Daily rhythms of left atrial pressure in beagle dogs with mitral valve regurgitation.

BACKGROUND: Mitral valve regurgitation (MR) causes increased left atrial pressure (LAP) and is associated with occurrence of clinical signs. It will be useful to understand diurnal variations of LAP for the management of MR. HYPOTHESIS: Circulatory parameters and diurnal rhythm are linked to clinical signs in cardiac diseases. LAP also exhibits a diurnal rhythm in dogs with MR. ANIMALS: Five healthy Beagle dogs weighing 9.8-12.8 kg (3 males and 2 females; aged 2 years) were used. METHODS: A radiotelemetry system for continuous measurement of LAP was used in this study. Rupture of the chordae tendineae was experimentally induced via left atriotomy, and a transmitter catheter was inserted into the left atrium. The body of the transmitter was implanted SC. After clinical condition was stabilized, the severity of MR was evaluated by echocardiography, and LAP was recorded for 72 consecutive hours for the analysis of diurnal variation. RESULTS: Abrupt increases in LAP, which averaged 16.7 mmHg, were observed at feeding periods. In contrast, strong diurnal LAP variations were found, with a significant but slight increase in daytime LAP compared with nighttime LAP. CONCLUSIONS AND CLINICAL IMPORTANCE: Diurnal LAP is characterized by a slight but significant nocturnal decrease and abrupt increases in response to excitation. The latter seemed to be more important considering the relationship with clinical manifestations. The clinical relevance of exercise restriction in the management of MR was acknowledged.

Efficacy of open patch-grafting under cardiopulmonary bypass for pulmonic stenosis in small dogs.

OBJECTIVE: To assess the efficacy of an open patch-graft technique under cardiopulmonary bypass (CPB) in small dogs. DESIGN AND METHODS: A retrospective analysis of 10 dogs with pulmonic stenosis. Records between 1992 and 2002 were reviewed. The effect of surgical correction was evaluated and perioperative parameters were compared between survivors and non-survivors. RESULTS: The postoperative pulmonary pressure gradient was reduced in all seven surviving patients. Mean +/- SE was 21.5 +/- 7.4 mmHg (range 3.0-54.2 mmHg) and 6/7 dogs were < 40 mmHg at 3 months postoperatively. Comparing the data between those patients that survived and those that did not, the preoperative pressure gradient (P = 0.04) and volume of the Glucose-Insulin-Kalium solution used (P = 0.001) were significantly higher in those that did not survive. CONCLUSION: Open patch-grafting can be performed in small-breed dogs and decreased the pulmonary pressure gradient in survivors at 3 months postoperatively. However, this technique is more invasive than balloon valvuloplasty and should be used cautiously in severely stenosed patients.

Development, content validity, and cross-cultural adaptation of a patient-reported outcome measure for real-time symptom assessment in irritable bowel syndrome.

BACKGROUND: End-of-day questionnaires, which are considered the gold standard for assessing abdominal pain and other gastrointestinal (GI) symptoms in irritable bowel syndrome (IBS), are influenced by recall and ecological bias. The experience sampling method (ESM) is characterized by random and repeated assessments in the natural state and environment of a subject, and herewith overcomes these limitations. This report describes the development of a patient-reported outcome measure (PROM) based on the ESM principle, taking into account content validity and cross-cultural adaptation. METHODS: Focus group interviews with IBS patients and expert meetings with international experts in the fields of neurogastroenterology & motility and pain were performed in order to select the items for the PROM. Forward-and-back translation and cognitive interviews were performed to adapt the instrument for the use in different countries and to assure on patients' understanding with the final items. KEY RESULTS: Focus group interviews revealed 42 items, categorized into five domains: physical status, defecation, mood and psychological factors, context and environment, and nutrition and drug use. Experts reduced the number of items to 32 and cognitive interviewing after translation resulted in a few slight adjustments regarding linguistic issues, but not regarding content of the items. CONCLUSIONS AND INFERENCES: An ESM-based PROM, suitable for momentary assessment of IBS symptom patterns was developed, taking into account content validity and cross-cultural adaptation. This PROM will be implemented in a specifically designed smartphone application and further validation in a multicenter setting will follow.

Effects of seven months' exposure to a static 0.2 T magnetic field on growth and glycolytic activity of human gingival fibroblasts.

Human gingival fibroblasts in confluent cultures were continuously exposed to a static 0.2 T magnetic field for 6 or 8 months. Culture flasks were not changed during the exposure, but culture medium was renewed. After dilution and mixing of the cultures surviving intact, field-exposed and sham-exposed cultures received further field- or sham-exposure on Sm-Co blocks. Rate of cell proliferation, histogram of the nuclear DNA content, rates of lactate production and glucose consumption and the ATP content were determined and cell morphology was investigated by both light- and electron-microscopy. Results show no marked differences between exposed and control cells.

THE TRIBES AND TRIBULATIONS OF LARYNGOPHARYNGEAL REFLUX: A REVIEW OF RECENT STUDIES WITH IMPLICATIONS FOR INTERDISCIPLINARY COLLABORATIONS BETWEEN OTOLARYNGOLOGISTS AND GASTROENTEROLOGISTS.

Laryngopharyngeal reflux has been recognized since 2006 (Montreal Consensus) as an extradigestive manifestation of gastroesophageal reflux disease. However, despite numerous research studies, the relationship between these two pathologies is yet to be fully understood. The aim of this paper is to review the literature of the last five years available via the PubMed database, looking at the controversies about the prevalence, pathophysiology and diagnosis of laryngopharyngeal reflux.

Tuberculosis of the larynx: clinical aspects in 19 patients.

Laryngeal tuberculosis continues to exist in spite of extensive tuberculosis eradication campaigns. We present 19 cases of laryngeal tuberculosis seen in our institution between 1982 and 1987. From the clinical findings it is clear that the localization of the lesions has changed since the preantibiotic era. Today the spread appears to be mainly via lymphatic and hematogenic routes, as opposed to the direct spread more common previously. The fibrosis caused by the lesions is incapacitating and frequently requires surgical correction.

Effects of time-varying electromagnetic fields on K+ (Rb+) fluxes and surface charge of HeLa cells.

The magnetic flux density was varied intermittently from 0.35 to 1.77T and from 0.07 to 1.54 or 1.77T by manual and automatic switchings, respectively, of the power source of an electromagnet. The durations of the "switching-on time" and "-off time" were varied but kept equal. An electric eddy current induced in the culture medium by changes in the magnetic flux density was simulated. When the durations were shorter than 10s, ouabain-sensitive Rb+ influx (active K+ influx) into cultured HeLa cells was significantly inhibited, but the ouabain-insensitive Rb+ influx (passive K+ influx) was not influenced significantly. Inhibition of active Rb+ influx increased with time during exposure for 2 h. Conversely, K+ efflux from the cells was significantly stimulated by the exposure. Microfluorometric examinations of cells loaded with the fluorescent pH indicator 4-heptadecyl-7-hydroxycoumarin (6 microM) and the membrane potential indicator diS-C3-(5) (1 microM) suggested increase in the negative charge on the cell surface during exposure. The observed changes in the K+ (Rb+) fluxes would be related to change in the electric properties of the cell surface caused by exposure to intermittent electromagnetic fields.

[Breech presentation. Management at the Dr. "Dario Fernández" Hospital]. / Presentación pélvica. Manejo en el hospital Dr. "Dario Fernández", ISSSTE.

The management of 73 breech presentation was reviewed, in order to see if cesarean section and adequate maneuvers improve, maternal or fetal outcome. From 33 to 36 weeks of gestational age, were 19.2%; from 37 to 42 weeks, 80.8%. Nulliparous, 53.4%; multiparous, 46.6%. Maternal morbidity was 15%; mortality, of zero. Fetal weight, 2500 to 3500 gm, 69.9%. Apgar scores at five minutes of 7 or more, were 90.5%. Adequate maneuvers during cesarean section with Apgar scores of seven o more, 97%; inadequate maneuvers, 62%. Fetal morbidity was 9.5%; and zero mortality. Congenital abnormalities, 6.8%. In conclusion, cesarean section and adequate maneuvers, improve perinatal outcome, in the breech presentation.