Mid-term follow-up after aortic valve replacement with the Carpentier Edwards Magna Ease prosthesis.

BACKGROUND: Approximately 250,000 heart valve operations are performed annually worldwide. An intensive research and development effort has led to progressively more advanced heart valve prostheses. The Carpentier-Edwards Perimount Magna Ease (CEPME) prosthesis represents the latest iteration of the Edwards Perimount series of aortic tissue valves. The current study aims to evaluate the midterm performance of this bioprosthesis. METHODS: Five hundred and eighteen patients with aortic stenosis underwent aortic valve replacement with the CEPME valve at Papworth Hospital between August 2008 and November 2011. After a minimum of 3 years from the index operation, eligible patients were retrospectively and consecutively recruited to participate. Recruitment was closed after 100 eligible patients had completed all study assessments. Investigations at follow-up included echocardiography, and NYHA status. Primary endpoints included valve performance measures. RESULTS: The mean age was 72 years, 64% were male and median follow-up was 5.1 years. NYHA status had improved in 66% of patients. The average postoperative peak and mean pressure gradients decreased by 51.2 mmHg (64.5%) and 31.8 mmHg (59.4%), with a significant improvement in NYHA status. The frequency of moderate aortic regurgitation was 3%. There was no evidence for structural valve deterioration. CONCLUSIONS: The CEPME has excellent mid-term durability. Its use effectively improves haemodynamics and functional capacity.

Experiences of the HIV Cascade of Care Among Indigenous Peoples: A Systematic Review.

Indigenous leaders remain concerned that systemic oppression and culturally unsafe care impede Indigenous peoples living with HIV from accessing health services that make up the HIV cascade of care. We conducted a systematic review to assess the evidence related to experiences of the HIV care cascade among Indigenous peoples in Australia, Canada, New Zealand, and United States. We identified 93 qualitative and quantitative articles published between 1996 and 2017 reporting primary data on cascade outcomes disaggregated by Indigenous identity. Twelve involved data from Australia, 52 from Canada, 3 from New Zealand and 26 from United States. The majority dealt with HIV testing/diagnosis (50). Relatively few addressed post-diagnosis experiences: linkage (14); retention (20); treatment initiation (21); adherence (23); and viral suppression (24). With the HIV cascade of care increasingly the focus of global, national, and local HIV agendas, it is critical that culturally-safe care for Indigenous peoples is available at all stages.

Analysis of sterigmatocystin in cereals, animal feed, seeds, beer and cheese by immunoaffinity column clean-up and HPLC and LC-MS/MS quantification.

A method is reported for the analysis of sterigmatocystin in various food and feed matrices using a commercial sterigmatocystin immunoaffinity column (IAC) for sample clean-up prior to HPLC analysis by UV with mass spectrometric detection (LC-MS/MS). Cereals (wheat, oats, rye, maize and rice), sunflower seeds and animal feed were spiked with sterigmatocystin at levels from 0.75 to 50 µg kg(-1) to establish method performance. Using acetonitrile/water extraction followed by IAC clean-up, and analysis by HPLC with detection at 325 nm, recoveries ranged from 68% to 106%, with repeatability from 4.2% to 17.5%. The limit of quantification with UV detection in these matrices was 1.5 µg kg(-1). For the analysis of beer and cheese the sample preparation prior to IAC clean-up was changed to accommodate the different properties of the matrix, prior to analysis by LC-MS/MS. For beer and cheese spiked at 5.0 µg kg(-1) the recoveries were 94% and 104%, and precision (RSDs) were 1.9% and 2.9% respectively. The limits of quantification by LC-MS/MS in beer and cheese were 0.02 and 0.6 µg kg(-1) respectively. The sterigmatocystin IAC was demonstrated to provide an efficient clean-up of various matrices to enable this mycotoxin to be determined by either HPLC with UV detection or LC-MS/MS.

Subnetwork-Specific Homeostatic Plasticity in Mouse Visual Cortex In Vivo.

Homeostatic regulation has been shown to restore cortical activity in vivo following sensory deprivation, but it is unclear whether this recovery is uniform across all cells or specific to a subset of the network. To address this issue, we used chronic calcium imaging in behaving adult mice to examine the activity of individual excitatory and inhibitory neurons in the same region of the layer 2/3 monocular visual cortex following enucleation. We found that only a fraction of excitatory neurons homeostatically recover activity after deprivation and inhibitory neurons show no recovery. Prior to deprivation, excitatory cells that did recover were more likely to have significantly correlated activity with other recovering excitatory neurons, thus forming a subnetwork of recovering neurons. These network level changes are accompanied by a reduction in synaptic inhibition onto all excitatory neurons, suggesting that both synaptic mechanisms and subnetwork activity are important for homeostatic recovery of activity after deprivation.

Immunoaffinity column cleanup with LC/MS/MS for the determination of chloramphenicol in honey and prawns: single-laboratory validation.

A single-laboratory validation was conducted to establish the effectiveness of an immunoaffinity column (IAC) cleanup procedure followed by LC/MS/MS for the determination of chloramphenicol (CAP) in honey and prawns. Honey is dissolved in buffer solution and centrifuged, and an aliquot applied to an IAC. For prawns, a portion of the homogenized sample is shaken with buffer and centrifuged, and an aliquot similarly applied to an IAC. For both matrix extracts, CAP is removed from the IAC with neat methanol, then directly analyzed by electrospray LC/MS/MS in the negative ionization mode using m/z 321 as a precursor ion and m/z 257 and 152 as qualifier and quantifier ions, respectively. Test portions of blank honey and prawns were fortified with CAP to give levels of 0.3, 1.0, and 5.0 microg/kg. Recoveries of CAP on 3 consecutive days ranged from 83-103% for honey and 84-108% for prawns. Based on results for fortified blank matrixes (triplicate at three levels), the RSD for repeatability (RSDr) averaged 8.4% for honey and 4.8% for prawns. The method LOD was 0.05 for prawns and 0.16 microg/kg for honey, both well below the minimum required method performance limit for CAP. The accuracy of the method was demonstrated by participation in proficiency testing, where satisfactory Z-scores were obtained for CAP in incurred samples of both honey and prawns. The method was shown to be applicable to a wide range of other matrixes, including milk, egg, royal jelly, meat, and seafood products.

Identification and subsequent removal of an interference by FAIMS in the bioanalysis of dianicline in animal plasma.

BACKGROUND: The determination of pharmacokinetic parameters requires accurate and reliable bioanalytical methods. Even using highly selective MS/MS, interferences can occur. This paper describes the source of some of these interferences with an example discussed involving the problem of a ketamine interference in a plasma assay. RESULTS: The introduction of field asymmetric waveform ion mobility spectrometry (FAIMS) removed the interference, enhanced signal-to-background and met GLP acceptance criteria. Relative to the non-FAIMS method, assay calibration characteristics were improved. The FAIMS source gave optimal performance following the introduction of a split in order to reduce the inlet flow to approximately 0.4 ml/min. CONCLUSION: The introduction of ion-mobility separation into a bioanalytical LC-MS/MS method can remove unexpected isobaric interferences without the need to redevelop the chromatography.