Endovascular intervention for the treatment of acute arterial gastrointestinal hemorrhage

The treatment of arterial gastrointestinal hemorrhage continues to evolve. Currently, most interventional radiologists approach bleeding both in the upper and lower gastrointestinal tract with intention to treat. Embolization has replaced local vasoconstrictive therapy as the catheter-based treatment of choice in many hospitals. Coaxial microcatheters have simplified embolotherapy and enabled lower gastrointestinal bleeding to be treated safely and effectively.     

Histamine H1 receptor occupancy by the new-generation antidepressants fluvoxamine and mirtazapine: a positron emission tomography study in healthy volunteers

Rationale

In gestational exposure studies, a fostered group is frequently used to control for drug-induced maternal effects. However, fostering itself has varying effects depending on the parameters under investigation

Objectives

This study was designed to assess whether maternal behavior contributed to enhanced acquisition (higher number of bar presses compared to controls) of nicotine self-administration (SA) displayed by offspring with gestational nicotine and ethanol (Nic+EtOH) exposure.

Methods

Offspring were exposed to Nic+EtOH throughout full gestation, that is, gestational days (GD) GD2–20 and during postnatal days 2–12 (PN2–12), the rodent third trimester equivalent of human gestation during which rapid brain growth and synaptogenesis occur. Young adult (PN60) male offspring acquired operant nicotine SA, using a model of unlimited (i.e., 23 h) access to nicotine.

Results

Gestational drug treatments did not alter litter parameters (body weight, volume distribution, crown–rump length, and brain weight) or postnatal growth of the offspring. Fostering increased locomotor activity to a novel environment on PN45 regardless of gestational treatment group. Surprisingly, fostering per se significantly increased the SA behavior of drug-naïve pair-fed controls, so that their drug-taking behavior resembled the enhanced nicotine SA observed in non-fostered offspring exposed to Nic+EtOH during gestation. In contrast, fostering did not change the SA behavior of the Nic+EtOH group.

Conclusions

Fostering is shown to be its own experimental variable, ultimately increasing the acquisition of nicotine SA in control, drug-naïve offspring. As such, the current dogma that fostering is required for our gestationally drug-exposed offspring is contraindicated.     

Outcomes of surgery for lung cancer in patients with atrial fibrillation as a preoperative comorbidity: a decade of experience at a single institution in Japan

Purpose

To investigate the surgical outcomes of surgery for non-small cell lung cancer (NSCLC) in patients with atrial fibrillation (AF) as a preoperative comorbidity.

Methods

Among 805 patients who underwent surgery for NSCLC, 27 (3.4%) had a history of AF. We analyzed the perioperative and long-term outcomes of these 27 patients.

Results

Fourteen patients (52%) had chronic AF and 13 (48%) had paroxysmal AF; being high rates of a comorbid illness. Nineteen patients (70%) underwent lobectomy, and 8 (30%) underwent sublobar resection. Ten patients (37%) received perioperative heparinization. There was no mortality. Other non-AF postoperative complications developed in 8 patients (30%), this incidence being higher than among the patients without AF (16%, 127 out of 778, p = 0.09). A thromboembolic event occurred in one patient (4%). With respect to the long-term outcomes, the 5-year overall survival and disease-free survival rates among the patients with AF were 70.3 and 60.8%, respectively, which were similar to those in the patients without AF (79.8 and 72.6%, p = 0.30 and 0.31).

Conclusions

Lung cancer surgery in patients with AF is safe and provides favorable long-term outcomes; however, thoracic surgeons should monitor these patients carefully for postoperative thromboembolic events.