo influence of anticoagulant drugs and the in vivo hemostatic system of the individual patient is dependent on the doctors clinical and laboratory experience. This article shortly reviews the laboratory interference of oral anticoagulants including the target-specific inhibitors dabigatran, rivaroxaban and apixaban on coagulation parameters and discusses the potential of several methods for measuring the anticoagulant effect of the direct oral anticoagulants.

Safety and immunogenicity of a vero cell culture-derived whole-virus H5N1 influenza vaccine in chronically ill and immunocompromised patients.

The development of vaccines against H5N1 influenza A viruses is a cornerstone of pandemic preparedness. Clinical trials of H5N1 vaccines have been undertaken in healthy subjects, but studies in risk groups have been lacking. In this study, the immunogenicity and safety of a nonadjuvanted cell culture-derived whole-virus H5N1 vaccine were assessed in chronically ill and immunocompromised adults.

Eradication of a chronic wound and driveline infection after redo-LVAD implantation.

A 48 year old patient with dilated cardiomyopathy and chronic acne inversa underwent implantation of a LVAD system (Heartmate II, Thoratec, USA) March 2011. During 2011 and 2012 the patient was repeatedly readmitted for treatment of driveline infection with MRSA. Colonization was controlled with Linezolid and Rifampicin however reoccurred after discontinuation.

Management of complications related to central venous catheters in cancer patients: an update.

Central venous catheters (CVCs) are important for the treatment of patients with cancer, especially in the perioperative and palliative care settings. These devices not only allow for the administration of chemotherapy, parenteral nutrition, and other intravenous therapies, but they may also improve the patients' quality of life by reducing the need for repeated peripheral venipunctures. Thrombotic and infectious complications are common, especially in the long-term use of CVCs.

CT volumetric assessment of pulmonary neoplasms after radiofrequency ablation: when to consider a second intervention?

Purpose: To determine the minimal follow-up time point to predict therapeutic response to radiofrequency (RF) ablation of lung tumors.

Materials And Methods: A retrospective study design was approved by the institutional review board. From January 2008 to January 2010, 78 patients (46 men and 32 women; mean age, 58.

Interplay between endothelin and erythropoietin in astroglia: the role in protection against hypoxia.

We show that, under in vitro conditions, the vulnerability of astroglia to hypoxia is reflected by alterations in endothelin (ET)-1 release and capacity of erythropoietin (EPO) to regulate ET-1 levels. Exposure of cells to 24 h hypoxia did not induce changes in ET-1 release, while 48-72 h hypoxia resulted in increase of ET-1 release from astrocytes that could be abolished by EPO. The endothelin receptor type A (ETA) antagonist BQ123 increased extracellular levels of ET-1 in human fetal astroglial cell line (SV-FHAS).

Comparison of the TruView infant EVO2 PCD™ and C-MAC video laryngoscopes with direct Macintosh laryngoscopy for routine tracheal intubation in infants with normal airways.

Objective: Videolaryngoscopy has mainly been developed to facilitate difficult airway intubation. However, there is a lack of studies demonstrating this method's efficacy in pediatric patients. The aim of the present study was to compare the TruView infant EVO2 and the C-MAC videolaryngoscope with conventional direct Macintosh laryngoscopy in children with a bodyweight ≤10 kg in terms of intubation conditions and the time to intubation.

Does the integration of personalized ultrasound change patient management in critical care medicine? Observational trials.

Objective. To test the influence of personalized ultrasound (PersUS) on patient management in critical care. Design of the Study.

Regional chemotherapy of the lung: transpulmonary chemoembolization in malignant lung tumors.

Standard treatment options in patients with lung cancer and pulmonary metastases are surgery, radiotherapy, chemotherapy, and immunotherapy. For reducing clinical complications of surgery and achieving a better local response, transpulmonary chemoembolization of the lungs is a possible interventional technique in which anticancer drugs are administered directly into a tumor through its feeding vessels followed by occlusive agents that are injected through the delivery catheter for blocking the vessel. This allows a longer contact period in the tumor with a higher cytostatic drug concentration.

Long-term results of aortic valve resuspension in patients with aortic valve insufficiency and aortic root aneurysm.

Objectives: 'The David technique' may provide an alternative to conduit implantation in patients with an aneurysm of the ascending aorta and aortic valve insufficiency.

Methods: From 1991 to 2013, the David technique was performed in 249 consecutive patients in our department. The patient mean age was 58 ± 14 years; 71 (29%) were female and 178 (71%) male.

Neoadjuvant chemoradiation versus perioperative chemotherapy followed by surgery in resectable adenocarcinomas of the esophagogastric junction: A retrospective single center analysis.

The current study presents a retrospective comparison, performed at a single academic center, of preoperative chemoradiation (CRT) and perioperative chemotherapy (CT) in addition to surgery in locally advanced but resectable adenocarcinoma of the esophagogastric junction (AEG). A total of 29 consecutive patients with locally advanced AEGs were retrospectively analyzed. Treatment consisted of preoperative CRT (mean dose, 45.

S100B, intraoperative neuromonitoring findings and their relation to clinical outcome in surgically treated intradural spinal lesions.

Background: Neurophysiological monitoring (IOM) consisting of somatosensory (SEPs), muscle (MEPs) and spinal motor evoked (D-wave; spinal MEPs) potentials is used to indicate injury related to surgical treatment of intradural and intramedullary lesions. Combining spinal and muscle MEPs reliably predicts long-term motor deficit. If spinal MEPs recording is not possible, additional markers-e.

Unusual acute and delayed skin reactions during and after whole-brain radiotherapy in combination with the BRAF inhibitor vemurafenib. Two case reports.

Background: Besides radiotherapy (RT) and surgery, the introduction of BRAF inhibitors like vemurafenib has provided new opportunities for treatment of patients with metastasized malignant melanomas. RT and vemurafenib are being increasingly used concurrently, although little is known about the potential side effects of this combination. Vemurafenib is known to cause severe cutaneous skin reactions such as phototoxicity and evidence is accumulating that RT may further enhance these side effects.

Methylene blue modulates transendothelial migration of peripheral blood cells.

Vasoplegia is a severe complication after cardiac surgery. Within the last years the administration of nitric oxide synthase inhibitor methylene blue (MB) became a new therapeutic strategy. Our aim was to investigate the role of MB on transendothelial migration of circulating blood cells, the potential role of cyclic cGMP, eNOS and iNOS in this process, and the influence of MB on endothelial cell apoptosis.

Prevalence of thrombophilia according to age at the first manifestation of venous thromboembolism: results from the MAISTHRO registry.

Thrombophilia is a well-established risk factor for a venous thromboembolic event (VTE), and it has been proposed that hereditary thrombophilia may substantially contribute to the development of VTE in young patients. We aimed to analyse the prevalence of thrombophilia with special regard to the age of VTE manifestation. The study cohort consisted of 1490 patients (58% females) with a median age 43 years at the time of their first VTE.

Main considerable factors for correct laboratory test interpretation under DOA treatment.

To avoid misinterpretation and mismanagement clinicians should be aware of the interference of new direct oral anticoagulants (DOA) on coagulation assays. A variety of oral anticoagulants targeting specific coagulation factors has already entered the market, and new indications for DOA will be released each year over the next few years. Due to their heterogeneous mode of action and different pharmacokinetic profile each DOA will vary in its effects on coagulations assays, and it is of current importance to recognize these variable effects.

Incidental findings in patients with multiple injuries: how to proceed?

Background: Multislice computed tomography (MSCT) is the diagnostic criterion standard for the initial evaluation of patients with suspected multiple injuries. Besides scanning for injuries directly related to the initial trauma, MSCT scans can reveal pathologies unrelated to the trauma of clinical relevance.The aim of the present study was to determine the frequency and follow-up course of incidental findings in patients with multiple injuries.

Finding of nevirapine extended release tablet remnants in stools does not threaten the success of combination antiretroviral therapy.

Objectives: The finding of nevirapine extended release (XR) tablet remnants in stools has raised concerns about emerging HIV-1 resistance. The aim of this study was to evaluate the characteristics and pharmacokinetic and virological outcomes of affected patients from clinical trials.

Methods: HIV-1-infected individuals reporting tablet remnants in stools during phase III (VERxVE and TRANxITION-studies)-clinical trials were evaluated for mean pharmacokinetic nevirapine concentrations in available blood trough samples and remnants from stool.

A machine-learned knowledge discovery method for associating complex phenotypes with complex genotypes. Application to pain.

Background: The association of genotyping information with common traits is not satisfactorily solved. One of the most complex traits is pain and association studies have failed so far to provide reproducible predictions of pain phenotypes from genotypes in the general population despite a well-established genetic basis of pain. We therefore aimed at developing a method able to prospectively and highly accurately predict pain phenotype from the underlying genotype.

Anatomic and flow dynamic considerations for safe right axillary artery cannulation.

Objectives: Neuroprotection is of paramount interest in cardiac surgery. Right axillary artery cannulation is well established in aortic surgery because it significantly improves survival and outcome, but malperfusion of the right brain after direct cannulation has been reported. Anatomically, 4 vessel segments are potentially amenable for cannulation of the subclavian and axillary arteries.

Magnetic resonance temperature imaging of laser-induced thermotherapy: assessment of fast sequences in ex vivo porcine liver.

Aim: To evaluate magnetic resonance sequences for T(1) and proton resonance frequency (PRF) thermometry during laser-induced thermotherapy (LITT) in liver tissue.

Materials & Methods: During LITT (1064 nm; 30 W; 3-cm diffuser; 2-3 min) in ex vivo porcine liver, temperature was measured (25-70°C) utilizing a fiberoptic thermometer and MRI was performed with a 1.5-T scanner through the following sequences: segmented echo planar imaging (seg-EPI) for the PRF method; fast low-angle shot (FLASH), inversion-recovery turbo FLASH (IRTF), saturation-recovery turbo FLASH (SRTF) and true-fast imaging (TRUFI) for the T(1) method.

Serum microRNA-1 and microRNA-122 are prognostic markers in patients with hepatocellular carcinoma.

Background: The identification of new biomarkers to predict the aggressiveness of hepatocellular carcinoma (HCC) and supplement the current set of prognosis and treatment algorithms is an important clinical need. Extracellular microRNAs (miRNAs) circulating in the blood are a new class of highly promising disease markers.

Aim: Here we investigated the prognostic potential of miR-1 and miR-122 in sera from patients with HCC.