• Mayer James posted an update 6 months, 3 weeks ago

    We demonstrated that PRL up-regulated phospho-JAK2, phsopho-STAT5 and β-casein expression, whereas LPS caused the opposite effects, and activated SOCS3. SOCS3 overexpression interrupted the JAK2-STAT5 pathway in BMECs. With SOCS3 was silenced, LPS could not activate the JAK2-STAT5 pathway, and no inhibition of β-casein expression was observed. In conclusion, we showed that LPS activated SOCS3 in BMECs, antagonized the JAK2-STAT5 pathway via SOCS3 regulation, and ultimately reduced β-casein expression in these cells.Intracardiac cement embolism (ICE) after percutaneous vertebroplasty is a rare, but dangerous complication, and guiding principles for its management are not well described. The management of this present case of ICE offers insight to facilitate the treatment decision making process in symptomatic patients requiring extraction.

    Safe introduction of novel mechanical circulatory support (MCS) devices into clinical practice is a challenging process. Single-arm trials using a control arm from existing database is an effective alternative that could be applied for regulatory approval. This study analyzes the capability of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database to establish objective performance criteria and select patient population that could be used for future single-arm MCS trials.

    Patients with INTERMACS profiles IM1-2 and IM3-5, who underwent implant of isolated Left Ventricular Assist Devises between 2014-2017 were included. Both cohorts were further stratified into Shock and Non-Shock groups using surrogate markers of shock (ECMO, temporary VAD, vasopressor infusions). Survival, transplant rates, adverse events, 6 min walk test and quality of life measures were obtained for all 4 groups at 6 and 12 months.

    Total of 7,907 patients were divided into IM1-2(n=3,909), IM3-5(n=3,998), Shock(n=3,469) and Non-Shock(n=3,040). Re-categorization occurred in 11% of patients from the IM3-5 group into the Shock group. Overall, patients in the Shock group had similar outcomes to the IM 1-2 group (1-year survival 86% vs 85%, p=0.74). Patients in the Non-Shock group also had similar outcomes to the IM 3-5 (1-year survival 90% vs 90%, p=0.43).

    INTERMACS database can successfully establish objective performance criteria and concurrent control group for single-arm trials that could be used to support regulatory approval of new, less invasive MCS. CRT0066101 purchase INTERMACS data allows reliable comparisons of outcomes and adverse events.

    INTERMACS database can successfully establish objective performance criteria and concurrent control group for single-arm trials that could be used to support regulatory approval of new, less invasive MCS. INTERMACS data allows reliable comparisons of outcomes and adverse events.We present the case of a 20-year-old male presenting a right lower intralobar pulmonary “horseshoe” sequestration extending into the left cavity supplied by four aberrant arteries from the thoracic descending aorta. The surgical approach for this exceptional and challenging presentation was based on thorough analysis of the chest CT scan aided by 3D reconstructions. The latter helped us better understand this complex malformation. Surgery was done by robot-assisted bilateral approach with en bloc extraction through the left side.

    In recent years, increased attention has turned towards the risk of chronic opioid usage following surgery. In this nationwide cohort study, we examined the rate of new persistent opioid use following cardiac surgery via sternotomy.

    All opioid-naïve patients undergoing heart surgery via sternotomy from 2005 to 2018 in Iceland, were included in the study. Naivety was defined as not filling an opioid prescription within six months preoperatively. Persistent opioid use was defined as filling of at least one opioid prescription during the first 90 days after surgery and another between 90-180 days after the operation. In addition to estimating the incidence of new persistent opioid use, differences in patient characteristics, survival and readmission rates were compared between the group with and without new persistent opioid use.

    Of 1,227 patients that underwent cardiac surgery via sternotomy during the study period, 925 were included in the study. Of those, 4.6% developed new persistent opioid use. When only patients who filled an opioid prescription postoperatively were included, 10.1% developed new persistent opioid use. Chronic obstructive pulmonary disease, preoperative usage of NSAIDs, gabapentinoids, and nitrates were associated with increased risk of new persistent opioid use. Patients with new persistent opioid use had neither higher rates of readmission nor all-cause mortality.

    The rate of new persistent opioid use following cardiac surgery was 4.6%. Future steps should identify strategies to minimize the development of new persistent opioid use.

    The rate of new persistent opioid use following cardiac surgery was 4.6%. Future steps should identify strategies to minimize the development of new persistent opioid use.

    Lung transplantation is the definitive surgical treatment for end-stage lung disease. However, infants comprise less than 5% of pediatric cases. We sought to provide an overview of infant lung transplantation outcomes over the past three decades using linked United Network for Organ Sharing (UNOS) and Pediatric Health Information System (PHIS) data.

    Infants undergoing lung transplant from 1989-2020 in UNOS were reviewed. UNOS and PHIS records for patients transplanted from 1995-2020 were linked using date of birth, gender, and date of surgery ± 3 days. We assessed underlying diagnoses, pre- and post-transplant extracorporeal membrane oxygenation support, re-transplant-free survival to discharge, hospital experience (≥1 annual transplant for ≥4 years in a five-year period), operative decade, bronchiolitis obliterans syndrome, long-term survival, and functional status at latest follow-up.

    112 lung transplants were performed in 109 infants over 31 years. 21 patients died pre-discharge, and 2 were re-transplanted during the same admission. We linked 80.6% (83/103) of UNOS and PHIS records. Hospital survival was lower for infants with idiopathic pulmonary hypertension and those transplanted at less experienced centers. All seven infants requiring postoperative extracorporeal membrane oxygenation support died. Median freedom from bronchiolitis obliterans syndrome was 8.1 (4.6-11.6) years. Following discharge, median survival was 10.3 (6.3-14.4) years, with improved ten-year survival for those transplanted from 2010-2020 (87.3%) versus 2000-2009 (52.4%, p=0.098) and 1989-1999 (34.1%, p=0.004). 84.6% (33/39) of survivors had minor or no restrictions at latest follow-up.

    Carefully selected infants experience promising short- and long-term outcomes following lung transplant.

    Carefully selected infants experience promising short- and long-term outcomes following lung transplant.

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