Notes

Aftereffect of mixed experience of this mineral nanoparticles and cadmium chloride about female zebrafish ovaries.
INTRODUCTION The potential drawbacks of surgical approaches to neck and base fractures of the mandibular condyle (visible scare, facial nerve injury) are still considered by many surgeons as a brake for open reduction and internal fixation. The aim of our study was to analyze the results in terms of access, scare quality and complications that could be noticed in a 12 years period of time with the use of the high sub-mandibular approach (HSMA) we first described in 2006 for the surgical treatment of neck and base fractures. MATERIAL AND METHOD All the files of patients operated on for condylar neck and base fractures approached by mean of a HSMA between January 2006 and December 2018 in our department and containing information concerning age, sex, type of fracture, kind of osteosynthesis material, operating time, name of the surgeon, postoperative complication linked to the approach, scare quality at 6 months follow-up at least were included. The skin incision and the dissection planes followed the original actures and to most of neck fractures. The very low rate of facial nerve complications is mainly explained by the plane by plane dissection making it very easy to avoid the facial nerve branches or to check them when encountered. The HSMA is particularly suited to the use of TCP plates as the upper holes of these plates, placed horizontally, are easy to reach from below. The HSMA is therefore still our preferred cutaneous approach to the condylar process. Failure of drugs and catheter ablations for the treatment of ventricular arrhythmias is still extremely relevant. Recently, stereotactic body radiotherapy has been introduced to treat therapy refractory patients. In this systematic review (PROSPERO, CRD42019133212), we aimed to summarize electrophysiological and histopathological effects of radioablation in animals, patients, and extracted and perfused hearts. A systematic search was performed in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Google Scholar, ClinicalTrials.gov and WHO-ICTRP, from inception to September 2019. Identified records were independently screened for eligibility by two reviewers. Risk of bias and methodological quality was assessed using the SYRCLE, the ROBINS-1 or Murad tool and tailored to the different study designs. We included 13 preclinical and 10 clinical publications. Large heterogeneity in study designs prompted a narrative synthesis approach. Baseline, (pre-)procedural details, outcome, target-tissue analyses and safety data were extracted and summarized. In animal studies evaluating electrophysiological parameters, radioablation induced a reduction in voltage/potential amplitude or bidirectional block in target areas in 93.2% of animals. AV-block (1st-3rd degree) was induced in 78.3% of animals and in studies evaluating ventricular arrhythmia inducibility, 75% reduction was achieved. In patients, predominantly ventricular tachycardias were targeted with >85% reduction in arrhythmia episodes during follow-up with an encouraging short-term safety profile. Preclinical and clinical evidence on efficacy and safety of radioablation is limited in both quantity and quality. The results of radioablation for therapy refractory patients with ventricular tachycardia are promising but further research is needed. BACKGROUND Injury to the cardiac venous structures can complicate left ventricular lead placement for cardiac resynchronization therapy (CRT). Little is known about the outcomes of coronary sinus (CS) dissection with or without perforation. OBJECTIVE To determine the outcomes in patients who had a CS injury during CRT implant. METHODS All patients undergoing procedures for CRT implant at the Cleveland Clinic (2001-2018) were enrolled in a prospectively maintained registry for procedural profiles and complications. All patients with cardiac venous injuries during the procedures were included. RESULTS Coronary sinus injury occurred in 35 of 5011 patients (0.7%, 6 perforations, 29 dissections without perforation). In patients with dissection in the absence of perforation, attempts at CS lead placement after dissection were successful in 21 of 29 patients. In those with perforation (n=6), CS lead placement was successful in one of them. Cardiac tamponade occurred in 2 patients and the procedure was aborted in both of them. Overall, CS lead placement failed in 13 patients (38%) but 9 underwent subsequent CRT with CS lead placement (n=6, median 58 days later) or epicardial leads (n=3). Three of the remaining 4 patients refused to undergo further procedures and the fourth died from a complicated course. CONCLUSIONS CS injury is not common during CRT implants and did not preclude successful lead placement in 23 of 35 patients during index procedure and 6 of 6 during subsequent attempted procedures. A low rate of mortality was observed in such patients, but CS injury was associated with increased morbidity. OBJECTIVES We aimed to describe bacterial co-infections and acute respiratory distress (ARDS) outcomes according to influenza type and subtype. METHODS A retrospective observational study was conducted from 2012 to 2016 in patients admitted to the respiratory intensive care unit (ICU) of Marseille university hospital for influenza-induced ARDS. Microbiological investigations, including multiplex molecular respiratory panel testing and conventional bacteriological cultures, were performed as part of the routine ICU care on the bronchoalveloar lavage collected at admission. Bacterial co-infections, ICU mortality, and respiratory function were investigated according to virus type and subtype. RESULTS Among the 45 ARDS-patients included, A(H1N1)pdm09 was the most frequent influenza virus identified (28/45 A(H1N1)pdm09, 8/45 A(H3N2), and 9/45 influenza B). Bacterial co-infections involving a total of 23 bacteria were diagnosed in 16/45 patients (36%). selleck compound A(H1N1)pdm09 patients presented fewer bacterial co-infections (17.9% vs. 50.0% for A(H3N2) patients and 77.8% for B patients; p less then 0.01). Overall, mortality at 90 days post-admission was 33.3% (15/45), and there was no significant difference between influenza type and subtype. The need for extracorporeal membrane oxygenation was more frequent for A(H1N1)pdm2009 (20/28, 71.4%) and B patients (7/9, 77.8%) as compared to the A(H3N2) subtype (1/8, 12.5%; p less then 0.01). A(H1N1)pdm09-ARDS patients were associated with fewer ventilation-free days at day 28 (median [IQR] 0[0-8] day) as compared with other influenza-ARDS patients (15 [0-25] days, p less then 0.05). CONCLUSIONS In a population of influenza-induced ARDS, A(H1N1)pdm09 was associated with fewer bacterial co-infections but poorer respiratory outcomes. These data underline the major role of A(H1N1)pdm09 subtype on influenza disease severity.
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