79 research outputs found
Reproducibility of native T1 mapping using ShMOLLI and MOLLI - implications for sample size calculation
Reply to Mistry et al. The Two Substrate Reduction Therapies for Type 1 Gaucher Disease Are Not Equivalent. Comment on “Hughes et al. Switching between Enzyme Replacement Therapies and Substrate Reduction Therapies in Patients with Gaucher Disease: Data from the Gaucher Outcome Survey (GOS). J. Clin. Med. 2022, 11, 5158”
Recreational marathon running does not cause exercise-induced left ventricular hypertrabeculation.
BACKGROUND: Marathon running in novices represents a natural experiment of short-term cardiovascular remodeling in response to running training. We examine whether this stimulus can produce exercise-induced left ventricular (LV) trabeculation. METHODS: Sixty-eight novice marathon runners aged 29.5 ± 3.2 years had indices of LV trabeculation measured by echocardiography and cardiac magnetic resonance imaging 6 months before and 2 weeks after the 2016 London Marathon race, in a prospective longitudinal study. RESULTS: After 17 weeks unsupervised marathon training, indices of LV trabeculation were essentially unchanged. Despite satisfactory inter-observer agreement in most methods of trabeculation measurement, criteria defining abnormally hypertrabeculated cases were discordant with each other. LV hypertrabeculation was a frequent finding in young, healthy individuals with no subject demonstrating clear evidence of a cardiomyopathy. CONCLUSION: Training for a first marathon does not induce LV trabeculation. It remains unclear whether prolonged, high-dose exercise can create de novo trabeculation or expose concealed trabeculation. Applying cut off values from published LV noncompaction cardiomyopathy criteria to young, healthy individuals risks over-diagnosis
Ultrafast Magnetic Resonance Imaging for Iron Quantification in Thalassemia Participants in the Developing World The TIC-TOC Study (Thailand and UK International Collaboration in Thalassaemia Optimising Ultrafast CMR)
Thalassemia is the most common monogenetic disorder worldwide, with 60 000
infants with thalassemia major born annually.1 Survival often depends on regular
blood transfusions to correct anemia and to reduce ineffective erythropoiesis, but
these transfusions can result in iron overload and organ failure unless chelation therapy
is undertaken. Serum ferritin levels continue to be used as a guide to chelation but are
unreliable, and the availability of cardiovascular magnetic resonance (CMR) T2* imaging
has transformed patient management by allowing organ-specific quantification of
iron content.
Countries with a high prevalence of thalassemia major have CMR, but magnet
time is expensive and analytic expertise lacking. The aim of TIC-TOC (Thailand and
UK International Collaboration in Thalassaemia Optimising Ultrafast CMR) was to
investigate whether ultrafast CMR mapping could provide reliable immediate diagnoses
of heart and liver iron content, eliminating the need for complex analysis, thus
reducing costs to a level within local resources. The research received approval by
the Institutional Review Board of the Faculty of Medicine at Chulalongkorn University.
All participants provided written informed consent.</p
Clinical application of MOLLI T1* for extracellular volume calculation in healthy volunteers and aortic stenosis
Use of Rapid Cardiac Magnetic Resonance Imaging (rCMR) to guide chelation therapy in patients with transfusion-dependent thalassemia in India UMIMI Study.
An instantaneous ECV with no blood sampling: using native blood T1 for hematocrit is as good as standard ECV
General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study
There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients’ (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16–22) and failed intubation in 1 in 312 (95%CI 1 in 169–667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)
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