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Differential effects of bicarbonate on severe hypoxia- and hypercapnia-induced cardiac malfunctions in diverse fish species.
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We tested in six fish species [Pacific lamprey (Lampetra richardsoni), Pacific spiny dogfish (Squalus suckleyi), Asian swamp eel (Monopterus albus), white sturgeon (Acipenser transmontanus), zebrafish (Danio rerio), and starry flounder (Platichthys stellatus)] the hypothesis that elevated extracellular [HCO<sub>3</sub><sup>-</sup>] protects spontaneous heart rate and cardiac force development from the known impairments that severe hypoxia and hypercapnic acidosis can induce. Hearts were exposed in vitro to either severe hypoxia (~ 3% of air saturation), or severe hypercapnic acidosis (either 7.5% CO<sub>2</sub> or 15% CO<sub>2</sub>), which reduced heart rate (in six test species) and net force development (in three test species). During hypoxia, heart rate was restored by [HCO<sub>3</sub><sup>-</sup>] in a dose-dependent fashion in lamprey, dogfish and eel (EC<sub>50</sub> = 5, 25 and 30 mM, respectively), but not in sturgeon, zebrafish or flounder. During hypercapnia, elevated [HCO<sub>3</sub><sup>-</sup>] completely restored heart rate in dogfish, eel and sturgeon (EC<sub>50</sub> = 5, 25 and 30 mM, respectively), had a partial effect in lamprey and zebrafish, and had no effect in flounder. Elevated [HCO<sub>3</sub><sup>-</sup>], however, had no significant effect on net force of electrically paced ventricular strips from dogfish, eel and flounder during hypoxia and hypercapnia. Only in lamprey hearts did a specific soluble adenylyl cyclase (sAC) inhibitor, KH7, block the HCO<sub>3</sub><sup>-</sup>-mediated rescue of heart rate during both hypoxia and hypercapnia, and was the only species where we conclusively demonstrated sAC activity was involved in the protective effects of HCO<sub>3</sub><sup>-</sup> on cardiac function. Our results suggest a common HCO<sub>3</sub><sup>-</sup>-dependent, sAC-dependent transduction pathway for heart rate recovery exists in cyclostomes and a HCO<sub>3</sub><sup>-</sup>-dependent, sAC-independent pathway exists in other fish species.
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2,334,401 |
Minimizing Pulse Check Duration Through Educational Video Review.
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The American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) recommend pulse checks of less than 10 seconds. We assessed the effect of video review-based educational feedback on pulse check duration with and without point-of-care ultrasound (POCUS).</AbstractText>Cameras recorded cases of CPR in the emergency department (ED). Investigators reviewed resuscitation videos for ultrasound use during pulse check, pulse check duration, and compression-fraction ratio. Investigators reviewed health records for patient outcomes. Providers received written feedback regarding pulse check duration and compression-fraction ratio. Researchers reviewed selected videos in multidisciplinary grand round presentations, with research team members facilitating discussion. These presentations highlighted strategies that include the following: limit on pulse check duration; emphasis on compressions; and use of "record, then review" method for pulse checks with POCUS. The primary endpoint was pulse check duration with and without POCUS.</AbstractText>Over 19 months, investigators reviewed 70 resuscitations with a total of 325 pulse checks. The mean pulse check duration was 11.5 ± 8.8 seconds (n = 224) and 13.8 ± 8.6 seconds (n = 101) without and with POCUS, respectively. POCUS pulse checks were significantly longer than those without POCUS (P = 0.001). Mean pulse check duration per three-month block decreased statistically significantly from study onset to the final study period (from 17.2 to 10 seconds [P<0.0001]) overall; decreased from 16.6 to 10.5 seconds (P<0.0001) without POCUS; and with POCUS from 19.8 to 9.88 seconds (P<0.0001) with POCUS. Pulse check times decreased significantly over the study period of educational interventions. The strongest effect size was found in POCUS pulse check duration (P = -0.3640, P = 0.002).</AbstractText>Consistent with previous studies, POCUS prolonged pulse checks. Educational interventions were associated with significantly decreased overall pulse-check duration, with an enhanced effect on pulse checks involving POCUS. Performance feedback and video review-based education can improve CPR by increasing chest compression-fraction ratio.</AbstractText>
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2,334,402 |
The Impact of Feeding Cannabidiol (CBD) Containing Treats on Canine Response to a Noise-Induced Fear Response Test.
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Interest is increasing regarding use of Cannabidiol (CBD) in companion animals due to anecdotal evidence of beneficial behavioral and health effects. The purpose of this investigation was to evaluate the influence of CBD on behavioral responses to fear-inducing stimuli in dogs. Sixteen dogs (18.1 ± 0.2 kg) were utilized in a replicated 4 × 4 Latin square design experiment with treatments arranged in a 2 × 2 factorial, consisting of control, 25 mg CBD, trazodone (100 mg for 10-20 kg BW, 200 mg for 20.1-40 kg BW), and the combination of CBD and trazodone. A fireworks model of noise-induced fear was used to assess CBD effectiveness after 7 d of supplementation. Each test lasted a total of 6 min and consisted of a 3 min environmental habituation phase with no noise and a 3 min noise phase with a fireworks track. Plasma was collected 1 h before, immediately after, and 1 h following testing for cortisol analysis. Behaviors in each 3 min block were video recorded, and heart rate (HR) sensors were fitted for collection of HR and HR variability parameters. Research personnel administering treats and analyzing behavioral data were blinded as to the treatments administered. Data were tested for normality using the UNIVARIATE procedure in SAS, then differences examined using the MIXED procedure with fixed effects of treatment, period, time, and treatment x time interaction. Inactivity duration and HR increased during the first minute of the fireworks track compared with 1 min prior (<i>P</i> < 0.001 and <i>P</i> = 0.011, respectively), indicating the fireworks model successfully generated a fear response. Trazodone lowered plasma cortisol (<i>P</i> < 0.001), which was unaffected by CBD (<i>P</i> = 0.104) or the combination with CBD (<i>P</i> = 0.238). Neither CBD nor trazodone affected the duration of inactivity (<i>P</i> = 0.918 and 0.329, respectively). Trazodone increased time spent with tail relaxed (<i>P</i> = 0.001). CBD tended to increase HR (<i>P</i> = 0.093) and decreased the peak of low- and high-frequency bands (LF and HF, <i>P</i> = 0.011 and 0.022, respectively). These results do not support an anxiolytic effect of CBD in dogs given 1.4 mg CBD/kg BW/d.
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2,334,403 |
Application of ultrasound-guided epidural catheter indwelling in painless labour.
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To study the application of ultrasound-guided indwelling epidural catheter in painless labour.</AbstractText>A total of 300 single-foetus cephalic position and full-term primipara who did not implement labour analgesia under the same conditions were randomly selected. According to the principle of random grouping, 150 pregnant women who requested and signed the informed consent for labour analgesia were selected as the analgesic group (group A). The other 150 pregnant women who experienced natural delivery without any analgesic measures were categorised as the control group. In the analgesic group, epidural anaesthesia was used when the uterine orifice reached 2.5 cm. The pain grade, motor nerve block, uterine contraction, foetal heart rate and the time of the first stage of labuor were recorded.</AbstractText>The results showed that the group receiving epidural block had lesser pain compared to the control group. The duration of first stage of labour of the analgesic group was significantly shorter than the group without analgesia.. There were no significant differences in the degree of motor nerve block, uterine contractions and foetal heart rate between the analgesic group and the control group.</AbstractText>The use of ultrasound-guided first stage indwelling epidural catheter had a significant effect in causing painless labour in the parturient.</AbstractText>
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2,334,404 |
The Footprints of Pacing Lead Position Using the 12-Lead Electrocardiograph.<Pagination><StartPage>350</StartPage><EndPage>361</EndPage><MedlinePgn>350-361</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.hlc.2020.08.029</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S1443-9506(20)31418-9</ELocationID><Abstract><AbstractText>The 12-lead resting electrocardiograph (ECG) of a patient with an implanted cardiac pacemaker is a snapshot of cardiac electrical activity at the time of recording and may provide valuable information on both pacemaker function and malfunction, as well as identifying the position of pacing leads in the heart. The traditional site for atrial pacing is within or adjacent to the right atrial appendage and paced P waves on the ECG have a normal frontal plane axis, whereas the traditional site for ventricular pacing is at the right ventricular apex with the ECG demonstrating a left bundle branch block configuration and a left axis. More recently, ventricular leads and to a lesser extent, atrial leads have been positioned in alternate non-traditional sites resulting in 12-lead ECG appearances which have characteristic features, that are generally poorly recognised. Left ventricular pacing results in a right bundle branch block configuration and an axis dependent on the position of the lead in the ventricle. This review will describe the ECG patterns of pacing lead positions in the right atrium and ventricle as well as positions in the left ventricle, whether intentional or unintentional.</AbstractText><CopyrightInformation>Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mond</LastName><ForeName>Harry G</ForeName><Initials>HG</Initials><AffiliationInfo><Affiliation>Department of Cardiology, The Royal Melbourne Hospital and the Department of Medicine, University of Melbourne, Melbourne, Vic, Australia; Cardioscan Pty Ltd, Melbourne, Vic, Australia. Electronic address: [email protected].</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>11</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>Australia</Country><MedlineTA>Heart Lung Circ</MedlineTA><NlmUniqueID>100963739</NlmUniqueID><ISSNLinking>1443-9506</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002037" MajorTopicYN="N">Bundle-Branch Block</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002304" MajorTopicYN="N">Cardiac Pacing, Artificial</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004562" MajorTopicYN="N">Electrocardiography</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="Y">instrumentation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006325" MajorTopicYN="N">Heart Atria</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">12-lead electrocardiograph</Keyword><Keyword MajorTopicYN="N">Cardiac pacing</Keyword><Keyword MajorTopicYN="N">Intentional left ventricular pacing</Keyword><Keyword MajorTopicYN="N">Right ventricular pacing</Keyword><Keyword MajorTopicYN="N">Unintentional left ventricular pacing</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>7</Month><Day>4</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>8</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>8</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>11</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>7</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>11</Month><Day>9</Day><Hour>5</Hour><Minute>28</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33162365</ArticleId><ArticleId IdType="doi">10.1016/j.hlc.2020.08.029</ArticleId><ArticleId IdType="pii">S1443-9506(20)31418-9</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33159785</PMID><DateRevised><Year>2020</Year><Month>11</Month><Day>07</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2047-2412</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Nov</Month><Day>07</Day></PubDate></JournalIssue><Title>European heart journal. Cardiovascular Imaging</Title><ISOAbbreviation>Eur Heart J Cardiovasc Imaging</ISOAbbreviation></Journal>Independent and incremental prognostic value of semiquantitative measures of tricuspid regurgitation severity in heart failure with preserved ejection fraction.
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The 12-lead resting electrocardiograph (ECG) of a patient with an implanted cardiac pacemaker is a snapshot of cardiac electrical activity at the time of recording and may provide valuable information on both pacemaker function and malfunction, as well as identifying the position of pacing leads in the heart. The traditional site for atrial pacing is within or adjacent to the right atrial appendage and paced P waves on the ECG have a normal frontal plane axis, whereas the traditional site for ventricular pacing is at the right ventricular apex with the ECG demonstrating a left bundle branch block configuration and a left axis. More recently, ventricular leads and to a lesser extent, atrial leads have been positioned in alternate non-traditional sites resulting in 12-lead ECG appearances which have characteristic features, that are generally poorly recognised. Left ventricular pacing results in a right bundle branch block configuration and an axis dependent on the position of the lead in the ventricle. This review will describe the ECG patterns of pacing lead positions in the right atrium and ventricle as well as positions in the left ventricle, whether intentional or unintentional.<CopyrightInformation>Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mond</LastName><ForeName>Harry G</ForeName><Initials>HG</Initials><AffiliationInfo><Affiliation>Department of Cardiology, The Royal Melbourne Hospital and the Department of Medicine, University of Melbourne, Melbourne, Vic, Australia; Cardioscan Pty Ltd, Melbourne, Vic, Australia. Electronic address: [email protected].</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>11</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>Australia</Country><MedlineTA>Heart Lung Circ</MedlineTA><NlmUniqueID>100963739</NlmUniqueID><ISSNLinking>1443-9506</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002037" MajorTopicYN="N">Bundle-Branch Block</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002304" MajorTopicYN="N">Cardiac Pacing, Artificial</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004562" MajorTopicYN="N">Electrocardiography</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="Y">instrumentation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006325" MajorTopicYN="N">Heart Atria</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">12-lead electrocardiograph</Keyword><Keyword MajorTopicYN="N">Cardiac pacing</Keyword><Keyword MajorTopicYN="N">Intentional left ventricular pacing</Keyword><Keyword MajorTopicYN="N">Right ventricular pacing</Keyword><Keyword MajorTopicYN="N">Unintentional left ventricular pacing</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>7</Month><Day>4</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>8</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>8</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>11</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>7</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>11</Month><Day>9</Day><Hour>5</Hour><Minute>28</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33162365</ArticleId><ArticleId IdType="doi">10.1016/j.hlc.2020.08.029</ArticleId><ArticleId IdType="pii">S1443-9506(20)31418-9</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33159785</PMID><DateRevised><Year>2020</Year><Month>11</Month><Day>07</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2047-2412</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Nov</Month><Day>07</Day></PubDate></JournalIssue><Title>European heart journal. Cardiovascular Imaging</Title><ISOAbbreviation>Eur Heart J Cardiovasc Imaging</ISOAbbreviation></Journal><ArticleTitle>Independent and incremental prognostic value of semiquantitative measures of tricuspid regurgitation severity in heart failure with preserved ejection fraction.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">jeaa264</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1093/ehjci/jeaa264</ELocationID><Abstract><AbstractText Label="AIMS" NlmCategory="OBJECTIVE">This study sought to determine the independent and incremental prognostic value of semiquantitative measures of tricuspid regurgitation (TR) severity over right heart remodelling and pulmonary hypertension (PH) in heart failure with preserved ejection fraction (HFpEF).<AbstractText Label="METHODS AND RESULTS" NlmCategory="RESULTS">Echocardiography was performed on 311 HFpEF patients. TR severity was defined by the semiquantitative measures [i.e. vena contracta width (VCW) and jet area] and by the guideline-based integrated qualitative approach (absent, mild, moderate, or severe). All-cause mortality or heart failure hospitalization occurred in 101 patients over a 2.1-year median follow-up. There was a continuous association between TR severity and the composite outcome with a hazard ratio (HR) of 1.17 per 1 mm increase of VCW [95% confidence interval (CI) 1.08-1.26, P < 0.0001]. Compared with patients with the lowest VCW category (≤1 mm), RV-adjusted HRs for the outcome were 1.99 (95% CI 1.05-3.77), 2.63 (95% CI 1.16-5.95), and 5.00 (95% CI 1.60-15.7) for 1-3, 3-7, and ≥7 mm VCW categories, respectively. TR severity as defined by the guideline-based approach showed a similarly graded association, but it was no longer significant in models including PH. In contrast, VCW remained independently and incrementally associated with the outcome after adjusting for established prognostic factors, as well as RV diameter and PH (fully adjusted HR 1.14 per 1 mm, 95% CI 1.02-1.27, P = 0.02; χ2 58.8 vs. 51.5, P = 0.03).<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The current data highlight the potential value of the semiquantitative measures of TR severity for the risk stratification in patients with HFpEF.
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2,334,405 |
Baseline ECG and Prognosis After Transcatheter Aortic Valve Implantation: The Role of Interatrial Block.<Pagination><StartPage>e017624</StartPage><MedlinePgn>e017624</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">e017624</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1161/JAHA.120.017624</ELocationID><Abstract><AbstractText>Background The clinical significance of conduction disturbances after transcatheter aortic valve implantation has been described; however, little is known about the influence of baseline ECGs in the prognosis of these patients. Our aim was to study the influence of baseline ECG parameters, including interatrial block (IAB), in the prognosis of patients treated with transcatheter aortic valve implantation. Methods and Results The BIT (Baseline Interatrial Block and Transcatheter Aortic Valve Implantation) registry included 2527 patients with aortic stenosis treated with transcatheter aortic valve implantation. A centralized analysis of baseline ECGs was performed. Patients were divided into 4 groups: normal P wave duration (<120 ms); partial IAB (P wave duration ≥120 ms, positive in the inferior leads); advanced IAB (P wave duration ≥120 ms, biphasic [+/-] morphology in the inferior leads); and nonsinus rhythm (atrial fibrillation/flutter and paced rhythm). The mean age of patients was 82.6±9.8 years and 1397 (55.3%) were women. A total of 960 patients (38.0%) had a normal P wave, 582 (23.0%) had partial IAB, 300 (11.9%) had advanced IAB, and 685 (27.1%) presented with nonsinus rhythm. Mean follow-up duration was 465±171 days. Advanced IAB was the only independent predictor of all-cause mortality (hazard ratio [HR], 1.48; 95% CI, 1.10-1.98 [<i>P</i>=0.010]) and of the composite end point (death/stroke/new atrial fibrillation) (HR, 1.51; 95% CI, 1.17-1.94 [<i>P</i>=0.001]). Conclusions Baseline ECG characteristics influence the prognosis of patients with aortic stenosis treated with transcatheter aortic valve implantation. Advanced IAB is present in about an eighth of patients and is associated with all-cause death and the composite end point of death, stroke, and new atrial fibrillation during follow-up.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Vicent</LastName><ForeName>Lourdes</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario Gregorio Marañón CIBERCV Madrid Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario 12 de Octubre CIBERCV Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fernández-Cordón</LastName><ForeName>Clara</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario Gregorio Marañón CIBERCV Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nombela-Franco</LastName><ForeName>Luis</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Cardiovascular Institute Hospital Clinico San Carlos, IdISSC Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Escobar-Robledo</LastName><ForeName>Luis Alberto</ForeName><Initials>LA</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital de la Santa Creu i Sant Pau. Fundación Investigación Cardiovascular. Programa-ICCC Cardiovascular Institut de Recerca del Hospital de la Santa Creu I Sant Pau IIB-Sant Pau Barcelona, Spain Barcelona Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ayesta</LastName><ForeName>Ana</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital Universitario Central de Asturias Oviedo Asturias Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ariza Solé</LastName><ForeName>Albert</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Cardiology Bellvitge University Hospital. L'Hospitalet de Llobregat Barcelona Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gómez-Doblas</LastName><ForeName>Juan José</ForeName><Initials>JJ</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital Universitario Virgen de la Victoria Málaga Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bernal</LastName><ForeName>Eva</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital Universitari Germans Trias i Pujol Badalona Barcelona Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tirado-Conte</LastName><ForeName>Gabriela</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Cardiovascular Institute Hospital Clinico San Carlos, IdISSC Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cobiella</LastName><ForeName>Javier</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Cardiovascular Institute Hospital Clinico San Carlos, IdISSC Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>González-Saldivar</LastName><ForeName>Hugo</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario Gregorio Marañón CIBERCV Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>López-Otero</LastName><ForeName>Diego</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital Cínico Universitario Santiago de Compostela Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Díez-Villanueva</LastName><ForeName>Pablo</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital Universitario de la Princesa Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sarnago</LastName><ForeName>Fernando</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario 12 de Octubre CIBERCV Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Armario</LastName><ForeName>Xavier</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital de la Santa Creu i Sant Pau. Fundación Investigación Cardiovascular. Programa-ICCC Cardiovascular Institut de Recerca del Hospital de la Santa Creu I Sant Pau IIB-Sant Pau Barcelona, Spain Barcelona Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bayés-de-Luna</LastName><ForeName>Antonio</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital de la Santa Creu i Sant Pau. Fundación Investigación Cardiovascular. Programa-ICCC Cardiovascular Institut de Recerca del Hospital de la Santa Creu I Sant Pau IIB-Sant Pau Barcelona, Spain Barcelona Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Martínez-Sellés</LastName><ForeName>Manuel</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario Gregorio Marañón CIBERCV Madrid Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Universidad Europea Universidad Complutense Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>Baseline Interatrial Block and Transcatheter Aortic Valve Implantation (BIT) Registry Investigators †</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>11</Month><Day>03</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Am Heart Assoc</MedlineTA><NlmUniqueID>101580524</NlmUniqueID><ISSNLinking>2047-9980</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001024" MajorTopicYN="N">Aortic Valve Stenosis</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001281" MajorTopicYN="N">Atrial Fibrillation</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004562" MajorTopicYN="N">Electrocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000074021" MajorTopicYN="N">Interatrial Block</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010138" MajorTopicYN="N">Pacemaker, Artificial</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011183" MajorTopicYN="N">Postoperative Complications</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012042" MajorTopicYN="N">Registries</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020521" MajorTopicYN="N">Stroke</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D065467" MajorTopicYN="N">Transcatheter Aortic Valve Replacement</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">ECG</Keyword><Keyword MajorTopicYN="N">TAVI</Keyword><Keyword MajorTopicYN="N">TAVR</Keyword><Keyword MajorTopicYN="N">interatrial block</Keyword><Keyword MajorTopicYN="N">pacemaker</Keyword><Keyword MajorTopicYN="N">prognosis</Keyword></KeywordList><CoiStatement>None.</CoiStatement><InvestigatorList><Investigator 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ValidYN="Y"><LastName>Gutiérrez</LastName><ForeName>Enrique</ForeName><Initials>E</Initials></Investigator><Investigator ValidYN="Y"><LastName>Elízaga</LastName><ForeName>Jaime</ForeName><Initials>J</Initials></Investigator><Investigator ValidYN="Y"><LastName>Fernández-Avilés</LastName><ForeName>Francisco</ForeName><Initials>F</Initials></Investigator><Investigator ValidYN="Y"><LastName>Alvarado Casas</LastName><ForeName>Teresa</ForeName><Initials>T</Initials></Investigator><Investigator ValidYN="Y"><LastName>Alfonso</LastName><ForeName>Fernando</ForeName><Initials>F</Initials></Investigator><Investigator ValidYN="Y"><LastName>Albarrán González de Trevilla</LastName><ForeName>Agustín</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>García Tejada</LastName><ForeName>Julio</ForeName><Initials>J</Initials></Investigator><Investigator ValidYN="Y"><LastName>Gómez Blázquez</LastName><ForeName>Iván Tomás</ForeName><Initials>IT</Initials></Investigator><Investigator ValidYN="Y"><LastName>Sarnago</LastName><ForeName>Fernando</ForeName><Initials>F</Initials></Investigator><Investigator ValidYN="Y"><LastName>Guerrero Morales</LastName><ForeName>Carme</ForeName><Initials>C</Initials></Investigator><Investigator ValidYN="Y"><LastName>Avanzas</LastName><ForeName>Pablo</ForeName><Initials>P</Initials></Investigator><Investigator ValidYN="Y"><LastName>Persia</LastName><ForeName>Yvan</ForeName><Initials>Y</Initials></Investigator><Investigator ValidYN="Y"><LastName>Moris</LastName><ForeName>Cesar</ForeName><Initials>C</Initials></Investigator><Investigator ValidYN="Y"><LastName>Cobiella</LastName><ForeName>Javier</ForeName><Initials>J</Initials></Investigator><Investigator ValidYN="Y"><LastName>Sanmartin Pena</LastName><ForeName>Xoan Carlos</ForeName><Initials>XC</Initials></Investigator><Investigator ValidYN="Y"><LastName>Lopez Pais</LastName><ForeName>Javier</ForeName><Initials>J</Initials></Investigator><Investigator ValidYN="Y"><LastName>Muñoz</LastName><ForeName>Antonio</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Muñoz</LastName><ForeName>Erika</ForeName><Initials>E</Initials></Investigator><Investigator ValidYN="Y"><LastName>Hernández</LastName><ForeName>José María</ForeName><Initials>JM</Initials></Investigator></InvestigatorList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>11</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>4</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>11</Month><Day>3</Day><Hour>8</Hour><Minute>38</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId 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Background The clinical significance of conduction disturbances after transcatheter aortic valve implantation has been described; however, little is known about the influence of baseline ECGs in the prognosis of these patients. Our aim was to study the influence of baseline ECG parameters, including interatrial block (IAB), in the prognosis of patients treated with transcatheter aortic valve implantation. Methods and Results The BIT (Baseline Interatrial Block and Transcatheter Aortic Valve Implantation) registry included 2527 patients with aortic stenosis treated with transcatheter aortic valve implantation. A centralized analysis of baseline ECGs was performed. Patients were divided into 4 groups: normal P wave duration (<120 ms); partial IAB (P wave duration ≥120 ms, positive in the inferior leads); advanced IAB (P wave duration ≥120 ms, biphasic [+/-] morphology in the inferior leads); and nonsinus rhythm (atrial fibrillation/flutter and paced rhythm). The mean age of patients was 82.6±9.8 years and 1397 (55.3%) were women. A total of 960 patients (38.0%) had a normal P wave, 582 (23.0%) had partial IAB, 300 (11.9%) had advanced IAB, and 685 (27.1%) presented with nonsinus rhythm. Mean follow-up duration was 465±171 days. Advanced IAB was the only independent predictor of all-cause mortality (hazard ratio [HR], 1.48; 95% CI, 1.10-1.98 [<i>P</i>=0.010]) and of the composite end point (death/stroke/new atrial fibrillation) (HR, 1.51; 95% CI, 1.17-1.94 [<i>P</i>=0.001]). Conclusions Baseline ECG characteristics influence the prognosis of patients with aortic stenosis treated with transcatheter aortic valve implantation. Advanced IAB is present in about an eighth of patients and is associated with all-cause death and the composite end point of death, stroke, and new atrial fibrillation during follow-up.</Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Vicent</LastName><ForeName>Lourdes</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario Gregorio Marañón CIBERCV Madrid Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario 12 de Octubre CIBERCV Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fernández-Cordón</LastName><ForeName>Clara</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario Gregorio Marañón CIBERCV Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nombela-Franco</LastName><ForeName>Luis</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Cardiovascular Institute Hospital Clinico San Carlos, IdISSC Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Escobar-Robledo</LastName><ForeName>Luis Alberto</ForeName><Initials>LA</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital de la Santa Creu i Sant Pau. Fundación Investigación Cardiovascular. Programa-ICCC Cardiovascular Institut de Recerca del Hospital de la Santa Creu I Sant Pau IIB-Sant Pau Barcelona, Spain Barcelona Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ayesta</LastName><ForeName>Ana</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital Universitario Central de Asturias Oviedo Asturias Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ariza Solé</LastName><ForeName>Albert</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Cardiology Bellvitge University Hospital. L'Hospitalet de Llobregat Barcelona Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gómez-Doblas</LastName><ForeName>Juan José</ForeName><Initials>JJ</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital Universitario Virgen de la Victoria Málaga Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bernal</LastName><ForeName>Eva</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital Universitari Germans Trias i Pujol Badalona Barcelona Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tirado-Conte</LastName><ForeName>Gabriela</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Cardiovascular Institute Hospital Clinico San Carlos, IdISSC Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cobiella</LastName><ForeName>Javier</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Cardiovascular Institute Hospital Clinico San Carlos, IdISSC Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>González-Saldivar</LastName><ForeName>Hugo</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario Gregorio Marañón CIBERCV Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>López-Otero</LastName><ForeName>Diego</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital Cínico Universitario Santiago de Compostela Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Díez-Villanueva</LastName><ForeName>Pablo</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital Universitario de la Princesa Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sarnago</LastName><ForeName>Fernando</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario 12 de Octubre CIBERCV Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Armario</LastName><ForeName>Xavier</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital de la Santa Creu i Sant Pau. Fundación Investigación Cardiovascular. Programa-ICCC Cardiovascular Institut de Recerca del Hospital de la Santa Creu I Sant Pau IIB-Sant Pau Barcelona, Spain Barcelona Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bayés-de-Luna</LastName><ForeName>Antonio</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital de la Santa Creu i Sant Pau. Fundación Investigación Cardiovascular. Programa-ICCC Cardiovascular Institut de Recerca del Hospital de la Santa Creu I Sant Pau IIB-Sant Pau Barcelona, Spain Barcelona Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Martínez-Sellés</LastName><ForeName>Manuel</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Cardiology Hospital General Universitario Gregorio Marañón CIBERCV Madrid Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Universidad Europea Universidad Complutense Madrid Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>Baseline Interatrial Block and Transcatheter Aortic Valve Implantation (BIT) Registry Investigators †</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>11</Month><Day>03</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Am Heart Assoc</MedlineTA><NlmUniqueID>101580524</NlmUniqueID><ISSNLinking>2047-9980</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001024" MajorTopicYN="N">Aortic Valve Stenosis</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001281" MajorTopicYN="N">Atrial Fibrillation</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004562" MajorTopicYN="N">Electrocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000074021" MajorTopicYN="N">Interatrial Block</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010138" MajorTopicYN="N">Pacemaker, Artificial</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011183" MajorTopicYN="N">Postoperative Complications</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012042" MajorTopicYN="N">Registries</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020521" MajorTopicYN="N">Stroke</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D065467" MajorTopicYN="N">Transcatheter Aortic Valve Replacement</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">ECG</Keyword><Keyword MajorTopicYN="N">TAVI</Keyword><Keyword MajorTopicYN="N">TAVR</Keyword><Keyword MajorTopicYN="N">interatrial block</Keyword><Keyword MajorTopicYN="N">pacemaker</Keyword><Keyword MajorTopicYN="N">prognosis</Keyword></KeywordList><CoiStatement>None.</CoiStatement><InvestigatorList><Investigator ValidYN="Y"><LastName>Serra</LastName><ForeName>Antonio</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Arzamendi</LastName><ForeName>Dabit</ForeName><Initials>D</Initials></Investigator><Investigator ValidYN="Y"><LastName>Millán</LastName><ForeName>Xavier</ForeName><Initials>X</Initials></Investigator><Investigator ValidYN="Y"><LastName>Díez-delHoyo</LastName><ForeName>Felipe</ForeName><Initials>F</Initials></Investigator><Investigator ValidYN="Y"><LastName>Grigorian</LastName><ForeName>Lilian</ForeName><Initials>L</Initials></Investigator><Investigator ValidYN="Y"><LastName>Juárez</LastName><ForeName>Miriam</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Vázquez</LastName><ForeName>M Eugenia</ForeName><Initials>ME</Initials></Investigator><Investigator ValidYN="Y"><LastName>Sanz</LastName><ForeName>Ricardo</ForeName><Initials>R</Initials></Investigator><Investigator ValidYN="Y"><LastName>Gutiérrez</LastName><ForeName>Enrique</ForeName><Initials>E</Initials></Investigator><Investigator ValidYN="Y"><LastName>Elízaga</LastName><ForeName>Jaime</ForeName><Initials>J</Initials></Investigator><Investigator ValidYN="Y"><LastName>Fernández-Avilés</LastName><ForeName>Francisco</ForeName><Initials>F</Initials></Investigator><Investigator ValidYN="Y"><LastName>Alvarado Casas</LastName><ForeName>Teresa</ForeName><Initials>T</Initials></Investigator><Investigator ValidYN="Y"><LastName>Alfonso</LastName><ForeName>Fernando</ForeName><Initials>F</Initials></Investigator><Investigator ValidYN="Y"><LastName>Albarrán González de Trevilla</LastName><ForeName>Agustín</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>García Tejada</LastName><ForeName>Julio</ForeName><Initials>J</Initials></Investigator><Investigator ValidYN="Y"><LastName>Gómez Blázquez</LastName><ForeName>Iván Tomás</ForeName><Initials>IT</Initials></Investigator><Investigator ValidYN="Y"><LastName>Sarnago</LastName><ForeName>Fernando</ForeName><Initials>F</Initials></Investigator><Investigator ValidYN="Y"><LastName>Guerrero Morales</LastName><ForeName>Carme</ForeName><Initials>C</Initials></Investigator><Investigator ValidYN="Y"><LastName>Avanzas</LastName><ForeName>Pablo</ForeName><Initials>P</Initials></Investigator><Investigator ValidYN="Y"><LastName>Persia</LastName><ForeName>Yvan</ForeName><Initials>Y</Initials></Investigator><Investigator ValidYN="Y"><LastName>Moris</LastName><ForeName>Cesar</ForeName><Initials>C</Initials></Investigator><Investigator ValidYN="Y"><LastName>Cobiella</LastName><ForeName>Javier</ForeName><Initials>J</Initials></Investigator><Investigator ValidYN="Y"><LastName>Sanmartin Pena</LastName><ForeName>Xoan Carlos</ForeName><Initials>XC</Initials></Investigator><Investigator ValidYN="Y"><LastName>Lopez Pais</LastName><ForeName>Javier</ForeName><Initials>J</Initials></Investigator><Investigator ValidYN="Y"><LastName>Muñoz</LastName><ForeName>Antonio</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Muñoz</LastName><ForeName>Erika</ForeName><Initials>E</Initials></Investigator><Investigator ValidYN="Y"><LastName>Hernández</LastName><ForeName>José María</ForeName><Initials>JM</Initials></Investigator></InvestigatorList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>11</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>4</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>11</Month><Day>3</Day><Hour>8</Hour><Minute>38</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33140688</ArticleId><ArticleId IdType="pmc">PMC7763710</ArticleId><ArticleId IdType="doi">10.1161/JAHA.120.017624</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Zhang X, Wang T, Lan R, Dai Q, Kang L, Wang L, Wang Y, Xu W, Xu B. 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Conduction abnormalities after transcatheter aortic valve implantation. J Geriatr Cardiol. 2018;15:105–112.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC5803544</ArticleId><ArticleId IdType="pubmed">29434632</ArticleId></ArticleIdList></Reference><Reference><Citation>Martinez‐Selles M, Bramlage P, Thoenes M, Schymik G. Clinical significance of conduction disturbances after aortic valve intervention: current evidence. Clin Res Cardiol. 2015;104:1–12.</Citation><ArticleIdList><ArticleId IdType="pubmed">24990451</ArticleId></ArticleIdList></Reference><Reference><Citation>Gaede L, Kim WK, Liebetrau C, Dorr O, Sperzel J, Blumenstein J, Berkowitsch A, Walther T, Hamm C, Elsasser A, et al. Pacemaker implantation after TAVI: predictors of AV block persistence. 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J Electrocardiol. 2019;57:100–103.</Citation><ArticleIdList><ArticleId IdType="pubmed">31629098</ArticleId></ArticleIdList></Reference><Reference><Citation>Bachhal V, Saini G, Jindal N, Sament R, Dadra A. GeoGebra: A reliable and free software for measuring acetabular cup anteversion on digitalized plain radiographs. J Clin Orthop Trauma. 2020;11:S201–s205.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC7068040</ArticleId><ArticleId IdType="pubmed">32189940</ArticleId></ArticleIdList></Reference><Reference><Citation>Ciuffo L, Bruña V, Martínez‐Sellés M, de Vasconcellos HD, Tao S, Zghaib T, Nazarian S, Spragg DD, Marine J, Berger RD, et al. Association between interatrial block, left atrial fibrosis, and mechanical dyssynchrony: Electrocardiography‐magnetic resonance imaging correlation. J Cardiovasc Electrophysiol. 2020;31:1719–1725.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC7703864</ArticleId><ArticleId IdType="pubmed">32510679</ArticleId></ArticleIdList></Reference><Reference><Citation>Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, González‐Juanatey JR, Harjola VP, Jankowska EA, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129–2200.</Citation><ArticleIdList><ArticleId IdType="pubmed">27206819</ArticleId></ArticleIdList></Reference><Reference><Citation>Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. 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Int J Cardiol. 2018;271:174–180.</Citation><ArticleIdList><ArticleId IdType="pubmed">29801761</ArticleId></ArticleIdList></Reference><Reference><Citation>Baturova MA, Lindgren A, Shubik YV, Carlson J, Platonov PG. Interatrial block in prediction of all‐cause mortality after first‐ever ischemic stroke. BMC Cardiovasc Disord. 2019;19:37.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC6371419</ArticleId><ArticleId IdType="pubmed">30744701</ArticleId></ArticleIdList></Reference><Reference><Citation>Rubaj A, Rucinski P, Kutarski A, Dabrowska‐Kugacka A, Oleszczak K, Zimon B, Trojnar M, Zapolski T, Drozd J, Tarkowski A, et al. Cardiac hemodynamics and proinflammatory cytokines during biatrial and right atrial appendage pacing in patients with interatrial block. J Interv Card Electrophysiol. 2013;37:147–154.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC3698432</ArticleId><ArticleId IdType="pubmed">23625090</ArticleId></ArticleIdList></Reference><Reference><Citation>Tichelbacker T, Bergau L, Puls M, Friede T, Mutze T, Maier LS, Frey N, Hasenfuss G, Zabel M, Jacobshagen C, et al. Insights into permanent pacemaker implantation following TAVR in a real‐world cohort. PLoS One. 2018;13:e0204503.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC6192571</ArticleId><ArticleId IdType="pubmed">30332419</ArticleId></ArticleIdList></Reference><Reference><Citation>Nazif TM, Dizon JM, Hahn RT, Xu K, Babaliaros V, Douglas PS, El‐Chami MF, Herrmann HC, Mack M, Makkar RR, et al. Predictors and clinical outcomes of permanent pacemaker implantation after transcatheter aortic valve replacement: the PARTNER (Placement of AoRtic TraNscathetER Valves) trial and registry. JACC Cardiovasc Interv. 2015;8:60–69.</Citation><ArticleIdList><ArticleId IdType="pubmed">25616819</ArticleId></ArticleIdList></Reference><Reference><Citation>Gonzalez‐Lopez E, Gallego‐Delgado M, Guzzo‐Merello G, de Haro‐Del Moral FJ, Cobo‐Marcos M, Robles C, Bornstein B, Salas C, Lara‐Pezzi E, Alonso‐Pulpon L, et al. Wild‐type transthyretin amyloidosis as a cause of heart failure with preserved ejection fraction. Eur Heart J. 2015;36:2585–2594.</Citation><ArticleIdList><ArticleId IdType="pubmed">26224076</ArticleId></ArticleIdList></Reference><Reference><Citation>Watanabe Y, Kozuma K, Hioki H, Kawashima H, Nara Y, Kataoka A, Nagura F, Nakashima M, Shirai S, Tada N, et al. Pre‐existing right bundle branch block increases risk for death after transcatheter aortic valve replacement with a balloon‐expandable valve. JACC Cardiovasc Interv. 2016;9:2210–2216.</Citation><ArticleIdList><ArticleId IdType="pubmed">27832846</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">33140044</PMID><DateRevised><Year>2021</Year><Month>07</Month><Day>27</Day></DateRevised><Article PubModel="Electronic"><Journal><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Oct</Month><Day>28</Day></PubDate></JournalIssue><Title>bioRxiv : the preprint server for biology</Title><ISOAbbreviation>bioRxiv</ISOAbbreviation></Journal><ArticleTitle>SARS-CoV-2 desensitizes host cells to interferon through inhibition of the JAK-STAT pathway.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">2020.10.27.358259</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1101/2020.10.27.358259</ELocationID><Abstract>SARS-CoV-2 can infect multiple organs, including lung, intestine, kidney, heart, liver, and brain. The molecular details of how the virus navigates through diverse cellular environments and establishes replication are poorly defined. Here, we performed global proteomic analysis of the virus-host interface in a newly established panel of phenotypically diverse, SARS-CoV-2-infectable human cell lines representing different body organs. This revealed universal inhibition of interferon signaling across cell types following SARS-CoV-2 infection. We performed systematic analyses of the JAK-STAT pathway in a broad range of cellular systems, including immortalized cell lines and primary-like cardiomyocytes, and found that several pathway components were targeted by SARS-CoV-2 leading to cellular desensitization to interferon. These findings indicate that the suppression of interferon signaling is a mechanism widely used by SARS-CoV-2 in diverse tissues to evade antiviral innate immunity, and that targeting the viral mediators of immune evasion may help block virus replication in patients with COVID-19.
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Evaluation of the Toxicity of Two Electron-Deficient Half-Sandwich Complexes against Human Lymphocytes from Healthy Individuals.
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Electron-deficient half-sandwich complexes are a class of under-studied organometallics with demonstrated potential as metallodrug candidates. This study investigates the effect of two 16-electron organoruthenium complexes ([(p-cym)Ru(benzene-1,2-dithiolato)] (1) and [(p-cym)Ru(maleonitriledithiolate)] (2)) on the cell viability of non-immortalised human lymphocytes from healthy individuals. The genotoxic effects of 1 and 2 in lymphocytes are also investigated by using the Comet and cytokinesis-block micronucleus assays. Gene expression studies were carried out on a panel of genes involved in apoptosis and the DNA damage-repair response. Results show that the two 16-electron complexes do not have significant effect on the cell viability of human lymphocytes from healthy individuals. However, an increase in DNA damage is induced by both compounds, presumably through oxidative stress production.
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2,334,407 |
Postoperative Thoracic Pain Treatment: Serratus Anterior or Erector Spinae Plane Block?
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 Thoracic surgery is one of the most painful surgeries. Effective analgesia is important in postoperative pain management. In this study, we aimed to compare the two new fascial block techniques.</AbstractText> A total of 107 patients who underwent thoracic surgery between October 2018 and November 2019 were retrospectively evaluated. The study included 59 patients in the serratus anterior plane block (SAPB) group and 48 patients in the erector spinae plane block (ESPB) group. Both groups were administered 30 mL of 0.25% bupivacaine and their morphine consumption was evaluated by a patient-controlled analgesia (PCA) method during the 2nd, 6th, 12th, 24th, and 48th postoperative hours. Pain was measured with the visual analog scale (VAS). Intraoperative mean arterial pressure (MAP) and heart rate (HR) were recorded.</AbstractText> During the first 24 hours, VAS values were significantly lower in the ESPB group (p</i> < 0.05). Moreover, morphine consumption was significantly lower in the ESPB group in the 24th and 48th hours (p</i> < 0.05). Intraoperative remifentanil consumption was also significantly lower in the ESPB group (p</i> < 0.05). Intraoperative MAP in the ESPB group was found to be significantly lower after the 4th hour. HR was similar in both groups.</AbstractText> ESPB was more effective compared with SAPB in postoperative thoracic pain management.</AbstractText>Thieme. All rights reserved.</CopyrightInformation>
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2,334,408 |
Axolotl liver regeneration is accomplished via compensatory congestion mechanisms regulated by ERK signaling after partial hepatectomy.
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Axolotls have remarkable organ-level regeneration capability. They can regenerate their limbs, tail, brain, gills, and heart. The liver had been considered to be a regenerative organ in these highly regeneration-competent animals. Therefore, no research had been performed on liver regeneration in urodele amphibians. In the present study, we focused on axolotl liver regeneration and found a unique regeneration mechanism compared with other vertebrates.</AbstractText>Partial hepatectomy (PH) was performed to assess axolotl liver regeneration. Regeneration was assessed using block-face imaging (CoMBi), histology, cell proliferation, weight gain, and Albumin (Alb) + area. Axolotl liver histology was compared with other vertebrates. Axolotl liver consists of Glisson's capsule, sinusoids, and hepatic cord with no apparent lobule structures. Hepatocytes were mononucleated or multinucleated. PH increased the multinucleated hepatocytes and the Alb + area, but there was no apparent liver shape recovery even 40 days after PH. Gene expression pattern suggests that no epimorphic regeneration takes place. We also found that the increase in the number of proliferating hepatocytes was regulated by ERK-signaling.</AbstractText>Our findings suggest that axolotls, which have epimorphic regeneration ability, regenerate their liver via unique mechanisms, compensatory congestion.</AbstractText>© 2020 American Association of Anatomists.</CopyrightInformation>
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2,334,409 |
Complexity of TNF-α Signaling in Heart Disease.
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Heart disease is a leading cause of death with unmet clinical needs for targeted treatment options. Tumor necrosis factor alpha (TNF-α) represents a master pro-inflammatory cytokine that plays an important role in many immunopathogenic processes. Anti-TNF-α therapy is widely used in treating autoimmune inflammatory disorders, but in case of patients with heart disease, this treatment was unsuccessful or even harmful. The underlying reasons remain elusive until today. This review summarizes the effects of anti-TNF-α treatment in patients with and without heart disease and describes the involvement of TNF-α signaling in a number of animal models of cardiovascular diseases. We specifically focused on the role of TNF-α in specific cardiovascular conditions and in defined cardiac cell types. Although some mechanisms, mainly in disease development, are quite well known, a comprehensive understanding of TNF-α signaling in the failing heart is still incomplete. Published data identify pathogenic and cardioprotective mechanisms of TNF-α in the affected heart and highlight the differential role of two TNF-α receptors pointing to the complexity of the TNF-α signaling. In the light of these findings, it seems that targeting the TNF-α pathway in heart disease may show therapeutic benefits, but this approach must be more specific and selectively block pathogenic mechanisms. To this aim, more research is needed to better understand the molecular mechanisms of TNF-α signaling in the failing heart.
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2,334,410 |
The effect of meloxicam on neonatal dairy calves: Immunoglobulin G uptake and preweaning performance.
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Objectives of this study were to determine effects of meloxicam administered in 2 forms on IgG uptake, growth, and health of preweaned calves. Sixteen Holstein bulls and 14 heifers with a body weight (BW) of 44.3 ± 5.24 kg were blocked by birth date in a randomized complete block design. Calves were removed from the dam before suckling, weighed, and randomly assigned to 1 of 3 treatments: (1) colostrum replacer (CR) at 0 h with no meloxicam (control; CON), (2) 1 mg/kg of BW of meloxicam in pill form before CR (PL), or (3) 1 mg/kg of BW of meloxicam mixed in solution with CR (SL). Calves were fed 675 g of dry matter of CR, providing a volume of 3 L and 180 g of IgG. Blood samples were collected at 0 h to analyze initial IgG and ketone concentrations, and at 6, 12, 18, and 24 h to analyze IgG uptake. At 24 h, calves were fed 432 g of dry matter of 24% crude protein milk replacer (MR) split in 2 feedings, and free choice starter and water until 42 d. Weekly blood samples were analyzed for glucose, plasma urea nitrogen, and ketone concentrations. Time of consumption of MR, BW, length, hip and withers height, and heart girth were recorded weekly. All calves achieved adequate transfer of immunity. Meloxicam did not affect apparent efficiency of absorption, serum total protein, or IgG uptake at 6, 18, and 24 h; however, meloxicam-treated calves had lesser IgG concentrations at 12 h (24.40 and 22.59 g/L for PL and SL, respectively) compared with CON (28.47 g/L). Meloxicam treatment did not affect BW. Calves that received PL tended to gain length at a faster rate (0.24 cm/d) than those that received SL (0.19 cm/d). Meloxicam treatment did not affect MR intake, time of consumption of MR, total dry matter intake, or feed efficiency. Meloxicam-treated calves tended to consume more starter (560.4 and 515.4 g/d for PL and SL, respectively) than those that received CON (452.6 g/d). Ketone levels tended to be greater in meloxicam-treated calves (0.15 and 0.17 mmol/L for PL and SL, respectively), suggesting improved rumen development compared with those that received CON (0.12 mmol/L). Meloxicam treatment did not affect plasma urea nitrogen . Glucose concentrations of calves that received PL (73.2 mg/dL) were less than those that received SL (83.3 mg/dL). Results of this study suggest that meloxicam given at 0 h offers positive effects on starter intake, and possibly rumen development, of preweaned dairy calves. Treatment PL, as compared with SL, offered positive results for rumen development, indicated by lower blood glucose levels.
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2,334,411 |
An unyielding valve leading to venous spasm during pacemaker implantation: a case report.
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Subclavian venous spasm is an uncommon complication during permanent pacemaker implantation. The exact aetiology of subclavian venous spasm is not clear but has been suggested to be due to either mechanical irritation of the vein during needle puncture or due to chemical irritation from contrast injection. Here, we report a case of an unyielding subclavian vein valve that impeded guidewire advancement and the repeated guidewire manipulation led to venous spasm.</AbstractText>A 45-year-old woman with a history of surgical repair of Tetrology of Fallot in childhood presented with symptomatic bifascicular block and underwent a permanent pacemaker implantation. A subclavian venogram done prior to the procedure showed a prominent valve in the distal portion of the vein. Following venous puncture, guidewire advancement was impeded by the prominent valve. The resulting guidewire manipulation led to subclavian venous spasm necessitating a medial subclavian venous puncture and access.</AbstractText>Prolonged mechanical irritation of the vein during pacemaker implantation may lead to venous spasm impeding pacemaker implantation. Early identification of an impeding valve and obtaining access medial to the valve may help prevent this uncommon complication.</AbstractText>© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.</CopyrightInformation>
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2,334,412 |
Membrane permeability of small molecules from unbiased molecular dynamics simulations.
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Permeation of many small molecules through lipid bilayers can be directly observed in molecular dynamics simulations on the nano- and microsecond timescale. While unbiased simulations provide an unobstructed view of the permeation process, their feasibility for computing permeability coefficients depends on various factors that differ for each permeant. The present work studies three small molecules for which unbiased simulations of permeation are feasible within less than a microsecond, one hydrophobic (oxygen), one hydrophilic (water), and one amphiphilic (ethanol). Permeabilities are computed using two approaches: counting methods and a maximum-likelihood estimation for the inhomogeneous solubility diffusion (ISD) model. Counting methods yield nearly model-free estimates of the permeability for all three permeants. While the ISD-based approach is reasonable for oxygen, it lacks precision for water due to insufficient sampling and results in misleading estimates for ethanol due to invalid model assumptions. It is also demonstrated that simulations using a Langevin thermostat with collision frequencies of 1/ps and 5/ps yield oxygen permeabilities and diffusion constants that are lower than those using Nosé-Hoover by statistically significant margins. In contrast, permeabilities from trajectories generated with Nosé-Hoover and the microcanonical ensemble do not show statistically significant differences. As molecular simulations become more affordable and accurate, calculation of permeability for an expanding range of molecules will be feasible using unbiased simulations. The present work summarizes theoretical underpinnings, identifies pitfalls, and develops best practices for such simulations.
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2,334,413 |
Troubleshooting Pacemaker Behavior: Consequence of Prolonged Ventriculoatrial Conduction.
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The event of repetitive nonreentrant ventriculoatrial synchrony (RNRVAS) and its course of cardiac device management has been authenticated. However, this context has not been well-documented in the presence of high-degree antegrade heart block. This case report will discuss the challenges of treatment in this subgroup of patients.
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2,334,414 |
Dexmedetomidine combined with suprascapular nerve block and axillary nerve block has a synergistic effect on relieving postoperative pain after arthroscopic rotator cuff repair.
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Suprascapular nerve block (SSNB) is the most commonly used block for the relief of postoperative pain from arthroscopic rotator cuff repair and can be used in combination with axillary nerve block (ANB). Dexmedetomidine (DEX) is a type of alpha agonist that can elongate the duration of regional block. The aim of this study was to compare the effects of the use of dexmedetomidine combined with SSNB and ANB with those of the use of SSNB and ANB alone on postoperative pain, satisfaction, and pain-related cytokines within the first 48 h after arthroscopic rotator cuff repair.</AbstractText>Forty patients with rotator cuff tears who had undergone arthroscopic rotator cuff repair were enrolled in this single-center, double-blinded randomized controlled trial study. Twenty patients were randomly allocated to group 1 and received ultrasound-guided SSNB and ANB using a mixture of 0.5 ml (50 μg) of DEX and 9.5 ml of 0.75% ropivacaine preemptively. The other 20 patients were allocated to group 2 and underwent ultrasound-guided SSNB and ANB alone using a mixture of 0.5 ml of normal saline and 9.5 ml of ropivacaine. The visual analog scale (VAS) for pain and patient satisfaction (SAT) scores were postoperatively checked within 48 h. The plasma interleukin (IL)-6, IL-8, IL-1β, cortisol, and serotonin levels were also postoperatively measured within 48 h.</AbstractText>Group 1 showed a significantly lower mean VAS (visual analog scale of pain) score 1, 3, 6, 12, 18 and 24 h after operation, and a significantly higher mean SAT (patient satisfaction) score 1, 3, 6, 12, 18, 24 and 36 h after the operation than group 2. Group 1 showed a significantly lower mean plasma IL-8 level 1 and 48 h after the operation, and a significantly lower mean IL-1β level 48 h after the operation than group 2. Group 1 showed a significantly lower mean plasma serotonin level 12 h after the operation than group 2. The mean timing of rebound pain in group 1 was significantly later than that in group 2 (36 h > 23 h, p = 0.007). Six patients each in groups 1 and 2 showed rebound pain. The others did not show rebound pain.</AbstractText>Ultrasound-guided SSNA and ANB with DEX during arthroscopic rotator cuff repair resulted in a significantly lower mean VAS score and a significantly higher mean SAT score within 48 h after the operation than SSNB and ANB alone. Additionally, SSNB and ANB with DEX tended to result in a later mean timing of rebound pain accompanied by significant changes in IL-8, IL-1β, and serotonin levels within 48 h after the operation. The present study could provide the basis for selecting objective parameters of postoperative pain in deciding the optimal use of medication for relieving pain.</AbstractText>Level I.</AbstractText>2015-20, ClinicalTrials.gov Identifier: NCT04398589.</AbstractText>2015-20, Hallym University Chuncheon Sacred Heart Hospital.</AbstractText>© 2020. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).</CopyrightInformation>
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2,334,415 |
Biocompatible Nanocomposites Based on Poly(styrene-<i>block</i>-isobutylene-<i>block</i>-styrene) and Carbon Nanotubes for Biomedical Application.
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In this study, we incorporated carbon nanotubes (CNTs) into poly(styrene-<i>block</i>-isobutylene-<i>block</i>-styrene) (SIBS) to investigate the physical characteristics of the resulting nanocomposite and its cytotoxicity to endothelial cells. CNTs were dispersed in chloroform using sonication following the addition of a SIBS solution at different ratios. The resultant nanocomposite films were analyzed by X-ray microtomography, optical and scanning electron microscopy; tensile strength was examined by uniaxial tension testing; hydrophobicity was evaluated using a sessile drop technique; for cytotoxicity analysis, human umbilical vein endothelial cells were cultured on SIBS-CNTs for 3 days. We observed an uneven distribution of CNTs in the polymer matrix with sporadic bundles of interwoven nanotubes. Increasing the CNT content from 0 wt% to 8 wt% led to an increase in the tensile strength of SIBS films from 4.69 to 16.48 MPa. The engineering normal strain significantly decreased in 1 wt% SIBS-CNT films in comparison with the unmodified samples, whereas a further increase in the CNT content did not significantly affect this parameter. The incorporation of CNT into the SIBS matrix resulted in increased hydrophilicity, whereas no cytotoxicity towards endothelial cells was noted. We suggest that SIBS-CNT may become a promising material for the manufacture of implantable devices, such as cardiovascular patches or cusps of the polymer heart valve.
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2,334,416 |
3D-Printed Ceramic Bone Scaffolds with Variable Pore Architectures.
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This study evaluated the mechanical properties and bone regeneration ability of 3D-printed pure hydroxyapatite (HA)/tricalcium phosphate (TCP) pure ceramic scaffolds with variable pore architectures. A digital light processing (DLP) 3D printer was used to construct block-type scaffolds containing only HA and TCP after the polymer binder was completely removed by heat treatment. The compressive strength and porosity of the blocks with various structures were measured; scaffolds with different pore sizes were implanted in rabbit calvarial models. The animals were observed for eight weeks, and six animals were euthanized in the fourth and eighth weeks. Then, the specimens were evaluated using radiological and histological analyses. Larger scaffold pore sizes resulted in enhanced bone formation after four weeks (<i>p</i> < 0.05). However, in the eighth week, a correlation between pore size and bone formation was not observed (<i>p</i> > 0.05). The findings showed that various pore architectures of HA/TCP scaffolds can be achieved using DLP 3D printing, which can be a valuable tool for optimizing bone-scaffold properties for specific clinical treatments. As the pore size only influenced bone regeneration in the initial stage, further studies are required for pore-size optimization to balance the initial bone regeneration and mechanical strength of the scaffold.
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2,334,417 |
Effect of Dexamethasone in Peripheral Nerve Blocks on Recovery of Nerve Function.
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Peripheral nerve blocks (PNBs) have revolutionized distal extremity surgery reducing pain and improving hospital efficiency. Perineural dexamethasone has been administered with PNBs to prolong their effects, although the safety of dexamethasone has not been established in the literature. This study aimed to determine if the addition of dexamethasone affected the postoperative neurological sensory status for foot and ankle surgeries and the recovery of nerve injuries. We hypothesized that the rate of persistent nerve injury would be higher in the dexamethasone group.</AbstractText>This is a retrospective observational cohort study of prospectively collected data of all patients from a single foot and ankle surgeon's practice. Perineural dexamethasone was routinely used as an adjunct by the regional anesthesia group until a clinical trend of increased paresthesia was found on short-term follow-up, which led to the discontinuation of its use. In this study, the cohort that received dexamethasone with ropivacaine was compared with the cohort that received ropivacaine alone. The primary outcome was a separate sensory nerve status sheet that was completed for every distal nerve territory for every patient at their follow-up visits at 2 weeks, 6 weeks, 3 months, and 6 months. Univariate analysis and a logistic regression model were used to determine the association between dexamethasone and delayed nerve recovery. A total of 250 patients were included in the study, with 117 patients in the dexamethasone group and 133 in the ropivacaine-only group.</AbstractText>The rates of nerve injuries were not different between the groups (72 [62%] in the dexamethasone group vs 79 [59%] in the ropivacaine-only group). However, nerve injury symptoms were more likely to persist and not fully recover in the dexamethasone group (n</i> = 47, 65%) compared with the ropivacaine-only group (n</i> = 32, 41%) (OR, 2.12; P</i> = .006).</AbstractText>Perineural dexamethasone added to PNBs may be associated with delayed nerve recovery after foot and ankle surgery. It may be prudent to avoid its use until its full safety profile is established in larger prospective trials.</AbstractText>Level III, retrospective comparative study.</AbstractText>
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2,334,418 |
Sugammadex for Fast-Track Surgery in Children Undergoing Cardiac Surgery: A Randomized Controlled Study.
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The purpose of this study was to evaluate the safety and efficacy of sugammadex for fast-track surgery in children undergoing cardiac surgery.</AbstractText>This was a prospective, randomized, controlled clinical study.</AbstractText>University hospital.</AbstractText>The study comprised 60 children undergoing cardiac surgery.</AbstractText>The children in group S received sugammadex, 4 mg/kg, for reversal of neuromuscular block, and the children in group N received neostigmine, 30 µg/kg, and atropine, 15 µg/kg.</AbstractText>The recovery time to a train-of-four of 0.9 and extubation time were significantly shorter in the group S than in group N (3.4 ± 1.2 min v 76.2 ± 20.5 min and 31.0 ± 6.4 min v 125.2 ± 21.6 min, respectively; p < 0.01). The heart rate after drug administration was higher in group S than in group N (102.7 ± 9.4 beats/min v 96.9 ± 8.5 beats/min; p = 0.03), whereas the mean arterial pressure after drug administration was similar in both groups. The length of hospital stay was shorter in group S (5.8 ± 1.0 v 6.5 ± 0.9 days; p = 0.03), and the hospitalization expenses were decreased in group S compared with that of group N ($1,036 ± $114 v $1,286 ± $187; p < 0.01). The incidence of postoperative atelectasis was less in group S than in group N (0 v 20%; p = 0.024).</AbstractText>Sugammadex can shorten the extubation time and reduce the incidence of postoperative atelectasis, with fewer adverse events, in children undergoing cardiac surgery. It may be beneficial to use sugammadex for fast-track surgery in children undergoing cardiac surgery.</AbstractText>Copyright © 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
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2,334,419 |
A Mediterranean Dietary Pattern Predicts Better Sleep Quality in US Women from the American Heart Association Go Red for Women Strategically Focused Research Network.
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Consumption of a Mediterranean diet has been linked to better sleep health in older, European populations. However, whether this dietary pattern is predictive of sleep quality in US women, a group prone to poor sleep, is unknown. This prospective cohort study of 432 US women (20-76 y; 60% racial/ethnic minority) evaluated whether compliance with a Mediterranean diet at baseline predicted sleep quality at 1-y follow-up. Alternate Mediterranean (aMed) diet scores and habitual sleep quality were computed from the validated Block Brief Food Frequency Questionnaire and Pittsburgh Sleep Quality Index (PSQI), respectively. Linear regression models evaluated prospective associations of the aMed diet pattern and its components with measures of sleep quality, after adjustment for age, BMI, race/ethnicity, education, and health insurance status. Higher baseline aMed scores were associated with lower PSQI scores (β = -0.30 ± 0.10, <i>p</i> < 0.01), indicative of better sleep quality, higher sleep efficiency (β = 1.20 ± 0.35, <i>p</i> < 0.001), and fewer sleep disturbances (β = -0.30 ± 0.12, <i>p</i> = 0.01) at 1-y. Fruit and vegetable consumption also predicted lower PSQI scores, higher sleep efficiency and fewer sleep disturbances (all <i>p</i> < 0.05). Higher legume intake predicted better sleep efficiency (β = 1.36 ± 0.55, <i>p</i> = 0.01). These findings suggest that adherence to a Mediterranean diet pattern should be evaluated as a strategy to promote sleep quality in US women.
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2,334,420 |
Primary Sjögren's syndrome in South Australia.
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To describe clinical and serological characteristics of a South Australian primary Sjögren's syndrome (pSS) cohort.</AbstractText>The South Australian Sjögren's Syndrome Research Clinic and Database is a clinical cohort of patients with pSS at a single site. Baseline clinical and laboratory data from 172 patients were retrospectively examined to determine their prevalence and clinical associations. Results were compared to findings from 10,500 patients from The Big Data Sjogren Project Consortium; an international, multicentre registry established in 2014, which included the South Australian data.</AbstractText>Of 172 South Australian patients with pSS, 90.1% were female with a mean age at diagnosis of 57 years. Ocular and oral sicca symptoms were common, affecting 97.1% and 99.4% respectively. Anti-Ro ± La positivity was detected in 82.6%, ANA positivity in 77%, and in 9% of patients both ANA and ENA were negative. Mean ESSDAI was 6.8 at baseline, slightly higher than the international cohort at 6.1; the most commonly positive domains being biological, articular and glandular. Pulmonary manifestations represented the most significant morbidity over time. Lymphoma was recorded in 5.2% of patients and congenital heart block in 4 offspring of 52 patients with longitudinal follow-up (7.7%), although incomplete data likely resulted in underestimation of both.</AbstractText>Despite the relatively small sample size of the South Australian cohort, clinical and serological characteristics correspond closely with international descriptions.</AbstractText>
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2,334,421 |
Adverse heart rate responses during beach-chair position for shoulder surgeries - A systematic review and meta-analysis of their incidence, interpretations and associations.
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Evaluations of adverse heart rate (HR)-responses and HR-variations during anaesthesia in beach-chair-position (BCP) for shoulder surgeries have not been done earlier. We analysed the incidence, associations, and interpretations of adverse HR-responses in this clinical setting.</AbstractText>We performed a meta-analysis of trials that reported HR-related data in anaesthetised subjects undergoing elective shoulder surgeries in BCP. Studies included prospective, randomised, quasi-randomised and non-randomised, controlled clinical trials as well as observational cohorts. Literature search was conducted in MEDLINE, EMBASE, CINHAL and the Cochrane Central Register of Controlled Trials of the 21st</sup> century. In the first analysis, we studied the incidence and associations of bradycardia/hypotension-bradycardia episodes (HBE) with respect to the type of anaesthesia and different pharmacological agents. In the second, we evaluated anaesthetic influences, associations and inter-relationships between monitored parameters with respect to HR-behaviours.</AbstractText>Among the trials designed with bradycardia/HBE as a primary end point, the observed incidence of bradycardia was 9.1% and that of HBE, 14.9% and 22.7% [(for Interscalene block (ISB) ± sedation) subjects and general anaesthesia (GA) + ISB, respectively]. There was evidence of higher observed risk of developing adverse HR-responses for GA subjects over ISB (Risk Difference, P</i> < 0.05). Concomitant use of β-agonists did not increase risk of HBEs (P</i> = 0.29, I</i> 2</sup>= 11.4%) or with fentanyl (P</i> = 0.45, I</i> 2</sup>= 0%) for ISB subjects (subgroup analysis). Fentanyl significantly influenced the HR-drop over time [meta-regression, estimates (standard error), 14.9 (5.4), 9.8 (4.3) and 17 (2.6); P</i> = 0.007, 0.024 and <0.001; for early, mid and delayed periods, respectively] in GA subjects. With respect to number of subjects experiencing cerebral desaturation events (CDEs), total intravenous anaesthesia (TIVA)- propofol had higher risk over inhalational anaesthesia (P</i> = 0.006, I</i> 2</sup> = 86.7%). Meta-correlation analysis showed relationships between the HR and rSO2</sub>(regional cerebral oxygen saturation) or SjvO2</sub>(jugular venous oxygen saturation) values (r = 0.608, 95%CI, 0.439 to 0.735, P</i> < 0.001, I</i> 2</sup>= 77.4% and r = 0.397, 95%CI, 0.151 to 0.597, P</i> < 0.001, I</i> 2</sup>= 64.3%, respectively).</AbstractText>There is not enough evidence to claim the associations of adverse HR-responses with any specific factor. HR-fall is maximal with fentanyl and its variability is associated with changes in rSO2</sub>. Fall in rSO2</sub> could be the common link triggering adverse HR-responses in BCP.</AbstractText>Copyright: © 2020 Indian Journal of Anaesthesia.</CopyrightInformation>
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2,334,422 |
A randomized controlled trial evaluating the hemodynamic impact of ultrasound-guided great auricular nerve block in middle ear microsurgery.
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The peri-operative effectiveness of ultrasound-guided great auricular nerve block (GANB) in patients, especially in adult patients undergoing middle ear microsurgery remains unclear. We hypothesized that ultrasound-guided GANB would decrease the hemodynamic responsiveness to incision and opioid consumption in middle ear microsurgery as well as the post-operative analgesia requirement.</AbstractText>Sixty patients undergoing middle ear microsurgery were randomized into two equal groups to receive either a GANB with 2 ml of 0.25% ropivacaine under ultrasound guidance (GANB group) or to receive a blank control intervention (without any performed injection) before general anesthesia inductions. The primary outcomes were hemodynamic changes of MAP (mean artery pressure) and HR (heart rate) to skin incision. The secondary endpoints were to determine the consumptions of propofol and remifentanil during the operation and the incidence of remedial analgesia 48 h post-operation to maintain VAS ≤ 3.</AbstractText>The MAP post incision in GANB group was significantly lower than that in control group (GANB group 93.83 ± 11.72 mmHg vs. control group 100.87 ± 12.65 mmHg, P = 0.029). The increases for MAP and HR post incision were also lower in GANB group (∆MAP GANB group 11.90 ± 8.32 mmHg vs. control group 19.83 ± 10.37 mmHg, P = 0.002; ∆HR GANB group 3.67 ± 5.30 beat min- 1</sup> vs. control group 8.23 ± 8.56 beat min- 1</sup>, P = 0.016). Remifentanil consumption was significantly decreased in GANB group (GANB group 401.55 ± 100.51 μg h- 1</sup> vs. control group 697.34 ± 215.45 μg h- 1</sup>, P = 0.000). The incidence of remedial analgesia post-operation in GANB group (5/30) was significantly lower than that in control group (20/30, P = 0.000).</AbstractText>Ultrasound-guided GANB decreases the hemodynamic responsiveness to incision and remifentanil consumption in middle ear microsurgery as well as the post-operative analgesia requirement.</AbstractText>This trial was retrospectively registered at http://www.chictr.org.cn with the registration number of ChiCTR1800014333 on 6 January, 2018.</AbstractText>
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2,334,423 |
Complete Heart Block Complicating Takotsubo Syndrome: Case Report and Literature Review.
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An 81-year-old woman presents with shortness of breath resulting in a diagnosis of picornavirus and complete heart block. Troponin was elevated and there was concern about acute coronary syndrome. The final diagnosis after echocardiogram and coronary angiogram was Takotsubo syndrome in addition to the heart block which required pacemaker insertion.
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2,334,424 |
Changes in Selected Physiological Parameters Following a Training Block of Specific Circuit Training Among National Top-level Basketball Players.
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The study aims at measuring the effects of six weeks of specific circuit training (SCT) according to the 15-15 modality, on selected physiological parameters in national top-level basketball players. It was an intervention study, undertaken with 44 senior players randomly assigned to two groups depending on the program: intervention (IG: n = 22; SCT) and control (CG: n = 22; usual content of the defending champion team's), submitted to a six-week training block. The heart rate recovery at 1 (HRR1) and then 2 (HRR2) minutes, the double product (DP) and <i>V̇</i>O<sub>2</sub>max were assessed prior to and at the end of the training period. As appropriate, the Student t-test on paired or independent samples, was used to compare measures and groups. At the end of the training period, the HRR1 decreased by 14.2% (p = 0.01) and 14.1% (p = 0.03) respectively in IG and CG. The mean HRR2 was higher in IG than in GC (63 ± 8 bpm <i>versus</i> 57 ± 6 bpm, p = 0.003) at the end of the training period. The variation of DP in IG was not significant (p = 0. 42) while it increased by 7.2% (p = 0.0005) in CG. The <i>V̇</i>O<sub>2</sub>max increased by 6.5% (p < 0. 001) in IG but not in CG (p = 0.50). The specific circuit training block in the 15-15 modality improved heart rate recovery at one minute and <i>V̇</i>O<sub>2</sub>max, but had no effect on the double product in the basketball players studied.
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2,334,425 |
Standardized massage interventions as protocols for the induction of psychophysiological relaxation in the laboratory: a block randomized, controlled trial.
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Health and disease are strongly linked to psychophysiological states. While stress research strongly benefits from standardized stressors, no established protocol focuses on the induction of psychophysiological relaxation. To maintain health, functioning regenerative systems are however likely as important as functioning stress systems. Thus, the identification of validated relaxation paradigms is needed. Here, we investigated whether standardized massages are capable of reliably inducing physiological and psychological states of relaxation. Relaxation was indicated by changes in high frequency heart rate variability (HF-HRV), a vagally-mediated heart rate variability component, and repeated ratings of subjective relaxation, and stress levels. Sixty healthy women were randomly assigned to a vagus nerve massage (n = 19), a soft shoulder massage (n = 22), or a resting control group (n = 19). During the intervention, HF-HRV and subjective relaxation increased, while subjective stress decreased significantly in all groups. Both massage interventions elicited significantly higher HF-HRV compared to the control group. Accordingly, both massage protocols increased psychophysiological relaxation, and may serve as useful tools in future research. However, future work will have to determine which of several protocols might be used as a gold standard to induce a psychophysiological state of relaxation in the laboratory.
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2,334,426 |
The impact of COVID-19 on thoracic surgery residency programs in the US: A program director survey.
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The coronavirus disease 2019 (COVID-19) has altered how the current generation of thoracic surgery residents are being trained. The aim of this survey was to determine how thoracic surgery program directors (PDs) are adapting to educating residents during the COVID-19 pandemic.</AbstractText>Thoracic surgery PDs of integrated, traditional (2 or 3 year), and combined 4 + 3 general/thoracic surgery training programs in the United States were surveyed between 17th April and 1st May 2020 during the peak of the COVID-19 pandemic in much of the United States. The 15-question electronic survey queried program status, changes to the baseline surgical practice, changes to didactic education, deployment/scheduling of residents, and effect of the pandemic on case logs and preparedness for resident graduation.</AbstractText>All 23 institutions responding had ceased elective procedures, and most had switched to telemedicine clinic visits. Online virtual didactic sessions were implemented by 91% of programs, with most (69.6%) observing same or increased attendance. PDs reported that 82.7% of residents were on a non-standard schedule, with most being deployed in a 1 to 2 week on, 1 to 2 week off block schedule. Case volumes were affected for both junior and graduating trainees, but a majority of PDs report that graduating residents will graduate on time without perceived negative effect on first career/fellowship position.</AbstractText>The COVID-19 pandemic has radically changed the educational approach of thoracic surgery programs. PDs are adapting educational delivery to optimize training and safety during the pandemic. Long-term effects remain uncertain and require additional study.</AbstractText>© 2020 Wiley Periodicals LLC.</CopyrightInformation>
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2,334,427 |
Ultrasound-guided suprainguinal fascia iliaca block combined with a sacral plexus block for lower extremity surgery: A case report.
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The anesthetic management of patients with severe pulmonary hypertension is different from that of normal, healthy patients, and regional nerve blocks are commonly used for them. Due to the individual variability of the course, distribution, and branching of the nerves below the inguinal ligament, the supra-inguinal fascia iliaca (SIFI) block has a wider and more stable blocking area. In combination with the sacral plexus block, they can satisfy the needs of surgical anesthesia below the hip.</AbstractText>A 46-year-old man with tuberculosis, chronic obstructive pulmonary disease, pulmonary heart disease, World Health Organization (WHO) class III pulmonary hypertension and right heart dysfunction, and American Society of Anesthesiologists physical status class III needed fixation of an intramedullary nail in the left lower extremity. Additionally, he had broken his left lower limb after a recent fall. Both general anesthesia and epidural anesthesia were not appropriate.</AbstractText>The patient had a clear history of tuberculosis, computerized tomography scan displayed destructive pneumonophthisis. Furthermore, he had chronic obstructive pulmonary disease and pulmonary heart disease.</AbstractText>An ultrasound-guided SIFI combined with a sacral plexus block was successfully performed for surgical anesthesia and avoided all hemodynamic fluctuations.</AbstractText>We successfully performed an ultrasound-guided SIFI combined with a sacral plexus block for surgical anesthesia and avoided all hemodynamic fluctuations.</AbstractText>Ultrasound-guided suprainguinal fascia iliaca block combined with a sacral plexus block can be suitable for anesthesia for patients with severe circulatory compromise.</AbstractText>
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2,334,428 |
A Mathematical Model of the Mouse Atrial Myocyte With Inter-Atrial Electrophysiological Heterogeneity.
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Biophysically detailed mathematical models of cardiac electrophysiology provide an alternative to experimental approaches for investigating possible ionic mechanisms underlying the genesis of electrical action potentials and their propagation through the heart. The aim of this study was to develop a biophysically detailed mathematical model of the action potentials of mouse atrial myocytes, a popular experimental model for elucidating molecular and cellular mechanisms of arrhythmogenesis. Based on experimental data from isolated mouse atrial cardiomyocytes, a set of mathematical equations for describing the biophysical properties of membrane ion channel currents, intracellular Ca<sup>2+</sup> handling, and Ca<sup>2+</sup>-calmodulin activated protein kinase II and β-adrenergic signaling pathways were developed. Wherever possible, membrane ion channel currents were modeled using Markov chain formalisms, allowing detailed representation of channel kinetics. The model also considered heterogeneous electrophysiological properties between the left and the right atrial cardiomyocytes. The developed model was validated by its ability to reproduce the characteristics of action potentials and Ca<sup>2+</sup> transients, matching quantitatively to experimental data. Using the model, the functional roles of four K<sup>+</sup> channel currents in atrial action potential were evaluated by channel block simulations, results of which were quantitatively in agreement with existent experimental data. To conclude, this newly developed model of mouse atrial cardiomyocytes provides a powerful tool for investigating possible ion channel mechanisms of atrial electrical activity at the cellular level and can be further used to investigate mechanisms underlying atrial arrhythmogenesis.
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2,334,429 |
Growth performance and apparent total tract nutrient digestibility of limit-fed diets containing wet brewer's grains to Holstein heifers.
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The objective of this study was to evaluate the growth performance and apparent total tract nutrient digestibility of Holstein heifers limit-fed diets containing different amounts of wet brewer's grains (WBG). A 12-wk randomized complete block study was conducted using 30 yearling Holstein heifers [378 ± 27 d of age, and body weight (BW) of 357.8 ± 27.6 kg (mean ± SD)]. Treatments were 0%, 10% and 20% of WBG on a dry matter (DM) basis and diets were formulated to be limit-fed for dry matter intake (DMI) at 2.35% of BW and provided 15% crude protein (CP) and 2.27 Mcal metabolizable energy/kg of DM. Dry matter intake was recorded daily, while BW and skeletal measurements were measured every 2 wk. During week 12, fecal samples were collected directly from the rectum over four consecutive days and composited by heifer to determine apparent total tract nutrient digestibility using acid detergent insoluble ash as a marker. Data were analyzed using the MIXED procedure of SAS. Dry matter intakes, BW, and average daily gain were not different among treatments (<i>P</i> = 0.2, <i>P</i> = 0.4, and <i>P</i> = 0.6, respectively). Dry matter intakes ranged from 8.6 to 9.0 kg/d. Average BW were 404.4, 411.5, and 409.3 kg for heifers fed the 0%, 10%, and 20% WBG diets, respectively. Average daily gains were 1.03, 1.04, and 0.96 kg/d for heifers fed the 0%, 10%, and 20% WBG diets respectively. Skeletal measurements and body condition scores (BCS) were not different among treatments except for the change in heart girth (<i>P</i> < 0.01) and initial BCS (<i>P</i> < 0.01). Apparent total tract digestibilities of DM, organic matter, CP, fat, and hemicellulose were greater or tended to be greater in heifers fed 0% and 20% WBG treatments than heifers fed 10 % WBG (<i>P</i> = 0.04, <i>P</i> = 0.04, <i>P</i> = 0.06, <i>P</i> = 0.06, and <i>P</i> = 0.01, respectively). Neutral detergent fiber, acid detergent fiber, and fat digestibilities were similar among treatments (<i>P</i> = 0.2, <i>P</i> = 0.3, and <i>P</i> = 0.3, respectively). During the digestibility phase, DMI tended to be greater (<i>P</i> = 0.08) for the 10% WBG treatment. These results demonstrate that limit-feeding heifers with diets containing up to 20% WBG could replace soybean- and corn-based concentrates in diets without adverse consequences to the heifer growth performance.
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2,334,430 |
Comparative Study of Retrobulbar Block versus Ketamine Infusion during Eye Enucleation/Evisceration (Randomized Controlled Trial).
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The aim of this study is to compare the safety and efficacy of retrobulbar block versus intraoperative ketamine infusion in eye enucleation or evisceration under general anesthesia.</AbstractText>Forty-five patients belonging to American Society of Anesthesiologists Physical Status I and II undergoing eye enucleation or evisceration were randomly allocated to three equal groups (15 patients each). General anesthesia was used as the standardized technique in all patients. Group R received a single retrobulbar injection, Group K received intravenous ketamine infusion, and Group C received normal saline with the same rate of ketamine infusion. Intraoperative heart rate and mean arterial pressure, recovery time, postoperative pain score, time to first rescue analgesic, number of patients who required rescue analgesia, and any adverse events were reported.</AbstractText>Postoperative pain Visual Analog Scale was significantly lower in R and K groups in comparison to the C group and was significantly higher in K than R group at 3, 6, 12, and 24 h. In addition, the time to first rescue analgesic was significantly longer in R group (429 ± 54 min) than that in K group (272 ± 34 min), but compared to both groups, it was longer in C group (52 ± 7 min). In K group, the recovery time was longer with higher sedation score in comparison to the other two groups.</AbstractText>Single retrobulbar injection and low-dose ketamine infusion are safe and effective when used as adjuvants to general anesthesia, but retrobulbar block provides better control of postoperative pain with prolonged time to first rescue analgesic and reduced analgesic consumption.</AbstractText>Copyright: © 2020 Anesthesia: Essays and Researches.</CopyrightInformation>
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To Compare the Changes in Hemodynamic Parameters and Blood Loss during Percutaneous Nephrolithotomy - General Anesthesia versus Subarachnoid Block.<Pagination><StartPage>72</StartPage><EndPage>74</EndPage><MedlinePgn>72-74</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.4103/aer.AER_14_20</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Percutaneous nephrolithotomy (PCNL) is done under general anesthesia (GA) in most of the centers. However, associated complications and cost are higher for GA than for regional anesthesia.</AbstractText><AbstractText Label="AIM" NlmCategory="OBJECTIVE">The aim of the study was to compare the efficacy of GA versus subarachnoid block (SAB) with regard to intraoperative blood loss and postoperative drop in hemoglobin (Hb) in patients undergoing PCNL.</AbstractText><AbstractText Label="SETTING AND DESIGN" NlmCategory="METHODS">This prospective, randomized, comparative clinical trial was carried out at a tertiary care hospital. After obtaining the institute ethical committee clearance (vide no 57/15), patients were randomly allocated into two groups using table of randomization (<i>n</i> = 30 each), Group A - GA, Group B - SAB.</AbstractText><AbstractText Label="MATERIALS AND METHODS" NlmCategory="METHODS">Intraoperative blood loss was assessed by measuring the Hb of irrigated fluid and postoperative drop in Hb concentration. Other parameters such as intraoperative mean arterial pressure and heart rate were also compared in these groups.</AbstractText><AbstractText Label="STATISTICAL ANALYSIS" NlmCategory="METHODS">The results are presented in frequencies, percentages, and mean ± standard deviation. The Chi-square test was used to compare the categorical variables between the groups. Unpaired <i>t</i>-test was used to compare the continuous variables between the groups.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Hemodynamic parameters were similar in both the groups preoperatively. The Hb drop was significant in Group A (1.28 ± 0.35 g.dl<sup>-1</sup>) as compared to Group B (1.10 ± 0.67 g.dl<sup>-1</sup>). On calculating Hb in irrigated fluid-blood mixture, it was found to be significantly higher in Group A (1.87 ± 0.44 g.L<sup>-1</sup>) as compared to Group B (1.25 ± 0.25 g.L<sup>-1</sup>).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Both GA and SAB are effective and safe in PCNL. However, SAB is associated with less blood loss as estimated by intraoperative blood loss and Hb drop.</AbstractText><CopyrightInformation>Copyright: © 2020 Anesthesia: Essays and Researches.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ranjan</LastName><ForeName>Ravi</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Malviya</LastName><ForeName>Deepak</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology and Critical Care Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Misra</LastName><ForeName>Shilpi</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology and Critical Care Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nath</LastName><ForeName>Soumya Sankar</ForeName><Initials>SS</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology and Critical Care Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rastogi</LastName><ForeName>Shivani</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology and Critical Care Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>03</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>India</Country><MedlineTA>Anesth Essays Res</MedlineTA><NlmUniqueID>101578762</NlmUniqueID><ISSNLinking>2229-7685</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Blood loss</Keyword><Keyword MajorTopicYN="N">general anesthesia</Keyword><Keyword MajorTopicYN="N">hemodynamics</Keyword><Keyword MajorTopicYN="N">nephrolithiasis</Keyword><Keyword MajorTopicYN="N">percutaneous nephrolithotomy</Keyword><Keyword MajorTopicYN="N">subarachnoid block</Keyword></KeywordList><CoiStatement>There are no conflicts of interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>2</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>2</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>2</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>8</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>8</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>8</Month><Day>28</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32843796</ArticleId><ArticleId IdType="pmc">PMC7428097</ArticleId><ArticleId IdType="doi">10.4103/aer.AER_14_20</ArticleId><ArticleId IdType="pii">AER-14-72</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Singh V, Sinha RJ, Sankhwar SN, Malik A. A prospective randomized study comparing percutaneous nephrolithotomy under combined spinal-epidural anesthesia with percutaneous nephrolithotomy under general anesthesia. Urol Int. 2011;87:293–8.</Citation><ArticleIdList><ArticleId IdType="pubmed">21921573</ArticleId></ArticleIdList></Reference><Reference><Citation>Dalela D, Goel A, Singh P, Shankhwar SN. Renal capsular block: A novel method for performing percutaneous nephrolithotomy under local anesthesia. J Endourol. 2004;18:544–6.</Citation><ArticleIdList><ArticleId IdType="pubmed">15333218</ArticleId></ArticleIdList></Reference><Reference><Citation>Tangpaitoon T, Nisoog C, Lojanapiwat B. Efficacy and safety of percutaneous nephrolithotomy (PCNL): A prospective and randomized study comparing regional epidural anesthesia with general anesthesia. Int Braz J Urol. 2012;38:504–11.</Citation><ArticleIdList><ArticleId IdType="pubmed">22951179</ArticleId></ArticleIdList></Reference><Reference><Citation>Elbealy M, Rashwan D, Kassim SA, Abbas S. A comparison of the effects of epidural anesthesia, lumber paravertebral block and general anesthesia in percutaneous nephrolithotomy. J Med Sci. 2008;8:170–6.</Citation></Reference><Reference><Citation>Ferreyra G, Long Y, Ranieri VM. Respiratory complications after major surgery. Curr Opin Crit Care. 2009;15:342–8.</Citation><ArticleIdList><ArticleId IdType="pubmed">19542885</ArticleId></ArticleIdList></Reference><Reference><Citation>Bhattarai R, Das C, Paudel B, Dangi S. Comparison of general versus spinal anesthesia in patients undergoing percutaneous nephrolithotomy: A prospective randomized study. J Nobel Med Coll. 2016;5:37–42.</Citation></Reference><Reference><Citation>Moawad HE, Hefnawy AS. Spinal versus general anesthesia for percutanaeous nephrolithotomy: A prospective randomized trial. Egypt J Anaesth. 2015;31:71–5.</Citation></Reference><Reference><Citation>Salam AA, Bahram NK, Memon SR. Percutaneous nephrolithotomy under spinal anesthesia. JOJ Uro Nephro. 2016;1:1–4.</Citation></Reference><Reference><Citation>Gupta A, Prakash R, Singh V, Bogra J, Kaushal D, Khan PM, et al. Comparative study of electrolytes and metabolic changes during percutaneous nephrolithotomy: Spinal vs. general anesthesia. Int J Clin Trials. 2014;1:41–8.</Citation></Reference><Reference><Citation>Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: Prospective study. J Endourol. 2004;18:715–22.</Citation><ArticleIdList><ArticleId IdType="pubmed">15659890</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32838330</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>28</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2666-0849</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>May</Month><Day>27</Day></PubDate></JournalIssue><Title>JACC. Case reports</Title><ISOAbbreviation>JACC Case Rep</ISOAbbreviation></Journal>WITHDRAWN: Complete Heart Block, Severe Ventricular Dysfunction and Myocardial Inflammation in a Child with COVID-19 Infection.
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The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.jaccas.2020.05.023>. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Venomous snakes elicit stronger fear than nonvenomous ones: Psychophysiological response to snake images.
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Snakes have been important ambush predators of both primates and human hunter-gatherers throughout their co-evolutionary history. Viperid snakes in particular are responsible for most fatal venomous snakebites worldwide and thus represent a strong selective pressure. They elicit intense fear in humans and are easily recognizable thanks to their distinctive morphotype. In this study, we measured skin resistance (SR) and heart rate (HR) in human subjects exposed to snake pictures eliciting either high fear (10 venomous viperid species) or disgust (10 nonvenomous fossorial species). Venomous snakes subjectively evaluated as frightening trigger a stronger physiological response (higher SR amplitude) than repulsive non-venomous snakes. However, stimuli presented in a block (more intense stimulation) do not trigger a stronger emotional response compared to sequentially presented stimuli (less intense stimulation). There are significant interindividual differences as subjects with high fear of snakes confronted with images of viperid snakes show stronger, longer-lasting, and more frequent changes in SR and higher HR compared to low-fear subjects. Thus, we show that humans demonstrate a remarkable ability to discriminate between dangerous viperids and harmless fossorial snakes, which is also reflected in distinct autonomous body responses.
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Evaluation of the dietary vitamin A requirement of finishing steers via systematic depletion and repletion, and its effects on performance and carcass characteristics.
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A randomized complete block design experiment with 30 yearling crossbred steers (initial average body weight [BW] = 297.6 ± 32.8 kg) fed a steam-flaked corn-based diet was used to evaluate finishing performance and carcass characteristics when provided with different concentrations of vitamin A (Rovimix A 1000; DSM Nutritional Products Ltd., Sisseln, Switzerland) subsequent to a depletion phase. Steers were blocked by BW (n = 5 blocks; 6 steers per block), assigned to pens (n = 2 steers per pen), and randomly assigned to one of the following dietary treatments: no added vitamin A (0IU; 0.0 IU/kg dry matter [DM] basis of additional vitamin A), vitamin A supplemented at the estimated National Academies of Sciences, Engineering, and Medicine (NASEM) requirement (2,200IU; 2,200 IU/kg of dietary DM of additional vitamin A), and vitamin A supplemented at 5× the estimated requirement (11,000IU; 11,000 IU/kg of dietary DM of additional vitamin A). The basal diet included minimal vitamin A activity (<200 IU of vitamin A activity/kg of dietary DM) via the provitamin A, beta-carotene. After all animals underwent a 91-d vitamin A depletion period, additional vitamin A was top-dressed at feeding via a ground corn carrier. Liver biopsy samples, BW, and blood were obtained on days -91, -35, 0, 28, 56, 84, and 112. Final BW was collected prior to shipping on day 112. Carcass data were collected by trained personnel upon harvest. Sera and liver samples were used to monitor circulating vitamin A and evaluate true vitamin A status of the cattle. Vitamin A status did not affect interim average daily gain or feed efficiency (G:F; P > 0.05). Throughout the duration of the study, dry matter intake for the 0IU cattle was depressed (P = 0.01). Differences were not observed across treatments for hot carcass weight, rib eye area, back fat thickness, kidney-pelvic-heart fat %, marbling score, or dressing percent (P ≥ 0.10). A treatment × day interaction occurred for both (P < 0.01) sera retinol and liver retinol during phase 2 of the trial. The treatments and sera retinol concentrations were incorporated into a repletion model, resulting in an estimation of liver retinol changes (P < 0.01; R2 = 0.682). However, models used to evaluate depleted animals were less effective. The current NASEM recommended that vitamin A requirement of 2,200 IU/kg is adequate for repletion of vitamin A status of feedlot steers.
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Selective optogenetic stimulation of fibroblasts enables quantification of hetero-cellular coupling to cardiomyocytes in a three-dimensional model of heart tissue.
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Besides providing mechanical stability, fibroblasts in the heart could modulate the electrical properties of cardiomyocytes. Here, we aim to develop a three-dimensional hetero-cellular model to analyse the electric interaction between fibroblasts and human cardiomyocytes in vitro using selective optogenetic de- or hyperpolarization of fibroblasts.</AbstractText>NIH3T3 cell lines expressing the light-sensitive ion channel Channelrhodopsin2 or the light-induced proton pump Archaerhodopsin were generated for optogenetic depolarization or hyperpolarization, respectively, and characterized by patch clamp. Cardiac bodies consisting of 50% fibroblasts and 50% human pluripotent stem cell-derived cardiomyocytes were analysed by video microscopy and membrane potential was measured with sharp electrodes. Myofibroblast activation in cardiac bodies was enhanced by transforming growth factor-β1 (TGF-β1)-stimulation. Connexin-43 expression was analysed by qPCR and fluorescence recovery after photobleaching. Illumination of Channelrhodopsin2 or Archaerhodopsin expressing fibroblasts induced inward currents and depolarization or outward currents and hyperpolarization. Transforming growth factor-β1-stimulation elevated connexin-43 expression and increased cell-cell coupling between fibroblasts as well as increased basal beating frequency and cardiomyocyte resting membrane potential in cardiac bodies. Illumination of cardiac bodies generated with Channelrhodopsin2 fibroblasts accelerated spontaneous beating, especially after TGF-β1-stimulation. Illumination of cardiac bodies prepared with Archaerhodopsin expressing fibroblasts led to hyperpolarization of cardiomyocytes and complete block of spontaneous beating after TGF-β1-stimulation. Effects of light were significantly smaller without TGF-β1-stimulation.</AbstractText>Transforming growth factor-β1-stimulation leads to increased hetero-cellular coupling and optogenetic hyperpolarization of fibroblasts reduces TGF-β1 induced effects on cardiomyocyte spontaneous activity. Optogenetic membrane potential manipulation selectively in fibroblasts in a new hetero-cellular cardiac body model allows direct quantification of fibroblast-cardiomyocyte coupling in vitro.</AbstractText>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: [email protected].</CopyrightInformation>
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The Safety and Efficacy of Ultrasound-Guided Serratus Anterior Plane Block (SAPB) Combined with Dexmedetomidine for Patients Undergoing Video-Assisted Thoracic Surgery (VATS): A Randomized Controlled Trial.
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Although video-assisted thoracic surgery (VATS) can significantly reduce postoperative pain, the incidence is as high as 30-50%. The purpose of this study was to explore the safety and efficacy of ultrasound-guided serratus anterior plane block (SAPB) combined with dexmedetomidine (Dex) for patients undergoing VATS.</AbstractText>Eighty patients were randomized into two groups (20 mL 0.5% ropivacaine plus 0.5 µg/kg or 1 µg/kg Dex). Primary outcome was the visual analog scale of pain while coughing (VASc) score at 24 h after surgery. Secondary outcomes included hemodynamics, sufentanil consumption, number of patients needing rescue analgesia, time to first rescue analgesic, total dose of rescue analgesic, satisfaction scores of patients and surgeons, time of chest tube removal, length of hospital stay, adverse effects, the prevalence of chronic pain and quality of life.</AbstractText>Compared with D1 group, visual analog scale of pain at rest (VASr) was significantly lower during the first 24 h after surgery, while VASc was significantly lower during the first 48 h after surgery (P</i><0.05). Mean arterial pressure was significantly decreased from T2 to T8, and heart rate was significantly decreased from T2 to T7 in the D2 group (P</i><0.05). Consumption of sevoflurane, remifentanil, DEX and the recovery time were significantly reduced in the D2 group (P</i> <0.05). Consumption of sufentanil 8-72 h after surgery was significantly lower in the D2 group (P</i><0.05). Additionally, the number of patients who required rescue analgesia, the time to the first dose of rescue analgesia, and the total dose of rescue analgesia was significantly lower in the D2 group (P</i><0.05).</AbstractText>The results of this study show that 1 µg/kg DEX is a beneficial adjuvant to ropivacaine for single-injection SAPB in VATS patients while stable hemodynamics were maintained.</AbstractText>© 2020 Li et al.</CopyrightInformation>
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Association between access to health-promoting facilities and participation in cardiovascular disease (CVD) risk screening among populations with low socioeconomic status (SES) in Singapore.
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Low socioeconomic status (SES) is a barrier for cardiovascular disease (CVD) risk screening and a determinant of poor CVD outcomes. This study examined the associations between access to health-promoting facilities and participation in a CVD risk screening program among populations with low SES residing in public rental flats in Singapore.</AbstractText>Data from Health Mapping Exercises conducted from 2013 to 2015 were obtained, and screening participation rates of 66 blocks were calculated. Negative binomial regression was used to test for associations between distances to four nearest facilities (i.e., subsidized private clinics, healthy eateries, public polyclinics, and parks) and block participation rate in CVD screening. We also investigated potential heterogeneity in the association across regions with an interaction term between distance to each facility and region.</AbstractText>The analysis consisted of 2069 participants. The associations were only evident in the North/North-East region for subsidized private clinic and park. Specifically, increasing distance to the nearest subsidized private clinic and park was significantly associated with lower [incidence rate ratio (IRR) = 0.88, 95% confidence interval (CI): 0.80-0.98] and higher (IRR = 1.93, 95%CI: 1.15-3.25) screening participation rates respectively.</AbstractText>Our findings could potentially inform the planning of future door-to-door screenings in urban settings for optimal prioritization of resources. To increase participation rates in low SES populations, accessibility to subsidized private clinics and parks in a high population density region should be considered.</AbstractText>
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Retinoschisis associated with Kearns-Sayre syndrome.
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Kearns-Sayre Syndrome (KSS) is characterized by pigmentary retinopathy, external ophthalmoplegia and heart block. We report on a now 24-year-old male with clinical retinoschisis and molecularly confirmed KSS.</AbstractText>Physical and complete ophthalmic examination, molecular diagnosis.</AbstractText>Over nine years of follow-up, the subject manifested progressive signs and symptoms of KSS, including external ophthalmoplegia/strabismus, ptosis, pigmentary retinopathy, corneal edema, Type I diabetes mellitus, gut dysmotility, sensorineural deafness and heart block. At age 21 he was incidentally found to have retinoschisis on optical coherence tomography that remained stable over three years follow-up. Sequencing of the RS1</i> gene revealed no pathogenic variants, effectively ruling out co-existing X-linked retinoschisis.</AbstractText>These findings suggest retinoschisis may be a rare manifestation of KSS. A trial of a carbonic anhydrase inhibitor was frustrated by coexisting corneal edema associated with the condition.</AbstractText>
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The impact of ultrasound-guided bilateral rectus sheath block in patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy - a retrospective study.
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Rectus sheath block (RSB) is known to attenuate postoperative pain and reduce perioperative opioid consumption. Thus, a retrospective study was performed to examine the effects of bilateral rectus sheath block (BRSB) in cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC).</AbstractText>A total of 178 patients undergoing CRS/HIPEC at our hospital were included. Patient information and anaesthesia-related indicators were collected from the electronic medical record (EMR) system. All subjects were divided into the following two groups: the G group (general anaesthesia) and the GR group (RSB combined with general anaesthesia). Patients in the GR group received 0.375% ropivacaine for BRSB before surgery. The primary outcomes included the total amount of remifentanil and rocuronium, the total consumption of dezocine after surgery, the visual analogue scale (VAS) score and the patient-controlled intravenous analgesia (PCIA) input dose at 1 h (T6), 6 h (T7), 12 h (T8), 24 h (T9) and 48 h (T10) after surgery. Other outcomes were also recorded, such as patient demographic data, the intraoperative heart rate (HR) and mean arterial pressure (MAP), and postoperative complications.</AbstractText>Compared with the G group, the GR group showed a shorter time to tracheal extubation (P < 0.05), a decreased total amount of remifentanil and rocuronium (P < 0.05), and a reduced VAS score, PCIA input dose and number of PCIA boluses at 1 h, 6 h and 12 h after surgery (P < 0.05). However, at 24 h and 48 h after surgery, there were no differences in the VAS score of pain at rest or during motion between the two groups (P > 0.05). Moreover, the incidence of hypertension, emergence agitation, delayed recovery, hypercapnia, and nausea and vomiting was lower in the GR group than in the G group (P < 0.05). There were no differences in the changes in MAP and HR during the surgery between the two groups (P > 0.05). No complications associated with nerve block occurred.</AbstractText>BRSB could provide short-term postoperative analgesia, reduce perioperative opioid consumption and reduce the incidence of postoperative complications. It is an effective and safe procedure in CRS/HIPEC.</AbstractText>
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Effect of Kangaroo Care and Oral Sucrose on Pain in Premature Infants: A Randomized Controlled Trial.
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Premature infants hospitalized in the neonatal intensive care unit are routinely exposed to many painful procedures. Pain experienced during the neonatal period may lead to negative outcomes, especially in preterm neonates, hence pain in infants should be reduced. Kangaroo care and oral sucrose are some of the methods that can help reduce pain.</AbstractText>This study aimed to compare the effects of kangaroo care and oral sucrose on pain relief in preterm infants during heel lancing.</AbstractText>Our study involved 64 infants. The infants were randomly divided into two groups using a randomized block design of drawing out slips from a thick, non-transparent envelope. There were 64 slips in this envelope (32 for kangaroo care and 32 for oral sucrose). Kangaroo care was given to the preterm infants in the first group and oral sucrose to those in the second group. In both groups, heart rate and oxygen saturation were measured and pain score was evaluated by two observers using the Premature Infant Pain Profile (PIPP) before, during, and 2 minutes after blood sampling by heel lancing.</AbstractText>There was a statistically significant difference between the groups in favor of the kangaroo group in terms of change in the PIPP values after heel lancing. Kangaroo care is more effective than oral sucrose in pain relief during heel lancing in preterm infants.</AbstractText>In addition to many benefits it offers to infants, kangaroo care can be used to reduce pain during painful procedures in premature infants.</AbstractText>Copyright © 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
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Effect of rumen-protected lysine on growth performance, carcass characteristics, and plasma amino acid profile in feedlot steers.
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The objective of this study was to evaluate growth performance, carcass characteristics, and plasma amino acid profiles of feedlot steers fed rumen-protected Lys. Forty-two Angus-cross steers (304 ± 25 kg) were blocked by weight and fed treatment diets for 180 d (growing days 0 to 55; finishing days 56 to 180): 1) Lys-deficient diet (CON; <i>n</i> = 12 steers), 2) Lys-adequate diet containing soybean meal (POS; <i>n</i> = 12 steers), or 3) Lys-deficient diet plus supplemental rumen-protected Lys (RPL; AjiPro-L; Ajinomoto Animal Nutrition North America, Eddyville, IA; <i>n</i> = 18 steers). Consecutive day bodyweights (BWs) were recorded to begin and end growing and finishing. Individual steer dry matter intake (DMI) was recorded. Blood was collected on days 0, 56, and 179 for analysis of physiological free amino acids. Steers were harvested on day 180 and carcass characteristics were recorded. Data were analyzed using Proc Mixed of SAS 9.4. Steer was the experimental unit and treatment was the fixed effect for all parameters. Block was a fixed effect for growth performance, feed intake, and carcass data. The day 0 value for each parameter of physiological free amino acids was used as a covariate during analysis. The CON steers had greater BW, average daily gain (ADG), and gain to feed (G:F) at the end of growing (day 56; <i>P</i> ≤ 0.05) vs. POS and RPL. The CON steers also had greater final BW (<i>P</i> = 0.04) and overall ADG (<i>P</i> = 0.04) than RPL, while POS was intermediate. Carcass characteristics were not different across treatments [hot carcass weight, dressing percent, ribeye area, back fat, kidney/pelvic/heart (KPH) percent, marbling, or calculated yield grade; <i>P</i> ≥ 0.13]. Plasma urea N was greater in POS steers on days 56 and 179 (<i>P</i> ≤ 0.04). Plasma Lys and Arg concentrations were greater in POS at day 56 (<i>P</i> ≤ 0.02); however, there was no difference among treatments for these two variables at day 179 (<i>P</i> ≥ 0.44). Steers in all treatments had greater DMI than predicted, causing a negative metabolizable Lys balance for all treatments during growing. Though the metabolizable Lys balance was positive for POS and RPL-fed steers during finishing, the increased metabolizable Lys in these treatments may have decreased performance if other amino acids were imbalanced due to increased intakes.
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RNA Binding Motif 5 (RBM5) in the CNS-Moving Beyond Cancer to Harness RNA Splicing to Mitigate the Consequences of Brain Injury.
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Gene splicing modulates the potency of cell death effectors, alters neuropathological disease processes, influences neuronal recovery, but may also direct distinct mechanisms of secondary brain injury. Therapeutic targeting of RNA splicing is a promising avenue for next-generation CNS treatments. RNA-binding proteins (RBPs) regulate a variety of RNA species and are prime candidates in the hunt for druggable targets to manipulate and tailor gene-splicing responses in the brain. RBPs preferentially recognize unique consensus sequences in targeted mRNAs. Also, RBPs often contain multiple RNA-binding domains (RBDs)-each having a unique consensus sequence-suggesting the possibility that drugs could be developed to block individual functional domains, increasing the precision of RBP-targeting therapies. Empirical characterization of most RBPs is lacking and represents a major barrier to advance this emerging therapeutic area. There is a paucity of data on the role of RBPs in the brain including, identification of their unique mRNA targets, defining how CNS insults affect their levels and elucidating which RBPs (and individual domains within) to target to improve neurological outcomes. This review focuses on the state-of-the-art of the RBP tumor suppressor <i>RNA binding motif 5</i> (RBM5) in the CNS. We discuss its potent pro-death roles in cancer, which motivated our interest to study it in the brain. We review recent studies showing that RBM5 levels are increased after CNS trauma and that it promotes neuronal death <i>in vitro</i>. Finally, we conclude with recent reports on the first set of RBM5 regulated genes identified in the intact brain, and discuss how those findings provide new clues germane to its potential function(s) in the CNS, and pose new questions on its therapeutic utility to mitigate CNS injury.
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Effect of oscillating feeding time and corn processing on performance and carcass characteristics of feedlot steers.
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The objectives of this experiment were to evaluate the effect of oscillating feeding time (OFT) and corn processing (CoP) on performance and carcass characteristics of feedlot cattle. One hundred sixty-five steers (initial body weight [BW] 277.2 ± 27.80 kg) were blocked by initial BW and allotted to 24 pens. Pens within each block were randomly assigned based on a 2 × 2 factorial arrangement of treatments. The two factors were CoP (whole shelled corn vs. ground corn [GC]) and feeding time (FT) (constant FT vs. 2 hours OFT). Animals were fed the same diet, only changing the CoP method depending on the treatment. Feed offered and feed refusals were collected daily. Body weight was collected at starting day of the experiment (d1) and every 28 d until the end of the experiment. At the end of the experiment, animals were harvested in a commercial slaughter facility, and carcass data were collected by a USDA grader. Animal growth performance and carcass characteristics data were analyzed with the PROC Mixed procedure (SAS) using CoP, FT, and their interaction as fixed variables; and treatments × pen within each block and block were considered random variables. There was no CoP by FT interaction differences (<i>P</i> > 0.10) on animal growth performance variables, nor on hot carcass weight, back fat, rib eye area, or the percentage of kidney, pelvic, and heart fat. There was a tendency for an interaction (<i>P</i> = 0.08) for marbling score, where the steers from the GC processing fed on the oscillating time had a lesser marbling score than the other three treatments. Oscillating feeding time improved (<i>P</i> = 0.05) average daily gain; but did not affect (<i>P</i> ≥ 0.11) dry matter intake (DMI), nor carcass characteristics compared with feeding at a similar time every day. There were no effects (<i>P</i> ≥ 0.11) of CoP on growth performance, nor carcass characteristics. In conclusion, a 2-hour oscillation in FT might not decrease steer feedlot performance. This may be due to the high degree of control of DMI with feed bunk management.
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2,334,443 |
The effectiveness of electronic pulsed soft tissue vibration compared with topical anaesthesia in reducing the pain of injection of local anaesthetics in adults: a randomized controlled split-mouth clinical trial.
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The purpose of this study was to evaluate the effectiveness of an electronic hand-held pulsed vibration device on the pain of local analgesia (LA) injection and physiologic changes. A prospective randomized controlled clinical trial using split-mouth (crossover) design was implemented. The control-side injection was performed after using topical anaesthesia. The experimental side injection was carried out without topical anaesthesia, but with the aid of a switched-on vibration device. Overall, 332 dental LA injections were given to 166 patients for routine exodontia. The pain at penetration and pain during injection were significantly lower in the experimental sides (vibrations sides) compared with those of the controls (P<0.001). Similarly, the heart rate changes at penetration and during injections were significantly lower in the experimental sides (P<0.001). The vibration device was clinically and statistically more effective than topical anaesthesia in the reduction of dental injection pain in adults, measured subjectively and objectively, regardless of the gender, injection technique (infiltration or block) or anxiety level.
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2,334,444 |
NLRP3 inflammasome-mediated microglial pyroptosis is critically involved in the development of post-cardiac arrest brain injury.
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Brain injury is the leading cause of death and disability in survivors of cardiac arrest, where neuroinflammation is believed to play a pivotal role, but the underlying mechanism remains unclear. Pyroptosis is a pro-inflammatory form of programmed cell death that triggers inflammatory response upon infection or other stimuli. This study aims to understand the role of microglial pyroptosis in post-cardiac arrest brain injury.</AbstractText>Sprague-Dawley male rats underwent 10-min asphyxial cardiac arrest and cardiopulmonary resuscitation or sham-operation. Flow cytometry analysis, Western blotting, quantitative real-time polymerase chain reaction (qRT-PCR), co-immunoprecipitation, and immunofluorescence were used to evaluate activated microglia and CD11b-positive leukocytes after cardiac arrest and assess inflammasome activation and pyroptosis of specific cellular populations. To further explore the underlying mechanism, MCC950 or Ac-YVAD-cmk was administered to block nod-like receptor family protein 3 (NLRP3) or caspase-1, respectively.</AbstractText>Our results showed that, in a rat model, successful resuscitation from cardiac arrest resulted in microglial pyroptosis and consequential inflammatory infiltration which was mediated by the activation of NLRP3 inflammasome. Targeting NLRP3 and caspase-1, the executor of pyroptosis, with selective inhibitors MCC950 and Ac-YVAD-cmk treatment significantly prevented microglial pyroptosis, reduced infiltration of leukocytes, improved neurologic outcome, and alleviated neuro-pathological damages after cardiac arrest in modeling rats.</AbstractText>This study demonstrates that microglial pyroptosis mediated by NLRP3 inflammasome is critically involved in the pathogenesis of post-cardiac arrest brain injury and provides a new therapeutic strategy.</AbstractText>
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2,334,445 |
Allosteric Coupling Between Drug Binding and the Aromatic Cassette in the Pore Domain of the hERG1 Channel: Implications for a State-Dependent Blockade.
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Human-ether-a-go-go-related channel (hERG1) is the pore-forming domain of the delayed rectifier K<sup>+</sup> channel in the heart which underlies the <i>I<sub>Kr</sub></i> current. The channel has been extensively studied due to its propensity to bind chemically diverse group of drugs. The subsequent hERG1 block can lead to a prolongation of the QT interval potentially leading to an abnormal cardiac electrical activity. The recently solved cryo-EM structure featured a striking non-swapped topology of the Voltage-Sensor Domain (VSD) which is packed against the pore-domain as well as a small and hydrophobic intra-cavity space. The small size and hydrophobicity of the cavity was unexpected and challenges the already-established hypothesis of drugs binding to the wide cavity. Recently, we showed that an amphipathic drug, ivabradine, may favorably bind the channel from the lipid-facing surface and we discovered a mutant (M651T) on the lipid facing domain between the VSD and the PD which inhibited the blocking capacity of the drug. Using multi-microseconds Molecular Dynamics (MD) simulations of wild-type and M651T mutant hERG1, we suggested the block of the channel through the lipid mediated pathway, the opening of which is facilitated by the flexible phenylalanine ring (F656). In this study, we characterize the dynamic interaction of the methionine-aromatic cassette in the S5-S6 helices by combining data from electrophysiological experiments with MD simulations and molecular docking to elucidate the complex allosteric coupling between drug binding to lipid-facing and intra-cavity sites and aromatic cassette dynamics. We investigated two well-established hERG1 blockers (ivabradine and dofetilide) for M651 sensitivity through electrophysiology and mutagenesis techniques. Our electrophysiology data reveal insensitivity of dofetilide to the mutations at site M651 on the lipid facing side of the channel, mirroring our results obtained from docking experiments. Moreover, we show that the dofetilide-induced block of hERG1 occurs through the intracellular space, whereas little to no block of ivabradine is observed during the intracellular application of the drug. The dynamic conformational rearrangement of the F656 appears to regulate the translocation of ivabradine into the central cavity. M651T mutation appears to disrupt this entry pathway by altering the molecular conformation of F656.
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2,334,446 |
Neurosarcoidosis Presentation as Adipsic Diabetes Insipidus Secondary to a Pituitary Stalk Lesion and Association with Anti-NMDA Receptor Antibodies.
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Sarcoidosis is a multisystemic inflammatory disease of unknown cause. It is characterized by the presence of noncaseating granuloma on a biopsy specimen. Clinical presentation varies across case report series with myriad of symptoms ranging from fever, respiratory symptoms, and skin lesions, or atypical symptoms like heart block or neurological symptoms. Hence, we report the case of a 22-year-old woman with encephalitis, a pituitary mass, and adipsic diabetes insipidus. The diagnostic approach did not end on the biopsy of the lesion, which reported noncaseating granulomas; on the contrary, it was the beginning of a path to exclude other causes of the central nervous system granulomas that ended with the diagnosis of the isolated central nervous system sarcoidosis. Also, we report the first proven association between anti-NMDA receptor antibodies and sarcoidosis.
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2,334,447 |
Risk of rectal puncture due to needle entry into the presacral space: Importance of measuring the distance between the rectum and sacrococcyx, and the thickness of the sacrococcyx.
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During ganglion impar block, the needle may approach the presacral space and the sacrum may be penetrated during caudal anesthesia. Because the rectum is in front of the sacrococcyx and is thus at risk for puncture, it is important to determine the distance between the sacrococcyx and rectum, as well as the thickness of the sacrococcyx.Computed tomography was used to measure the distance between the rectum and sacrococcyx, as well as the thickness of the sacrococcyx. The distances between the coccyx and rectum, sacrococcygeal joint and rectum, sacral level 5 ('sacrum 5') and rectum, and 'sacrum 4 to 5 junction' and rectum were measured. The results were compared based on the presence or absence of stools in the rectum. The thickness of the sacrococcyx was measured at the sacrum 4 to 5 junction and sacrococcygeal joint.In total, 1264 patients were included in this study. All distances were less than 1 mm in both males and females, with the exception of the distance between the coccyx and rectum in males. In both males and females, there was no significant difference in distance between the sacrococcyx and rectum according to the presence or absence of feces in the rectum, but there was a difference in the distance between sacrum 5 and the rectum in males (P = .048). Several male and female patients showed thicknesses of less than 5 mm at the sacrococcygeal joint.Some patients have a distance of less than 1 mm between the sacrum and rectum. Practitioners should exercise caution when applying a needle to the presacral space. If the sacrum is accidentally penetrated during caudal block, rectum puncture cannot be ruled out. Excretion of feces does not influence the distance between the sacrococcyx and rectum in females.
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2,334,448 |
Classification of heart sounds based on the combination of the modified frequency wavelet transform and convolutional neural network.
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We purpose a novel method that combines modified frequency slice wavelet transform (MFSWT) and convolutional neural network (CNN) for classifying normal and abnormal heart sounds. A hidden Markov model is used to find the position of each cardiac cycle in the heart sound signal and determine the exact position of the four periods of S1, S2, systole, and diastole. Then the one-dimensional cardiac cycle signal was converted into a two-dimensional time-frequency picture using the MFSWT. Finally, two CNN models are trained using the aforementioned pictures. We combine two CNN models using sample entropy (SampEn) to determine which model is used to classify the heart sound signal. We evaluated our model on the heart sound public dataset provided by the PhysioNet Computing in Cardiology Challenge 2016. Experimental classification performance from a 10-fold cross-validation indicated that sensitivity (Se), specificity (Sp) and mean accuracy (MAcc) were 0.95, 0.93, and 0.94, respectively. The results showed the proposed method can classify normal and abnormal heart sounds with efficiency and high accuracy. Graphical abstract Block diagram of heart sound classification.
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2,334,449 |
Hematological and Running Performance Modification of Trained Athletes after Reverse vs. Block Training Periodization.
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The aim of the present study was to analyze the effect of block (BP) and a reverse training periodization (RP) in the hematological and running performance of amateur trained athletes. Modifications in hematological, aerobic, and anaerobic running performance and countermovement jump before and after twelve weeks of BP vs. RP training programs were analyzed in 16 trained athletes (eight males: 40.0 ± 6.2 years; 179.2 ± 12.8 cm; 73.8 ± 12.2 kg; and eight females: 34.2 ± 4.1 years; 163.4 ± 9.6 cm; 57.0 ± 11.0 kg). A significant decrease in heart rate (HR) at ventilatory threshold (VT1) (<i>p</i> = 0.031; ES = 1.40) was observed in RP without changes in BP. In addition, RP increased significantly VO<sub>2</sub>max (<i>p</i> = 0.004; ES = 0.47), speed at VO<sub>2</sub>max (<i>p</i> = 0.001; ES = 1.07), HR at VT2 (<i>p</i> < 0.001; ES = 1.32) and VT1 (<i>p</i> = 0.046; ES = 0.57), while BP improved VO<sub>2</sub>max (<i>p</i> = 0.004; ES = 0.51), speed at VO<i><sub>2</sub></i>max (<i>p</i> = 0.016; ES = 0.92), and HR at VT2 (<i>p</i> = 0.023; ES = 0.78). In addition, only RP increased anaerobic performance in a running-based anaerobic sprint test (RAST) (mean sprint: <i>p</i> = 0.009; ES = 0.40, best sprint: <i>p</i> = 0.019; ES = 0.30 and total time: <i>p</i> = 0.009; ES = 0.40). Moreover, both types of training periodization proposed in this study maintained hematological values and efficiently improved jump performance (<i>p</i> = 0.044; ES = 0.6) in RP and <i>p</i> = 0.001; ES = 0.75 in BP). Therefore, twelve weeks of either RP or BP is an effective strategy to increase jump and aerobic running performance maintaining hematological values, but only RP increases anaerobic running performance.
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2,334,450 |
Impact of vitamins A, B, C, D, and E supplementation on improvement and mortality rate in ICU patients with coronavirus-19: a structured summary of a study protocol for a randomized controlled trial.
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This study will evaluate the main hypothesis that supplementation with vitamins A, B, C, D, and E significantly improves the severity and mortality rate in ICU patients with COVID-19.</AbstractText>This study is a randomized, single-blinded, two-arm (1:1 ratio) parallel group clinical trial.</AbstractText>We are conducting this study in patients with COVID-19 admitted to intensive care units at the Imam Khomeini Hospital Complex in Tehran, Iran. The inclusion criteria are as follows: (1) aged between 20 and 60 years, (2) both male and female patients with COVID-19, (3) clinical or definitive diagnosis (using polymerase chain reaction (PCR) test), (4) patients have not participated in other clinical trials, and (5) no renal or hepatic abnormalities. The exclusion criteria are as follows: (1) patients with specific and rare viral diseases such as HIV and (2) patients who have been undergoing chemotherapy for the past month.</AbstractText>Duration of intervention: 7 days from randomization Intervention in the treatment group: Vitamin A 25,000 IU daily Vitamin D 600,000 IU once during study Vitamin E 300 IU twice daily Vitamin C is taken four times per day B vitamins are taken as a daily Soluvit [which included thiamine nitrate 3.1 mg, sodium riboflavin phosphate 4.9 mg (corresponding to vitamin B2</sub> 3.6 mg), nicotinamide 40 mg, pyridoxine hydrochloride 4.9 mg (corresponding to vitamin B6</sub> 4.0 mg), sodium pantothenate 16.5 mg (corresponding to pantothenic acid 15 mg), sodium ascorbate 113 mg (corresponding to vitamin C 100 mg), biotin 60 μg, folic acid 400 μg, and cyanocobalamin 5 μg] The control group will not receive any supplements or placebo. All supplements are made in Iran except for Soluvit (from Fresenius Kabi, New Zealand).</AbstractText>1. Weight, height, and BMI 2. Severity of pulmonary involvement according to CT scan 3. Respiratory support (invasive or non-invasive) 4. Percentage of oxygen saturation (SpO2 level) 5. Serum levels of WBC, CRP, ESR, IL6, IFN-G, and TNF-α 6. The patient's body temperature 7. The presence or absence of involvement of organs other than the lungs (e.g., heart, liver, kidneys) 8. Duration of hospitalization 9. Mortality rate RANDOMIZATION: At baseline, eligible patients were randomly assigned to a 1:1 ratio to one of two groups: intervention and control. Block randomization is used based on the gender of patients.</AbstractText><AbstractText Label="BLINDING (MASKING)" NlmCategory="UNASSIGNED">Patients are unaware of being placed in the intervention or control groups after signing consent. All treatment staff will be aware of which group each of the patients is in due to the specific conditions of the ICU and the absence of placebo for the control group.</AbstractText><AbstractText Label="NUMBERS TO BE RANDOMIZED (SAMPLE SIZE)" NlmCategory="UNASSIGNED">The researchers plan to include 60 patients in total, with 30 patients in each group.</AbstractText>This is the first version of the protocol which started on April 2, 2020. Recruitment began April 2, 2020, and is expected to be complete by July 4, 2020.</AbstractText>The Iranian Registry of Clinical Trials IRCT20200319046819N1 . Registered on April 4, 2020 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol (Fig. 1, Table 1).</AbstractText>
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2,334,451 |
Sex-Specific Effects of the Nlrp3 Inflammasome on Atherogenesis in LDL Receptor-Deficient Mice.
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In the <i>Ldlr</i> <sup><i>-/-</i></sup> mouse model of atherosclerosis, female <i>Nlrp3</i> <sup><i>-/-</i></sup> bone marrow chimera and <i>Nlrp3</i> <sup><i>-/-</i></sup> mice developed significantly smaller lesions in the aortic sinus and decreased lipid content in aorta en face, but a similar protection was not observed in males. Ovariectomized female mice lost protection from atherosclerosis in the setting of NLRP3 deficiency, whereas atherosclerosis showed a greater dependency on NLRP3 in castrated males. Thus, castration increased the dependency of atherosclerosis on the NLRP3 inflammasome, suggesting that testosterone may block inflammation in atherogenesis. Conversely, ovariectomy reduced the dependency on NLRP3 inflammasome components for atherogenesis, suggesting that estrogen may promote inflammasome-mediated atherosclerosis.
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2,334,452 |
Clinical Phenotype and Genetic Features of a Pair of Chinese Twins with Kearns-Sayre Syndrome.
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Kearns-Sayre Syndrome (KSS) is a severe mitochondrial disorder involving the central nervous system, eyes, ears, skeletal muscles, and heart. The mitochondrial DNA (mtDNA) rearrangements, especially the deletions, are present in almost all KSS patients and considered as the disease-causing factor. However, the size and position of mtDNA deletions are distinct in different individuals. In this study, we report the case of a pair of Chinese twins with KSS. The twin patients revealed typical KSS clinical symptoms, including heart block, bilateral sensorineural hearing loss, progressive external ophthalmoplegia, exercise intolerance, proximal limb weakness, and endocrine disorders. Using long-range polymerase chain reactions (long-range PCR) and next-generation sequencing (NGS), the genetic features of the twin patients were investigated. A large 6600 bp mtDNA deletion, ranging from position 8702 to 15,302, was detected in both patients. To our knowledge, this kind of mtDNA deletion has never been described previously. Our study enriched the mutation spectrum of KSS and showed that NGS is a powerful tool for detecting mtDNA large variants.
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2,334,453 |
Personalized dosing of nicotine replacement therapy versus standard dosing for the treatment of individuals with tobacco dependence: study protocol for a randomized placebo-controlled trial.
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Medications for smoking cessation are currently only effective in helping a minority of smokers quit. Drug development is slow and expensive; as such, there is much interest in optimizing the effectiveness of existing treatments and medications. Current standard doses of nicotine replacement therapy are not effective for many smokers, and in many cases, the amount of nicotine provided is much less than when a smoker is smoking their usual number of cigarettes. The proposed study will test if titrating the dose of the nicotine patch (up to 84 mg) will improve quitting success compared to those receiving a 21-mg nicotine patch with increasing doses of placebo patch.</AbstractText>This is a multicenter, pragmatic, two-arm, placebo-controlled, block randomized controlled trial. We will recruit participants who smoke at least 10 cigarettes daily and are interested in making a quit attempt. After 2 weeks of usual treatment with a 21-mg patch, participants who fail to quit smoking (target n = 400) will be randomized to receive escalating doses of a nicotine patch vs matching placebo patches for an additional 10 weeks or up to a maximum dose of 84 mg per day. Those who stop smoking during the first 2 weeks of usual treatment will continue with 21 mg patch treatment for 10 weeks and will form an additional comparison arm. In addition to the medication, participants will receive brief behavioral counseling at each study visit. The primary outcome will be biochemically confirmed continuous abstinence from smoking during the last 4 weeks of treatment (weeks 9 to 12).</AbstractText>Research evidence supporting the effectiveness of personalized doses of nicotine replacement therapy could change current practice in a variety of healthcare settings. Given the evidence that quitting smoking at any age diminishes the risk of tobacco-related morbidity and mortality, even small increases in absolute quit rates can have a substantial population-level impact on reducing smoking-related disease, mortality rates, and associated healthcare costs.</AbstractText>ClinicalTrials.gov, NCT03000387 . Registered on 22 December 2016.</AbstractText>
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2,334,454 |
Comprehensive assessment of PD-L1 immunohistochemistry on paired tissue and cytology specimens from non-small cell lung cancer.
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PD-L1 staining assessed by immunohistochemistry (IHC) is a predictive biomarker used to select advanced stage non-small cell lung carcinoma (NSCLC) patients who are likely to respond to PD-1/PD-L1 inhibitors. Cytology specimens represent a significant percentage of the diagnostic samples and additional data are required to show that they provide reliable PD-L1 results when compared to tissue specimens. We aimed to compare PD-L1 staining obtained from patient-matched tissue and cytology specimens. We also want to assess the feasibility of PD-L1 testing on cell blocks with two assays by evaluating the intra- and inter-observer agreement and the level of difficulty for determining the percentage of stained tumor cells (TPS).</AbstractText>Forty-six patients with NSCLC were selected. Each patient provided a surgical specimen and a cytology sample (cell block) and/or a biopsy at diagnosis. PD-L1 staining using Agilent PD-L1 IHC 28-8 pharmDx and VENTANA PD-L1 (SP263) assays was evaluated by four pathologists using the TPS. Sixty slides were rescored to document intra-observer agreement. Pathologists were asked to score the level of difficulty for evaluating PD-L1 TPS for each slide. Fleiss's and Cohen's kappas (k) were used to assess the agreement between paired specimens as well as intra- and inter-observer agreement.</AbstractText>The concordance in PD-L1 TPS between cell blocks and surgical specimens (k varying from 0.56 to 0.82) or biopsies (k from 0.43 to 0.81) was moderate to substantial, depending on the cut-off. On cell blocks, inter-observer agreement was substantial (k from 0.74 to 0.82) and intra-observer agreement was almost perfect (k from 0.85 to 0.93). The perceived difficulty of PD-L1 evaluation of cell blocks was not different from surgical specimens but more difficult than biopsy samples.</AbstractText>PD-L1 TPS was concordant between cell blocks and tissue specimens, mainly at 10, 25 and 50 % cut-offs. PD-L1 evaluation on cell blocks was feasible and reproducible between different observers and assays.</AbstractText>Copyright © 2020 Elsevier B.V. All rights reserved.</CopyrightInformation>
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2,334,455 |
Data-Driven Development of an Institutional "Gross-Only" Policy for the Examination of Select Surgical Pathology Specimens.
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To determine diagnostic, workflow, and economic implications of instituting a gross-only policy at our institution.</AbstractText>Retrospective (2017) key word searches were performed to identify "gross-only" cases for which microscopic evaluation could potentially be omitted, but was performed, and those who underwent gross evaluation per surgeon request. Cases were evaluated for type(s), part(s), block volume, turnaround time, demographics, and diagnosis. Laboratory costs and reimbursement were evaluated.</AbstractText>In total, 448 potential gross-only cases with 472 specimens consisted of atherosclerotic plaques (33.5%), bariatric stomach/bowel (32.6%), hernia (15.7%), heart valves (12.7%), and other (5.9%). Four (2.6%) bariatric surgery cases had Helicobacter pylori infection; these were the only cases with "significant" histologic findings. Cost analysis revealed that converting all potential gross-only specimens to gross only would result in overall losses based on average reimbursements, most influenced by bariatric specimens (Current Procedural Terminology code 88307), comprising 65.2% of estimated loss.</AbstractText>Establishing a gross-only policy should be guided by established recommendations but institutionally individualized and data driven. It was reasonable for us to establish a gross-only policy for most evaluated specimens, while excluding bariatric stomach specimens in which microscopic pathology could be missed, given the lack of H pylori screening at our institution.</AbstractText>© American Society for Clinical Pathology, 2020. All rights reserved. For permissions, please e-mail: [email protected].</CopyrightInformation>
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2,334,456 |
Spinal extradural arteriovenous fistula after lumbar epidural injection: CT angiographic diagnosis using 3D-volume rendering.
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Spinal extradural arteriovenous fistulas (SEDAVFs) are a rare form of spinal arteriovenous fistulas, the etiology of which has not been completely elucidated. To our knowledge, this is the first reported case of SEDAVF that may have been caused by a spinal procedure. This report describes a 50-year-old female patient who presented with an SEDAVF at the L3/4 level that developed 3 years after a transforaminal epidural block due to disc extrusion, after which she underwent no other operation or trauma. From routine spine magnetic resonance imaging, disc sequestration was considered more likely than vascular malformation. However, on lumbar CT angiography (CTA) and three-dimensional volume rendering images (3D-VRI), the lesion showed good association with arteries of the aortic branches, allowing us to confirm the exact diagnosis of the lesion as SEDAVF. A limitation of 3D-VRI reconstruction is the difficulty in separate visualization of the vertebral body and blood vessels. On follow-up CTA, 3D dual-energy computed tomography (DECT) depicted smaller vascular structures and showed their anatomical relationships to the bone. While spinal angiography has been traditionally known as the gold standard for SEDAVF diagnosis, CTA with 3D-VRI, especially obtained by DECT, allows clinicians to make an accurate diagnosis and treatment plan that are difficult to judge by routine MRI.
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2,334,457 |
Sleep Quality and its various correlates: A community-based study among geriatric population in a community development block of Purba Bardhaman district, West Bengal.
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In the elderly population, sleep problems are prevalent and have known to be associated with many factors. There are many adverse consequences of decreased sleep such as heart disease, diabetes, depression, accidents, impaired cognition, and poor quality of life. Correlates of poor sleep quality have not been well explored in Indian research.</AbstractText>The present study aimed to measure prevalence of poor sleep quality among elderly and its association with different factors.</AbstractText>A cross-sectional study was conducted during June-November 2018 in a randomly selected block of Purba Bardhaman district. Cluster random sampling was applied to select required sample of 180 elderly people (≥60 years) from 30 villages. Study tools used were Pittsburgh Sleep Quality Index (PSQI), 5-Item Geriatric Depression Scale (GDS), Generalized Anxiety Disorder 7-item scale (GAD-7), Global Physical Activity Questionnaire (GPAQ), and a pretested schedule for sociodemographic and other variables. The study had approval from Institutional Ethics Committee. Chi-square tests and multivariable logistic regression were performed using SPSS V16.</AbstractText>Prevalence of poor sleep quality (GPSQI ≥5) was 68.89%. Median Global PSQI (GPSQI) score was 7.00 (4.00-11.00). Multivariable logistic regression revealed that marital status, vital events in past one month, anxiety status, and depression were significantly associated with sleep quality. Those who were unmarried/widowed, having vital events in past one month in the family, and severe anxiety and depression were having significantly higher odds of developing poor sleep quality.</AbstractText>Poor sleep quality is high among elderly and measures toward the significant correlates are thus emphasized.</AbstractText>Copyright: © 2020 Journal of Family Medicine and Primary Care.</CopyrightInformation>
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2,334,458 |
Large Inter-Individual Differences in Responses to a Block of High Intensity Aerobic Interval Training: A Case Series in National-level Cyclists and Triathletes.
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The aim was to investigate individual responses on VO2max</sub> and performance to a block of high intensity aerobic interval training (HIIT) in national-level endurance athletes.</AbstractText>National-level cyclists and triathletes (five men and two women, 31 ± 3.3 years, VO2max</sub> 65.1 ± 3.3 ml·kg-1</sup>·min-1</sup>) conducted 14 HIIT sessions (4×4 min uphill running at 90-95% maximal heart rate) in nine days during preseason. VO2max</sub> in running and cycling, lactate threshold (LT) in cycling, oxygen cost of cycling (CC</sub>), and a cycling time-trial (TT) were tested two days pre and seven days post intervention. Feasibility was determined using attendance rates, adherence (defined as completing all sessions), and reported adverse events.</AbstractText>The results showed that adherence was 100% with 100% attendance rate. No adverse events were reported. TT (-75.6 ± 50.8 seconds, p < 0.0001) but not VO2max</sub> cycling (-0.2 ± 4.6 ml×kg-1</sup>×min-1</sup>, p = 0.53) or running (0.2 ± 1.2 ml×kg-1</sup>×min-1</sup>, p = 0.85) was improved on group level. The individual responses varied from -8.2% to +14.5% change in VO2max</sub>, and -7.5% to +0.8% in TT.</AbstractText>The large inter-individual differences in responses call for tailor-making HIIT blocks, mapping of biomarkers to avoid overtraining, and studying the effects of such blocks with longer follow-up than seven days.</AbstractText>
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2,334,459 |
Effect of Intravenous Paracetamol with Bupivacaine Scalp Nerve Block on Haemodynamics Response as Well as Anaesthetic Requirements during Supratentorial Craniotomies.
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Noxious stimuli during craniotomy may encourage hypertension and tachycardia, which may rise to morbidity in patients with intracranial hypertension. After craniotomy a moderate level of postoperative pain observed. The objective of this study was to observe the effect of intravenous paracetamol with bupivacaine scalp nerve block (SNB) on haemodynamics response as well as anaesthetic & analgesic requirements during supratentorial craniotomies. This is a single-blind, placebo-controlled, randomized clinical trial carried out in the Neurosurgery operation theatre from August 2015 to July 2017 under supervision of Department of Anaesthesia, Analgesia and Intensive Care Medicine of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. A total of 40 patients aged 18-60 years with supratentorial space occupying lesion undergoing craniotomy under general anaesthesia who were attended in the department of Neurosurgery, BSMMU were enrolled in this study and they were divided randomly into two groups, 20 patients in each. The Group A received 100ml normal saline infusion and 0.25% bupivacaine (20ml) in scalp block, while the Group B received intravenous injection paracetamol (1gm) and 0.25% bupivacaine (total 20ml) in scalp block. Statistical analyses were obtained Statistical Packages for Social Sciences (SPSS-22). The mean systolic blood pressure varied within the normal range in both groups. The mean DBP of Group B remained significantly lower than that of Group A in different follow up except at 30 minutes and 60 minutes after dura incision. However, mean MAP of Group B remained significantly lower than that of Group A in different time interval. The mean heart rate of Group B remained significantly lower than that of Group A. The mean intraoperative propofol as well as fentanyl requirements were significantly decreased in Group B in comparison to Group A. The combination of intravenous paracetamol with bupivacaine scalp nerve block provides better intra-operative haemodynamic stability and neurosurgical compliances for the patients undergoing supratentorial craniotomies under general anaesthesia.
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2,334,460 |
miR-21, Mediator, and Potential Therapeutic Target in the Cardiorenal Syndrome.
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Oligonucleotide-based therapies are currently gaining attention as a new treatment option for relatively rare as well as common diseases such as cardiovascular disease. With the remarkable progression of new sequencing technologies, a further step towards personalized precision medicine to target a disease at a molecular level was taken. Such therapies may employ antisense oligonucleotides to modulate the expression of both protein coding and non-coding RNAs, such as microRNAs. The cardiorenal syndrome (CRS) is a complex and severe clinical condition where heart and renal dysfunction mutually affect one another. The underlying mechanisms remain largely unknown and current treatments of CRS are mainly supportive therapies which slow down the progression of the disease, but hardly improve the condition. The small non-coding RNA, microRNA-21 (miR-21), is dysregulated in various heart and kidney diseases and has been repeatedly suggested as therapeutic target for the treatment of CRS. Impressive preclinical results have been achieved by an antisense oligonucleotide-based therapy to effectively block the pro-fibrotic traits of miR-21. Since microRNA-mediated pathways are generally very well-conserved, there is considerable commercial interest with regards to clinical translation. In this review, we will summarize the role of miR-21 within the heart-kidney axis and discuss the advantages and pitfalls of miR-21 targeting therapeutic strategies in CRS.
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2,334,461 |
Machine perfusion of circulatory determined death hearts: A scoping review.
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Ex vivo machine perfusion (EVMP) is reported to can successfully be applied for donor heart preservation. To respond to the organ shortage, some centres also accept hearts from marginal donors such as non-heart beating donors (NHBD) or hearts donated after cardiac death (DCD) for heart transplantation (HTx). Clinical as well as preclinical science on EVMP of DCD hearts seems to be promising but the ideal perfusion practice itself appears unclear.</AbstractText>In accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA), this systematic review scopes all EVMP techniques for human and animal DCD heart preservation and addresses three specific questions, which refer to (a) the perfusion solutions, (b) the perfusion parameters and respective target values and (c) if possible, a direct comparison between cold static storage (CSS) and EVMP.</AbstractText>Search results predominantly consisted of animal studies. Either perfusion with a crystalloid or blood-based solution, each with cardioplegic or non-cardioplegic properties was used. Some perfusates were supplemented with specific pharmacological medication to block pathophysiological pathways, which are involved in ischemia/reperfusion injury or edema formation. Besides normothermic EVMP with oxygenated blood, a wide range of temperature was applied in all approaches, with the lowest temperature at 4 °C. Pressure controlled anterograde Langendorff perfusion was applied mostly. If investigated, crystalloid machine perfusion was presented superior to CSS.</AbstractText>Only blood based EVMP was introduced into clinical practice. More research, clinical as well as preclinical, is needed to develop the ideal EVMP technique, in terms of blood or crystalloid perfusion.</AbstractText>Copyright © 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
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2,334,462 |
Effects of ultrasound guided ganglion stellate blockade on intraoperative and postoperative hemodynamic responses in laparoscopic gynecologic surgery.
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Laparoscopic gynecologic surgery is one of the most well-known procedures. Pneumoperitoneum with carbon dioxide insufflation can cause unfavorable hemodynamic effects due to catecholamine and vasopressin release.</AbstractText>To examine the effects of stellate ganglion block on hemodynamic response and postoperative pain.</AbstractText>In a prospective double blinded randomized parallel study we included 40 patients with ASA physical status I and II, aged between 18 and 50 years with a gynecologic problem candidate for laparoscopic surgery under general anesthesia. The patients were randomly divided into two groups. Fifteen minutes before anesthesia induction, the patients underwent ultrasound guided stellate ganglion block with 10 ml of lidocaine 1% and the control group underwent stellate ganglion block using 10 ml of distilled water as placebo. After induction of general anesthesia, systolic and diastolic blood pressure and heart rate were recorded, especially after blowing of CO2</sub> gas, the position change, depletion of CO2</sub>, and tracheal extubation in recovery. The postoperative pain was calculated using the visual analogue scale (VAS) at three times (0, 30, and 24 h after surgery).</AbstractText>Our results showed that mean systolic and diastolic blood pressure and heart rate did not show any significant difference at the measurement times (p > 0.05), and mean VAS of patients in the two groups was significantly different for the three measurement times except 24 h after surgery (p < 0.05).</AbstractText>Stellate ganglion block before laparoscopic gynecologic surgery has no significant effect on intraoperative and postoperative hemodynamic responses; however, it can decrease VAS in the early postoperative period.</AbstractText>Copyright: © 2019 Fundacja Videochirurgii.</CopyrightInformation>
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2,334,463 |
The XVth Banff Conference on Allograft Pathology the Banff Workshop Heart Report: Improving the diagnostic yield from endomyocardial biopsies and Quilty effect revisited.
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The XVth Banff Conference on Allograft Pathology meeting was held on September 23-27, 2019, in Pittsburgh, Pennsylvania, USA. During this meeting, two main topics in cardiac transplant pathology were addressed: (a) Improvement of endomyocardial biopsy (EMB) accuracy for the diagnosis of rejection and other significant injury patterns, and (b) the orphaned lesion known as Quilty effect or nodular endocardial infiltrates. Molecular technologies have evolved in recent years, deciphering pathophysiology of cardiac rejection. Diagnostically, it is time to integrate the histopathology of EMBs and molecular data. The goal is to incorporate molecular pathology, performed on the same paraffin block as a companion test for histopathology, to yield more accurate and objective EMB interpretation. Application of digital image analysis from hematoxylin and eosin (H&E) stain to multiplex labeling is another means of extracting additional information from EMBs. New concepts have emerged exploring the multifaceted significance of myocardial injury, minimal rejection patterns supported by molecular profiles, and lesions of arteriolitis/vasculitis in the setting of T cell-mediated rejection (TCMR) and antibody-mediated rejection (AMR). The orphaned lesion known as Quilty effect or nodular endocardial infiltrates. A state-of-the-art session with historical aspects and current dilemmas was reviewed, and possible pathogenesis proposed, based on advances in immunology to explain conflicting data. The Quilty effect will be the subject of a multicenter project to explore whether it functions as a tertiary lymphoid organ.
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2,334,464 |
Analgesic Efficacy of Preemptive Transversus Abdominis Plane Block in Patients Undergoing Laparoscopic Colorectal Cancer Surgery.
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Despite rapid advancements in laparoscopic surgical devices and techniques, pain remains a significant issue. We examined the efficacy of preemptive transversus abdominis plane (TAP) block for acute postoperative pain in patients undergoing laparoscopic colorectal cancer surgery. We retrospectively analyzed 153 patients who underwent laparoscopic colorectal cancer surgery with or without TAP block; among them, 142 were allocated to the TAP or non-TAP group. We performed between-group comparisons of demographic, clinical, and anesthetic data and pain scores at a postoperative anesthesia care unit (PACU) and at postoperative days 1, 3, and 5. There were no significant between-group differences in demographic and clinical characteristics. The mean arterial pressure, heart rate, and minimum alveolar concentration (MAC) were significantly lower in the TAP group at the start and end of surgery. The post-extubation bispectral index was significantly higher in the TAP group. There were no significant between-group differences in the pain scores and opioid consumption at the PACU or at postoperative days 1, 3, and 5, or in the time to pass flatus, the hospital stay length, and postoperative complications. Preemptive TAP block showed an intraoperative, but not postoperative, analgesic effect, characterized by a low mean arterial pressure, heart rate, and MAC.
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2,334,465 |
Role of a Brief Intensive Observation Area with a Dedicated Team of Doctors in the Management of Acute Heart Failure Patients: A Retrospective Observational Study.
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<i>Background and objectives</i>: Acute heart failure (AHF) is one of the main causes of hospitalization in Western countries. Usually, patients cannot be admitted directly to the wards (access block) and stay in the emergency room. Holding units are clinical decision units, or observation units, within the ED that are able to alleviate access block and to contribute to a reduction in hospitalization. Observation units have also been shown to play a role in specific clinical conditions, like the acute exacerbation of heart failure. This study aimed to analyze the impact of a brief intensive observation (OBI) area on the management of acute heart failure (AHF) patients. The OBI is a holding unit dedicated to the stabilization of unstable patients with a team of dedicated physicians. <i>Materials and Methods</i>: We conducted a retrospective and single-centered observational study with retrospective collection of the data of all patients who presented to our emergency department with AHF during 2017. We evaluated and compared two cohorts of patients, those treated in the OBI and those who were not, in terms of the reduction in color codes at discharge, mortality rate within the emergency room (ER), hospitalization rate, rate of transfer to less intensive facilities, and readmission rate at 7, 14, and 30 days after discharge. <i>Results</i>: We enrolled 920 patients from 1<sup>st</sup> January to 31<sup>st</sup> December. Of these, 61% were transferred to the OBI for stabilization. No statistically significant difference between the OBI and non-OBI populations in terms of age and gender was observed. OBI patients had worse clinical conditions on arrival. The patients treated in the OBI had longer process times, which would be expected, to allow patient stabilization. The stabilization rate in the OBI was higher, since presumably OBI admission protected patients from "worse condition" at discharge. <i>Conclusions</i><i>:</i> Data from our study show that a dedicated area of the ER, such as the OBI, has progressively allowed a change in the treatment path of the patient, where the aim is no longer to admit the patient for processing but to treat the patient first and then, if necessary, admit or refer. This has resulted in very good feedback on patient stabilization and has resulted in a better management of beds, reduced admission rates, and reduced use of high intensity care beds.
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2,334,466 |
A bitless bridle does not limit or prevent dynamic laryngeal collapse.
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Bits have often been incriminated as a cause of upper respiratory tract obstruction in horses; however, no scientific studies are available to confirm or refute these allegations. Clinical signs of dynamic laryngeal collapse associated with poll flexion (DLC) are induced when susceptible horses are ridden or driven into the bit.</AbstractText>To determine whether use of Dr Cook's™</sup> Bitless Bridle, instead of a conventional snaffle bit bridle, would reduce the severity of DLC in affected horses measured objectively using inspiratory tracheal pressures.</AbstractText>Intervention study using each horse as its own control in a block randomised order.</AbstractText>Nine Norwegian Swedish Coldblooded trotters previously diagnosed with DLC were exercised on two consecutive days using a standardised high-speed treadmill protocol with either a conventional bridle with a snaffle bit, or Dr Cook's™</sup> Bitless Bridle. Head and neck position, rein tension, inspiratory tracheal pressure measurements, and laryngeal videoendoscopy recordings were obtained. A heart rate greater than 200 bpm, and similar degrees of poll flexion/head height, had to be achieved in both bridles for the individual horse's data to be included for comparison.</AbstractText>Seven horses' data met the inclusion criteria. The change in mean inspiratory tracheal pressure between free and flexion phases in the bitless bridle (-15.2 ± 12.3 cmH2</sub> O) was significantly greater (P < .001) than in the snaffle bit bridle (-9.8 ± 7.9 cmH2</sub> O). Mean inspiratory pressure during the free phase was significantly (P < .001) more negative with the snaffle bit bridle (-32.3 ± 6.3 cmH2</sub> O), vs the bitless bridle (-28.5 ± 6.9 cmH2</sub> O). Mean pressures in flexion phase, snaffle bridle (-42.1 ± 10.8 cmH2</sub> O), vs bitless bridle (-43.7 ± 15.6 cmH2</sub> O) where not significantly different between bridles (P = .2).</AbstractText>Small sample size due to difficulty recruiting suitable clinical cases.</AbstractText>This study could not provide any clear evidence that the effect of a snaffle bit in a horse's mouth influences the development or severity of DLC. Instead, head and neck angles induced by rein tension seem to be the key event in provoking DLC in susceptible horses.</AbstractText>© 2020 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.</CopyrightInformation>
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2,334,467 |
Tracheostomy in the COVID-19 era: global and multidisciplinary guidance.
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Global health care is experiencing an unprecedented surge in the number of critically ill patients who require mechanical ventilation due to the COVID-19 pandemic. The requirement for relatively long periods of ventilation in those who survive means that many are considered for tracheostomy to free patients from ventilatory support and maximise scarce resources. COVID-19 provides unique challenges for tracheostomy care: health-care workers need to safely undertake tracheostomy procedures and manage patients afterwards, minimising risks of nosocomial transmission and compromises in the quality of care. Conflicting recommendations exist about case selection, the timing and performance of tracheostomy, and the subsequent management of patients. In response, we convened an international working group of individuals with relevant expertise in tracheostomy. We did a literature and internet search for reports of research pertaining to tracheostomy during the COVID-19 pandemic, supplemented by sources comprising statements and guidance on tracheostomy care. By synthesising early experiences from countries that have managed a surge in patient numbers, emerging virological data, and international, multidisciplinary expert opinion, we aim to provide consensus guidelines and recommendations on the conduct and management of tracheostomy during the COVID-19 pandemic.
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2,334,468 |
Establishing Core Cardiovascular Outcome Measures for Trials in Hemodialysis: Report of an International Consensus Workshop.<Pagination><StartPage>109</StartPage><EndPage>120</EndPage><MedlinePgn>109-120</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1053/j.ajkd.2020.01.022</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0272-6386(20)30585-0</ELocationID><Abstract><AbstractText>Cardiovascular disease (CVD) affects more than two-thirds of patients receiving hemodialysis and is the leading cause of death in this population, yet CVD outcomes are infrequently and inconsistently reported in trials in patients receiving hemodialysis. As part of the Standardised Outcomes in Nephrology-Haemodialysis (SONG-HD) initiative, we convened a consensus workshop to discuss the potential use of myocardial infarction and sudden cardiac death as core outcome measures for CVD for use in all trials in people receiving hemodialysis. Eight patients or caregivers and 46 health professionals from 15 countries discussed selection and implementation of the proposed core outcome measures. Five main themes were identified: capturing specific relevance to the hemodialysis population (acknowledging prevalence, risk, severity, unique symptomology, and pathophysiology), the dilemmas in using composite outcomes, addressing challenges in outcome definitions (establishing a common definition and addressing uncertainty in the utility of biomarkers in hemodialysis), selecting a meaningful metric for decision making (to facilitate comparison across trials), and enabling and incentivizing implementation (by ensuring that cardiologists are involved in the development and integration of the outcome measure into registries, trial design, and reporting guidelines). Based on these themes, participants supported the use of myocardial infarction and sudden cardiac death as core outcome measures of CVD to be reported in all hemodialysis trials.</AbstractText><CopyrightInformation>Copyright © 2020 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>O'Lone</LastName><ForeName>Emma</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia. Electronic address: [email protected].</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Viecelli</LastName><ForeName>Andrea K</ForeName><Initials>AK</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Craig</LastName><ForeName>Jonathan C</ForeName><Initials>JC</Initials><AffiliationInfo><Affiliation>College of Medicine and Health, Flinders University, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tong</LastName><ForeName>Allison</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sautenet</LastName><ForeName>Benedicte</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Tours University, Tours, France; Department of Nephrology-Hypertension, Dialysis, Renal Transplantation, Tours Hospital, Tours, France; INSERM U1246, Tours, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Herrington</LastName><ForeName>William G</ForeName><Initials>WG</Initials><AffiliationInfo><Affiliation>Medical Research Council Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Herzog</LastName><ForeName>Charles A</ForeName><Initials>CA</Initials><AffiliationInfo><Affiliation>Division of Cardiology, Department of Medicine, Hennepin County Medical Center/University of Minnesota, MN.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jafar</LastName><ForeName>Tazeen H</ForeName><Initials>TH</Initials><AffiliationInfo><Affiliation>Program in Health Services & Systems Research, Duke-NUS Graduate Medical School, Singapore; Department of Community Health Science, Aga Khan University, Karachi, Pakistan; Section of Nephrology, Department of Medicine, Aga Khan University, Karachi, Pakistan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jardine</LastName><ForeName>Meg</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>The George Institute for Global Health, Sydney, Australia; Concord Repatriation General Hospital, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Krane</LastName><ForeName>Vera</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Division of Nephrology, Department of Medicine I, University Hospital, Würzburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Levin</LastName><ForeName>Adeera</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Malyszko</LastName><ForeName>Jolanta</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Dialysis and Internal Medicine, Warsaw Medical University, Warsaw, Poland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rocco</LastName><ForeName>Michael V</ForeName><Initials>MV</Initials><AffiliationInfo><Affiliation>Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Strippoli</LastName><ForeName>Giovanni</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy; Medical Scientific Office, Diaverum, Lund, Sweden; Diaverum Academy, Bari, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tonelli</LastName><ForeName>Marcello</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Division of Nephrology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Angela Yee Moon</ForeName><Initials>AYM</Initials><AffiliationInfo><Affiliation>Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wanner</LastName><ForeName>Christoph</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Division of Nephrology, Department of Medicine I, University Hospital, Würzburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zannad</LastName><ForeName>Faiez</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Université de Lorraine, Inserm CIC 1433 and INI-CRCT, CHU de Nancy, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Winkelmayer</LastName><ForeName>Wolfgang C</ForeName><Initials>WC</Initials><AffiliationInfo><Affiliation>Selzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, TX.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wheeler</LastName><ForeName>David C</ForeName><Initials>DC</Initials><AffiliationInfo><Affiliation>Department of Renal Medicine, University College London, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>SONG-HD CVD Consensus Workshop Investigators</CollectiveName></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>MR/R007764/1</GrantID><Acronym>MRC_</Acronym><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>05</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Kidney Dis</MedlineTA><NlmUniqueID>8110075</NlmUniqueID><ISSNLinking>0272-6386</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002318" MajorTopicYN="Y">Cardiovascular Diseases</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002986" MajorTopicYN="N">Clinical Trials as Topic</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D032921" MajorTopicYN="Y">Consensus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004493" MajorTopicYN="N">Education</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006282" MajorTopicYN="N">Health Personnel</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D038622" MajorTopicYN="N">Internationality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017063" MajorTopicYN="N">Outcome Assessment, Health Care</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010358" MajorTopicYN="N">Patient Participation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006435" MajorTopicYN="N">Renal Dialysis</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012955" MajorTopicYN="N">Societies, Medical</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Hemodialysis (HD)</Keyword><Keyword MajorTopicYN="N">cardiovascular disease (CVD)</Keyword><Keyword MajorTopicYN="N">core outcome set</Keyword><Keyword MajorTopicYN="N">end-stage renal disease (ESRD)</Keyword><Keyword MajorTopicYN="N">heart failure (HF)</Keyword><Keyword MajorTopicYN="N">myocardial infarction (MI)</Keyword><Keyword MajorTopicYN="N">outcomes</Keyword><Keyword MajorTopicYN="N">outcomes research</Keyword><Keyword MajorTopicYN="N">patient-centered outcome (PRO)</Keyword><Keyword MajorTopicYN="N">sudden cardiac death (SCD)</Keyword><Keyword MajorTopicYN="N">trial design</Keyword></KeywordList><InvestigatorList><Investigator ValidYN="Y"><LastName>Craig</LastName><ForeName>Jonathan C</ForeName><Initials>JC</Initials></Investigator><Investigator ValidYN="Y"><LastName>Tong</LastName><ForeName>Allison</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Manns</LastName><ForeName>Braden</ForeName><Initials>B</Initials></Investigator><Investigator ValidYN="Y"><LastName>Pecoits-Filho</LastName><ForeName>Roberto</ForeName><Initials>R</Initials></Investigator><Investigator ValidYN="Y"><LastName>Harris</LastName><ForeName>Tess</ForeName><Initials>T</Initials></Investigator><Investigator ValidYN="Y"><LastName>Wheeler</LastName><ForeName>David C</ForeName><Initials>DC</Initials></Investigator><Investigator ValidYN="Y"><LastName>Winkelmayer</LastName><ForeName>Wolfgang</ForeName><Initials>W</Initials></Investigator><Investigator ValidYN="Y"><LastName>Levin</LastName><ForeName>Adeera</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>O'Lone</LastName><ForeName>Emma</ForeName><Initials>E</Initials></Investigator><Investigator ValidYN="Y"><LastName>Herrington</LastName><ForeName>William G</ForeName><Initials>WG</Initials></Investigator><Investigator ValidYN="Y"><LastName>Herzog</LastName><ForeName>Chuck A</ForeName><Initials>CA</Initials></Investigator><Investigator ValidYN="Y"><LastName>Rocco</LastName><ForeName>Michael V</ForeName><Initials>MV</Initials></Investigator><Investigator ValidYN="Y"><LastName>Strippoli</LastName><ForeName>Giovanni</ForeName><Initials>G</Initials></Investigator><Investigator ValidYN="Y"><LastName>Jardine</LastName><ForeName>Meg</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Kleinpeter</LastName><ForeName>Myra</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Ju</LastName><ForeName>Angela</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Cho</LastName><ForeName>Yeoungjee</ForeName><Initials>Y</Initials></Investigator><Investigator ValidYN="Y"><LastName>Gutman</LastName><ForeName>Talia</ForeName><Initials>T</Initials></Investigator><Investigator ValidYN="Y"><LastName>Bernier-Jean</LastName><ForeName>Amelie</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>James</LastName><ForeName>Laura</ForeName><Initials>L</Initials></Investigator><Investigator ValidYN="Y"><LastName>Hamiwka</LastName><ForeName>Lorraine</ForeName><Initials>L</Initials></Investigator><Investigator ValidYN="Y"><LastName>Viecelli</LastName><ForeName>Andrea K</ForeName><Initials>AK</Initials></Investigator><Investigator ValidYN="Y"><LastName>Jardine</LastName><ForeName>Alan</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Bello</LastName><ForeName>Amino</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Stengel</LastName><ForeName>Benedicte</ForeName><Initials>B</Initials></Investigator><Investigator ValidYN="Y"><LastName>Schiller</LastName><ForeName>Brigitte</ForeName><Initials>B</Initials></Investigator><Investigator ValidYN="Y"><LastName>Johnson</LastName><ForeName>David</ForeName><Initials>D</Initials></Investigator><Investigator ValidYN="Y"><LastName>Bavlovlenkov</LastName><ForeName>Elena</ForeName><Initials>E</Initials></Investigator><Investigator ValidYN="Y"><LastName>Caskey</LastName><ForeName>Fergus</ForeName><Initials>F</Initials></Investigator><Investigator ValidYN="Y"><LastName>Gillespie</LastName><ForeName>Barbara</ForeName><Initials>B</Initials></Investigator><Investigator ValidYN="Y"><LastName>Block</LastName><ForeName>Geoffrey</ForeName><Initials>G</Initials></Investigator><Investigator ValidYN="Y"><LastName>Phan</LastName><ForeName>Hai An</ForeName><Initials>HA</Initials></Investigator><Investigator ValidYN="Y"><LastName>Heerspink</LastName><ForeName>Hiddo Lambers</ForeName><Initials>HL</Initials></Investigator><Investigator ValidYN="Y"><LastName>Madero</LastName><ForeName>Magdalena</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Ruospo</LastName><ForeName>Marinella</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Unruh</LastName><ForeName>Mark</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Laville</LastName><ForeName>Maurice</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Bansal</LastName><ForeName>Nisha</ForeName><Initials>N</Initials></Investigator><Investigator ValidYN="Y"><LastName>Mark</LastName><ForeName>Patrick</ForeName><Initials>P</Initials></Investigator><Investigator ValidYN="Y"><LastName>Blankestijn</LastName><ForeName>P J</ForeName><Initials>PJ</Initials></Investigator><Investigator ValidYN="Y"><LastName>Roy-Chaudhury</LastName><ForeName>Prabir</ForeName><Initials>P</Initials></Investigator><Investigator ValidYN="Y"><LastName>Perlman</LastName><ForeName>Rachel</ForeName><Initials>R</Initials></Investigator><Investigator ValidYN="Y"><LastName>Agarwal</LastName><ForeName>Rajiv</ForeName><Initials>R</Initials></Investigator><Investigator ValidYN="Y"><LastName>Mehrotra</LastName><ForeName>Rajnish</ForeName><Initials>R</Initials></Investigator><Investigator ValidYN="Y"><LastName>Seliger</LastName><ForeName>Stephen</ForeName><Initials>S</Initials></Investigator><Investigator ValidYN="Y"><LastName>Shafi</LastName><ForeName>Tariq</ForeName><Initials>T</Initials></Investigator><Investigator ValidYN="Y"><LastName>Hiemstra</LastName><ForeName>Thomas</ForeName><Initials>T</Initials></Investigator><Investigator ValidYN="Y"><LastName>Jassal</LastName><ForeName>Vanita</ForeName><Initials>V</Initials></Investigator><Investigator ValidYN="Y"><LastName>Perkovic</LastName><ForeName>Vlado</ForeName><Initials>V</Initials></Investigator><Investigator ValidYN="Y"><LastName>Simplice</LastName><ForeName>Amanda</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>White</LastName><ForeName>David</ForeName><Initials>D</Initials></Investigator><Investigator ValidYN="Y"><LastName>Eilers</LastName><ForeName>Denise</ForeName><Initials>D</Initials></Investigator><Investigator ValidYN="Y"><LastName>Alexander</LastName><ForeName>Herbert</ForeName><Initials>H</Initials></Investigator><Investigator ValidYN="Y"><LastName>Landry</LastName><ForeName>Yvonne</ForeName><Initials>Y</Initials></Investigator><Investigator ValidYN="Y"><LastName>Landry</LastName><ForeName>Gennifer</ForeName><Initials>G</Initials></Investigator><Investigator ValidYN="Y"><LastName>Wilkie</LastName><ForeName>Caroline</ForeName><Initials>C</Initials></Investigator></InvestigatorList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>8</Month><Day>5</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>1</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>5</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>5</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32414662</ArticleId><ArticleId IdType="doi">10.1053/j.ajkd.2020.01.022</ArticleId><ArticleId IdType="pii">S0272-6386(20)30585-0</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32414227</PMID><DateRevised><Year>2021</Year><Month>06</Month><Day>15</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1827-1898</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>May</Month><Day>14</Day></PubDate></JournalIssue><Title>Panminerva medica</Title><ISOAbbreviation>Panminerva Med</ISOAbbreviation></Journal>Activation of FXR receptor reduces damage of ET-1 on H9C2 cardiomyocytes by activating AMPK signaling pathway.
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Cardiovascular disease (CVD) affects more than two-thirds of patients receiving hemodialysis and is the leading cause of death in this population, yet CVD outcomes are infrequently and inconsistently reported in trials in patients receiving hemodialysis. As part of the Standardised Outcomes in Nephrology-Haemodialysis (SONG-HD) initiative, we convened a consensus workshop to discuss the potential use of myocardial infarction and sudden cardiac death as core outcome measures for CVD for use in all trials in people receiving hemodialysis. Eight patients or caregivers and 46 health professionals from 15 countries discussed selection and implementation of the proposed core outcome measures. Five main themes were identified: capturing specific relevance to the hemodialysis population (acknowledging prevalence, risk, severity, unique symptomology, and pathophysiology), the dilemmas in using composite outcomes, addressing challenges in outcome definitions (establishing a common definition and addressing uncertainty in the utility of biomarkers in hemodialysis), selecting a meaningful metric for decision making (to facilitate comparison across trials), and enabling and incentivizing implementation (by ensuring that cardiologists are involved in the development and integration of the outcome measure into registries, trial design, and reporting guidelines). Based on these themes, participants supported the use of myocardial infarction and sudden cardiac death as core outcome measures of CVD to be reported in all hemodialysis trials.<CopyrightInformation>Copyright © 2020 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>O'Lone</LastName><ForeName>Emma</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia. Electronic address: [email protected].</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Viecelli</LastName><ForeName>Andrea K</ForeName><Initials>AK</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Craig</LastName><ForeName>Jonathan C</ForeName><Initials>JC</Initials><AffiliationInfo><Affiliation>College of Medicine and Health, Flinders University, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tong</LastName><ForeName>Allison</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sautenet</LastName><ForeName>Benedicte</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Tours University, Tours, France; Department of Nephrology-Hypertension, Dialysis, Renal Transplantation, Tours Hospital, Tours, France; INSERM U1246, Tours, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Herrington</LastName><ForeName>William G</ForeName><Initials>WG</Initials><AffiliationInfo><Affiliation>Medical Research Council Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Herzog</LastName><ForeName>Charles A</ForeName><Initials>CA</Initials><AffiliationInfo><Affiliation>Division of Cardiology, Department of Medicine, Hennepin County Medical Center/University of Minnesota, MN.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jafar</LastName><ForeName>Tazeen H</ForeName><Initials>TH</Initials><AffiliationInfo><Affiliation>Program in Health Services & Systems Research, Duke-NUS Graduate Medical School, Singapore; Department of Community Health Science, Aga Khan University, Karachi, Pakistan; Section of Nephrology, Department of Medicine, Aga Khan University, Karachi, Pakistan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jardine</LastName><ForeName>Meg</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>The George Institute for Global Health, Sydney, Australia; Concord Repatriation General Hospital, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Krane</LastName><ForeName>Vera</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Division of Nephrology, Department of Medicine I, University Hospital, Würzburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Levin</LastName><ForeName>Adeera</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Malyszko</LastName><ForeName>Jolanta</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Dialysis and Internal Medicine, Warsaw Medical University, Warsaw, Poland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rocco</LastName><ForeName>Michael V</ForeName><Initials>MV</Initials><AffiliationInfo><Affiliation>Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Strippoli</LastName><ForeName>Giovanni</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy; Medical Scientific Office, Diaverum, Lund, Sweden; Diaverum Academy, Bari, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tonelli</LastName><ForeName>Marcello</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Division of Nephrology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Angela Yee Moon</ForeName><Initials>AYM</Initials><AffiliationInfo><Affiliation>Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wanner</LastName><ForeName>Christoph</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Division of Nephrology, Department of Medicine I, University Hospital, Würzburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zannad</LastName><ForeName>Faiez</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Université de Lorraine, Inserm CIC 1433 and INI-CRCT, CHU de Nancy, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Winkelmayer</LastName><ForeName>Wolfgang C</ForeName><Initials>WC</Initials><AffiliationInfo><Affiliation>Selzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, TX.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wheeler</LastName><ForeName>David C</ForeName><Initials>DC</Initials><AffiliationInfo><Affiliation>Department of Renal Medicine, University College London, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>SONG-HD CVD Consensus Workshop Investigators</CollectiveName></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>MR/R007764/1</GrantID><Acronym>MRC_</Acronym><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>05</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Kidney Dis</MedlineTA><NlmUniqueID>8110075</NlmUniqueID><ISSNLinking>0272-6386</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002318" MajorTopicYN="Y">Cardiovascular Diseases</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002986" MajorTopicYN="N">Clinical Trials as Topic</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D032921" MajorTopicYN="Y">Consensus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004493" MajorTopicYN="N">Education</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006282" MajorTopicYN="N">Health Personnel</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D038622" MajorTopicYN="N">Internationality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017063" MajorTopicYN="N">Outcome Assessment, Health Care</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010358" MajorTopicYN="N">Patient Participation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006435" MajorTopicYN="N">Renal Dialysis</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012955" MajorTopicYN="N">Societies, Medical</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Hemodialysis (HD)</Keyword><Keyword MajorTopicYN="N">cardiovascular disease (CVD)</Keyword><Keyword MajorTopicYN="N">core outcome set</Keyword><Keyword MajorTopicYN="N">end-stage renal disease (ESRD)</Keyword><Keyword MajorTopicYN="N">heart failure (HF)</Keyword><Keyword MajorTopicYN="N">myocardial infarction (MI)</Keyword><Keyword MajorTopicYN="N">outcomes</Keyword><Keyword MajorTopicYN="N">outcomes research</Keyword><Keyword MajorTopicYN="N">patient-centered outcome (PRO)</Keyword><Keyword MajorTopicYN="N">sudden cardiac death (SCD)</Keyword><Keyword MajorTopicYN="N">trial design</Keyword></KeywordList><InvestigatorList><Investigator ValidYN="Y"><LastName>Craig</LastName><ForeName>Jonathan C</ForeName><Initials>JC</Initials></Investigator><Investigator ValidYN="Y"><LastName>Tong</LastName><ForeName>Allison</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Manns</LastName><ForeName>Braden</ForeName><Initials>B</Initials></Investigator><Investigator ValidYN="Y"><LastName>Pecoits-Filho</LastName><ForeName>Roberto</ForeName><Initials>R</Initials></Investigator><Investigator ValidYN="Y"><LastName>Harris</LastName><ForeName>Tess</ForeName><Initials>T</Initials></Investigator><Investigator ValidYN="Y"><LastName>Wheeler</LastName><ForeName>David C</ForeName><Initials>DC</Initials></Investigator><Investigator ValidYN="Y"><LastName>Winkelmayer</LastName><ForeName>Wolfgang</ForeName><Initials>W</Initials></Investigator><Investigator ValidYN="Y"><LastName>Levin</LastName><ForeName>Adeera</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>O'Lone</LastName><ForeName>Emma</ForeName><Initials>E</Initials></Investigator><Investigator ValidYN="Y"><LastName>Herrington</LastName><ForeName>William G</ForeName><Initials>WG</Initials></Investigator><Investigator ValidYN="Y"><LastName>Herzog</LastName><ForeName>Chuck A</ForeName><Initials>CA</Initials></Investigator><Investigator ValidYN="Y"><LastName>Rocco</LastName><ForeName>Michael V</ForeName><Initials>MV</Initials></Investigator><Investigator ValidYN="Y"><LastName>Strippoli</LastName><ForeName>Giovanni</ForeName><Initials>G</Initials></Investigator><Investigator ValidYN="Y"><LastName>Jardine</LastName><ForeName>Meg</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Kleinpeter</LastName><ForeName>Myra</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Ju</LastName><ForeName>Angela</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Cho</LastName><ForeName>Yeoungjee</ForeName><Initials>Y</Initials></Investigator><Investigator ValidYN="Y"><LastName>Gutman</LastName><ForeName>Talia</ForeName><Initials>T</Initials></Investigator><Investigator ValidYN="Y"><LastName>Bernier-Jean</LastName><ForeName>Amelie</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>James</LastName><ForeName>Laura</ForeName><Initials>L</Initials></Investigator><Investigator ValidYN="Y"><LastName>Hamiwka</LastName><ForeName>Lorraine</ForeName><Initials>L</Initials></Investigator><Investigator ValidYN="Y"><LastName>Viecelli</LastName><ForeName>Andrea K</ForeName><Initials>AK</Initials></Investigator><Investigator ValidYN="Y"><LastName>Jardine</LastName><ForeName>Alan</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Bello</LastName><ForeName>Amino</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>Stengel</LastName><ForeName>Benedicte</ForeName><Initials>B</Initials></Investigator><Investigator ValidYN="Y"><LastName>Schiller</LastName><ForeName>Brigitte</ForeName><Initials>B</Initials></Investigator><Investigator ValidYN="Y"><LastName>Johnson</LastName><ForeName>David</ForeName><Initials>D</Initials></Investigator><Investigator ValidYN="Y"><LastName>Bavlovlenkov</LastName><ForeName>Elena</ForeName><Initials>E</Initials></Investigator><Investigator ValidYN="Y"><LastName>Caskey</LastName><ForeName>Fergus</ForeName><Initials>F</Initials></Investigator><Investigator ValidYN="Y"><LastName>Gillespie</LastName><ForeName>Barbara</ForeName><Initials>B</Initials></Investigator><Investigator ValidYN="Y"><LastName>Block</LastName><ForeName>Geoffrey</ForeName><Initials>G</Initials></Investigator><Investigator ValidYN="Y"><LastName>Phan</LastName><ForeName>Hai An</ForeName><Initials>HA</Initials></Investigator><Investigator ValidYN="Y"><LastName>Heerspink</LastName><ForeName>Hiddo Lambers</ForeName><Initials>HL</Initials></Investigator><Investigator ValidYN="Y"><LastName>Madero</LastName><ForeName>Magdalena</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Ruospo</LastName><ForeName>Marinella</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Unruh</LastName><ForeName>Mark</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Laville</LastName><ForeName>Maurice</ForeName><Initials>M</Initials></Investigator><Investigator ValidYN="Y"><LastName>Bansal</LastName><ForeName>Nisha</ForeName><Initials>N</Initials></Investigator><Investigator ValidYN="Y"><LastName>Mark</LastName><ForeName>Patrick</ForeName><Initials>P</Initials></Investigator><Investigator ValidYN="Y"><LastName>Blankestijn</LastName><ForeName>P J</ForeName><Initials>PJ</Initials></Investigator><Investigator ValidYN="Y"><LastName>Roy-Chaudhury</LastName><ForeName>Prabir</ForeName><Initials>P</Initials></Investigator><Investigator ValidYN="Y"><LastName>Perlman</LastName><ForeName>Rachel</ForeName><Initials>R</Initials></Investigator><Investigator ValidYN="Y"><LastName>Agarwal</LastName><ForeName>Rajiv</ForeName><Initials>R</Initials></Investigator><Investigator ValidYN="Y"><LastName>Mehrotra</LastName><ForeName>Rajnish</ForeName><Initials>R</Initials></Investigator><Investigator ValidYN="Y"><LastName>Seliger</LastName><ForeName>Stephen</ForeName><Initials>S</Initials></Investigator><Investigator ValidYN="Y"><LastName>Shafi</LastName><ForeName>Tariq</ForeName><Initials>T</Initials></Investigator><Investigator ValidYN="Y"><LastName>Hiemstra</LastName><ForeName>Thomas</ForeName><Initials>T</Initials></Investigator><Investigator ValidYN="Y"><LastName>Jassal</LastName><ForeName>Vanita</ForeName><Initials>V</Initials></Investigator><Investigator ValidYN="Y"><LastName>Perkovic</LastName><ForeName>Vlado</ForeName><Initials>V</Initials></Investigator><Investigator ValidYN="Y"><LastName>Simplice</LastName><ForeName>Amanda</ForeName><Initials>A</Initials></Investigator><Investigator ValidYN="Y"><LastName>White</LastName><ForeName>David</ForeName><Initials>D</Initials></Investigator><Investigator ValidYN="Y"><LastName>Eilers</LastName><ForeName>Denise</ForeName><Initials>D</Initials></Investigator><Investigator ValidYN="Y"><LastName>Alexander</LastName><ForeName>Herbert</ForeName><Initials>H</Initials></Investigator><Investigator ValidYN="Y"><LastName>Landry</LastName><ForeName>Yvonne</ForeName><Initials>Y</Initials></Investigator><Investigator ValidYN="Y"><LastName>Landry</LastName><ForeName>Gennifer</ForeName><Initials>G</Initials></Investigator><Investigator ValidYN="Y"><LastName>Wilkie</LastName><ForeName>Caroline</ForeName><Initials>C</Initials></Investigator></InvestigatorList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>8</Month><Day>5</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>1</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>5</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>5</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32414662</ArticleId><ArticleId IdType="doi">10.1053/j.ajkd.2020.01.022</ArticleId><ArticleId IdType="pii">S0272-6386(20)30585-0</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32414227</PMID><DateRevised><Year>2021</Year><Month>06</Month><Day>15</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1827-1898</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>May</Month><Day>14</Day></PubDate></JournalIssue><Title>Panminerva medica</Title><ISOAbbreviation>Panminerva Med</ISOAbbreviation></Journal><ArticleTitle>Activation of FXR receptor reduces damage of ET-1 on H9C2 cardiomyocytes by activating AMPK signaling pathway.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.23736/S0031-0808.20.03930-0</ELocationID><Abstract><AbstractText Label="BACKGROUND">To investigate the effect of Farnesoid X receptor (FXR) on oxidative stress injury of H9C2 cardiomyocytes induced by endothelin-1 (ET-1), and to explore the possible mechanism.<AbstractText Label="METHODS">H9C2 cardiomyocytes were treated with ET-1 at concentrations of 10-8, 10-7 and 10-6 mmol/L for 12, 24, 36, and 48 h, respectively. At the same time, oxidative stress injury models were established. After the oxidative stress injury model was established, GW4064 (FXR agonist), siRNA-FXR (the virus interfered with FXR expression) and FXR empty virus were treated for 48 h. CCK-8 method was used to observe the survival rate of cardiomyocytes. Biochemical kit method was used to detect Creatine Kinase (CK) contents, CAT and mitochondrial activity. Western blot was used to detect the protein expression of SOD1, AMPK and p-AMPK. And real-time PCR was used to detect GPX1 mRNA, GPX3 mRNA, Sirt1 mRNA, PGC-1α mRNA expression levels.<AbstractText Label="RESULTS">At the concentrations of 10-8, 10-7 and 10-6 mmol/L, ET-1 could induce the decrease of mitochondrial complex I and III activity, and increase of CK content in H9C2 cardiomyocytes. Moreover, with the increase of ET-1 concentration and the extension of culture time, the oxidative stress damage of cardiomyocytes became more serious. After ET-1 intervention, the expressions of p-AMPK protein, Sirt1 mRNA and PGC-1α mRNA were decreased. The 2 μmol/L GW4064 could effectively improve the oxidative stress induced by ET-1, and compared with the ET-1 group, the survival rate of H9C2 cardiomyocytes increased obviously. In addition, the CK content was decreased. On the contrary, the mitochondrial complex I and III, and CAT activity increased significantly, and the expressions of SOD1 and p-AMPK protein, Sirt1 mRNA and PGC-1α mRNA increased obviously. However, siRNA-FXR can partially block the improvement effect of FXR agonist on cardiomyocytes injury.<AbstractText Label="CONCLUSIONS">Activation of FXR receptor may reduce the damage of ET-1 on H9C2 cardiomyocytes by activating AMPK signaling pathway.
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2,334,469 |
The Emerging Role of Gut Dysbiosis in Cardio-metabolic Risk Factors for Heart Failure.
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To summarize the recent evidence that supports a role for the gut microbiota, microbiota-derived metabolites, and dysbiosis on cardiovascular risk factors, and to discuss the neuro-cardio-metabolic mechanisms that link gut microbiota and heart failure.</AbstractText>There is growing evidence that the gut microbiota communicates with and impacts the cardiovascular system, contributing to the development of heart failure once it becomes out of balance (i.e. gut dysbiosis). The exact mechanisms of how the gut microbiota influences cardiovascular outcomes are not fully understood, but immune dysregulation and disturbance of neuro-enteroendocrine hormones seem to be involved. The disturbances in the gut microbiota influence the progression of several risk factors for heart failure, including atherosclerosis, obesity, diabetes, kidney disease and hypertension. In turn, these conditions also act to regulate the gut microbiota through the deterioration of the integrity of the intestinal barrier and the release of neurotransmitters and gastrointestinal hormones. In normal and healthy physiological conditions, these interactions are homeostatic and tightly controlled. However, a combination of environmental exposures (e.g. antibiotics use and Western diet) and the host's intrinsic conditions (e.g. genetics and fluid status) can result in the breakdown of intestinal homeostasis and further progression of cardiovascular risk factors, which lead to the development of heart failure. Manipulation of the gut microbiota may have the potential to improve cardiovascular outcomes by ameliorating immune system dysregulation, enteroendocrine disruptions, and neurohormonal activation in patients with cardiovascular risk factors for heart failure.</AbstractText>
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2,334,470 |
Low intake of dietary fibre among Brazilian adolescents and association with nutritional status: cross-sectional analysis of Study of Cardiovascular Risks in Adolescents data.
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To evaluate dietary fibre intake in Brazilian adolescents and its association with nutritional status.</AbstractText>This was a cross-sectional study including data from the Brazilian multicentre Study of Cardiovascular Risks in Adolescents (ERICA). Data analysed were geographic region, sex, age, nutritional status, sexual maturation stage, socioeconomic status, school type and level of physical activity. For nutritional status classification, BMI/age was used by sex. Dietary intake was assessed by 24-h recall. Dietary fibre intake was expressed in g/d, and adequacy was determined using dietary reference intake (DRI) values. Complex sample design was considered in statistical analysis, and logistic regression was used to estimate OR for fibre intake and nutritional status.</AbstractText>Brazilian municipalities with more than 100 000 inhabitants.</AbstractText>A total of 71 740 adolescents aged 12-17 years were included.</AbstractText>The average total dietary fibre intake was 19·1 g/d (95 % CI 18·5, 19·7), and only 13·1 % (95 % CI 11·6, 14·7) of Brazilian adolescents reached the recommendations. The results of logistic regression analysis adjusted for geographic region, sex and type of school showed that overweight and obese adolescents were 1·6 and 1·8 times more likely, respectively, to have inadequate dietary fibre intake (P < 0·0001).</AbstractText>Brazilian adolescents had a significantly inadequate dietary fibre intake. This was particularly notable in adolescents with excess weight. Education policies on nutrition must be implemented, as dietary fibre plays an important role in the prevention and treatment of obesity and other chronic diseases.</AbstractText>
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2,334,471 |
Effects of reducing crude protein concentration in starter feed containing constant rumen undegradable protein on dairy calves performance.
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This study aimed at investigating the effects of decreasing crude protein (CP) in diets with constant rumen undegradable protein (RUP) content on dry matter (DM) intake, growth, feed efficiency (FE) and blood parameters in calves in a randomized complete block design. Dietary treatments included: (a) a calf starter containing 200 g/kg CP (62 g/kg RUP, based on DM), (b) a starter containing 180 g/kg CP (65 g/kg RUP, based on DM) and (c) a starter containing 160 g/kg CP (65 g/kg RUP, based on DM). A total 42 newborn male and female Holstein calves were fed 8 L milk/day until day 45, after which they were weaned and continued the experiment until day 75. Solid feed intake and total DM intake were measured daily, and body weight and skeletal growth parameters including withers height and heart girth were recorded weekly. Blood samples were collected on days 45 and 75. Solid feed intake, total DM intake, weaning weight, average daily gain from birth to weaning and from birth to 75 days, final weight and FE were not affected by the experimental treatments. In addition, skeletal growth parameters were similar among groups. Glucose concentration was similar among treatments; however, calves fed the starter containing 160 g/kg CP had significantly lower plasma concentrations of albumin and urea nitrogen compared with those fed starters containing 180 and 200 g/kg CP. These results indicate that CP level in the calf starter could be decreased to 160 g/kg DM if RUP levels stay at 65 g/kg DM, without negatively affecting feed intake and calf performance.
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2,334,472 |
miR-200b/200a/429 Cluster Stimulates Ovarian Cancer Development by Targeting ING5.
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Ovarian cancer is the second most common gynaecological malignancy, and microRNAs (miRNAs) play important role in the cancer development. Here, we found that the level of miR-200b/200a/429 was significantly increased in serum and tumor tissues of patients with stage-I ovarian cancer. Consistent with these results, we detected increased expression levels of miR-200b/200a/429 in ovarian cancer cell lines compared with the human nontumorigenic ovarian epithelial cell line T80. The overexpression of miR-200b/200a/429 in T80 cells stimulated proliferation and caused their growth in soft agar and tumor formation in nude mice. Furthermore, we determined that miR-200b/200a/429 targets inhibitor of growth family 5 (ING5) and that the overexpression of ING5 can block miR-200b/200a/429-induced T80 cell transformation and tumorigenesis. Our findings suggest that miR-200b/200a/429 may be a useful biomarker for the early detection of ovarian cancer and that miR-200b/200a/429 significantly contributes to ovarian cancer development through ING5.
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2,334,473 |
Combined spinal epidural for labour analgesia and caesarean section: indications and recommendations.
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Even if its use is scarce in most countries, many articles concerning combined spinal epidural (CSE) were published. In this review, we present the latest advances concerning CSE in obstetrics.</AbstractText>During labour, CSE improves epidural analgesia quality. Epidural with intradural opioids can produce maternal hypotension and foetal heart rate abnormalities (FHR-Ab), without increasing the caesarean section rate. For caesarean section, CSE decreases the neuraxial block failure rate, with no significant increase of complications. Epidural volume extension (EVE) after CSE for caesarean section could be an interesting option even though more evidence is needed.</AbstractText>For labour analgesia, CSE has the fastest onset time of analgesia. Its side effects have no consequences on maternal, labour or foetal outcomes. It provides better analgesia than epidural analgesia and can be used for external cephalic version and high-risk patients. For caesarean section, CSE has become the reference neuraxial technique for low-dose spinal anaesthesia, with higher success rate compared with regular spinal anaesthesia. Recent systematic revisions did not confirm this superiority. CSE offers the advantage of EVE, intraoperative top-ups, postoperative administration of neuraxial opioids and local anaesthetics. The risk of complications is balanced by the benefits of the technique.</AbstractText>
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2,334,474 |
Naltrexone as a Novel Therapeutic for Diabetic Corneal Complications.
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Diabetes is a widespread autoimmune disorder that affects nearly 10% of the adult population in the United States. In addition to the primary disease, there are numerous complications associated with inflammation including abnormalities of the heart, visual system, and peripheral nervous system. More than half of the individuals with diabetes will have one or more ocular related complications such as dry eye disease (DED), keratopathy, or retinopathy. Research over the last 3 decades has focused on the role of the opioid growth factor - opioid growth factor receptor (OGF-OGFr) axis as a regulatory system that maintains homeostasis in corneal epithelialization and tear secretion. In diabetes, OGF appears to be dysregulated resulting in decreased cell replication and increased corneal surface sensitivity. Utilization of naltrexone as a topical therapeutic to block the OGF-OGFr axis results in reversal of dry eye and restoration of corneal sensitivity and rates of corneal re-epithelialization. Naltrexone treatment at dosages that are substantially lower than systemically approved doses appear to be safe and effective therapy for corneal surface abnormalities associated with diabetes.
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2,334,475 |
Estimation of the vascular resistance amplifier in the renal vascular bed in conscious hypertensive rabbits: comparison with the total peripheral vasculature.
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The vascular amplifier in hypertension is a result of structural changes in resistance arteries. We estimated the vascular amplifier hypertensive:normotensive (H:N) ratio in the renal bed compared with the total peripheral bed in conscious rabbits during infusion of vasoconstrictor and vasodilator stimuli.</AbstractText>Rabbits were subjected to bilateral renal cellophane wrap or sham operation. A perivascular ultrasonic flow probe was implanted on the left renal artery to measure renal blood flow. A catheter was inserted into the thoracic aorta for agonist administration. Blood pressure, heart rate and renal blood flow were measured on three separate days in conscious rabbits with intact effectors, ganglionic block or neurohumoral block. Dose-response curves were constructed to intra-arterial infusion of noradrenaline, angiotensin II, adenosine and acetylcholine.</AbstractText>Resting renal vascular resistance in hypertensive rabbits was markedly decreased by ganglionic block and further by neurohumoral block. With effectors intact, ganglionic block or neurohumoral block, the H:N ratio for renal vascular resistance was 2.32, 1.72 or 1.72, respectively. The ratio was generally maintained during the infusion of constrictor and dilator drugs although distortions occurred at higher concentrations of constrictor or dilator drugs.</AbstractText>Estimation of the renal resistance amplifier in renal wrap hypertension with neurohumoral block accords with our earlier estimates of the total peripheral resistance amplifier (1.79). This vascular resistance amplifier is consistent with a decrease in internal radius through structural remodelling in the renal vascular bed as is reflected in the total arterial circulation in hypertension.</AbstractText>© 2020 The Author(s).</CopyrightInformation>
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2,334,476 |
A Randomized Controlled Comparison of Epidural Analgesia Onset Time and Adverse Reactions During Labor With Different Dose Combinations of Bupivacaine and Sufentanil.
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The purpose was to compare the effects of 3 different dose combinations of bupivacaine and sufentanil on the onset of analgesia and the occurrence of side effects.</AbstractText>One hundred sixty-nine pregnant women were randomly assigned to 3 groups: the B1S5 group received 0.1% bupivacaine+5 μg sufentanil in 15 mL; the B125S5 group received 0.125% bupivacaine+5 μg sufentanil in 15 mL; and the B1S10 group received 0.1% bupivacaine+10 μg sufentanil in 15 mL. The primary outcome was the analgesic onset time, and the secondary outcomes were mode of delivery, patient satisfaction, maternal and neonatal side effects (pruritus, hypotension, sedation, motor block, decreased fetal heart rate, fever, and interference with breastfeeding).</AbstractText>The median (inter-quartile range) time to achieve effective analgesia was significantly faster in the B125S5 group than in the B1S5 group (10 [11-14 {4-30}] min vs. 15 [17-20 {5-30}] min, P<0.001). There was no significant difference in the analgesia onset time between the B1S10 and B125S5 groups (10 [11-14 {4-30}] min vs. 12 [13-15 {3-30}] min, P=0.202). Pruritus, hypotension, motor block, maternal satisfaction, delivery mode, decreased fetal heart rate, total bupivacaine dose and breastfeeding scores were not significantly different among the 3 groups except the sufentanil dosage and incidence of mild drowsiness and fever (the B1S10 group had significantly higher fever than the other groups).</AbstractText>The B125S5 combination may be superior to the B1S5 and B1S10 combinations as an initial dose for epidural analgesia to achieve rapid effective analgesia with minimal side effects.</AbstractText>
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2,334,477 |
Loss of excitatory amino acid transporter restraint following chronic intermittent hypoxia contributes to synaptic alterations in nucleus tractus solitarii.
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Peripheral viscerosensory afferent signals are transmitted to the nucleus tractus solitarii (nTS) via release of glutamate. Following release, glutamate is removed from the extrasynaptic and synaptic cleft via excitatory amino acid transporters (EAATs), thus limiting glutamate receptor activation or over activation, and maintaining its working range. We have shown that EAAT block with the antagonist <i>threo</i>-β-benzyloxyaspartic acid (TBOA) depolarized nTS neurons and increased spontaneous excitatory postsynaptic current (sEPSC) frequency yet reduced the amplitude of afferent (TS)-evoked EPSCs (TS-EPSCs). Interestingly, chronic intermittent hypoxia (CIH), a model of obstructive sleep apnea (OSA), produces similar synaptic responses as EAAT block. We hypothesized EAAT expression or function are downregulated after CIH, and this reduction in glutamate removal contributes to the observed neurophysiological responses. To test this hypothesis, we used brain slice electrophysiology and imaging of glutamate release and TS-afferent Ca<sup>2+</sup> to compare nTS properties of rats exposed to 10 days of normoxia (Norm; 21%O<sub>2</sub>) or CIH. Results show that EAAT blockade with (3<i>S</i>)-3-[[3-[[4-(trifluoromethyl)benzoyl]-amino]phenyl]methoxy]-l-aspartic acid (TFB-TBOA) in Norm caused neuronal depolarization, generation of an inward current, and increased spontaneous synaptic activity. The latter augmentation was eliminated by inclusion of tetrodotoxin in the perfusate. TS stimulation during TFB-TBOA also elevated extracellular glutamate and decreased presynaptic Ca<sup>2+</sup> and TS-EPSC amplitude. In CIH, the effects of EAAT block are eliminated or attenuated. CIH reduced EAAT expression in nTS, which may contribute to the attenuated function seen in this condition. Therefore, CIH reduces EAAT influence on synaptic and neuronal activity, which may lead to the physiological consequences seen in OSA and CIH.<b>NEW & NOTEWORTHY</b> Removal of excitatory amino acid transporter (EAAT) restraint increases spontaneous synaptic activity yet decreases afferent [tractus solitarius (TS)]-driven excitatory postsynaptic current (EPSC) amplitude. In the chronic intermittent hypoxia model of obstructive sleep apnea, this restraint is lost due to reduction in EAAT expression and function. Thus EAATs are important in controlling elevated glutamatergic signaling, and loss of such control results in maladaptive synaptic signaling.
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2,334,478 |
Comparing the Effect of Bupivacaine and Ropivacaine in Cesarean Delivery with Spinal Anesthesia.
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Spinal anesthesia is the most common technique used for cesarean delivery due to some advantages compared to regional anesthesia. It is easily performed and provides a rapid onset of block. Though bupivacaine is a generally used long-acting amide type local anesthetic drug for spinal anesthesia, ropivacaine may sometimes be selected.</AbstractText>This prospective, randomized, double-blinded study was aimed at comparing clinical efficacy and safety between ropivacaine and bupivacaine during cesarean section.</AbstractText>After getting ethical committee approval and written informed consent, 65 women who referred to Imam Khomeini Hospital of Ahvaz, Iran in 2018 were chosen for elective cesarean delivery under spinal anesthesia. They were randomly allocated to receive either ropivacaine 1% (n = 33) or bupivacaine 0.5% (n = 32). Afterwards, the differences in the anesthetic efficacy, vital signs, and hemodynamics of participants between the two groups were recorded.</AbstractText>Duration of sensory block was shorter in the ropivacaine group than bupivacaine group (132.5 ± 21.6 min vs. 175.8 ± 26.2 min; P < 0.001). Ropivacaine also produced a shorter duration of motor blockade than bupivacaine (124.8 ± 20.2 min vs. 168.2 ± 21.7 min; P < 0.001). There is no difference between the two groups in terms of systolic and diastolic blood pressure, but the heart rate of patients in the bupivacaine group is significantly higher than the ropivacaine group.</AbstractText>The results suggest that ropivacaine and bupivacaine are two efficient drugs in anesthesia in the cesarean section, ropivacaine is a better choice due to little influence on the hemodynamics and shorter duration of sensory block and motor block which are useful for the recovery and also safe to the patients.</AbstractText>Copyright © 2020, Author(s).</CopyrightInformation>
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2,334,479 |
Identification of Novel Targets of RBM5 in the Healthy and Injured Brain.
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The tumor suppressor RNA-binding motif 5 (RBM5) regulates the expression levels and cassette exon-definition (i.e. splicing) of a select set of mRNAs in a tissue-specific manner. Most RBM5-regulated targets were identified in oncological investigations and frequently involve genes which mediate apoptotic cell death. Little is known about the role of RBM5 in the brain. Also, it is unclear if a brain injury may be required to detect RBM5 mediated effects on pro-apoptotic genes due to their low expression levels in the healthy adult CNS at baseline. Conditional/floxed (brain-specific) gene deleter mice were generated to elucidate CNS-specific RBM5 mRNA targets. Male/female mice were subjected to a severe controlled cortical impact (CCI) traumatic brain injury (TBI) in order to increase the background expression of pro-death mRNAs and facilitate testing of the hypothesis that RBM5 inhibition decreases post-injury upregulation of caspases/FAS in the CNS. As expected, a CCI increased caspases/FAS mRNA in the injured cortex. RBM5 KO did not affect their levels or splicing. Surprisingly, KO increased the mRNA levels of novel targets including casein kinase 2 alpha prime interacting protein (Csnka2ip/CKT2) - a gene not thought to be expressed in the brain, contrary to findings here. Twenty-two unique splicing events were also detected in KOs including increased block-inclusion of cassette exons 20-22 in regulating synaptic membrane exocytosis 2 (Rims2). In conclusion, here we used genome-wide transcriptomic analysis on healthy and injured RBM5 KO mouse brain tissue to elucidate the first known gene targets of this enigmatic RBP in this CNS.
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2,334,480 |
Diabetic Agents, From Metformin to SGLT2 Inhibitors and GLP1 Receptor Agonists: JACC Focus Seminar.
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Given the intersection between diabetes mellitus and cardiovascular disease (CVD), pharmacologic agents used to treat type 2 diabetes mellitus must show cardiovascular safety. Comorbid conditions, including heart failure and chronic kidney disease, are increasingly prevalent in patients with diabetes; therefore, they also play a large role in drug safety. Although biguanides, sulfonylurea, glitazones, and dipeptidyl peptidase 4 inhibitors have variable effects on cardiovascular events, sodium glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists have consistently shown safety and reduction in cardiovascular events in patients with established CVD. These medications are becoming essential tools for cardioprotection for patients with diabetes and CVD. They may also have roles in primary prevention and renal protection. This paper will review the cardiovascular impact, adverse effects, and possible mechanisms of action of pharmacologic agents used to treat patients with type 2 diabetes.
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2,334,481 |
Acute Effects of Intermittent Physical Activity on Perceptions of Exercise-Related Fatigue in Children.
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To investigate the acute effects of intermittent activity performed at varying intensities on the perceptions of exercise-related fatigue in children.</AbstractText>A total of 30 children completed 4 experimental conditions in random order, which consisted of 8 hours of sitting interrupted with 20 two-minute low-, moderate-, or high-intensity activity breaks or 20 two-minute sedentary breaks. The perceptions of exercise-related fatigue were determined via the Subjective Exercise Experience Scale at the beginning (0 breaks), middle (after 10 breaks), and end (after 20 breaks) of each condition.</AbstractText>The average heart rate was significantly higher with increasing exercise intensity (sedentary: 89.6 ± 1.2 beats/min, low: 114.6 ± 1.8 beats/min, moderate: 147.2 ± 1.8 beats/min, and high: 172.3 ± 1.8 beats/min, P < .0001). There was no significant main effect of condition (sedentary: -0.5 ± 0.6, low: -1.0 ± 0.7, moderate: -0.2 ± 0.5, and high: -0.6 ± 1.2; P = .86) and time (10-0 breaks: -0.7 ± 0.5 and 20-0 breaks: -0.5 ± 0.5; P = .45), nor time by condition interaction (P = .99) on change in exercise-related fatigue.</AbstractText>Incorporating intermittent activity into physical activity programs may help to reduce barriers to regular exercise by minimizing perceptions of exercise-related fatigue in children.</AbstractText>
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2,334,482 |
The Enhanced Liver Fibrosis test is associated with liver-related outcomes in postmenopausal women with risk factors for liver disease.
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Chronic liver disease (CLD) is usually asymptomatic but earlier detection is critical to permit life-saving interventions for those at risk due to high alcohol consumption and increased body mass index (BMI). The aim of this study was to estimate the association between the Enhanced Liver Fibrosis (ELF) test and liver-related events (LRE) and its performance in predicting LRE in postmenopausal women with risk factors in a nested case-control study within the United Kingdom Trial of Ovarian Cancer Screening (UKCTOCS).</AbstractText>In a cohort of 95,126 we performed a case-control study measuring ELF in blinded samples from 173 participants with self-reported high alcohol use and / or BMI ≥25 kg/m2</sup> comprising all 58 cases who developed LRE and 115 controls matched for age, alcohol and BMI who did not develop LRE during median follow-up of 8.5 years.</AbstractText>Using Cox regression at an ELF threshold of 10.51 hazard ratios (HR) for LRE were 4.88 (95% confidence interval (CI) 2.37-10.03) (unadjusted model) and 4.62 (95% CI 2.12-10.08) (adjusted for deprivation and self-reported hypertension, heart disease, hypercholesterolaemia and diabetes). At a threshold of 9.8 HR for LRE were 2.21 (95% CI 1.22-3.97) (unadjusted model) and 2.18 (95% CI 1.19-4.01) (adjusted). ELF was evaluated as a time dependent variable by generating time-dependent Cox models; HRs at an ELF threshold of 10.51 were 1.94 (95% CI 1.10-3.39) (unadjusted) and 2.05 (95% CI 1.16-3.64) (adjusted) and at a threshold of 9.8 HRs were 1.85 (95% CI 1.09-3.15) (unadjusted) and 1.80 (95% CI 1.04-3.13) (adjusted). Area under the receiver operating characteristic curve for recruitment ELF predicting LRE was 0.58 (95% CI 0.49-0.68), and for second subsequent ELF 0.61 (95% CI 0.52-0.71).</AbstractText>This study demonstrates the association between ELF and CLD in postmenopausal women with risk factors for liver disease, creating the opportunity to intervene to reduce liver-related mortality and morbidity. Although larger studies are required, these results demonstrate the potential of ELF as a prognostic tool in health checks in primary care.</AbstractText>This study is nested in UKCTOCS. UKCTOCS is registered as an International Standard Randomised Controlled Trial, number ISRCTN22488978. Registered 06/04/2000.</AbstractText>
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2,334,483 |
Blocking properties of terguride at the 5-HT<sub>2</sub> receptor subtypes mediating cardiovascular responses in the rat.
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In vitro studies have suggested that terguride blocks the contractile and relaxant responses produced by 5-hydroxytryptamine (5-HT) via 5-HT<sub>2A/2B</sub> receptors. This study has now investigated terguride's blocking properties on central/peripheral 5-HT<sub>2</sub> receptors in anaesthetized or pithed rats. Male Wistar anaesthetized/pithed rats were cannulated for recording blood pressure and heart rate and for i.v. administration of several compounds. In both groups of rats, i.v. bolus injections of 5-HT or (±)-DOI (a 5-HT<sub>2</sub> receptor agonist; 1-1000 μg/kg) produced dose-dependent increases in diastolic blood pressure and heart rate. These responses were dose-dependently antagonized by terguride (10-3000 μg/kg). In anaesthetized rats, i.v. bolus injections of BW723C86 (a 5-HT<sub>2B</sub> receptor agonist; 1-1000 μg/kg) produced dose-dependent increases in diastolic blood pressure and not dose-dependent increases in heart rate, while in pithed rats, these responses were attenuated. The vasopressor responses elicited by BW723C86 in anaesthetized rats were dose-dependently blocked by terguride (10-300 μg/kg), whereas its the tachycardic responses were dose-independently blocked. These results, taken together, suggest that terguride behaved as an antagonist at the 5-HT<sub>2</sub> receptors located in the central nervous system and (or) the systemic vasculature. This is the first evidence demonstrating that terguride can block central/peripheral 5-HT<sub>2</sub> receptors mediating cardiovascular responses in anaesthetized or pithed rats.
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2,334,484 |
Low-Dose Ketamine for Outpatient Hysteroscopy: A Prospective, Randomised, Double-Blind Study.
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Outpatient hysteroscopy is often accompanied by pain and discomfort along with frequent occurrence of bradycardia and hypotension. This study aimed to observe if intravenous low-dose ketamine reduces the pain scores along with lowering the incidence of bradycardia and hypotension during hysteroscopy.</AbstractText>This prospective, randomised, double-blind trial was conducted in operating rooms in a tertiary care hospital. In this study, we enrolled 72 patients with American Society of Anesthesiologists status I to II undergoing hysteroscopy. We randomised patients into two groups, and both groups received paracervical block. The control group received intravenous pentazocine and promethazine along with saline infusion. The ketamine group received ketamine infusion (0.75 mg kg-1</sup> bolus followed by infusion at the rate of 10 mcg kg-1</sup> min-1</sup>). We analysed visual analogue scale (VAS), rescue analgesic consumption, hemodynamic parameters, lowest recorded heart rate, blood pressure, level of sedation, patient's comfort, surgeon's satisfaction and nursing staff's satisfaction.</AbstractText>Analysis of the data revealed that the pain scores were similar in both the groups (p=0.493, p<0.001). Rescue analgesic was required by 47% patients in control group, compared to only 5.6% patients in ketamine group. Episodes of bradycardia and hypotension were more pronounced in the control group than in the ketamine group [77.4±10.9 vs. 78.4±5.5; 67.6±8 vs. 70.1±6 respectively] (p<0.001). Patient comfort and surgeon's satisfaction were higher in the ketamine group, but nursing satisfaction was higher in the control group. Disorientation was present in 75% patients in the ketamine group as compared to none in the control group.</AbstractText>We concluded that low-dose ketamine in day-care hysteroscopy is an effective and safe agent.</AbstractText>© Copyright 2020 by Turkish Anaesthesiology and Intensive Care Society.</CopyrightInformation>
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2,334,485 |
Toxicity of canola-derived glucosinolates in pigs fed resistant starch-based diets.
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A study was conducted to determine effects of reducing hindgut pH through dietary inclusion of high-amylose cornstarch (HA-starch) on growth performance, organ weights relative to live body weight (BW), blood thyroid hormone levels, and glucosinolate degradation products of nursery pigs fed cold-pressed canola cake (CPCC). A total of 240 pigs (initial BW: 7.1 kg), which had been weaned at 21 d of age, were housed in 40 pens (6 pigs per pen) and fed 4 diets (10 pens per diet) in a randomized complete block design for 28 d. Four diets were a basal diet with CPCC at 0 or 40%, and with HA-starch at 0 or 40% in a 2 × 2 factorial arrangement. The diets were fed in two phases: Phase 1 from day 0 to 14 and Phase 2 from day 14 to 28 and were formulated to have the same net energy, standardized ileal digestible AA, Ca, and standardized total tract digestible P contents. Dietary inclusion of CPCC and HA-starch was achieved by a partial or complete replacement of corn, soybean meal, and soy protein. At the end of the study, one pig from each pen was euthanized to determine organ weights, blood parameters, hindgut pH, and glucosinolate degradation products. Dietary CPCC reduced (P < 0.05) overall average daily gain (ADG) by 15%; increased (P < 0.05) relative weights of liver and thyroid gland by 27% and 64%, respectively; and reduced (P < 0.05) serum tetraiodothyronine (T4) level from 30.3 to 17.8 ng/mL. Heart, kidney, and gastrointestinal tract weights; serum triiodothyronine level; and hindgut pH of pigs were unaffected by dietary CPCC. Dietary HA-starch reduced (P < 0.05) overall ADG, relative weight of thyroid gland, cecal, and colonic pH; but increased (P < 0.05) relative weight of colon; tended to increase (P = 0.062) serum T4 level. Dietary CPCC and HA-starch interacted (P = 0.024) on relative weight of thyroid gland such that dietary CPCC increased (P < 0.05) weight of thyroid gland for HA-starch-free diet (120 vs. 197 mg/kg of BW) but not for HA-starch-containing diet (104 vs. 130 mg/kg of BW). Dietary CPCC and HA-starch interacted (P = 0.001) on cecal isothiocyanate content such that dietary CPCC increased (P < 0.05) level of isothiocyanates for HA-starch-containing diet but not for HA-starch-free diet. In conclusion, dietary CPCC reduced growth performance, increased liver, size and interfered with thyroid gland functions of pigs. However, the negative effects of dietary CPCC on thyroid gland functions of nursery pigs were alleviated by dietary HA-starch.
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2,334,486 |
Effectiveness, Safety, and Predictive Potential in Ultrasound-Guided Stellate Ganglion Blockades for the Treatment of Sympathetically Maintained Pain.
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Evaluating the effectiveness of stellate ganglion blockades (SGBs) proves challenging, since the criteria defining a successful blockade are controversial. This may be one reason for the scarcity of studies on this topic, thus forcing clinical guidelines to remain conservative in recommending SGBs. Moreover, factors to predict which patients will benefit from blockade series are not yet available.</AbstractText>The objectives of this study were to evaluate through a clinical approach SGBs' effectiveness performed under ultrasound guidance (us-SGB) and to identify factors to predict effectiveness.</AbstractText>We retrospectively analyzed 809 us-SGBs in 105 patients with complex regional pain syndrome (CRPS) and neuropathic pain syndromes (all potentially including sympathetically maintained pain) regarding pain reduction. Volume and type of local anesthetics, magnitude of pain, temperature of the dorsal hands, heart rate, blood pressure, and occurrence of Horner's syndrome or complications were assessed.</AbstractText>Pain reduction after a blockade series was highly significant and showed no significant correlation with change of temperature, vital signs, or Horner's syndrome. For patients with neuropathic pain, the predictive potential for pain reduction following a blockade series lies within the range of pain reduction after the first blockade. In a literature comparison, incidences of complications (hoarseness 3.9%, dysphagia 3.4%, hematoma 0.6%) were lower than in non-ultrasound-guided techniques.</AbstractText>Data indicate that us-SGBs are safe and effective in reducing sympathetically maintained pain in patients with CRPS and neuropathic pain syndromes. Pain reduction after the first blockade may predict total pain reduction after a blockade series. Other clinical measures seem unsuitable to predict effectiveness.</AbstractText>© 2020 World Institute of Pain.</CopyrightInformation>
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2,334,487 |
HMGB1 in nasal inflammatory diseases: a reappraisal 30 years after its discovery.
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High mobility group protein box 1 (HMGB1) is a protein belonging to the alarmin family. HMGB1 has a relevant role in starting the inflammatory cascade by means of receptors, such as RAGE and TLR. HMGB1 supports transcription of many genes in interactions with many transcription factors, including NF-kB. The axis HMGB1-RAGE-NF-kB has, therefore, a pivotal role in the inflammatory cascade. HMGB1 controls the production of several pro-inflammatory cytokines and the proliferation and activation of many inflammatory cells.</AbstractText>The present report concerns the role of HMGB1 in nasal inflammatory disorders, including allergic and non-allergic rhinitis, and chronic rhinosinusitis with nasal polyps. HMGB1 modulation has been the aim of several studies. The literature search included recent papers that covered this topic.</AbstractText>As HMGB1 has a pivotal role in inflammatory events, its modulation could be attractive for designing new therapeutic strategies. In this regard, glycyrrhetic acid (GA), the active component of Glycyrrhiza glabra</i>, can efficiently block HMGB1. Promising reports seem to suggest that GA could exert favorable anti-inflammatory activity in patients with nasal inflammatory disorders.</AbstractText>
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2,334,488 |
Effects of deep neuromuscular block on surgical workspace conditions in laparoscopic bariatric surgery: a systematic review and meta-analysis of randomized controlled trials.
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It has been hypothesized that routine use of deep neuromuscular block (dNMB) is advisable in laparoscopic bariatric surgery to optimize workspace conditions. dNMB seems to have advantages in laparoscopic procedures on non-obese patients as it improves surgical space conditions and reduces postoperative pain scores. This systematic review and meta-analysis aimed at comparing the impact of deep vs. moderate NMB (mNMB) on surgical conditions and outcomes, including duration of surgery and postoperative pain in patients undergoing laparoscopic bariatric surgery.</AbstractText>Studies were identified from Medline, Embase and Cochrane library (update: Sep 1, 2019). Randomized controlled trials (RCTs) comparing dNMB with mNMB were identified if they reported surgeon satisfaction for workspace conditions (primary outcome). The effects of dNMB on surgery duration and postoperative pain (secondary outcomes) were also investigated.</AbstractText>Of the 45 retrieved records, four were finally included. dNMB improved the surgeon's satisfaction score about workspace (on a scale ranging from 1 to 5), with a mean difference (MD) of 0.52 (95% CI: 0.36-0.68). Surgical duration was not affected by block level (MD: -3.29 minutes; 95% CI: from -14.35 to 7.76). Only one study showed that dNMB also decreased postoperative pain.</AbstractText>It was found that dNMB helps improve surgical space conditions in patients undergoing laparoscopic bariatric surgery whereas it fails to shorten procedure duration. More high-quality large-sampled RCTs are needed to confirm these results. The relationship between dNMB use and other clinical outcomes, such as complications occurrence, needs to be further investigated.</AbstractText>
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2,334,489 |
Robotic Staged Bilateral Selective Postganglionic Sympathectomy for Upper-Extremity Hyperhidrosis.
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The prevalence of compensatory hyperhidrosis (CH) has been reported to be as high as 80% in patients following thoracic sympathectomy for upper-extremity hyperhidrosis. The CH rate is 7.2% with simultaneous bilateral robotic selective dorsal sympathectomy. We reviewed the results in patients who underwent staged bilateral robotic selective dorsal sympathectomy (SBRSS).</AbstractText>A case series analysis of patients who underwent SBRSS was performed. A surgical robot was used to divide the postganglionic sympathetic fibers and communicating rami to intercostal nerves 2, 3, and 4. The sympathetic chain was left intact. The operation was performed on the dominant side, and the same procedure was then performed on the contralateral side after 4 weeks. The success of the sympathectomy was determined by intraoperative temperature measurement, patient interviews, and the Hyperhidrosis Disease Severity Scale.</AbstractText>There were 47 patients (22 men, 25 women), with a mean age of 22 ± 3 years. Minor complications were seen in 4% of patients. One patient had transient heart block. One patient had transient partial Horner's syndrome. Forty percent of patients had transient CH after the first surgery, and 45% had transient CH after sympathectomy on the contralateral side. There were no deaths. The median hospitalization was 3 days. At a mean follow-up of 28 ± 6 months, 46/47 patients (98%) had sustained relief of hyperhidrosis. In one patient (1/47, 2%), hyperhidrosis recurred on the first operated side. One patient (2%) exhibited sustained CH.</AbstractText>SBRSS is associated with a lower rate of CH than when the procedure is performed bilaterally in a simultaneous fashion. This procedure is associated with the lowest reported rate of CH.</AbstractText>
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2,334,490 |
Berberine Hampers Influenza A Replication through Inhibition of MAPK/ERK Pathway.
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Berberine (BBR) is an isoquinoline alkaloid which exhibits a variety of biological and therapeutic properties, and has been reported by some to block replication of the influenza virus. However, contradictory results have also been presented, and the mechanistic explanation is lacking.</AbstractText>A panel of cell lines (Madin-Darby canine kidney (MDCK), adenocarcinoma human alveolar basal epithelial cells (A549), lung epithelial type I (LET1)) and primary human airway epithelial cells (HAE) susceptible to influenza virus infection were infected with a seasonal influenza A virus in the presence or absence of BBR. Cytotoxicity towards cell lines was measured using XTT assay. The yield of the virus was analyzed using RT-qPCR. To study the molecular mechanism of BBR, confocal microscopy and Western blot analyses of cellular fractions were applied.</AbstractText>Our results show cell-type-dependent anti-influenza properties of BBR in vitro which suggests that the compound acts on the cell and not the virus. Importantly, BBR hampers influenza replication in primary human airway epithelium 3D cultures that mimic the natural replication site of the virus. Studies show that the influenza A virus upregulates the mitogen-activated protein kinase/extracellular signal-related kinase (MAPK/ERK) pathway and hijacks this pathway for nucleolar export of the viral ribonucleoprotein. Our results suggest that BBR interferes with this process and hampers influenza A replication.</AbstractText>
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2,334,491 |
Inhibitory Effective Perturbations of Cilobradine (DK-AH269), A Blocker of HCN Channels, on the Amplitude and Gating of Both Hyperpolarization-Activated Cation and Delayed-Rectifier Potassium Currents.
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Cilobradine (CIL, DK-AH269), an inhibitor of hyperpolarization-activated cation current (<i>I</i><sub>h</sub>), has been observed to possess pro-arrhythmic properties. Whether and how CIL is capable of perturbing different types of membrane ionic currents existing in electrically excitable cells, however, is incompletely understood. In this study, we intended to examine possible modifications by it or other structurally similar compounds of ionic currents in pituitary tumor (GH<sub>3</sub>) cells and in heart-derived H9c2 cells. The standard whole-cell voltage-clamp technique was performed to examine the effect of CIL on ionic currents. GH<sub>3</sub>-cell exposure to CIL suppressed the density of hyperpolarization-evoked <i>I</i><sub>h</sub> in a concentration-dependent manner with an effective IC<sub>50</sub> of 3.38 μM. Apart from its increase in the activation time constant of <i>I</i><sub>h</sub> during long-lasting hyperpolarization, the presence of CIL (3 μM) distinctly shifted the steady-state activation curve of <i>I</i><sub>h</sub> triggered by a 2-s conditioning pulse to a hyperpolarizing direction by 10 mV. As the impedance-frequency relation of <i>I</i><sub>h</sub> was studied, its presence raised the impedance magnitude at the resonance frequency induced by chirp voltage. CIL also suppressed delayed-rectifier K<sup>+</sup> current (<i>I</i><sub>K(DR)</sub>) followed by the accelerated inactivation time course of this current, with effective IC<sub>50</sub> (measured at late <i>I</i><sub>K(DR)</sub>) or <i>K</i><sub>D</sub> value of 3.54 or 3.77 μM, respectively. As the CIL concentration increased 1 to 3 μM, the inactivation curve of <i>I</i><sub>K(DR)</sub> elicited by 1- or 10-s conditioning pulses was shifted to a hyperpolarizing potential by approximately 10 mV, and the recovery of <i>I</i><sub>K(DR)</sub> inactivation during its presence was prolonged. The peak Na<sup>+</sup> current (<i>I</i><sub>Na</sub>) during brief depolarization was resistant to being sensitive to the presence of CIL, yet to be either decreased by subsequent addition of A-803467 or enhanced by that of tefluthrin. In cardiac H9c2 cells, unlike the CIL effect, the addition of either ivabradine or zatebradine mildly led to a lowering in <i>I</i><sub>K(DR)</sub> amplitude with no conceivable change in the inactivation time course of the current. Taken together, the compound like CIL, which was tailored to block hyperpolarization-activated cation (HCN) channels effectively, was also capable of altering the amplitude and gating of <i>I</i><sub>K(DR)</sub>, thereby influencing the functional activities of electrically excitable cells, such as GH<sub>3</sub> cells.
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2,334,492 |
ApoA-1 improves glucose tolerance by increasing glucose uptake into heart and skeletal muscle independently of AMPKα<sub>2</sub>.<Pagination><StartPage>100949</StartPage><MedlinePgn>100949</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">100949</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.molmet.2020.01.013</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S2212-8778(20)30021-1</ELocationID><Abstract><AbstractText Label="OBJECTIVE">Acute administration of the main protein component of high-density lipoprotein, apolipoprotein A-I (ApoA-1), improves glucose uptake in skeletal muscle. The molecular mechanisms mediating this are not known, but in muscle cell cultures, ApoA-1 failed to increase glucose uptake when infected with a dominant-negative AMP-activated protein kinase (AMPK) virus. We therefore investigated whether AMPK is necessary for ApoA-1-stimulated glucose uptake in intact heart and skeletal muscle in vivo.</AbstractText><AbstractText Label="METHODS">The effect of injection with recombinant human ApoA-1 (rApoA-1) on glucose tolerance, glucose-stimulated insulin secretion, and glucose uptake into skeletal and heart muscle with and without block of insulin secretion by injection of epinephrine (0.1 mg/kg) and propranolol (5 mg/kg), were investigated in 8 weeks high-fat diet-fed (60E%) wild-type and AMPKα<sub>2</sub> kinase-dead mice in the overnight-fasted state. In addition, the effect of rApoA-1 on glucose uptake in isolated skeletal muscle ex vivo was studied.</AbstractText><AbstractText Label="RESULTS">rApoA-1 lowered plasma glucose concentration by 1.7 mmol/l within 3 h (6.1 vs 4.4 mmol/l; p < 0.001). Three hours after rApoA-1 injection, glucose tolerance during a 40-min glucose tolerance test (GTT) was improved compared to control (area under the curve (AUC) reduced by 45%, p < 0.001). This was accompanied by an increased glucose clearance into skeletal (+110%; p < 0.001) and heart muscle (+100%; p < 0.001) and an increase in glucose-stimulated insulin secretion 20 min after glucose injection (+180%; p < 0.001). When insulin secretion was blocked during a GTT, rApoA-1 still enhanced glucose tolerance (AUC lowered by 20% compared to control; p < 0.001) and increased glucose clearance into skeletal (+50%; p < 0.05) and heart muscle (+270%; p < 0.001). These improvements occurred to a similar extent in both wild-type and AMPKα<sub>2</sub> kinase-dead mice and thus independently of AMPKα<sub>2</sub> activity in skeletal- and heart muscle. Interestingly, rApoA-1 failed to increase glucose uptake in isolated skeletal muscles ex vivo.</AbstractText><AbstractText Label="CONCLUSIONS">In conclusion, ApoA-1 stimulates in vivo glucose disposal into skeletal and heart muscle independently of AMPKα<sub>2</sub>. The observation that ApoA-1 fails to increase glucose uptake in isolated muscle ex vivo suggests that additional systemic effects are required.</AbstractText><CopyrightInformation>Copyright © 2020 The Author(s). Published by Elsevier GmbH.. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Fritzen</LastName><ForeName>Andreas Mæchel</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Section of Molecular Physiology, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Domingo-Espín</LastName><ForeName>Joan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Experimental Medical Science, Lund University, S-221 84, Lund, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lundsgaard</LastName><ForeName>Anne-Marie</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Section of Molecular Physiology, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kleinert</LastName><ForeName>Maximilian</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Section of Molecular Physiology, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark; Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Zentrum München, German Research Center for Environmental Health, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Israelsen</LastName><ForeName>Ida</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Section of Molecular Physiology, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carl</LastName><ForeName>Christian S</ForeName><Initials>CS</Initials><AffiliationInfo><Affiliation>Section of Molecular Physiology, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nicolaisen</LastName><ForeName>Trine S</ForeName><Initials>TS</Initials><AffiliationInfo><Affiliation>Section of Molecular Physiology, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kjøbsted</LastName><ForeName>Rasmus</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Section of Molecular Physiology, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jeppesen</LastName><ForeName>Jacob F</ForeName><Initials>JF</Initials><AffiliationInfo><Affiliation>Global Drug Discovery, Novo Nordisk Cambridge, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wojtaszewski</LastName><ForeName>Jørgen F P</ForeName><Initials>JFP</Initials><AffiliationInfo><Affiliation>Section of Molecular Physiology, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lagerstedt</LastName><ForeName>Jens O</ForeName><Initials>JO</Initials><AffiliationInfo><Affiliation>Department of Experimental Medical Science, Lund University, S-221 84, Lund, Sweden; Lund Institute of Advanced X-ray and Neutron Science (LINXS), Lund, Sweden. Electronic address: [email protected].</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kiens</LastName><ForeName>Bente</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Section of Molecular Physiology, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark. Electronic address: [email protected].</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>03</Month><Day>04</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Mol Metab</MedlineTA><NlmUniqueID>101605730</NlmUniqueID><ISSNLinking>2212-8778</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C505693">APOA1 protein, human</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D016632">Apolipoprotein A-I</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D001786">Blood Glucose</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007328">Insulin</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D011994">Recombinant Proteins</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 2.7.11.1</RegistryNumber><NameOfSubstance UI="C534978">AMPK alpha2 subunit, mouse</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 2.7.11.31</RegistryNumber><NameOfSubstance UI="D055372">AMP-Activated Protein Kinases</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D055372" MajorTopicYN="N">AMP-Activated Protein Kinases</DescriptorName><QualifierName UI="Q000235" MajorTopicYN="N">genetics</QualifierName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016632" MajorTopicYN="N">Apolipoprotein A-I</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001786" MajorTopicYN="N">Blood Glucose</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D059305" MajorTopicYN="N">Diet, High-Fat</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005951" MajorTopicYN="N">Glucose Tolerance Test</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007328" MajorTopicYN="N">Insulin</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000078790" MajorTopicYN="N">Insulin Secretion</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="N">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D051379" MajorTopicYN="N">Mice</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008810" MajorTopicYN="N">Mice, Inbred C57BL</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008822" MajorTopicYN="N">Mice, Transgenic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018482" MajorTopicYN="N">Muscle, Skeletal</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009206" MajorTopicYN="N">Myocardium</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011994" MajorTopicYN="N">Recombinant Proteins</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015398" MajorTopicYN="N">Signal Transduction</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="Y">drug effects</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">AMP-Activated protein kinase (AMPK)</Keyword><Keyword MajorTopicYN="N">Apolipoprotein A-1 (ApoA-1)</Keyword><Keyword MajorTopicYN="N">Glucose uptake</Keyword><Keyword MajorTopicYN="N">Insulin</Keyword><Keyword MajorTopicYN="N">Metabolism</Keyword><Keyword MajorTopicYN="N">Skeletal muscle</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>10</Month><Day>2</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>1</Month><Day>3</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>1</Month><Day>24</Day></PubMedPubDate><PubMedPubDate 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AMP-activated protein kinase: the current landscape for drug development. Nature Reviews Drug Discovery. 2019 10-0019.</Citation><ArticleIdList><ArticleId IdType="pubmed">30867601</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32243875</PMID><DateRevised><Year>2020</Year><Month>04</Month><Day>03</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1556-3871</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Mar</Month><Day>13</Day></PubDate></JournalIssue><Title>Heart rhythm</Title><ISOAbbreviation>Heart Rhythm</ISOAbbreviation></Journal>Permanent conduction system pacing for congenitally corrected transposition of the great arteries: A Pediatric and Congenital Electrophysiology Society (PACES)/International Society for Adult Congenital Heart Disease (ISACHD) Collaborative Study.
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Acute administration of the main protein component of high-density lipoprotein, apolipoprotein A-I (ApoA-1), improves glucose uptake in skeletal muscle. The molecular mechanisms mediating this are not known, but in muscle cell cultures, ApoA-1 failed to increase glucose uptake when infected with a dominant-negative AMP-activated protein kinase (AMPK) virus. We therefore investigated whether AMPK is necessary for ApoA-1-stimulated glucose uptake in intact heart and skeletal muscle in vivo.</AbstractText>The effect of injection with recombinant human ApoA-1 (rApoA-1) on glucose tolerance, glucose-stimulated insulin secretion, and glucose uptake into skeletal and heart muscle with and without block of insulin secretion by injection of epinephrine (0.1 mg/kg) and propranolol (5 mg/kg), were investigated in 8 weeks high-fat diet-fed (60E%) wild-type and AMPKα2</sub> kinase-dead mice in the overnight-fasted state. In addition, the effect of rApoA-1 on glucose uptake in isolated skeletal muscle ex vivo was studied.</AbstractText>rApoA-1 lowered plasma glucose concentration by 1.7 mmol/l within 3 h (6.1 vs 4.4 mmol/l; p < 0.001). Three hours after rApoA-1 injection, glucose tolerance during a 40-min glucose tolerance test (GTT) was improved compared to control (area under the curve (AUC) reduced by 45%, p < 0.001). This was accompanied by an increased glucose clearance into skeletal (+110%; p < 0.001) and heart muscle (+100%; p < 0.001) and an increase in glucose-stimulated insulin secretion 20 min after glucose injection (+180%; p < 0.001). When insulin secretion was blocked during a GTT, rApoA-1 still enhanced glucose tolerance (AUC lowered by 20% compared to control; p < 0.001) and increased glucose clearance into skeletal (+50%; p < 0.05) and heart muscle (+270%; p < 0.001). These improvements occurred to a similar extent in both wild-type and AMPKα2</sub> kinase-dead mice and thus independently of AMPKα2</sub> activity in skeletal- and heart muscle. Interestingly, rApoA-1 failed to increase glucose uptake in isolated skeletal muscles ex vivo.</AbstractText>In conclusion, ApoA-1 stimulates in vivo glucose disposal into skeletal and heart muscle independently of AMPKα2</sub>. The observation that ApoA-1 fails to increase glucose uptake in isolated muscle ex vivo suggests that additional systemic effects are required.</AbstractText>Copyright © 2020 The Author(s). Published by Elsevier GmbH.. All rights reserved.</CopyrightInformation>
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2,334,493 |
A New Paroxetine-Based GRK2 Inhibitor Reduces Internalization of the <i>μ</i>-Opioid Receptor.
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G protein-coupled receptor (GPCR) kinases (GRKs) play a key role in terminating signals initiated by agonist-bound GPCRs. However, chronic stimulation of GPCRs, such as that which occurs during heart failure, leads to the overexpression of GRKs and maladaptive downregulation of GPCRs on the cell surface. We previously reported the discovery of potent and selective families of GRK inhibitors based on either the paroxetine or <b>GSK180736A</b> scaffold. A new inhibitor, <b>CCG258747</b>, which is based on paroxetine, demonstrates increased potency against the GRK2 subfamily and favorable pharmacokinetic parameters in mice. <b>CCG258747</b> and the closely related compound <b>CCG258208</b> also showed high selectivity for the GRK2 subfamily in a kinome panel of 104 kinases. We developed a cell-based assay to screen the ability of <b>CCG258747</b> and 10 other inhibitors with different GRK subfamily selectivities and with either the paroxetine or <b>GSK180736A</b> scaffold to block internalization of the <i>μ</i>-opioid receptor (MOR). <b>CCG258747</b> showed the best efficacy in blocking MOR internalization among the compounds tested. Furthermore, we show that compounds based on paroxetine had much better cell permeability than those based on <b>GSK180736A</b>, which explains why <b>GSK180736A</b>-based inhibitors, although being potent in vitro, do not always show efficacy in cell-based assays. This study validates the paroxetine scaffold as the most effective for GRK inhibition in living cells, confirming that GRK2 predominantly drives internalization of MOR in the cell lines we tested and underscores the utility of high-resolution cell-based assays for assessment of compound efficacy. SIGNIFICANCE STATEMENT: G protein-coupled receptor kinases (GRKs) are attractive targets for developing therapeutics for heart failure. We have synthesized a new GRK2 subfamily-selective inhibitor, <b>CCG258747</b>, which has nanomolar potency against GRK2 and excellent selectivity over other kinases. A live-cell receptor internalization assay was used to test the ability of GRK2 inhibitors to impart efficacy on a GRK-dependent process in cells. Our data indicate that <b>CCG258747</b> blocked the internalization of the <i>μ</i>-opioid receptor most efficaciously because it has the ability to cross cell membranes.
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2,334,494 |
The Importance of Sleep Fragmentation on the Hemodynamic Dipping in Obstructive Sleep Apnea Patients.
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Obstructive sleep apnea (OSA) has been associated with non-dipping blood pressure (BP). The precise mechanism is still under investigation, but repetitive oxygen desaturation and arousal induced sleep fragmentation are considered the main contributors.</AbstractText>We analyzed beat-to-beat measurements of hemodynamic parameters (HPs) during a 25-min period of wake-sleep transition. Differences in the mean HP values for heart rate (HR), systolic BP (SBP), and stroke volume (SV) during wake and sleep and their standard deviations (SDs) were compared between 34 controls (C) and 22 OSA patients. The Student's t</i>-test for independent samples and the effect size by Cohen's d</i> (d) were calculated. HP evolution was investigated by plotting the measured HP values against each consecutive pulse wave. After a simple regression analysis, the calculated coefficient beta (SCB) was used to indicate the HP evolution. We furthermore explored by a hierarchical block regression which variables increased the prediction for the SCB: model 1 BMI and age, model 2 + apnea/hypopnea index (AHI), and model 3 + arousal index (AI).</AbstractText>Between the two groups, the SBP increased in OSA and decreased in C resulting in a significant difference (p</i> = 0.001; d</i> = 0.92). The SV demonstrated a similar development (p</i> = 0.047; d</i> = 0.56). The wake/sleep variation of the HP measured by the SD was higher in the OSA group-HR: p</i> < 0.001; d</i> = 1.2; SBP: p</i> = 0.001; d</i> = 0.94; and SV: p</i> = 0.005; d</i> = 0.82. The hierarchical regression analysis of the SCB demonstrated in SBP that the addition of AI to AHI resulted in ΔR</i> 2</sup>: +0.163 and ΔF + 13.257 (p</i> = 0.001) and for SV ΔR</i> 2</sup>: +0.07 and ΔF 4.83 (p</i> = 0.003). The AI but not the AHI remained statistically significant in the regression analysis model 3-SBP: β = 0.717, p</i> = 0.001; SV: β = 0.469, p</i> = 0.033.</AbstractText>In this study, we demonstrated that in OSA, the physiological dipping in SBP and SV decreased, and the variation of all investigated parameters increased. Hierarchical regression analysis indicates that the addition of the AI to BMI, age, and AHI increases the prediction of the HP evolution following sleep onset for both SBP and SV and may be the most important variable.</AbstractText>Copyright © 2020 Staats, Barros, Fernandes, Grencho, Reis, Matos, Valença, Marôco, de Almeida and Bárbara.</CopyrightInformation>
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2,334,495 |
Arthroscopic Iliac Bone Block Augmentation for Glenoid Reconstruction: Transglenoid Fixation Technique Using an All-Suture Anchor.
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Arthroscopic Bankart repair of anterior instability has shown relatively good results, but its effectiveness is unclear in cases wherein there is a bone defect in the glenoid bone. The surgical management of recurrent anterior shoulder instability with severe glenoid bone loss has been challenging until now. Therefore the Latarjet procedure was introduced as an alternative that provided good results in cases of full instability with a bone defect. In cases of recurrent anterior shoulder instability, bone defects are often present within the glenoid. To restore glenohumeral stability, a bone augmentation procedure is required, and the Latarjet procedure to use bony transfer from the coracoid is the most popular technique. However, resorption of the bone graft with metal screw protrusion is a serious concern, whereas the relative contribution of the dynamic sling effect of the Latarjet procedure remains controversial. The Latarjet procedure also destroys the normal kinematics, resulting in side effects such as scapular dyskinesia. Here we introduce an arthroscopic anterior bone block procedure for reconstructing anterior glenoid bone defects using an autologous iliac crest graft. This technique enables precise bone block placement and fixation using one all-suture anchor instead of screw fixation.
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2,334,496 |
Micra leadless pacemaker retrieval in a pediatric patient.
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We present a case of a 13-year old patient with partially reversibly post-operative heart block who underwent leadless pacemaker placement. After post-anesthesia wretching/gagging episode she developed device microdislodgement and increased/intolerable capture thresholds. The device was removed and another placed with adequate thresholds for good longevity.
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2,334,497 |
Safety and immunogenicity of the tetravalent, live-attenuated dengue vaccine Butantan-DV in adults in Brazil: a two-step, double-blind, randomised placebo-controlled phase 2 trial.
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The Butantan Institute has manufactured a lyophilised tetravalent live-attenuated dengue vaccine Butantan-DV, which is analogous to the US National Institutes of Health (NIH) TV003 admixture. We aimed to assess the safety and immunogenicity of Butantan-DV.</AbstractText>We did a two-step, double-blind, randomised placebo-controlled phase 2 trial at two clinical sites in São Paulo, Brazil. We recruited healthy volunteers aged 18-59 years; pregnant women, individuals with a history of neurological, heart, lung, liver or kidney disease, diabetes, cancer, or autoimmune diseases, and individuals with HIV or hepatitis C were excluded. Step A was designed as a small bridge-study between Butantan-DV and TV003 in DENV-naive participants. In step A, we planned to randomly assign 50 dengue virus (DENV)-naive individuals to receive two doses of Butantan-DV, TV003, or placebo, given 6 months apart. In step B, we planned to randomly assign 250 participants (DENV-naive and DENV-exposed) to receive one dose of Butantan-DV or placebo. Participants were randomly assigned, by computer-generated block randomisation (block sizes of five); participants in step A were randomly assigned (2:2:1) to receive Butantan-DV, TV003, or placebo and participants in step B were randomly assigned (4:1) to receive Butantan-DV or placebo. Participants and study staff were unaware of treatment allocation. The primary safety outcome was the frequency of solicited and unsolicited local and systemic adverse reactions within 21 days of the first vaccination, analysed by intention to treat. The primary immunogenicity outcome was seroconversion rates of the DENV-1-4 serotypes measured 91 days after the first vaccination, analysed in the per-protocol population, which included all participants in step A, and all participants included in step B who completed all study visits with serology sample collection. This trial is registered with ClinicalTrials.gov, NCT01696422.</AbstractText>Between Nov 5, 2013, and Sept 21, 2015, 300 individuals were enrolled and randomly assigned: 155 (52%) DENV-naive participants and 145 (48%) DENV-exposed participants. Of the 155 DENV-naive participants, 97 (63%) received Butantan-DV, 17 (11%) received TV003, and 41 (27%) received placebo. Of the 145 DENV-exposed participants, 113 (78%) received Butantan-DV, three (2%) received TV003, and 29 (20%) received placebo. Butantan-DV and TV003 were both immunogenic, well-tolerated, and no serious adverse reactions were observed. In step A, rash was the most frequent adverse event (16 [845] of 19 participants in the Butantan-DV group and 13 [76%] of 17 participants in the TV003 group). Viraemia was similar between the Butantan-DV and TV003 groups. Of the 85 DENV-naive participants in the Butantan-DV group who attended all visits for sample collection for seroconversion analysis and thus were included in the per-protocol analysis population, 74 (87%) achieved seroconversion to DENV-1, 78 (92%) to DENV-2, 65 (76%) to DENV-3, and 76 (89%) to DENV-4. Of the 101 DENV-exposed participants in the Butantan-DV group who attended all visits for sample collection for seroconversion analysis, 82 (81%) achieved seroconversion to DENV-1, 79 (78%) to DENV-2, 83 (82%) to DENV-3, and 78 (77%) to DENV-4.</AbstractText>Butantan-DV and TV003 were safe and induced robust, balanced neutralising antibody responses against the four DENV serotypes. Efficacy evaluation of the Butantan-DV vaccine is ongoing.</AbstractText>Intramural Research Program US NIH National Institute of Allergy and Infectious Diseases, Brazilian National Bank for Economic and Social Development, Fundação de Amparo à Pesquisa do Estado de São Paulo, and Fundação Butantan.</AbstractText>Copyright © 2020 Elsevier Ltd. All rights reserved.</CopyrightInformation>
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2,334,498 |
Pectoral nerve blocks decrease postoperative pain and opioid use after pacemaker or implantable cardioverter-defibrillator placement in children.
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Pectoral nerve blocks (PECs) can reduce intraprocedural anesthetic requirements and postoperative pain. Little is known about the utility of PECs in reducing pain and narcotic use after pacemaker (PM) or implantable cardioverter-defibrillator (ICD) placement in children.</AbstractText>The purpose of this study was to determine whether PECs can decrease postoperative pain and opioid use after PM or ICD placement in children.</AbstractText>A single-center retrospective review of pediatric patients undergoing transvenous PM or ICD placement between 2015 and 2020 was performed. Patients with recent cardiothoracic surgery or neurologic/developmental deficits were excluded. Demographics, procedural variables, postoperative pain, and postoperative opioid usage were compared between patients who had undergone PECs and those who had undergone conventional local anesthetic (Control).</AbstractText>A total of 74 patients underwent PM or ICD placement; 20 patients (27%) underwent PECs. There were no differences between PECs and Control with regard to age, weight, gender, type of device placed, presence of congenital heart disease, type of anesthesia, procedural time, or complication rates. Patients who underwent PECs had lower pain scores at 1, 2, 6, 18, and 24 hours compared to Control. PECs patients had a lower mean cumulative pain score [PECs 1.5 (95% confidence interval [CI] 0.8-2.2) vs Control 3.1 (95% CI 2.7-3.5); P <.001] and lower total opioid use [PECs 6.0 morphine milligram equivalent (MME)/m2</sup> (95% CI 3.4-8.6) vs Control 15.0 MME/m2</sup> (95% CI 11.8-18.2); P = .001] over the 24 hours postimplant.</AbstractText>PECs reduce postoperative pain scores and lower total opioid usage after ICD or PM placement. PECs should be considered at the time of transvenous device placement in children.</AbstractText>Copyright © 2020 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
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2,334,499 |
The physiological and biochemical effects of gaming: A review.
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Recreational, seated video gaming (gaming) has become a favorite pastime of children, adolescents, and adults (gamers) in developed countries. Some engage in gaming behavior for more than 6 h daily, which can subsequently lead to less time spent being physically active. Gaming can potentially have a serious impact on the physiology and biochemistry of gamers and can influence both short-term and long-term health. The aim of this review was to provide an overview of what is known about how gaming affects physiological and biochemical parameters in the human body and how studies have previously been designed and to discuss how studies can be designed moving forward.</AbstractText>The literature search included material from three scientific databases (PubMed, EMBASE, and Web of Science) using a two-block search strategy. To be included in this review, studies had to investigate a biochemical or physiological aspect of sedentary, video game-related activities. Studies that investigated neurological, psychologic or musculoskeletal outcomes along with physiological or biochemical outcomes in gaming were eligible for inclusion. Studies regarding psychiatric conditions were excluded as this subject was outside the scope of this review. Additionally, non-English language articles were excluded.</AbstractText>A total of 5417 articles were screened, 138 studies from the literature search and 4 studies from reference lists were selected for further evaluation. The studies were evaluated based on their abstracts or full texts, and 51 studies were eventually included in the review. Thirty-seven studies included physiological results, seven studies included biochemical results, and seven studies included both. Several outcomes such as heart rate, blood pressure, blood glucose levels, and cortisol levels, were the subjects of a large number of investigations.</AbstractText>This field is heterogenic and does not lend itself to firm conclusions. Tentatively, it seems reasonable to conclude that heart rate variability studies show that gaming increases activity in the sympathetic nervous system. More high-quality studies are required, and the lack of studies using uniform, standardized designs and realistic gaming sessions (i.e., longer than 30 min) limits our current knowledge.</AbstractText>Copyright © 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
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