Safety and clinical effect of i.v. infusion of cyclopropyl-methoxycarbonyl etomidate (ABP-700), a soft analogue of etomidate,in healthy subjects

Background

Cyclopropyl-methoxycarbonyl metomidate, or ABP-700, is a second generation analogue of etomidate, developed to retain etomidate's beneficial haemodynamic and respiratory profile but diminishing its suppression of the adrenocortical axis. The objective of this study was to characterise the safety and efficacy of 30-min continuous infusions of ABP-700, and to assess its effect on haemodynamics and the adrenocortical response in healthy human volunteers.

Characteristic pattern of pleural effusion in electrical impedance tomography images of critically ill patients

Background

Electrical impedance tomography (EIT) is increasingly used for continuous monitoring of ventilation in intensive care patients. Clinical observations in patients with pleural effusion show an increase in out-of-phase impedance changes. We hypothesised that out-of-phase impedance changes are a typical EIT finding in patients with pleural effusion and could be useful in its detection.

Pathological Bases and Clinical Impact of Intratumor Heterogeneity in Clear Cell Renal Cell Carcinoma

Purpose of Review

Intratumor heterogeneity is an inherent event in tumor development that is receiving much attention in the last years since it is responsible for most failures of current targeted therapies. The purpose of this review is to offer clinicians an updated insight of the multiple manifestations of a complex event that impacts significantly patient’s life.

Recent Findings

Clear cell renal cell carcinoma is the most common renal tumor and a paradigmatic example of a heterogeneous neoplasm. Next-generation sequencing has demonstrated that intratumor heterogeneity encompasses genetic, epigenetic, and microenvironmental variability. Currently accepted protocols of tumor sampling seem insufficient in unveiling intratumor heterogeneity with reliability and need to be updated. This variability challenges the precise morphological diagnosis, its molecular characterization, and the selection of optimal personalized therapies in clear cell renal cell carcinoma, a neoplasm traditionally considered chemo- and radio-resistant.

Summary

We review the state of the art of the different approaches to intratumor heterogeneity in clear cell renal cell carcinomas, from the simple morphology to the most sophisticated massive sequencing tools.

     

Geographic variations in clinical presentation and outcomes of decompressive surgery in patients with symptomatic degenerative cervical myelopathy: analysis of a prospective,international multicenter cohort study of 757 patients

Background Context

Degenerative cervical myelopathy (DCM) is a progressive degenerative spine disease and the most common cause of spinal cord impairment in adults worldwide. Few studies have reported on regional variations in demographics, clinical presentation, disease causation, and surgical effectiveness.

Magnetic resonance imaging of the lumbar spine: determining clinical impact and potential harm from overuse

Background

Lumbar spine magnetic resonance imaging is frequently said to be “overused” in the evaluation of low back pain, yet data concerning the extent of overuse and the potential harmful effects are lacking.

Dynamics of MRI lesion development in an animal model of viral-induced acute progressive CNS demyelination

Theiler's murine encephalitis virus (TMEV) infection in mice is an established model of CNS demyelinating diseases. The aim of the study was to determine the chronological pattern of lesion development in this model of monophasic fulminant demyelinating disease. We followed six highly susceptible interferon-gamma receptor knockout mice with serial in vivo brain magnetic resonance imaging (MRI) studies to determine changes in overall T2 lesion load and gadolinium enhancement. Altogether, 163 individual lesions were followed over 52 days. The number of lesions increased linearly with time. Four chronological patterns of lesion development were seen: (a) expanding lesions (48.5% of all lesions, 54.05% volume contribution); (b) expanding-retracting lesions (20.85% of all lesions, 15.03% volume contribution); (c) fluctuating lesions (16.6% of all lesions, 28.8% volume contribution); (d) stable lesions (14.05% of all lesions, 2.12% volume contribution). Gadolinium enhancement was not seen in the evolution of every lesion. Enhancement was both time- and lesion type-dependent. Early in the disease course (<43 days after infection), enhancement was almost always seen, later on (>43 days after infection) it was only seen in 8% of new lesions. All of fluctuating, 85.3% of expanding, 83.5% of expanding-retracting, and 56.5% of stable lesions were associated with gadolinium enhancement. We conclude that the MRI features of TMEV-induced demyelination in this model showed four unique chronological patterns, and inconsistent gadolinium enhancement. These novel findings may provide new insights into the pathogenesis of acute fulminant multiple sclerosis (MS).     

Reaktive Sauerstoffspezies und Gefäßdegeneration

Zeitschrift für Herz-,Thorax- und Gefäßchirurgie - Reaktive Sauerstoffspezies (ROS) erlangen in der derzeitigen Diskussion um die Genese der kardiovaskulären Degeneration eine...     

Literaturübersicht 2017 zur Koronarchirurgie

Zeitschrift für Herz-,Thorax- und Gefäßchirurgie - Die Koronarchirurgie ist ein wichtiger Bestandteil der Behandlung der koronaren Herzkrankheit (KHK). Seit der Einführung der...