Delayed left subclavian artery pseudoaneurysm following transcatheter aortic valve implantation

In 10-15% of patients undergoing transcatheter aortic valve implantation (TAVI), the femoral artery approach is precluded owing to insufficient caliber or tortuosity of the vessel. In these subjects, the subclavian (SC) or the axillary (AX) access can be used; these have proved equivalent to the femoral artery approach in terms of both survival and the rate of vascular complications. The SC or AX approach usually require a surgical cut-down under general anesthesia or deep sedation, though cases have been described in which the percutaneous technique has been adopted. Furthermore, SC and AX access may be burdened by complications, such as vessel perforation or rupture, or the formation of aneurysms at the site of incision

Quenched lattice calculation of the vector channel B --> D* l nu decay rate

We calculate, in the continuum limit of quenched lattice QCD, the form factor that enters the decay rate of the semileptonic decay B --> D* l nu. By using the step scaling method (SSM), previously introduced to handle two scale problems in lattice QCD, and by adopting flavor twisted boundary conditions we extract F(w) at finite momentum transfer and at the physical values of the heavy quark masses. Our results can be used in order to extract the CKM matrix element Vcb by the experimental decay rate without model dependent extrapolations. The value of Vcb agrees with the one obtained from the B --> D l nu channel and makes us confident that the quenched approximation well applies to these transitions.Comment: 11 pages, 8 figure

Analytic solutions and Singularity formation for the Peakon b--Family equations

Using the Abstract Cauchy-Kowalewski Theorem we prove that the $b$-family equation admits, locally in time, a unique analytic solution. Moreover, if the initial data is real analytic and it belongs to $H^s$ with $s > 3/2$, and the momentum density $u_0 - u_{0,{xx}}$ does not change sign, we prove that the solution stays analytic globally in time, for $b\geq 1$. Using pseudospectral numerical methods, we study, also, the singularity formation for the $b$-family equations with the singularity tracking method. This method allows us to follow the process of the singularity formation in the complex plane as the singularity approaches the real axis, estimating the rate of decay of the Fourier spectrum

Arterial stiffness, endothelial and cognitive function in subjects with type 2 diabetes in accordance with absence or presence of diabetic foot syndrome.

BACKGROUND: Endothelial dysfunction is an early marker of cardiovascular disease so endothelial and arterial stiffness indexes are good indicators of vascular health. We aimed to assess whether the presence of diabetic foot is associated with arterial stiffness and endothelial function impairment. METHODS: We studied 50 subjects with type 2 diabetes mellitus and diabetic foot syndrome (DFS) compared to 50 diabetic subjects without diabetic foot, and 53 patients without diabetes mellitus, by means of the mini mental state examination (MMSE) administered to evaluate cognitive performance. Carotid-femoral pulse wave velocity (PWV) and augmentation index (Aix) were also evaluated by Applanation tonometry (SphygmoCor version 7.1), and the RH-PAT data were digitally analyzed online by Endo-PAT2000 using reactive hyperemia index (RHI) values. RESULTS: In comparison to diabetic subjects without diabetic foot the subjects with diabetic foot had higher mean values of PWV, lower mean values of RHI, and lower mean MMSE. At multinomial logistic regression PWV and RHI were significantly associated with diabetic foot presence, whereas ROC curve analysis had good sensitivity and specificity in arterial PWV and RHI for diabetic foot presence. CONCLUSIONS: Pulse wave velocity and augmentation index, mean RHI values, and mean MMSE were effective indicators of diabetic foot. Future research could address these issues by means of longitudinal studies to evaluate cardiovascular event incidence in relation to arterial stiffness, endothelial and cognitive markers

Lattice QCD determination of m_b, f_B and f_Bs with twisted mass Wilson fermions

We present a lattice QCD determination of the b quark mass and of the B and B_s decay constants, performed with N_f=2 twisted mass Wilson fermions, by simulating at four values of the lattice spacing. In order to study the b quark on the lattice, two methods are adopted in the present work, respectively based on suitable ratios with exactly known static limit and on the interpolation between relativistic data, evaluated in the charm mass region, and the static point, obtained by simulating the HQET on the lattice. The two methods provide results in good agreement. For the b quark mass in the MSbar scheme and for the decay constants we obtain m_b(m_b)=4.29(14) GeV, f_B=195(12) MeV, f_Bs=232(10) MeV and f_Bs/f_B=1.19(5). As a byproduct of the analysis we also obtain the results for the f_D and f_Ds decay constants: f_D=212(8) MeV, f_Ds=248(6) MeV and f_Ds/f_D=1.17(5).Comment: 23 pages, 10 figures, 2 tables. Added appendix showing the agreement of the data for the ratios with the HQE prediction. Matching JHEP published versio

Multicenter evaluation of use of dried blood spot compared to conventional plasma in measurements of globotriaosylsphingosine (LysoGb3) concentration in 104 Fabry patients.

Abstract Objectives Fabry disease (FD) is an X-linked lysosomal storage disorder, resulting from a deficiency of the enzyme α-galactosidase A, responsible for breaking down glycolipids such as globotriaosylceramide and its deacylated derivative, globotriaosylsphingosine (LysoGb3). Here, we compare the levels of LysoGb3 in dried blood spots (DBS) and plasma in patients with classic and late-onset phenotypes. Methods LysoGb3 measurements were performed in 104 FD patients, 39 males and 65 females. Venous blood was collected. A portion was spotted onto filter paper and another portion separated to obtain plasma. The LysoGb3 concentrations in DBS and plasma were determined by highly sensitive electrospray ionization liquid chromatography tandem mass spectrometry. Agreement between different matrices was assessed using linear regression and Bland Altman analysis. Results The method on DBS was validated by evaluating its precision, accuracy, matrix effect, recovery, and stability. The analytical performances were verified by comparison of a total of 104 paired DBS and plasma samples from as many FD patients (representing 46 GLA variants). There was a strong correlation between plasma and the corresponding DBS LysoGb3 concentrations, with few exceptions. Discrepancies were observed in anemic patients with typically low hematocrit levels compared to the normal range. Conclusions The method proved to be efficient for the rapid analysis of LysoGb3. DBS provides a convenient, sensitive, and reproducible method for measuring LysoGb3 levels for diagnosis, initial phenotypic assignment, and therapeutic monitoring in patients with FD

Safety and efficacy of topiramate in neonates with hypoxic ischemic encephalopathy treated with hypothermia (NeoNATI).

Abstract Background Despite progresses in neonatal care, the mortality and the incidence of neuro-motor disability after perinatal asphyxia have failed to show substantial improvements. In countries with a high level of perinatal care, the incidence of asphyxia responsible for moderate or severe encephalopathy is still 2–3 per 1000 term newborns. Recent trials have demonstrated that moderate hypothermia, started within 6 hours after birth and protracted for 72 hours, can significantly improve survival and reduce neurologic impairment in neonates with hypoxic-ischemic encephalopathy. It is not currently known whether neuroprotective drugs can further improve the beneficial effects of hypothermia. Topiramate has been proven to reduce brain injury in animal models of neonatal hypoxic ischemic encephalopathy. However, the association of mild hypothermia and topiramate treatment has never been studied in human newborns. The objective of this research project is to evaluate, through a multicenter randomized controlled trial, whether the efficacy of moderate hypothermia can be increased by concomitant topiramate treatment. Methods/Design Term newborns (gestational age ≥ 36 weeks and birth weight ≥ 1800 g) with precocious metabolic, clinical and electroencephalographic (EEG) signs of hypoxic-ischemic encephalopathy will be randomized, according to their EEG pattern, to receive topiramate added to standard treatment with moderate hypothermia or standard treatment alone. Topiramate will be administered at 10 mg/kg once a day for the first 3 days of life. Topiramate concentrations will be measured on serial dried blood spots. 64 participants will be recruited in the study. To evaluate the safety of topiramate administration, cardiac and respiratory parameters will be continuously monitored. Blood samplings will be performed to check renal, liver and metabolic balance. To evaluate the efficacy of topiramate, the neurologic outcome of enrolled newborns will be evaluated by serial neurologic and neuroradiologic examinations. Visual function will be evaluated by means of behavioural standardized tests. Discussion This pilot study will explore the possible therapeutic role of topiramate in combination with moderate hypothermia. Any favourable results of this research might open new perspectives about the reduction of cerebral damage in asphyxiated newborns. Trial registration Current Controlled Trials ISRCTN62175998; ClinicalTrials.gov Identifier NCT01241019; EudraCT Number 2010-018627-25</p

Mechanical Properties of Dual-Cured Resin Luting Agents for Ceramic Restoration

Purpose: The aim of the present study was to evaluate the mechanical properties including surface hardness, flexural strength, and flexural modulus of two dual-cured resin luting agents (New Resin Cement [NRC] and Variolink II [VLII]) irradiated through four different thickness of leucite ceramics (0, 1, 2, and 3 mm) and their shear bond strength to zirconia ceramic (Cercon) using each ceramic primer. Materials and Methods: Knoop hardness was measured on a thin layer of resin luting agent on the ceramic surface. Three-point bending tests were performed after 24 h storage at 37°C. Two different-shaped zirconia ceramic specimens with or without sandblasting with alumina were treated with each primer. The specimens were then cemented together with each resin luting agent. Half of the specimens were stored in water at 37°C for 24 h and the other half were thermocycled 5,000 times. Results: VLII revealed statistically higher Knoop hardness and flexural modulus than NRC for each thickness of ceramic. No significant differences in flexural strength were observed between VLII and NRC for each ceramic spacer. Reduction of the mechanical properties with increase of ceramic thickness varied for each property. However, these properties were similar between the two materials. Blasting with alumina was significantly effective for increasing shear bond strength of both resin luting agents before and after thermal cycling. The use of New Ceramic Primer showed the highest shear bond strength and maintained bond durability after 5,000 thermocycles. Conclusion: Mechanical properties of NRC dual-cured resin luting agent appear adequate for ceramic restorations.This is an electronic version of an Article published in Journal of Prosthodontics 16(5): 370-376, 2007