The Aortix device: Support in a tube.

The use of percutaneous mechanical support devices is becoming more embedded within the therapeutic armamentarium for patients presenting with decompensated heart failure, cardiogenic shock, and patients undergoing high risk PCI. The Aortix device offers a new approach to percutaneous support that appears to be safe to implement and overcomes some of the drawbacks of the extant devices. Further investigation remains warranted to evaluate its ultimate utility and place among the approach to the patient in need of circulatory support.

Waiting for Godot: Anticipating answers on embolic protection unlikely to arrive.

For symptomatic and asymptomatic patient with high or intermediate risk of CEA complications, CAS with the use of EPDs has a very low rate of in-hospital stroke and death There is no statistically significant difference in ipsilateral stroke/TIA and any stroke/TIA between the different device platforms Further efforts to assess differences between EPD devices would likely need to involve a surrogate endpoint due to the very low rates of clinical events.

Sites of colonization in hospitalized patients with infections caused by extended-spectrum beta-lactamase organisms: a prospective cohort study.

BACKGROUND: The objective of this study was to determine whether patients infected with extended-spectrum beta-lactamase (ESBL)-producing organisms are colonized at multiple body sites. METHODS: This was a prospective cohort study at a tertiary care center in Beirut, Lebanon. Hospitalized patients with infections caused by ESBL-producing organisms were included. Cultures were obtained from the primary site of infection as well as from other sites (skin, nasopharynx, urine, rectum). Molecular analysis was performed on isolates to determine clonal relatedness. RESULTS: One hundred patients were included in the study. Only 22 patients had positive cultures from sites other than the primary site of infection. The most common ESBL gene was CTX-M-15 followed by TEM-1. In 11 of 22 patients, isolates collected from the same patient were 100% genetically related, while in the remaining patients, genomic relatedness ranged from 42.9% to 97.1%. CONCLUSIONS: Colonization at sites other than the primary site of infection was not common among our patient population infected with ESBL-producing organisms. The dynamics of transmission of these bacterial strains should be studied in further prospective studies to determine the value of routine active surveillance and the need for expanded precautions in infected and colonized patients.