Patent arterial duct, bottle-meal, and fatal myocardial ischaemia

A patent arterial duct in pre-term neonates is frequent. Systemic complications consecutive to left-to-right shunting are well known but fatal myocardial ischaemia has not been described till now. The presented premature baby died from catecholamine refractory cardiogenic shock. Autoptic examination revealed acute ischaemic changes predominantly in the inner third of myocardium, speaking of coronary hypoperfusion due to a steal phenomenon secondary to the patent arterial duct.

Multimodal Registration Procedure for the Initial Spatial Alignment of a Retinal Video Sequence to a Retinal Composite Image

Accurate placement of lesions is crucial for the effectiveness and safety of a retinal laser photocoagulation treatment. Computer assistance provides the capability for improvements to treatment accuracy and execution time. The idea is to use video frames acquired from a scanning digital ophthalmoscope (SDO) to compensate for retinal motion during laser treatment. This paper presents a method for the multimodal registration of the initial frame from an SDO retinal video sequence to a retinal composite image, which may contain a treatment plan. The retinal registration procedure comprises the following steps: 1) detection of vessel centerline points and identification of the optic disc; 2) prealignment of the video frame and the composite image based on optic disc parameters; and 3) iterative matching of the detected vessel centerline points in expanding matching regions. This registration algorithm was designed for the initialization of a real-time registration procedure that registers the subsequent video frames to the composite image. The algorithm demonstrated its capability to register various pairs of SDO video frames and composite images acquired from patients.

Improvement of migraine headaches after percutaneous closure of patent foramen ovale for secondary prevention of paradoxical embolism

Patent foramen ovale (PFO) has been linked to migraine, and an improvement in migraine prevalence or frequency has been reported after PFO closure for other reasons. We sought to identify whether there is a specific patient population of migraineurs which may be more susceptible to benefiting from PFO closure.

Prevention of stroke in patients with patent foramen ovale

Patent foramen ovale is found in 24% of healthy adults and 38% of patients with cryptogenic stroke. This ratio and case reports indicate that patent foramen ovale and stroke are associated, probably because of paradoxical embolism. In healthy people with patent foramen ovale, embolic events are not more frequent than in controls, and therefore no primary prevention is needed. However, once ischaemic events occur, the risk of recurrence is substantial and prevention becomes an issue. Acetylsalicylic acid and warfarin reduce this risk to the same level as in patients without patent foramen ovale. Patent foramen ovale with a coinciding atrial septal aneurysm, spontaneous or large right-to-left shunt, or multiple ischaemic events potentiates the risk of recurrence. Transcatheter device closure has therefore become an intriguing addition to medical treatment, but its therapeutic value still needs to be confirmed by randomised-controlled trials.

Real-time polymerase chain-reaction detection of pathogens is feasible to supplement the diagnostic sequence for urinary tract infections

To evaluate, in a prospective pilot study, the feasibility of identifying pathogens in urine using real-time polymerase chain reaction (PCR), and to compare the results with the conventional urine culture-based procedures.

Next-state comfort in learning a vertical stick transportation sequence

Over the last decade, the end-state comfort effect (e.g., Rosenbaum et al., 2006) has received a considerable amount of attention. However, some of the underlying mechanisms are still to be investigated, amongst others, how sequential planning affects end-state comfort and how this effect develops over learning. In a two-step sequencing task, e.g., postural comfort can be planned on the intermediate position (next state) or on the actual end position (final state). It might be hypothesized that, in initial acquisition, next state’s comfort is crucial for action planning but that, in the course of learning, final state’s comfort is taken more and more into account. To test this hypothesis, a variant of Rosenbaum’s vertical stick transportation task was used. Participants (N = 16, right-handed) received extensive practice on a two-step transportation task (10,000 trials over 12 sessions). From the initial position on the middle stair of a staircase in front of the participant, the stick had to be transported either 20 cm upwards and then 40 cm downwards or 20 cm downwards and then 40 cm upwards (N = 8 per subgroup). Participants were supposed to produce fluid movements without changing grasp. In the pre- and posttest, participants were tested on both two-step sequencing tasks as well as on 20 cm single-step upwards and downwards movements (10 trials per condition). For the test trials, grasp height was calculated kinematographically. In the pretest, large end/next/final-state comfort effects for single-step transportation tasks and large next-state comfort effects for sequenced tasks were found. However, no change in grasp height from pre- to posttest could be revealed. Results show that, in vertical stick transportation sequences, the final state is not taken into account when planning grasp height. Instead, action planning seems to be solely based on aspects of the next action goal that is to be reached.

Figulla PFO occluder versus Amplatzer PFO occluder for percutaneous closure of patent foramen ovale

Percutaneous closure of patent foramen ovale (PFO) has been shown safe and feasible using several devices. The Occlutech Figulla single layer PFO Occluder (FPO) constitutes an alternative to the Amplatzer PFO Occluder (APFO).