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Background: Neonatal jaundice is one of the most common neonatal problems especially in preterm ones. Preterm babies are treated with different types of phototherapy. Preterm neonates have a weak antioxidant defense mechanism. Both the hyperbilirubinemia and phototherapy have an impact on this antioxidant defense system. Objective: In the current study we aimed to assess the effect of hyperbilirubinemia and phototherapy in the oxidant/antioxidant status of preterm newborns. Subjects and Methods: Thirty late preterm (≥35 weeks) neonates with non-hemolytic neonatal jaundice in the 3-9 days of life were involved in the preset study, and received phototherapy. 15 healthy neonates of the same gestational and postnatal age without jaundice were included as a control. We assessed the total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI). Results: TOS and OSI were significantly higher (P<0.01); TAC level was significantly lower (P<0. 01); in jaundiced preterm neonates than in control group. Following phototherapy there were significant increase in TOS and OSI (P<0. 01) and decrease in TAC (P<0.001). Conclusions: Both hyperbilirubinemia and phototherapy induce oxidative stress in preterm neonates. [ABSTRACT FROM AUTHOR]

The number of procedures for upgrading implantable devices for cardiac resynchronization therapy has increased considerably during the last decade. A major challenge that operators face in these circumstances is occlusion of the access vein. We have modified a pull-through method to overcome this obstacle. Six consecutive patients with occluded access veins and well-developed collateral networks underwent a procedure in which the occluded vein was recanalized by snaring the existing atrial lead via transfemoral access. Upgrading the device was successful in all patients; none had intraprocedural complications. Our experience shows that our modified pull-through technique may be a feasible alternative for upgrading cardiac resynchronization therapy in patients with venous occlusion. [ABSTRACT FROM AUTHOR]

Cuttings of Bougainvillea x buttiana "Mrs Butt" were cultured in peat moss [after treating with 1000 ppm indolebutric acid (IBA) or without] or hydroponic units contained: water, quarter Hoagland strength, half Hoagland strength, full Hoagland strength, 2.5 ppm, 5 ppm or 20 ppm IBA solutions. Results showed that treating cuttings with IBA at 1000 ppm before culturing was more effective than culturing without treating. Among the different hydroponic solution treatments, IBA solution at medium (5 ppm) or high concentration (10 ppm) had the best results, since they produced the highest values of rooting percentage, number of roots/cutting, number of shoots/cutting, shoot length, number of leaves/shoot and survival percentage. Also, using of 10 ppm IBA solution resulted in initiating the first root more rapidly than all other treatments. [ABSTRACT FROM AUTHOR]

Fungal keratitis is one of the major causes of microbial keratitis that may lead to corneal blindness. Many problems related to diagnosis and therapy are encountered in fungal keratitis, including difficulty in obtaining laboratory diagnoses and the availability and efficacy of antifungal medications. Intensive and prolonged use of antifungal topical preparations may not be enough. The use of antifungal medications is considered the main treatment for fungal keratitis. It is recommended to start antifungal therapy after confirmation of the clinical diagnosis with a smear or positive cultures. Topical application of antifungal medications is a mainstay for the treatment of fungal keratitis; however, systemic, intra-stromal, or intra-cameral routes may be used. Therapeutic keratoplasty is the main surgical procedure approved for the management of fungal keratitis with good success rate. Intrastromal corneal injection of antifungal medications may result in steady-state drug levels within the corneal tissue and prevent intervals of decreased antifungal drug concentration below its therapeutic level. In cases of severe fungal keratitis with deep stromal infiltration not responding to treatment, intracameral injection of antifungal agents may be effective. Collagen cross-linking has been proposed to be beneficial for cases of fungal keratitis as a stand-alone therapy or as an adjunct to antifungal medications. Although collagen cross-linking has been extensively studied in the past few years, its protocol still needs many modifications to optimize UV fluence levels, irradiation time, and concentration of riboflavin to achieve 100% microbial killing. [ABSTRACT FROM AUTHOR]

BACKGROUND: Aldosterone antagonists have been proven to be beneficial in severe heart failure (HF) as a result of systolic dysfunction. We sought to determine if there is a disparity in their utilization compared with ACE inhibitors and β-adrenoceptor antagonists (β-blockers). METHODS: In the first part of the study, we asked physicians to answer a questionnaire presenting a hypothetical HF patient. In the second part, we reviewed hospital charts of patients with HF exacerbation. RESULTS: Spironolactone was used less frequently than other drugs. At home, 75.0% of patients were receiving ACE inhibitors, 66.7% received β-blockers, and 38.2% received spironolactone (p < 0.001). During the admission, 93.1% of patients received ACE inhibitors and 58.3% received spironolactone (p < 0.001). CONCLUSIONS: Despite good evidence, underutilization of aldosterone antagonists in patients matching the population of the RALES (Randomized Aldactone Evaluation Study) trial persists in both outpatient and inpatient settings. The difference between the usage of ACE inhibitors and spironolactone is significant in patients with systolic dysfunction equally qualifying for both medications. [ABSTRACT FROM AUTHOR]

Two new implantable cardioverter defibrillator systems developed for compatibility with magnetic resonance imaging demonstrate safety and efficacy in the Evera MRI and ProMRI trials, with no significant changes in ventricular pacing threshold < 5.0 V or ventricular sensing. In addition, there were no serious device-related events in both studies. [ABSTRACT FROM AUTHOR]

Aims: Initial studies of catheter-based renal arterial sympathetic denervation to lower blood pressure in resistant hypertensive patients renewed interest in the sympathetic nervous system's role in the pathogenesis of hypertension. However, the SYMPLICITY HTN-3 study failed to meet its prespecified blood pressure lowering efficacy endpoint. To date, only a limited number of studies have described the microanatomy of renal nerves, of which, only two involve humans.Methods and Results: Renal arteries were harvested from 15 cadavers from the Klinikum Osnabruck and Schuchtermann Klinik, Bad Rothenfelde. Each artery was divided longitudinally in equal thirds (proximal, middle, and distal), with each section then divided into equal superior, inferior, anterior, and posterior quadrants, which were then stained. Segments containing no renal nerves were given a score value = 0, 1-2 nerves with diameter <300 µm a score = 1; 3-4 nerves or nerve diameter 300-599 µm a score = 2, and >4 nerves or nerve diameter ≥600 µm a score = 3. A total of 22 renal arteries (9 right-sided, 13 left-sided) were suitable for examination. Overall, 691 sections of 5 mm thickness were prepared. Right renal arteries had significantly higher mean innervation grade (1.56 ± 0.85) compared to left renal arteries (1.09 ± 0.87) (P < 0.001). Medial (1.30 ± 0.59) and distal (1.39 ± 0.62) innervation was higher than the proximal (1.17 ± 0.55) segments (p < 0.001). When divided in quadrants, the anterior (1.52 ± 0.96) and superior (1.71 ± 0.89) segments were more innervated compared to posterior (0.96 ± 0.72) and inferior (0.90 ± 0.68) segments (P < 0.001).Conclusions: That the right renal artery has significantly higher innervation scores than the left. The anterior and superior quadrants of the renal arteries scored higher in innervation than the posterior and inferior quadrants did. The distal third of the renal arteries are more innervated than the more proximal segments. These findings warrant further evaluation of the spatial innervation patterns of the renal artery in order to understand how it may enhance catheter-based renal arterial denervation procedural strategy and outcomes.Condensed Abstract: The SYMPLICITY HTN-3 study dealt a blow to the idea of the catheter-based renal arterial sympathetic denervation. We investigated the location and patterns of periarterial renal nerves in cadaveric human renal arteries. To quantify the density of the renal nerves we created a novel innervation score. On average the right renal arteries were significantly more densely innervated than the left renal arteries, the anterior and superior segments were significantly more innervated compared to the posterior and inferior segments, absolute innervation scores in the proximal third of the left or right renal arteries were always lower when compared to distal segments. These findings may enhance catheter-based renal arterial denervation procedural strategy and outcomes. [ABSTRACT FROM AUTHOR]