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Anatomic Approach as well as Results in youngsters Going through Percutaneous Pericardiocentesis.
retinoblastoma management. Routine clinical audit of retinoblastoma management can identify areas for clinical practice change.
To evaluate the efficacy of pretreatment with topical betamethasone in Ahmed glaucoma valve (AGV) implantation.

Randomized clinical trial.

Sixty-two eyes from 62 patients undergoing AGV.

We randomly assigned patients undergoing AGV to 2 arms of the study. The case group received AGV implantation with preoperative betamethasone eye drops, and the control group did not receive preoperative betamethasone. Follow-up examinations were performed on postoperative day 1, at least weekly for 4 weeks, and then every 1 to 3 months. Our main outcome measure was the rate of success, defined as intraocular pressure (IOP) <15 mm Hg and IOP ≤18 mm Hg.

We analyzed 62 eyes divided to case (n = 33) and control (n = 29) groups. The success rate was significantly higher in the intervention group than in the control group at 12 months postoperatively when considering either IOP < 15 or IOP < 18 mm Hg as success (p < 0.001) and also at 6 months when considering IOP < 18 mm Hg as success (p < 0.041). The reduction in the number of antiglaucoma medications used postoperatively was significantly higher in the betamethasone group at follow-up at 1 and 3 months and 1 year.

Pretreatment with topical betamethasone in AGV implantations increases the success rate and reduces the need for medications.
Pretreatment with topical betamethasone in AGV implantations increases the success rate and reduces the need for medications.Advances in image processing and computer hardware have enabled the development of user-friendly software which operate in real-time and can be used in the catheterization laboratory to facilitate percutaneous coronary intervention (PCI). The two dimensional-(2D) quantitative coronary angiography (QCA) systems that have traditionally been used to assess lesion severity have been replaced by 3D-QCA systems, enabling more reliable evaluation of vessel geometry and lesion dimensions. This also allows 3D reconstruction of coronary bifurcation anatomy and generation of models that can be processed by computational fluid dynamic techniques to reliably detect flow-limiting lesions. More recently, software has been introduced that has the capability of generating a digital silhouette of the coronary arteries superimposed onto X-ray angiography to facilitate wire crossing and stent placement, and potentially reduce contrast use. In parallel, methodologies have been developed that operate with an accessible interface and can process intravascular imaging data, reliably quantify lesion severity and co-register intravascular and X-ray angiographic data to comprehensively assess plaque distribution and guide PCI. The above advances are used in daily practice to improve procedural results and outcomes. This review aims to provide an overview of the developments in the field - it presents the computer-based technologies that have been designed to accurately assess lesion severity, summarizes the advantages and limitations of the systems introduced to co-register imaging data and discusses the potential value of the existing and emerging software in the catheterization laboratory.
Stable chest pain is a common indication for cardiac catheterization. We assessed the prognostic value of the Prospective Multicenter Imaging Study for Evaluation (PROMISE) Minimal-Risk Tool in identifying patients who are at very low risk of obstructive coronary artery disease (CAD) or downstream cardiovascular adverse outcomes.

We applied the PROMISE Minimal-Risk Tool to consecutive patients without known CAD who underwent elective cardiac catheterization for stable angina from January 1, 2000 to December 31, 2014 in the Duke Databank for Cardiovascular Disease (DDCD). Patients with scores >0.46 (top decile of lowest-risk from the PROMISE cohort) were classified as low-risk. Logistic regression modeling compared likelihood of freedom from obstructive coronary artery disease on index angiography, 2-year survival, and 2-year survival free of myocardial infarction (MI) and MI/revascularization between low- and non low-risk patients. Alternative cut points to define low- risk patients were also explored.st pain patients referred to cardiac catheterization as low risk. These patients have a low prevalence of obstructive CAD and better survival than non-low risk patients. While this suggests that these patients are unlikely to benefit from catheterization, further research is needed to confirm a favorable downstream prognosis with medical management alone.
The PROMISE minimal-risk tool identifies 17% of stable chest pain patients referred to cardiac catheterization as low risk. These patients have a low prevalence of obstructive CAD and better survival than non-low risk patients. While this suggests that these patients are unlikely to benefit from catheterization, further research is needed to confirm a favorable downstream prognosis with medical management alone.The vagus nerve innervates many organs, and most, if not all, of its motor fibers are cholinergic. However, no one knows its organizing principles-whether or not there are dedicated neurons with restricted targets that act as "labeled lines" to perform certain functions, including two opposing ones (gastric contraction versus relaxation). By performing unbiased transcriptional profiling of DMV cholinergic neurons, we discovered seven molecularly distinct subtypes of motor neurons. Then, by using subtype-specific Cre driver mice, we show that two of these subtypes exclusively innervate the glandular domain of the stomach where, remarkably, they contact different enteric neurons releasing functionally opposing neurotransmitters (acetylcholine versus nitric oxide). Thus, the vagus motor nerve communicates via genetically defined labeled lines to control functionally unique enteric neurons within discrete subregions of the gastrointestinal tract. learn more This discovery reveals that the parasympathetic nervous system utilizes a striking division of labor to control autonomic function.
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