Infective Endocarditis After Percutaneous Device Closure of Atrial Septal Defects: Incidence, Diagnosis, and Treatment. Case Report and Literature Review.

Infective endocarditis (IE) on atrial septal defect (ASD) closure devices, while extremely rare, has been reported to be more frequent early after the procedure. We describe a case of late IE after percutaneous closure of patent foramen ovale (PFO). We also performed a literature review on this subject. We reviewed a total of 42,365 patients who were treated with percutaneous devices: 13,916 for ostium secundum (OS) (32%), 24,726 for PFO (58%) and 3,723 for OS+PFO (8%). Among these patients, we identified 50 cases of IE after atrial septal defect device closure (0.001%). In contrast to previous reports, nearly 66% of IE in this setting occurred late, after at least 6 months from the procedure (33/50 patients). A statistical analysis clearly showed that the mean time from the procedure to IE increased in the last five years, probably associated with a change in antiplatelet therapy after ASD closure. Management of IE on an ASD occluder should always be discussed in the setting of a multidisciplinary heart team that includes a cardiologist, cardiac surgeon, and anesthetist. While surgical strategies gave excellent results, conservative management might be considered in cases of small IE vegetations and for patients in good general condition. However, in these cases, the patient must be closely observed with repeated blood and instrumental tests.

Successful rescue of an apocrine gland carcinoma metastatic to the cervical lymph nodes by mitoxantrone coupled with trains of permeabilizing electrical pulses (electrochemotherapy).

Canine apocrine gland carcinoma is a locally aggressive neoplasm that can occasionally lead to metastatic spread, thus mimicking the behavior of their human counterpart. In this paper we describe the successful treatment of a cervical metastatic spread of this neoplasia by using mitoxantrone selectively driven within the tumor cells by trains of biphasic pulses. The dog experienced tumor reduction from the first cycle of electrochemotherapy (ECT) and complete remission by the time of its fourth session. Neither systemic or local toxicities were detected during the whole course of therapy. The dog is in complete remission after six months from his last treatment. Electrochemotherapy is a safe and efficacious therapy for metastatic carcinoma and warrants further investigation.

A new biotin derivative-DOTA conjugate as a candidate for pretargeted diagnosis and therapy of tumors.

The synthesis of a new biotin derivative, the (CO) reduced N-aminohexyl biotinamido derivative, designed to be serum biotinidase resistant, and its conjugation to the chelator DOTA through an amide bond at one of the four carboxymethyl chains are described. The (90)Y-labeled conjugate was able to bind avidin at different Av/conjugate molar ratios with good results. The preclinical results indicate that this new biotin-DOTA conjugate is a good candidate for pretargeted diagnosis and therapy of tumors.