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Patterson Dixon posted an update 6 months, 2 weeks ago
Arrhythmia-induced cardiomyopathy (AIC) is characterized by improvement in left ventricular ejection fraction (LVEF) following arrhythmia treatment. Predictors of recovery in LVEF are not well understood.
We evaluated predictors of AIC recovery in a large multicenter cohort.
In total, 243 patients (age 65 ± 11, 73% male) with AIC caused by atrial fibrillation (49%), atrial tachycardia (20%), and premature ventricular contractions (PVCs; 31%) were treated and included. LVEF was assessed before and after treatment. Patients were stratified by arrhythmia duration (known vs. unknown ), arrhythmia type, LVEF, and presence of structural heart disease (SHD).
Arrhythmia treatment was rhythm control in 95%. Median arrhythmia duration in the KN group was 47 months (25-75th percentile, 24-80 months). Post treatment LVEF was higher in KN group (55.9 ± 7 vs. 46.2 ± 12%; p < .0001) but the degree of LVEF improvement was similar (21.2 ± 9 vs. 19.4 ± 11; p = .16). Comparing highest quareatment.
There are no commercially available handheld blood creatinine analyzers validated in goats.
The objective of the study was to validate the accuracy of a handheld point-of-care (POC) analyzer (Nova StatSensor) for quantifying blood creatinine concentration in goats. A secondary objective was to compare this POC against a chemistry analyzer to classify goats as normal or having mild or moderate azotemia.
Sixty-three goats admitted to a referral hospital.
Cross-sectional study. Venous blood was obtained, and creatinine concentration was measured by the POC in duplicate. Plasma was submitted for creatinine determination via the chemistry analyzer (gold standard).
A total of 101 blood samples were collected from 63 goats. There was high repeatability for creatinine concentrations obtained by the POC (adjusted R
= .97, P < .0001). Correlation of POC concentrations with those reported by the chemistry analyzer was moderate (adjusted R
= .57, P < .0001). When correctly categorizing goats with mild azotemia, the POC demonstrated a sensitivity of 73.3% and a specificity of 88.3%. For moderate to severe azotemia, the POC had a sensitivity of 75.0% and specificity of 97.5%.
The Nova StatSensor POC provided above average accuracy for measuring blood creatinine concentration in goats compared with the gold standard test.
The Nova StatSensor POC provided above average accuracy for measuring blood creatinine concentration in goats compared with the gold standard test.For decades, basic research on the underlying mechanisms of nociception has held promise to translate into efficacious treatments for patients with pain. Despite great improvement in the understanding of pain physiology and pathophysiology, translation to novel, effective treatments for acute and chronic pain has however been limited, and they remain an unmet medical need. In this opinion paper bringing together pain researchers from very different disciplines, the opportunities and challenges of translational pain research are discussed. The many factors that may prevent the successful translation of bench observations into useful and effective clinical applications are reviewed, including interspecies differences, limited validity of currently available preclinical disease models of pain, and limitations of currently used methods to assess nociception and pain in non-human and human models of pain. Many paths are explored to address these issues, including the backward translation of observations made in patients and human volunteers into new disease models that are more clinically relevant, improved generalization by taking into account age and sex differences, and the integration of psychobiology into translational pain research. Finally, it is argued that preclinical and clinical stages of developing new treatments for pain can be improved by better preclinical models of pathological pain conditions alongside revised methods to assess treatment-induced effects on nociception in human and non-human animals. Significance For decades, basic research of the underlying mechanisms of nociception has held promise to translate into efficacious treatments for patients with pain. Despite great improvement in the understanding of pain physiology and pathophysiology, translation to novel, effective treatments for acute and chronic pain has however been limited, and they remain an unmet medical need.
Expanded carrier screening (ECS) utilizes high-throughput next-generation sequencing to evaluate an individual’s carrier status for multiple conditions. Combined malonic and methylmalonic aciduria (CMAMMA) due to ACSF3 deficiency is a rare inherited disease included in such screening panels. Some cases have been reported with metabolic symptoms in childhood yet other cases describe a benign clinical course, suggesting the clinical phenotype is not well defined.
Clinical and laboratory findings during the prenatal period were obtained retrospectively from medical records.
A 37-year-old nulliparous woman and her partner were each identified as carriers of ACSF3 variants and presented at 9weeks gestation for prenatal genetic consultation. The couple received extensive genetic counseling and proceeded with chorionic villus sampling at 11weeks gestation. selleck chemicals Subsequent analysis confirmed that the fetus inherited both parental ACSF variants. The couple was devastated by the results and after reviewing options of pregnancy continuation and termination, they decided to terminate the pregnancy. Following this decision, the patient was diagnosed with acute stress disorder.
This case highlights how expanded carrier screening adds complexity to reproductive decision-making. Stronger guidelines and additional research are needed to direct and evaluate the timing, composition, and implementation of ECS panels.
This case highlights how expanded carrier screening adds complexity to reproductive decision-making. Stronger guidelines and additional research are needed to direct and evaluate the timing, composition, and implementation of ECS panels.