[Common femoral artery bailout stenting with covered stent graft due to TAVR vascular complication: Clinical long term follow-up]. / Suivi clinique après implantation d'un stent couvert dans l'artère fémorale commune au décours immédiat d'une complication vasculaire per-TAVI.

BACKGROUND: Vascular complications are frequent in the context of transcatheter aortic valve replacement and may require the implantation of a covered stent graft in the common femforal artery. However, common femoral artery is considered to be at high risk of stent fracture or occlusion due to high mobility of the hip joint. PATIENTS AND METHODS: We analyzed medical records of patients with transcatheter aortic valve replacement related vascular complications between 2015 and 2018, treated with commom femoral artery transluminal angioplasty or surgery. Vascular complications or suspect symptoms were followed up by phone calls. RESULTS: Among 552 patients, 43 patients were included. Twelve (11.6 %) were managed by prolonged balloon inflation, 5 (11.6 %) by first line surgery and 26 (60.4 %) by the implantation of a covered stent graft. Among the latter group, the covered stent graft was efficient in 24 patients (92.3 %). The median follow-up was 430 days [3-1499]. The first-line surgery group had a higher risk of red blood cell transfusion and all causes mortality. At follow-up, no patient had suspicious symptoms of vascular covered stent complication. Four patients (9.3 %) had US-doppler or CT vascular imaging at follow-up, showing no evidence of stent fracture or occlusion. CONCLUSION: In our study, the implantation of a covered stent graft in the common femoral artery was an efficient and safe strategy for the management of transcatheter aortic valve replacement related vascular complications.

An estimation of US horse-owner/caregiver willingness-to-pay for daily use and infectious upper respiratory disease treatment options.

BACKGROUND: Equine injury and disease cause two types of costs for those financially responsible for treating and caring for the infected horse(s); direct costs of treating the horse and indirect cost of lost use of the horse for a period of time to the user of the horse (daily horse use). Indirect costs are more difficult to estimate but pose significant financial implications for equine-owners/caregivers. Additionally, there exists a gap in existing research regarding the valuation of infectious treatment options in horses. OBJECTIVE: To estimate the value a US horse-owner/caregiver places on daily horse use and describe respondents' willingness-to-pay for various attributes of equine treatment options. STUDY DESIGN: Online questionnaire survey. METHODS: An online questionnaire was provided to equine-owners and caretakers, and owner demographic, horse care and horse use information from respondents were requested. Additionally, respondents were presented with hypothetical disease treatment options with the following attributes: daily dosage, number of days of rest required, route of administration and out-of-pocket cost to the owner/caretaker through a choice experiment. Data were analysed using a rank-ordered logit analysis and willingness-to-pay estimates for daily use and treatment options were calculated. RESULTS: Results suggest that the average horse-owner with an uninsured and insured horse is willing to pay $12.07 (95% confidence interval: -$15.01, -$9.69) and $17.95 (95% confidence interval: -$25.30, -$11.20) per day to reduce lost use days required (due to need for rest) respectively. Respondents showed preferences for oral administration over treatments requiring i.m. injections. MAIN LIMITATIONS: As this study employed an online survey it was subjected to self-selection bias and a sample size calculation was not performed. CONCLUSIONS: Veterinarians and pharmaceutical companies may use these results when promoting various treatment options to horse-owners/caregivers and in product development. Additionally, promotion efforts may be targeted towards equine-owners with higher daily use values (owners with insured horses).

[The Harlequin Baby syndrome. A new case]. / Le syndrome du bébé arlequin. Une nouvelle observation.

The Harlequin baby syndrome is a rare but lethal ichtyosis. We report a new case of a primiparous woman of 28 years of age who had a pregnancy that progressed normally with the delivery of a child of 2,450 grams whose Apgar was 9 at one minute and 10 at three minutes, but who died after living just 24 hours. The reason for this work is to try to analyse the features that are known about possible treatment and antenatal diagnosis of the Harlequin baby syndrome. It has been suggested that vitamin A supplements should be given for several years because the skin state may be improved. On the other hand morbidity is likely to remain serious particularly from the point of view of growth and psychomotor development. Antenatal diagnosis using skin biopsy can be obtained after 23 weeks of amenorrhoea using a fetoscope; it shows the 25% of cases recur. At present the only treatment if a recurrence does occur is to terminate the pregnancy.

[The value of antibiotic prophylaxis during intrauterine procedures during vaginal delivery. A comparative study of 500 patients]. / Intérêt de l'antibioprophylaxie lors de gestes intra-utérins au cours d'un accouchement par voie basse. Etude comparative à partir de 550 patientes.

This comparative study carried out on 550 patients has made it possible for us to show how valuable prophylactic antibiotic therapy is when certain intra-uterine manipulations (such as forceps delivery, manual removal of the placenta or exploration of the cavity of the uterus) are carried out during vaginal delivery. Furthermore, we have been able to show that there are certain risk factors of which the most important are premature rupture of the membranes, infected liquor, birth weight of the infant less than 2,500 g and epidural analgesia. The financial study has shown that it is cheaper to use prophylactic antibiotics when the comparison is made with the cost of treating complications of infection associated with these intra-uterine procedures.