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Background: Left ventricular (LV) unloading prior to primary angioplasty in patients experiencing acute myocardial infarction holds promise for mitigating reperfusion injury and minimizing infarct size., Case Summary: This report delves into the utilization of left atrial venoarterial extracorporeal membrane oxygenation (LAVA-ECMO) as a pre-percutaneous transluminal coronary angioplasty (PTCA) intervention strategy aimed at augmenting circulatory support while unloading the LV. Three cases of patients with ST elevation myocardial infarction involving the left ascending coronary artery who underwent LAVA-ECMO before primary PTCA are presented. Each patient maintained robust LV systolic function following weaning from ECMO support., Discussion: These cases underscore the potential benefits of mechanical LV unloading prior to revascularization in reducing infarct size and mitigating the risk of post-myocardial infarction heart failure., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Objectives: Lung cancer is a main contributor to all newly diagnosed cancers worldwide. The chemoprotective effect of the influenza vaccine among patients with hypertension remains unclear. Methods: A total of 37,022 patients with hypertension were retrospectively enrolled from the Taiwan National Health Insurance Research Database. These patients were further divided into a vaccinated group ( n = 15,697) and an unvaccinated group ( n = 21,325). Results: After adjusting for sex, age, comorbidities, medications, level of urbanization and monthly income, vaccinated patients had a significantly lower risk of lung cancer occurrence than unvaccinated patients (adjusted hazard ratio [aHR]: 0.56, 95% confidence interval [CI]: 0.47-0.67). A potential protective effect was observed for both sexes and in the elderly age group. With a greater total number of vaccinations, a potentially greater protective effect was observed (aHR: 0.75, 95% CI 0.60-0.95; aHR: 0.66, 95% CI: 0.53-0.82; aHR: 0.26, 95% CI: 0.19-0.36, after receiving 1, 2-3 and ≥4 vaccinations, respectively). Conclusion: Influenza vaccination was associated with a lower risk of lung cancer among patients with hypertension. The potentially chemoprotective effect appeared to be dose dependent., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2023 Jong, Zheng, Zheng, Lin, Chiu, Hsu, Fang, Hao, Chen, Yang, Lee and Liu.)

Previous studies have indicated that influenza vaccination reduces the development of lung cancer. However, the protective effects of influenza vaccination on primary liver cancer in patients with chronic kidney disease (CKD) are unclear. This cohort study identified 12,985 patients aged at least 55 years who had received a diagnosis of CKD between 1 January 2001 and 31 December 2012 from the National Health Insurance Research Database of Taiwan. The patients were classified according to vaccination status. Propensity score matching was used to reduce selection bias. Cox proportional hazards regression analysis was used to evaluate the correlation between influenza vaccination and primary liver cancer in patients with CKD. The prevalence of primary liver cancer was lower in patients with CKD who had received an influenza vaccine (adjusted hazard ratio: 0.45, 95% confidence interval [CI]: 0.35−0.58, p < 0.001). The protective effects were observed regardless of sex, age, and comorbidities. Moreover, dose-dependent protective effects were observed. In the subgroup analysis, where the patients were classified by the number of vaccinations received, the adjusted hazard ratios for 1, 2−3, and ≥4 vaccinations were 0.86 (95% CI: 0.63−1.17), 0.45 (95% CI: 0.31−0.63), and 0.21 (95% CI: 0.14−0.33), respectively. In conclusion, influenza vaccination was associated with a lower incidence of liver cancer in patients with CKD.

Purpose: To report the result of the bone graft retrograde pedicled with the tibialis anterior muscle belly for the treatment of bone defect of tibia., Methods: Between 2017 and 2020, the bone graft pedicled with the tibialis anterior muscle was applied for the treatment of 11 patients with a cortical defect and nonunion of the tibia due to trauma and one patient with segmental bone defect caused by tramatic osteomyelitis. The tibialis anterior has the largest muscle belly, but has not been commonly used due to functional disability following use as transposition muscle flap. New anatomic and clinical data confirm that the distal half of this group of muscles can be transposed with the tendon left intact with no noticeable loss of muscle function. Based on the vascular nutrition of this muscle, we performed a retrograde pedicled bone graft using the muscle belly, thus preserving the function of this muscle., Result: The operation was relatively simple and early bone unions have been achieved without any complications., Conclusion: The bone graft pedicled with the tibialis anterior muscle is useful for the treatment of bone defect of the tibia., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Indian Orthopaedics Association 2022.)

Gluten proteins from wheat can induce celiac disease (CD) in genetically susceptible individuals. Specific gluten peptides can be presented by antigen presenting cells to gluten-sensitive T-cell lymphocytes leading to CD. During the last decades, a significant increase has been observed in the prevalence of CD. This may partly be attributed to an increase in awareness and to improved diagnostic techniques, but increased wheat and gluten consumption is also considered a major cause. To analyze whether wheat breeding contributed to the increase of the prevalence of CD, we have compared the genetic diversity of gluten proteins for the presence of two CD epitopes (Glia-α9 and Glia-α20) in 36 modern European wheat varieties and in 50 landraces representing the wheat varieties grown up to around a century ago. Glia-α9 is a major (immunodominant) epitope that is recognized by the majority of CD patients. The minor Glia-α20 was included as a technical reference. Overall, the presence of the Glia-α9 epitope was higher in the modern varieties, whereas the presence of the Glia-α20 epitope was lower, as compared to the landraces. This suggests that modern wheat breeding practices may have led to an increased exposure to CD epitopes. On the other hand, some modern varieties and landraces have been identified that have relatively low contents of both epitopes. Such selected lines may serve as a start to breed wheat for the introduction of 'low CD toxic' as a new breeding trait. Large-scale culture and consumption of such varieties would considerably aid in decreasing the prevalence of CD.