Comparison of outcomes in patients with abandoned versus extracted implantable cardioverter defibrillator leads

SummaryBackgroundDespite the increased number of implantable cardioverter defibrillator (ICD) recipients and the frequent need for device upgrading and/or occurrence of lead malfunction, the optimal approach to managing abandoned leads remains debated. Aims To determine the rate and type of complications related to either abandoned or extracted ICD leads. Methods Patients with abandoned or extracted leads were identified retrospectively. Patient medical records were reviewed to assess long-term lead or device malfunction, defibrillation test values before and after lead abandonment or extraction, and appropriateness of delivered shocks and subsequent surgical procedures related to devices or leads. Results A total of 58 ICD patients with 47 extracted and 34 abandoned leads were identified. After a mean follow-up of 3.2 ± 2.6 years, the defibrillation test was not affected by either abandoned or extracted leads (23.4 ± 6.6 J vs 25.4 ± 4.9 J, respectively; P = 0.24). There were no differences in the number of ICD-related surgical procedures after extracting versus abandoning leads (22% vs 12%, respectively; P = 0.3) or in the thromboembolic event rate (7.7% vs 6.3%; P = 0.83). During follow-up, no differences in the occurrence of major complications or appropriate/inappropriate shocks were observed between patients with or without abandoned leads. Conclusion We observed no difference in rates of immediate or medium-term complications between extracting versus abandoning leads. Lead abandonment remains an alternative and safe option when extraction does not appear mandatory according to the age of the leads or experience of the operating centre

A kinetic type extended model for dense gases and macromolecular fluids

Extended thermodynamics is an important theory which is appreciated from mathematicians and physicists. Following its ideas and considering the macroscopic approach with suggestions from the kinetic one, we find in this paper, the solution of an interesting model: the model for dense gases and macromolecular fluids

From macro to nano: Linking quantitative CEUS perfusion parameters to CD4+ T cells subtypes in spondyloarthtitis

The onset and progression of immune-mediated inflammatory arthritis, such as rheumatoid arthritis and spondyloarthritis, are linked to the IL23-IL17 immune axis, so that many therapeutic strategies aim at modulating this pathway. However, there is so far no possibility of an in vivo direct monitoring, without a biopsy, of the specific T cells involved in this modulation. Synovial perfusion, and thus synovial angiogenesis, has been recognized as a sensitive and early marker of inflammation that can be evaluated via quantitative analysis of contrast-enhanced ultrasound imaging data. © 2017 IEEE

Interaction between Mycobacterium tuberculosis, Mycobacterium bovis, Mycobacterium avium subspecies paratuberculosis with the enteric glia and microglial cells

<p>Abstract</p> <p>Background</p> <p>We investigated the interaction of <it>Mycobacterium avium </it>subspecies <it>paratuberculosis, M. bovis </it>and <it>M. tuberculosis </it>and different glial cells (enteric glial and microglial cells) in order to evaluate the infecting ability of these microorganisms and the effects produced on these cells, such as the evaluation of cytokines expression.</p> <p>Results</p> <p>Our experiments demonstrated the adhesion of <it>M. paratuberculosis </it>to the enteroglial cells and the induction of IL-1A and IL-6 expression; <it>M. tuberculosis </it>and <it>M. bovis </it>showed a good adhesive capability to the enteric cell line with the expression of the following cytokines: IL-1A and IL-1B, TNF-α, G-CSF and GM-CSF; <it>M. bovis </it>induced the expression of IL-6 too.</p> <p>The experiment performed with the microglial cells confirmed the results obtained with the enteroglial cells after the infection with <it>M. tuberculosis </it>and <it>M. bovis</it>, whereas <it>M. paratuberculosis </it>stimulated the production of IL-1A and IL-1B.</p> <p>Conclusion</p> <p>Enteroglial and microglial cells, could be the target of pathogenic mycobacteria and, even if present in different locations (Enteric Nervous System and Central Nervous System), show to have similar mechanism of immunomodulation.</p