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At least 631 records · Page 35Linked to original sources

A case report to influence therapeutic philosophy when presented with the findings on laparoscopy of a unilateral hydrosalpinx with a contralateral diseased but patent fallopian tube without hydrosalpinx.

PURPOSE: To determine if a patent fallopian tube associated with hydrosalpinx can be associated with unexplained implantation failure of morphological superior embryos. METHODS: Salpingectomy was performed on a woman with a patent fallopian tube who had failed to conceive despite the previous transfer of 27 superior quality embryos. A single embryo was transferred using minimal stimulation. RESULTS: Conception and normal delivery occurred. CONCLUSIONS: A patent tube with a hydrosalpinx may be associated with failure of embryos to implant. Salpingectomy can correct this defect.

Adult↗

Antibacterial agents: patent highlights January 2005 to June 2005.

This review summarizes patents claiming novel antibacterial agents published between January and June 2005. A total of 50 patents covering beta-lactam antibiotics, beta-lactamase inhibitors, macrolide, oxazolidinone, quinolone and quinoline derivatives, and miscellaneous agents such as peptide deformylase inhibitors are selected for review. The majority of the patents disclosed the syntheses and biological activities of novel agents, and novel uses, improved chemical processes and formulations of known antibiotics. Details of a novel 2,3-dihydro-6-nitro-imidazo[2,1-b]oxazole derivative with excellent activity against Mycobacterium tuberculosis, among others, are also presented.

Animals↗

[Transcatheter closure of patent foramen ovale in patients with platypnea-orthodeoxia].

Platypnea-orthodeoxia is a rare syndrome characterized by the occurrence of dyspnea and hypoxemia on adoption of an upright posture (i.e., orthodeoxia) and by the absence of symptoms and hypoxemia in decubitus. This syndrome is frequently related to patent foramen ovale and right-to-left shunting. We describe two patients in whom patent foramen ovale with right-to-left shunting was observed on transthoracic and transesophageal echocardiography and who had platypnea-orthodeoxia in the absence of pulmonary disease. They underwent transcatheter closure using an Amplatz device. The echocardiographic diagnosis and closure procedure are discussed. These case reports demonstrate that closure of patent foramen ovale is an effective treatment for platypnea-orthodeoxia.

Aged↗

[Cardiopulmonary exercise test in the evaluation of exercise capacity in patients with Ebstein anomaly and patent ostium secundum atrial septal defect aged over 30 years].

UNLABELLED: There are few data available on applying the cardiopulmonary exercise test for evaluation of cardiac exercise capacity in adult patients with congenital heart diseases. The aim of the study was to perform this test in adults with Ebstein anomaly and patients with patent ASD II (atrial septal defect) and determination of potential relationships between these parameters and echocardiographically assessed hemodynamic indices. MATERIAL AND METHODS: Twenty patients with Ebstein anomaly mean aged 40.3 +/- 12.3 years were studied. Control group consisted of 19 individuals at mean age of 39.9 years. Echocardiography was performed for the evaluation of severity of the disease. Additionally, 36 patients with ASD II were included, mean age 44.7 +/- 8.2 years. The control group consisted of 25 individuals at mean age of 45.6 years. Maximum exercise treadmill test was carried out and resting and exercise spirometry. RESULTS: Ebstein anomaly. Maximum oxygen uptake, minute ventilation, maximum heart rate and blood pressure at peak exercise were significantly lower in study patients than in control group. VE/VCO2 was increased. No differences were observed between groups with respect to spirometric parameters. Oxygen uptake decreased along with the severity of the disease. ASD II. Maximum oxygen uptake, minute ventilation, maximum heart rate and blood pressure at peak exercise and spirometric parameters were significantly lower in study patients than in control group. Significant negative correlations were shown for VO2 (maximum oxygen uptake) and Qp:Qs (pulmonary to systemic flow ratio) (p = 0.004), maximum heart rate - HRmax and HRmax% and RV (end-diastolic right ventricular diameter) (p = 0.02 i p = 0.01), RV and systolic pressure at peak exercise (p = 0.03), obstruction marker FEV1 and RV (p = 0.04) and between RVSP (right ventricular end-systolic pressure) (p = 0.01). Negative correlation was observed between RQ (respiratory quotient) and RVSP (p = 0.004), and positive correlation between HRmax and VO2 (p = 0.005). CONCLUSIONS: The exercise capacity of adults with Ebstein anomaly and those with patent ASD II is significantly reduced. It decreases along with the echocardiographic severity of the disease in Ebstein anomaly patients and it seems to result from the right ventricular volume overload in patients with patent ASD II.

Abnormalities, Multiple↗

[The seated position in patent foramen ovale?].

Anesthetic management of patients presenting for posterior cranial fossa surgery in the seated position includes detection and treatment of venous air embolism. Atrial positioning of a central venous (cv) line may be verified by either X-ray or an atrial ECG tracing. We report a case where a chest X-ray film proved superior. A 26-year-old white female was scheduled for posterior cranial fossa exploration. A cv line was inserted via the left antecubital vein; the chest X-ray film documented correct positioning of the catheter tip within the atrium but an aberrant course of the superior vena cava. Echocardiography was performed in the induction room and indicated a patent foramen ovale. In view of the risk of paradoxical air embolism, surgery was postponed. Subsequent cardiologic and radiologic examinations revealed a patent foramen ovale and a persisting left superior vena cava draining into a dilated coronary sinus. Surgery was rescheduled and carried out uneventfully in the prone position. This case demonstrates: 1) an advantage of a thoracic-X-ray film compared to atrial ECG tracing as not only the catheter tip position, but also the course of the catheter can be identified; and 2) the usefulness of preoperative screening for a patent foramen ovale in patients scheduled for surgery in the seated position.

Adult↗

Influence of diethylcarbamazine on the patent period of infection in periodic Brugia malayi.

The patent period of infection which reflects the fecundic life span of the adult female worm was estimated for periodic B. malayi in south India by using immigration death model. Longitudinal data on natural loss of infection or that due to different degrees of DEC pressure in a cohort population of microfilaria carriers after a three years period, were used for the estimations. The patent period of infection was estimated to be 3.45 yr under natural conditions (without DEC therapy), which was reduced to 1.67 yr following one full course of selective therapy (6 mg/kg body wt/day for 12 days). When selective therapy was supplemented with four rounds of biannual single-dose mass DEC therapy (6 mg/kg body wt) the patent period was further reduced to 1.34 yr. The proportion loss of infection was relatively higher in microfilaria carriers who discontinued DEC selective therapy, when compared to natural loss. The percentage reduction in the mean microfilaria count was observed to decrease with increasing DEC pressure. Neither sex nor the age of the host was found to influence the fecundic life span or the survival of female adult worm.

Adolescent↗

Prevalence of patent Baylisascaris procyonis infection in raccoons (Procyon lotor) in Ithaca, New York.

The prevalence of patent Baylisascaris procyonis infection in raccoons was determined by examining fecal samples collected between July 1986 and May 1987 in Ithaca, New York. September, October, and November had the highest prevalence of infection (35-48%). Significant differences (P less than 0.001) were found when months were grouped by season to test the hypothesis that a fecal sample's probability of being positive does not vary from month to month. Fall was the season contributing most to the overall chi-square statistic. Host sex/age class and prevalence of patent infection were investigated. The raccoons were aged as either juveniles or adults. A significantly higher prevalence of patent infection (P less than 0.001) was found in juveniles when compared to adults. No statistically significant difference was found in other comparisons of host sex and age. Contingency analysis tested the independence of sex/age class/season and presence of eggs. The results of the test were significant (P less than 0.001).

Animals↗

Patent ductus venosus: problems in assessment and management.

A congenitally patent ductus venosus is the rarest form of portosystemic shunt. Although it occurs in the absence of serious parenchymal liver disease, it may be associated with hepatic encephalopathy. This case report describes a 49-year-old man with a patent ductus venosus who presented with recurrent bouts of encephalopathy but few other features of chronic liver disease. Ligation of the shunt was followed by life-threatening complications. The portal venous system must be carefully assessed before closure of a patent ductus venosus is attempted.

Hepatic Encephalopathy↗

Treatment of patent urachus associated with a congenital imperforate urethra in a calf.

Patent urachus is a common condition in calves which is frequently associated with omphalitis. A membranous urethral diaphragm prevented closure of the urachus in a female calf. The patent urachus was complicated by an ascending infection of the intraabdominal umbilical remnants. Following surgical removal of the urachus and umbilical vessels along with transection of the membranous diaphragm the calf experienced an uncomplicated recovery. This case stresses the importance of assuring urethral patency when managing a case of patent urachus.

Abnormalities, Multiple↗

Liver transplantation in patients with patent splenorenal shunts.

Patent distal splenorenal shunts (Warren shunt) have been reported to cause decreases in the portal perfusion pressure and the total hepatic blood flow. Such hemodynamic alterations could have adverse effects on the transplanted liver. The experience with hepatic replacement in four patients with patent Warren shunts is reported. Operative findings were phlebosclerotic portal veins of small size and diminished portal blood flows. Hepatofugal collateral channels created by the construction of the Warren shunt were eliminated by division of the shunt and splenectomy in three patients and splenectomy alone in the other. All patients recovered; thus the presence of a patent Warren shunt should not be a contraindication for hepatic transplantation.

Adult↗

Patent Toxocara canis infection in ascarid-naive dogs.

The effect of feeding different numbers of Toxocara canis eggs on patent intestinal infections was studied in 45 ascarid-naive 62--64-day-old pups and 6 adult dogs. Twenty-four of 25 pups fed 10 to 1,000 eggs developed patent intestinal infections, whereas none of the 20 pups fed 10,000 eggs developed patent intestinal infection. Three of 6 presumably ascarid-naive dogs, 7, 10, and 52 months old fed 100 eggs each, developed intestinal infections.

Animals↗

[Thrombosed type aortic dissection showing changes in the false lumen to the patent type].

Thirty-four patients with acute aortic dissection with thrombosed false lumen were reviewed. In 4 cases (12%), the false lumens changed to the patent type. Changes in the false lumens were revealed by contrast-enhanced CT performed from day 2 to day 19 (mean, day 12.5) after the onset. The entry site was located at the descending aorta in 3 cases, and was unknown in 1 case. In 2 cases, the entry site corresponded with ulcer-like projections that had been pointed out at the thrombosed false lumen. One patient presented with moderate back pain when the false lumen changed, while the others were symptom free. During the follow-up period, 2 patients died of rupture of the false lumen. One patient was treated with a surgical operation. The patent false lumen became re-thrombosed in 1 patient. Although the majority of cases of thrombosed aortic dissection are considered to have a good prognosis, some cases change to the patent type without clinical symptoms. Radiologists should be aware of the unstable nature of the thrombosed type aortic dissection, and follow-up examinations should be performed at least once a week for three weeks after the onset of dissection.

Acute Disease↗

[Results of coronary surgery in mildly symptomatic patients with left ventricular dysfunction, multivessel disease and stenotic single residual patent vessel].

BACKGROUND: While efficacy of coronary artery bypass surgery in patients with depressed left ventricular function and myocardial ischemia is widely recognized, its results in patients in the absence of clinical evidence of myocardial ischemia remain uncertain. The purpose of this study was to evaluate the effects of coronary revascularization in comparison with conventional medical therapy in subjects with ischemic cardiomyopathy and myocardial ischemia presumed on the basis of angiographic anatomy but not demonstrated by functional testings. METHODS: We selected retrospectively patients who underwent coronary angiography from 1986 trough 1993 and met the following criteria: presence of three-vessel coronary artery disease, occlusion of two and significant luminal narrowing (> or = 50%) of the third major epicardial artery, left ventricular dysfunction (ejection fraction < or = 40%), no angina or presence of mild angina, absence of inducible ischemia on exercise test and, when performed, of redistribution in the vascular territory of the patent vessel. RESULTS: Thirty-one consecutive patients underwent isolated surgical revascularization treatment, while thirty medically treated patients with matched clinical characteristics were selected. Age (61 +/- 10 vs 62 +/- 9), gender (M/F 27/3 vs 24/7), NYHA class I-II (53 vs 62%) or NYHA III-IV (47 vs 38%), incidence of previous infarction (87 vs 94%), number of reversible defects in the vascular territory of the patient vessel on stress scintigraphy (0.6 vs 0.5), patent vessel (right coronary artery 7 vs 10; left circumflex 14 vs 12; left anterior descending 9 vs 9) and left ventricular ejection fraction (28 +/- 8 vs 31 +/- 7), were similar in the two groups (medical vs surgical). Surgically treated patients exhibited a lower proportion of overall cardiac deaths (7/31, 23% vs 19/30, 63%; p < 0.001), and more prolonged survival (67 +/- 9.3 vs 34 +/- 2.5 months; p = 0.04, Mantel and Cox test) than medically treated patients, respectively. The incidence of perioperative myocardial infarction was 10% (3/31). Causes of cardiac death were myocardial ischemia (9/19; 47%), sudden death (5/19; 26%) and heart failure (5/19; 26%) in medical patients, while were surgery (3 cases) and surgery related infection (1 case) (total 4/7; 57%), myocardial ischemia (1/7; 14%), sudden death (1/7; 14%) and heart failure (1/7; 14%) in surgical patients. Cox proportional hazard regression analysis with survival as the dependent variable, identified treatment, surgical or medical, as the best predictor of cardiac events (chi square improvement 9.36, p = 0.002). The next most powerful predictors were NYHA class and ACE-inhibitors treatment (chi square improvement 4.47 and 2.79, respectively). CONCLUSIONS: In patients with left ventricular dysfunction, multivessel coronary artery disease and single patent but stenotic residual vessel, coronary artery bypass grafting appear to offer a better survival than medical therapy, even in the absence of clinically evident myocardial ischemia.

Aged↗

Patent gut infections in immunosuppressed adult C57BL/6N mice following intraperitoneal injection of Cryptosporidium parvum oocysts.

Two experiments were conducted to determine if intraperitoneal (i.p.) and/or subcutaneous (s.c.) injection of Cryptosporidium parvum oocysts could produce patent gut infections in dexamethasone (DEX) or dexamethasone phosphate (DEXp)-immunosuppressed adult female C57BL/6N mice. The results from experiment 1 were suggestive but did not unequivocally demonstrate that i.p. injection of oocysts could produce patent gut infections in these mice. In experiment 2, all mice were individually caged, immunosuppressed with DEXp (groups 1 and 2) or DEX (groups 3 and 4), and administered C. parvum oocysts either by orogastric intubation (groups 1 and 3), i.p. (group 2), or s.c. (group 4). All but 1 mouse in groups 1 and 3 began shedding oocysts in their feces on day 3 post-infection (PI). Mice in these 2 groups continued to shed oocysts until they were killed on day 17 PI. Mice administered oocysts s.c. did not shed oocysts. In group 2, 1 mouse died, 1 failed to shed oocysts, and 1 began shedding oocysts on day 3 PI. The remaining 5 mice started shedding oocysts on either days 8, 10, or 14 PI and continued to shed oocysts until they were killed. We conclude that immunosuppressed adult C57BL/6N mice administered oocysts i.p. can develop patent gut infections with C. parvum.

Animals↗

[Non-surgical closure of type-II atrial-septal defect and patent foramen ovale].

In the past the standard therapy for significant atrial septal defect was surgical closure. In the presence of a patent foramen ovale with otherwise unexplained (cryptogenic) cerebral embolism, the therapy was oral anticoagulation or antiplatelet therapy. Surgery was considered only in the event of recurrence. Percutaneous transcatheter occlusion of atrial septal defect and patent foramen ovale is a new and valuable alternative to surgical closure. This report presents current knowledge and our own experience of nonsurgical closure of atrial septal defects and patent foramen ovale.

Cardiac Surgical Procedures↗

The morality of human gene patents.

This paper discusses the morality of patenting human genes and genetic technologies. After examining arguments on different sides of the issue, the paper concludes that there are, at present, no compelling reasons to prohibit the extension of current patent laws to the realm of human genetics. However, since advances in genetics are likely to have profound social implications, the most prudent course of action demands a continual reexamination of genetics laws and policies in light of ongoing developments in science and technology.

Commodification↗

Familial patent ductus arteriosus and bicuspid aortic valve with hand anomalies: a novel heart-hand syndrome.

The association between cardiac and limb defects, particularly those affecting the hand, has been well documented by the delineation of several heart-hand syndromes. Based on observations with a three-generation family with seven affected individuals, we describe a novel heart-hand syndrome comprising patent ductus arteriosus, bicuspid aortic valve, 5th metacarpal hypoplasia, and brachydactyly. The inheritance pattern was consistent with autosomal dominance, although X-linked dominance could not be excluded. Penetrance appeared to be complete, but there was variability of the cardiac and hand phenotypes. Because this new syndrome closely resembled Char syndrome (patent ductus arteriosus, 5th finger middle phalangeal hypoplasia, and minor facial anomalies), multipoint linkage analysis was performed using polymorphic DNA markers spanning the recently identified Char syndrome critical region at chromosomal bands 6p12-p21.1. This analysis formally excluded this 3-cM region, documenting that the two traits are not allelic. In sum, a novel heart-hand syndrome involving left ventricular outflow and aortic arch as well as an ulnar ray derivative has been identified. Because the hand anomalies can be subtle, thorough evaluation is suggested for families inheriting these cardiac defects as a mendelian trait.

Alleles↗

Hemolysis following coil embolization of a patent ductus arteriosus.

We describe the development of hemolysis from moderate residual shunting across a patent ductus arteriosus following coil embolization. The fall in hemoglobin levels from 11.6 to 6.0 gm/dl necessitated a second coil procedure which resulted in complete closure of the residual shunting and resolution of hemolysis. Therefore, appearance of anemia following coil embolization of patent ductus arteriosus should be monitored closely; however, repeat coil embolization with elimination of residual shunt will lead to prompt recovery of normal hemoglobin levels.

Anemia, Hemolytic↗