Bertelsenherskind1772

Background There are limited data regarding differences in vascular responses between first-generation sirolimus-eluting stents (1G-SES) and bare-metal stents (BMS) >10 years after implantation. Methods and Results We retrospectively investigated 223 stents (105 1G-SES, 118 BMS) from 131 patients examined by optical coherence tomography (OCT) >10 years after implantation. OCT analysis included determining the presence or absence of a lipid-laden neointima, calcified neointima, macrophage accumulation, malapposition, and strut coverage. Neoatherosclerosis was defined as having lipid-laden neointima. OCT findings were compared between the 1G-SES and BMS groups, and the predictors of neoatherosclerosis were determined. The median stent age at the time of OCT examinations was 12.3 years (interquartile range 11.0-13.2 years). There were no significant differences in patient characteristics between the 1G-SES and BMS groups. On OCT analysis, there was no difference in the prevalence of neoatherosclerosis and calcification between 1G-SES and BMS. Multivariable logistic regression analysis revealed that stent size, stent length, and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use were significant predictors of neoatherosclerosis. In addition, uncovered and malapposed struts were more prevalent with 1G-SES than BMS. Conclusions After >10 years since implantation, the prevalence of neoatherosclerosis was no different between 1G-SES and BMS, whereas uncovered struts and malapposition were significantly more frequent with 1G-SESs.Background We hypothesized that symptom presentation in patients with acute myocardial infarction (AMI) may affect their management and subsequent outcome. Methods and Results Using Rural AMI Registry data, 1,337 consecutive patients with AMI who underwent percutaneous coronary intervention were analyzed. Typical symptoms were defined as any symptoms of chest pain or pressure due to myocardial ischemia. We considered the specific symptoms of dyspnea, nausea, or vomiting as atypical symptoms. The primary outcome was 30-day mortality. There were 150 (11.2%) and 1,187 (88.8%) patients who presented with atypical and typical symptoms, respectively. read more Those who presented with atypical symptoms were significantly older (mean [±SD] age 74±12 vs. 68±13 years; P less then 0.001) and had a higher Killip class (46.7% vs. 21.8%; P less then 0.001) than patients presenting with typical symptoms. The prevalence of door-to-balloon time of ≤90 min was significantly lower in patients with atypical than typical symptoms (40.0% vs. 66.3%; P less then 0.001). At 30 days, there were 55 incidents of all-cause death. Multivariate Cox proportional hazards regression analysis revealed that symptom presentation was associated with 30-day mortality (hazard ratio 2.33; 95% confidence interval 1.20-4.38; P less then 0.05). Conclusions Atypical symptoms in patients with AMI are less likely to lead to timely reperfusion and are associated with increased risk of 30-day mortality.Background The impact of preprocedural visit-to-visit blood pressure variability (BPV) on pulmonary vein isolation (PVI) outcome in patients with hypertension (HTN) and atrial fibrillation (AF) remains unclear. Methods and Results This study enrolled 138 AF patients with HTN who underwent successful PVI. Patients were classified into 2 groups, those with AF recurrence (AF-Rec; n=42) and those without AF recurrence (No-AF-Rec; n=96). Blood pressure (BP) was measured at least 3 times during sinus rhythm, and systolic and diastolic BPV (Sys-BPV and Dia-BPV, respectively) were defined as the standard deviation of BP. Clinical characteristics were compared between the 2 groups, and the relationship between BPV and AF recurrence was investigated. Sys-BPV and Dia-BPV were significantly higher in the AF-Rec than No-AF-Rec group (Sys-BPV 10.6±3.7 vs. 6.9±3.5; Dia-BPV 7.3±3.1 vs. 4.8±3.0; P5.7 were independent predictors of AF recurrence (hazard ratios 3.736 and 2.958, respectively; P less then 0.05 for both). Conclusions Sys-BPV and Dia-BPV were associated with AF recurrence in AF patients with HTN.COVID-19 has proven itself to be one of the most important events of the last two centuries. This defining moment in our lives has created wide-ranging discussions in many segments of our societies, both politically and socially. Over time, the pandemic has been associated with many social and political topics, as well as sentiments and emotions. Twitter offers a platform to understand these effects. The primary objective of this study is to capture the awareness and sentiment about COVID-19-related issues and to find how they relate to the number of cases and deaths in a representative region of the United States. The study uses a unique dataset consisting of over 46 million tweets from over 91,000 users in 88 counties of the state of Ohio, a state-of-the-art deep learning model to measure and detect awareness and emotions. The data collected is analyzed using OLS regression and System-GMM dynamic panel. Findings indicate that the pandemic has drastically changed the perception of the Republican party in the society. Individual motivations are strongly influenced by ideological choices and this ultimately affects individual pandemic-related outcomes. The paper contributes to the literature by expanding the knowledge on COVID-19 (i), offering a representative result for the United States by focusing on an "average" state like Ohio (ii), and incorporating the sentiment and emotions into the calculation of awareness (iii).

Spinal muscular atrophy (SMA) is defined as a neuromuscular disorder induced by progressive weakness of the skeletal muscle and is usually accompanied by progressive spinal deformity including scoliosis. The newly developed Nusinersen, which is the first approved drug worldwide for SMA, requires accurate intrathecal injection, which is sometimes difficult in patients with severe spinal deformity.

For an accurate intrathecal approach in patients who have spinal fusion surgery to treat neuromuscular scoliosis, we have combined an L3 laminectomy with spinal correction and fusion surgery. Here, we review four cases of SMA in patients who underwent the additional L3 laminectomy during surgery to treat spinal scoliosis. A successful intrathecal approach was made using fluoroscopic guidance in all four patients, who were then administered with Nusinersen.

Our findings show that additional lumbar laminectomy during surgery for spinal scoliosis has effectively allowed for intrathecal injection of Nusinersen.

Our findings show that additional lumbar laminectomy during surgery for spinal scoliosis has effectively allowed for intrathecal injection of Nusinersen.