Cardiac I-1c overexpression with reengineered AAV improves cardiac function in swine ischemic heart failure.

Cardiac gene therapy has emerged as a promising option to treat advanced heart failure (HF). Advances in molecular biology and gene targeting approaches are offering further novel options for genetic manipulation of the cardiovascular system. The aim of this study was to improve cardiac function in chronic HF by overexpressing constitutively active inhibitor-1 (I-1c) using a novel cardiotropic vector generated by capsid reengineering of adeno-associated virus (BNP116).

Safety and efficacy of addition of VEGFR and EGFR-family oral small-molecule tyrosine kinase inhibitors to cytotoxic chemotherapy in solid cancers: a systematic review and meta-analysis of randomized controlled trials.

Background: The approach of combining cytotoxic chemotherapy with oral small molecule tyrosine kinase inhibitors (TKIs) has been explored in a large number of randomized trials, in a variety of tumor. We performed a systematic review and meta-analysis to evaluate the safety and efficacy of this therapeutic approach.

Patients And Methods: PubMed and the ASCO databases were searched up to March 2013.

A systematic review of predictive and prognostic biomarkers for VEGF-targeted therapy in renal cell carcinoma.

Background: Vascular endothelial growth factor (VEGF)-targeted therapy is the currently standard treatment for advanced and metastatic renal cell carcinoma (RCC). Multiple candidate predictive and prognostic biomarkers have been evaluated. We performed a systematic review and graded the available evidence on the biomarkers for VEGF-targeted therapy in RCC.

Risk of hematologic toxicities in patients with solid tumors treated with everolimus: a systematic review and meta-analysis.

We performed a systematic review and meta-analysis of hematologic toxicities associated with everolimus, an oral mammalian target of rapamycin (mTOR) inhibitor. Eligible studies included phase II and III trials of patients with solid tumors on 10mg of everolimus daily describing events of neutropenia, thrombocytopenia, anemia or lymphopenia. The incidence of everolimus-associated all-grade and high-grade (Grade 3-4) hematologic toxicities were, respectively: neutropenia: 21.

Risk of hypertension in cancer patients treated with sorafenib: an updated systematic review and meta-analysis.

Sorafenib, a multi-kinase inhibitor, has been reported to be associated with hypertension (HTN). However, the risk of severe HTN with sorafenib treatment has not been well described. We performed an up-to-date meta-analysis of high-grade HTN in cancer patients treated with sorafenib.

Prognostic impact of terminal T wave inversions on presentation in patients with ST-elevation myocardial infarction undergoing urgent percutaneous coronary intervention.

Introduction: Terminal T wave inversions (TTWI) indicate advanced stages of ST-elevation myocardial infarction (STEMI). The present study investigated whether TTWI predict unfavorable in-hospital outcomes in STEMI patients treated with urgent percutaneous coronary intervention (PCI).

Methods: A retrospective cohort study was performed with consecutive 188 STEMI cases undergoing urgent PCI.

Risk of hypothyroidism in patients with cancer treated with sunitinib: a systematic review and meta-analysis.

Background: The multitargeted tyrosine kinase inhibitor sunitinib is used in various cancers. Clinical studies have reported a substantial variation in the incidence of hypothyroidism associated with sunitinib, without a systemic attempt to synthesize these data.

Methods: We searched Medline databases for relevant clinical trials published up to May 2012.

Tpeak - Tend and Tpeak - Tend /QT ratio as markers of ventricular arrhythmia risk in cardiac resynchronization therapy patients.

Background: Cardiac resynchronization therapy (CRT) increases transmural dispersion of repolarization (TDR) and can be pro-arrhythmic. However, overall arrhythmia risk was not increased in large-scale CRT clinical trials. Increased TDR as measured by T(peak ) -T(end) (TpTe) was associated with arrhythmia risk in CRT in a single-center study.

The Use of Ranolazine in the Management of Recurrent Atrial Fibrillation After Percutaneous Radiofrequency Ablation.

Long-term medical treatment options for atrial fibrillation (AF) include rate-control as well as rhythm-control therapy with various antiarrhythmics. However, because of the limited efficacy and potential side effects of these medications, percutaneous and surgical ablations in AF patients have evolved as alternative or additional approaches to achieve rhythm-control. Nonetheless, arrhythmia recurrences may also occur after these procedures.

Comparison of left ventricular stroke volume assessment by two- and three-dimensional echocardiography in a swine model of acute myocardial infarction validated by thermodilution method.

Background: Accurate left ventricular stroke volume (LVSV) measurement is clinically important in patients presenting with acute myocardial infarction. Three-dimensional echocardiography (3DE) is expected to overcome limitations of two-dimensional echocardiography (2DE). However, inaccuracy in volumetry by 3DE has often been reported hindering further clinical application.

Meta-analysis of accuracy of left ventricular mass measurement by three-dimensional echocardiography.

Left ventricular (LV) hypertrophy is a fundamental prognostic factor in a variety of cardiac diseases. Three-dimensional echocardiography (3DE) has achieved better estimation of LV mass than 2-dimensional echocardiography. However, significant underestimation has often been reported, and no previous study has synthesized these data.

Identification of residual risk factors for the development of venous thromboembolism in medical inpatients receiving subcutaneous heparin therapy for prophylaxis.

Objectives: Venous thromboembolism (VTE) such as pulmonary embolism and deep venous thrombosis is the most common cause of preventable morbidity and mortality in hospitalized patients. Prophylaxis is recommended for medical patients older than 40 years with at least one risk factor. However, the currently recommended regimen prevents only about half of in-hospital VTE.

Effectiveness of Telemetry Guidelines in Predicting Clinically Significant Arrhythmias in Hospitalized Patients.

Background: Cardiac rhythm monitoring is widely applied on hospitalized patients. However, its value has not been evaluated systematically.

Methods: This study considered the utility of our institutional telemetry guidelines in predicting clinically significant arrhythmias.

Underestimation of left atrial volume by three-dimensional echocardiography validated by magnetic resonance imaging: a meta-analysis and investigation of the source of bias.

Background: Left atrial volume (LAV) is a fundamental prognostic factor in a variety of cardiac diseases including atrial fibrillation, heart failure, and valvular diseases. Developing a repeatable, noninvasive, and accurate method of measuring LAV is crucial. Three-dimensional echocardiography (3DE) has achieved better estimation of LAV than two-dimensional echocardiography.

Acute ST Elevation Myocardial Infarction in Patients With Immune Thrombocytopenia Purpura: A Case Report.

Acute myocardial infarction (AMI) in patients with immune thrombocytopenic purpura (ITP) is rare. We describe a case of AMI in patient with ITP. An 81-year-old woman presented with acute inferoposterior MI with low platelet count on admission (34,000/µl).

Accuracy of right ventricular volumes and function determined by three-dimensional echocardiography in comparison with magnetic resonance imaging: a meta-analysis study.

Background: Determining right ventricular (RV) function is challenging because of the complex anatomy of the right ventricle. Three-dimensional echocardiography (3DE) has achieved better estimation, but underestimations of volumes and ejection fraction (EF) has often been reported, and no previous study has synthesized these data. The investigators performed a meta-analysis on the bias and examined the related factors.

Relation of race (Asian, African-American, European-American, and Hispanic) to activated clotting time after weight-adjusted bolus of heparin during percutaneous coronary intervention.

A weight-adjusted bolus of heparin (70 to 100 IU/kg) is recommended to achieve adequate anticoagulation during percutaneous coronary intervention (PCI). Proper dosing is mandatory to avoid bleeding and thrombotic complications. We investigated whether sensitivity to heparin is affected by difference in race.

Ventricular arrhythmias in patients treated with methadone for opioid dependence.

Purpose: Over the last decade, there has been a significant rise in reported cases of methadone induced QT prolongation (QTP) and Torsades de Pointes (TdP) in patients treated for opioid dependence. Optimal management of these patients is challenging.

Methods: We report a case series of 12 consecutive patients admitted to our institution with methadone-induced QTP and ventricular arrhythmias.

Relationship between proteinuria and venous thromboembolism.

Nephrotic syndrome is known to cause venous thromboembolism (VTE) due to urine loss of antithrombin III and activation of the coagulation system. We hypothesized that the degree of proteinuria may predict the development of VTE. This was a retrospective case-controlled study of in-patients urban academic teaching hospital from April, 2007 to March, 2009 and who had undergone an imaging study for VTE.

Termination of recurrent ventricular tachycardia by continuous positive airway pressure ventilation.

We report a case of hypertrophic cardiomyopathy with recurrent ventricular tachycardia that resolved after initiating continuous positive airway pressure therapy.

Interpretation of electrocardiograms by first-year residents: the need for change.

Background: Prior studies have shown that misinterpretation of the electrocardiogram (ECG) can lead to inappropriate diagnoses and clinical decisions. This may be particularly true during the first month of postgraduate training. This study was designed to assess proficiency in ECG interpretation among residents at the start of their internal medicine (IM) residency.

Telemetry monitoring guidelines for efficient and safe delivery of cardiac rhythm monitoring to noncritical hospital inpatients.

Telemetry monitoring is a limited resource in most hospitals. Few clinical studies have established firm criteria for inpatient telemetry. At our urban institution, we have developed and incorporated guidelines to identify patients who benefit from cardiac rhythm monitoring.

The role of heart-type fatty acid-binding protein in the diagnosis of acute coronary syndrome.

Background: Heart-type fatty acid-binding protein (H-FABP) is a membrane-bound protein that facilitates transport of fatty acids from the blood into the heart. It is currently being used outside the United States for the early diagnosis of myocardial infarction (MI). However, previous studies have shown inconsistent correlation of H-FABP with standard cardiac biomarkers.

Sequential pituitary MR imaging in Sheehan syndrome: report of 2 cases.

We present the evolution of pituitary changes in the cases of 2 patients with Sheehan syndrome as assessed by MR imaging. Both patients had severe postpartum hemorrhage, symptoms of pituitary gland apoplexy, and hypopituitarism. Sequential MR imaging demonstrated evidence of ischemic infarct in the pituitary gland with enlargement followed by gradual shrinkage during several months, to pituitary atrophy.