Gallium-67 Single-Photon Emission Computed Tomography Affects Management of Infections of Left Ventricular Assist Devices.

Our institution employs gallium-67 single-photon emission computed tomography low-dose CT (Ga-SPECT-CT) to determine the presence and extent of left ventricular assist device (LVAD) infections. We present a retrospective single-center study of 41 LVAD recipients who underwent Ga-SPECT-CT from January 2011 to June 2018 to determine whether Ga-SPECT-CT led to changes in antimicrobial therapy, LVAD revision or exchange, or application for 1A exception. The average age was 56.6 years, predominantly male (80.5%) and diabetic (68.3%), divided between ischemic (48.8%) and nonischemic (51.2%) cardiomyopathy. The majority had HeartMate II devices (82.9%). Device-related infections were classified as possible (12.2%), probable (36.6%), proven (36.6%), or rejected (14.6%). Sensitivity was 68.6% and specificity was 100%. Most VAD-specific infections were percutaneous deep driveline infections (DRIs) (34.1%), and VAD-related infections were primarily bloodstream infections (31.7%). Staphylococcus aureus was the major pathogen isolated. Gallium-67 single-photon emission computed tomography low-dose CT resulted in changes in management in more than half (53.7%) of patients: starting (24.4%) or stopping (17.1%) antimicrobial therapy, LVAD revision (22.0%) or exchange (12.2%), and the application for 1A exception for transplant listing (17.1%). We conclude that Ga-SPECT-CT is an effective modality for determining the presence and extent of LVAD DRIs, and contributed to a change in management in more than half of cases.

Organization and morphology of thalamocortical neurons of mouse ventral lateral thalamus.

The ventral lateral nucleus of the thalamus (VL) serves as a central integrative center for motor control, receiving inputs from the cerebellum, striatum, and cortex and projecting to the primary motor cortex. We aimed to determine the somatotopy and morphological features of the thalamocortical neurons within mouse VL. Retrograde tracing studies revealed that whisker-related VL neurons were found relatively anterior and medial to those labeled following injection of retrograde tracer into hindpaw motor areas. Simultaneous injections of fluorescent microspheres in both cortical regions did not result in double-labeled neurons in VL. Quantitative analysis of dendritic and somatic morphologies did not reveal any differences between hindpaw and whisker thalamocortical neurons within VL. The morphology of the thalamocortical neurons within mouse VL is similar to those in other mammals and suggests that mouse can be used as a model system for studying thalamocortical transformations within the motor system as well as plasticity following sensory deprivation or enrichment.