Percutaneous mitral valve repair : Outcome improvement with operator experience and a second-generation device

Background and aim: Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve not only for procedural outcomes but also for patient selection. The aim of the study was to compare a contemporary series of patients undergoing PMVR using a second-generation Mitraclip device (Mitraclip NT) with previous cohorts treated with a first-generation system. Methods: This multicenter study collected individual data from 18 centers between 2012 and 2017. The cohort was divided into three groups according to the use of the first-generation Mitraclip during the first (control-1) or second half (control-2) or the Mitraclip NT sys-tem. Results: A total of 545 consecutive patients were included in the study. Among all, 182 (33.3%), 183 (33.3%), and 180 (33.3%) patients underwent mitral repair in the control-1, control-2, and NT cohorts, respectively. Procedural success was achieved in 93.3% of patients without differences between groups. Major adverse events did not statistically differ among groups, but there was a higher rate of pericardial effusion in the control-1 group (4.3%, 0.6%, and 2.6%, respectively; p = 0.025). The composite endpoint of death, surgery, and admission for congestive heart failure (CHF) at 12 months was lower in the NT group (23.5% in control-1, 22.5% in control-2, and 8.3% in the NT group; p = 0.032). Conclusions: The present paper shows that contemporary clinical outcomes of patients undergoing PMVR with the Mitraclip system have improved over time

Abnormal Liver Function Test in Patients Infected with Coronavirus (SARS-CoV-2): A Retrospective Single-Center Study from Spain

The outbreak of the novel coronavirus SARS-CoV-2 epidemic has rapidly spread and still poses a serious threat to healthcare systems worldwide. In the present study, electronic medical records containing clinical indicators related to liver injury in 799 COVID-19-confirmed patients admitted to a hospital in Madrid (Spain) were extracted and analyzed. Correlation between liver injury and disease outcome was also evaluated. Serum levels of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Gamma-glutamyltransferase (GGT), Alkaline phosphatase (ALP), Lactate dehydrogenase (LDH) and AST/ALT ratio were elevated above the Upper Limit of Normal (ULN) in 25.73%, 49.17%, 34.62%, 24.21%, 55.84% and 75% of patients, respectively. Interestingly, significant positive correlation between LDH levels and the AST/ALT ratio with disease outcome was found. Our data showed that SARS-CoV-2 virus infection leads to mild, but significant changes in serum markers of liver injury. The upregulated LDH levels as well as AST/ALT ratios upon admission may be used as additional diagnostic characteristic for COVID-19 patients

Role of age and comorbidities in mortality of patients with infective endocarditis

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups:<65 years, 65 to 80 years, and = 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 = 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients =80 years who underwent surgery were significantly lower compared with other age groups (14.3%, 65 years; 20.5%, 65-79 years; 31.3%, =80 years). In-hospital mortality was lower in the <65-year group (20.3%, <65 years;30.1%, 65-79 years;34.7%, =80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%, =80 years; p = 0.003).Independent predictors of mortality were age = 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI = 3 (HR:1.62; 95% CI:1.39–1.88), and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared, the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age = 80 years, high comorbidity (measured by CCI), and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans – anteaters, sloths, and armadillos – have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with 24 domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, ten anteaters, and six sloths. Our dataset includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data-paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the south of the USA, Mexico, and Caribbean countries at the northern portion of the Neotropics, to its austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n=5,941), and Cyclopes sp. has the fewest (n=240). The armadillo species with the most data is Dasypus novemcinctus (n=11,588), and the least recorded for Calyptophractus retusus (n=33). With regards to sloth species, Bradypus variegatus has the most records (n=962), and Bradypus pygmaeus has the fewest (n=12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other datasets of Neotropical Series which will become available very soon (i.e. Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans dataset

First observation and amplitude analysis of the B- -> D+K-pi(-) decay

The B-→D+K-π- decay is observed in a data sample corresponding to 3.0 fb-1 of pp collision data recorded by the LHCb experiment during 2011 and 2012. Its branching fraction is measured to be B(B-→D+K-π-)=(7.31±0.19±0.22±0.39)×10-5 where the uncertainties are statistical, systematic and from the branching fraction of the normalization channel B-→D+π-π-, respectively. An amplitude analysis of the resonant structure of the B-→D+K-π- decay is used to measure the contributions from quasi-two-body B-→D0∗(2400)0K-, B-→D2∗(2460)0K-, and B-→DJ∗(2760)0K- decays, as well as from nonresonant sources. The DJ∗(2760)0 resonance is determined to have spin 1

First observation and amplitude analysis of the B−→D+K−π− decay

The B−→D+K−π− decay is observed in a data sample corresponding to 3.0  fb−1 of pp collision data recorded by the LHCb experiment during 2011 and 2012. Its branching fraction is measured to be B(B−→D+K−π−)=(7.31±0.19±0.22±0.39)×10−5 where the uncertainties are statistical, systematic and from the branching fraction of the normalization channel B−→D+π−π−, respectively. An amplitude analysis of the resonant structure of the B−→D+K−π− decay is used to measure the contributions from quasi-two-body B−→D∗0(2400)0K−, B−→D∗2(2460)0K−, and B−→D∗J(2760)0K− decays, as well as from nonresonant sources. The D∗J(2760)0 resonance is determined to have spin 1

Management of Patients With Crohn's Disease and Ulcerative Colitis During the Coronavirus Disease-2019 Pandemic: Results of an International Meeting

The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) is the only global organization devoted to the study of and management of the inflammatory bowel diseases (IBDs), namely, Crohn?s disease and ulcerative colitis. Membership is composed of physician-scientists who have established expertise in these diseases. The organization hosts an annual meeting and a number of working groups addressing issues of the epidemiology of IBD, diet and nutrition, and the development and use of treatments for IBD. There are currently 89 members of IOIBD representing 26 different countries. The organization has taken particular interest in the coronavirus disease-2019 (COVID-19) pandemic and how it may affect the IBD patient population. This document summarizes the results of 2 recent virtual meetings of the group and subsequent expert guidance for patients and providers

Dalitz plot analysis ofB0→D¯0π+π−decays

The resonant substructures of $B^0 \to \overline{D}^0 \pi^+\pi^-$ decays are studied with the Dalitz plot technique. In this study a data sample corresponding to an integrated luminosity of 3.0 fb$^{-1}$ of $pp$ collisions collected by the LHCb detector is used. The branching fraction of the $B^0 \to \overline{D}^0 \pi^+\pi^-$ decay in the region $m(\overline{D}^0\pi^{\pm})>2.1$ GeV$/c^2$ is measured to be $(8.46 \pm 0.14 \pm 0.29 \pm 0.40) \times 10^{-4}$, where the first uncertainty is statistical, the second is systematic and the last arises from the normalisation channel $B^0 \to D^*(2010)^-\pi^+$. The $\pi^+\pi^-$ S-wave components are modelled with the Isobar and K-matrix formalisms. Results of the Dalitz plot analyses using both models are presented. A resonant structure at $m(\overline{D}^0\pi^-) \approx 2.8$ GeV$/c^{2}$ is confirmed and its spin-parity is determined for the first time as $J^P = 3^-$. The branching fraction, mass and width of this structure are determined together with those of the $D^*_0(2400)^-$ and $D^*_2(2460)^-$ resonances. The branching fractions of other $B^0 \to \overline{D}^0 h^0$ decay components with $h^0 \to \pi^+\pi^-$ are also reported. Many of these branching fraction measurements are the most precise to date. The first observation of the decays $B^0 \to \overline{D}^0 f_0(500)$, $B^0 \to \overline{D}^0 f_0(980)$, $B^0 \to \overline{D}^0 \rho(1450)$, $B^0 \to D_3^*(2760)^- \pi^+$ and the first evidence of $B^0 \to \overline{D}^0 f_0(2020)$ are presented.Comment: 64 pages, 17 figure