Growth and Differentiation of Transplanted W/Wv Marrow

This paper reports new data on the effect of the action of the mutant genesW and W^v on murine hemopoiesis. Our studies demonstrate that the presenceof these mutant genes produces: (1) a macrocytic anemia with neithergranulocytopenia nor thrombocytopenia; (2) a severe defect in the earlystages of hemopoietic repopulation manifested by (a) an apparent block inthe differentiation of immature cells into erythroid precursors, and (b) a greatly reduced rate of proliferation of differentiated hemopoietic elements.

These data demonstrate the existence of genetic influence on repopulationand differentiation of transplanted marrow and suggest that severe anemia mayresult not only from defects in the late stages of erythroid development butalso from abnormalities in the early stages of erythroid maturation andhemopoietic repopulation.

Submitted on February 15, 1967 Accepted on May 5, 1967     

Safety of Transcatheter Aortic Valve Implantation in a Hospital With Visiting On‐Site Cardiac Surgery

Objectives

To describe the feasibility and safety of transcatheter aortic valve implantation (TAVI) with a visiting on‐site cardiac surgery program for surgical back‐up.

Background

Both European and American guidelines recommend institutional cardiac surgery back‐up for TAVI. However, the conversion to cardiac surgery is very rare, many complications of TAVI can be managed by catheter techniques and a visiting team can also provide surgical stand‐by. Therefore, the need for institutional cardiac surgery (by a surgeon who routinely performs conventional surgical valve replacement at the institution performing TAVI) has been questioned.

Methods

A retrospective review of consecutive TAVI cases with visiting on‐site cardiac surgery was performed. Key demographic, echocardiographic, and procedural data were collected prospectively.

Results

A total of 97 patients (81.9 ± 6.3 years) with high‐risk criteria (log Euroscore 21.6 ± 14.4, chronic renal failure 39.2%, severe systolic dysfunction 24.7%) underwent TAVI with visiting on‐site cardiac surgery at our institution. Local anesthesia with or without conscious sedation was used in 94.8% of patients. Procedural technical success was 100%, with 2 episodes of tamponade (both treated with pericardiocentesis) and a 16.5% vascular complication rate (all treated conservatively or percutaneously). Thirty‐day mortality was 3.1%, with 5.2% rate of stroke and 8.2% rate of major bleeding. There were no conversions to surgery.

Conclusions

TAVI can be done safely in the setting of a hospital with visiting on‐site cardiac surgery. This requires careful patient selection, experienced operators and surgeons in experienced centers with well‐established criteria and processes of care. In this setting, it may be an option for hospitals without institutional cardiac surgery. (J Interven Cardiol 2015;28:76–81)

     

A child-to-child programme in rural Jamaica

A child-to-child programme was carried out in six rural schools in Jamaica. School children in grades 4 and 5 were taught concepts of nutrition, environmental and personal hygiene, and child development. The children were encouraged to take messages home to their parents and improve the care of their younger siblings. Four hundred and twenty-three children and 90 mothers and guardians from four of the project schools were evaluated and compared with 199 children and 47 parents from two control schools. The project children showed higher scores on a test of knowledge in the topics at the end of the year. They also improved in some practices at home. The mothers improved in knowledge in some areas but not in their practices. We consider the results sufficiently encouraging to justify incorporating the programme into the country's education curriculum for primary schools.     

The effect of lorazepam on memory and event-related potentials in heavy and light social drinkers

To investigate the effects of heavy social drinking on sober cognitive processing, event-related potentials were recorded from 13 heavy social drinkers and 13 light social drinkers in the presence and absence of a pharmacological challenge (i.e., lorazepam). Event-related potentials were elicited by a task reuqiring continuous recognition memory for visually presented words. The heavy social drinkers exhibited shorter P2 latencies than the light in the task) versus “new” words. Lorazepam increased motor reaction time to correctly identified old words and produced a deficit in recognition memory only in the light social drinkers. Light social drinkers had an increased P300 latency anda larger P300 amplitude to new words in the lorazepam treatment. The differences in cognitive functioning evident between heavy and light social drinkers were reflected in event-related potential deviations and appear to indicate a tolerance in heavy social drinkers to the effects of lorazepam.     

Dermatoses in five related female carriers of X-linked chronic granulomatous disease

Eight female members of a family with X-linked chronic granulomatous disease were identified. Five were shown to be carriers of the disease gene. Each of these female carriers of the gene had a history of skin eruptions. The identification of the carrier state is important as genetic counselling should be offered and the prenatal diagnosis of this disorder is possible.     

The Usefulness of a Stretch-Polyester Pouch to Encase Implanted Pacemakers and Defibrillators

This study was undertaken to assess the effects of enclosing permanent pacemaker and ICD pulse generators in a stretch-polyester pouch prior to implantation. Follow-up of 223 patients with oversized pacemakers and with ICDs and 344 witb standard-sized pacemaker pulse generators showed that the pouch was effective in decreasing the frequency of pulse generator migration and extrusion.