Safety and Effectiveness of Advanced Retrieval Techniques for Inferior Vena Cava Filters Compared with Standard Retrieval Techniques: A Systematic Review of the Literature and Meta-Analysis.

PURPOSE: To investigate the pooled safety and effectiveness of advanced retrieval techniques for inferior vena cava (IVC) filters compared with standard retrieval techniques through a systematic review of the literature and meta-analysis. MATERIALS AND METHODS: A systematic search of retrievable IVC filters between 1980 and 2020 was conducted. Studies were included if both standard and advanced retrieval techniques were utilized in the same cohort, retrieval success rates and adverse event rates were described for each technique, and advanced techniques were employed after the failure of standard techniques. Study heterogeneity was assessed by the I2 statistic. The outcomes included retrieval success rates and adverse event rates for standard and advanced retrieval techniques. RESULTS: Of 1,631 articles, 21 (1%) studies met inclusion criteria. The study heterogeneity was high with an I2 of 98%. The pooled random-effects outcomes included an overall standard retrieval success rate of 76% (95% confidence interval [CI], 65%-84%), with minor and major adverse event rates of 1% (95% CI, 0%-1%) and 1% (95% CI, 0%-1%), respectively. The overall pooled advanced retrieval success rates were 90% (95% CI, 82%-94%), with minor and major adverse event rates of 5% (95% CI, 2%-9%) and 4% (95% CI, 2%-6%), respectively. The standard retrievals were 16% less likely (risk ratio) to be successful (95% CI, 32% less likely to 4% more likely; P = .11). The major and minor adverse event rates were 88% and 84% less likely in standard retrievals compared with advanced retrievals, respectively (95% CI, 86%-94%; P < .0001; 95% CI, 70%-91%; P < .0001). CONCLUSIONS: Advanced retrieval techniques for IVC filters permit a higher retrieval success rate with low adverse event rates in cases of standard retrieval failure.

Effect of chronic perinatal hypoxia on the role of rho-kinase in pulmonary artery contraction in newborn lambs.

Exposure to chronic hypoxia during gestation predisposes infants to neonatal pulmonary hypertension, but the underlying mechanisms remain unclear. Here, we test the hypothesis that moderate continuous hypoxia during gestation causes changes in the rho-kinase pathway that persist in the newborn period, altering vessel tone and responsiveness. Lambs kept at 3,801 m above sea level during gestation and the first 2 wk of life were compared with those with gestation at low altitude. In vitro studies of isolated pulmonary arterial rings found a more forceful contraction in response to KCl and 5-HT in high-altitude compared with low-altitude lambs. There was no difference between the effects of blockers of various pathways of extracellular Ca(2+) entry in low- and high-altitude arteries. In contrast, inhibition of rho-kinase resulted in significantly greater attenuation of 5-HT constriction in high-altitude compared with low-altitude arteries. High-altitude lambs had higher baseline pulmonary artery pressures and greater elevations in pulmonary artery pressure during 15 min of acute hypoxia compared with low-altitude lambs. Despite evidence for an increased role for rho-kinase in high-altitude arteries, in vivo studies found no significant difference between the effects of rho-kinase inhibition on hypoxic pulmonary vasoconstriction in intact high-altitude and low-altitude lambs. We conclude that chronic hypoxia in utero results in increased vasopressor response to both acute hypoxia and serotonin, but that rho-kinase is involved only in the increased response to serotonin.

Optoperforation of single, intact Arabidopsis cells for uptake of extracellular dye-conjugated dextran.

A plant science research goal is to manipulate single cells in an intact organism in order to study their interactions with neighboring cells. Based on a technique previously demonstrated in isolated plant cells, mammalian cells and cyanobacteria, Arabidopsis epidermal cells were optoperforated to allow for uptake of external cascade blue-labeled dextrans. Adverse organelle responses were determined to be minimal and dye retention was demonstrated for at least 72 hours. This technique overcomes the physical challenges presented by the plant cell wall and demonstrates the feasibility of in situ optoperforation.

Tobacco smoking and its consequences on reproductive health: the impact of a lifestyle choices including cigarette smoke exposure on fertility and birth defects.

There are several life style choices which may impact fertility and thus national birth rate. Epidemiological cohort studies indicates that modification of life style habits, among them nicotine consumption can influence reproductive health. Influence of tobacco smoking on reproductive health has to be analyzed within the context of the influence of body mass index, caffeine and alcohol consumption, exercise, maternal and paternal age, and stress. Approximately 27% Polish women and 23% Americans smoke cigarettes during their reproductive years. Cohort studies directly showed the relationship between nicotine consumption and decrease in fertility among smoking women. Besides there is evidence that smoking leads to higher rate of congenital heart defects, limbs abnormalities, central nervous malformations among infants born to smoking mothers. Finally, the relationship between smoking and decreased fertility should be of great concern since Polish fertility rate has dropped from 1989 till 2007 year from 2,1 to 1,27 respectively. Programs focused on improvement in national birth rate should focus also on decrease smoking rates among women.

Diaphragmatic Injury with Empyema Development after Microwave Ablation of a Liver Dome Lesion.

Percutaneous microwave ablation (MWA) of the liver is a minimally invasive procedure that utilizes high frequency electromagnetic waves to generate heat and induce tumor necrosis. MWA has been proven to be a safe and effective treatment option for primary and metastatic liver tumors. The treatment of liver dome lesions can present a technical challenge due to the proximity of the hepatic dome to the diaphragm and lung parenchyma. In this report, we present a case of diaphragmatic injury and subsequent empyema following MWA of a liver dome lesion.

The impact of second-hand tobacco smoke exposure on pregnancy outcomes, infant health, and the threat of third-hand smoke exposure to our environment and to our children.

Smoking during pregnancy is associated with various adverse effects on pregnancy and fetal development, carries a lot of serious complications such as spontaneous abortion, placental abruption, and reduced birth weight of the newborn. Children of smoking mothers have an increased risk of premature birth, low birth weight, sudden infant death syndrome and respiratory diseases during infancy. Smoking also causes long-term risk of maternal health problems such as: heart disease, cancer, emphysema, chronic obstructive pulmonary disease and higher mortality rate. Because women are more likely to quit smoking during pregnancy than at any other time, there are attempts to increase motivation and help them to stop smoking at the procreative phase of their life. The article describes interventions that are carried out in Loma Linda, where the educational program "When You Smoke Your Baby Smokes" reminds parents about the health effects of smoking during pregnancy and harmful impact on child's health caused by second-hand smoke. Another threat to health and environment of our children, is the nicotine coming from indirect exposure to tobacco smoke. Residual nicotine that persists in high concentrations on the interior surfaces, including clothing, is forming in the reaction of nitric acid carcinogenic compounds of specific nitrosamines. In addition, ozone and related atmospheric oxidants react with nicotine smoke or smoke coming from the second-hand smoke, giving the smallest particles with high risk of asthma. Efforts towards reducing exposure to tobacco smoke coming from the passive and indirect smoking should be placed at a high priority throughout the European Union.

Depolarization-dependent contraction increase after birth and preservation following long-term hypoxia in sheep pulmonary arteries.

Membrane depolarization is critical to pulmonary arterial (PA) contraction. Both L-type Ca(2+) channels (Ca(L)) and Rho-kinase are important signaling components of this process and mitochondrial and non-mitochondrial generated superoxides can be part of the signaling process. Maturation and long-term hypoxia (LTH) each can modify depolarization-dependent contraction and the role of superoxides. By the use of wire myography, we tested the hypothesis that maturation and LTH increase pulmonary arterial reactivity to high-K(+)-induced membrane depolarization through enhancements in the importance of Ca(L)and Rho-kinase-dependent pathways. The data show that maturation, but not LTH, increases contraction to 125 mM KCl (high-K(+)) without altering the EC(50). High-K(+)-dependent contraction was inhibited to a similar extent in fetal and adult PA by multiple Ca(L) blockers, including 10 µM diltiazem, 10 µM verapamil, and 10 µM nifedipine. Postnatal maturation increased the role for 10 µM nifedipine-sensitive Ca(L), and decreased that for 10 µM Y-27632-sensitive Rho-kinase. In all groups, the combination of nifedipine and Y-27632 effectively inhibited high-K(+) contraction. Tempol (3 mM) but not 100 µM apocynin slightly reduced contraction in arteries from fetal hypoxic and adult normoxic and hypoxic sheep, indicating a limited role for non-mitochondrial derived superoxide to high-K(+)-induced contraction. Western immunoblot for alpha smooth muscle actin indicated small increases in relative abundance in the adult. The data suggest that while Ca(L) therapies more effectively vasodilate PA in adults and rho-kinase therapies are more effective in newborns, combination therapies would provide greater efficacy in both young and mature patients regardless of normoxic or hypoxic conditions.