High rate of SVR with DAA in haemophiliacs with HCV infection: Three decades of follow‐up of a Portuguese single‐centre cohort

Abstract Introduction Pacing leads remain the weak link of current pacemaker systems. Various differences in design and material exist among companies. Lead performance is mainly assessed via post-marketing studies of the manufacturing companies. Reliable independent reports are rare. We aimed to study the early and long-term performance of the Microport (formerly Sorin/Livanova) Beflex and Vega leads at our centre, for which a lead survival >99% at 3 years has been reported by the company. Method In this single centre, retrospective study we analysed the performance of all right ventricular Microport pacemaker leads implanted at our centre between January 2014 and January 2018. Only first pacemaker implants were considered. Lead failure was defined as any lead issue requiring reintervention during follow-up (dislocation, perforation, electrical abnormalities such as lead noise or excessively high thresholds). Results A total of 271 Microport right ventricular pacing leads were implanted (233 Beflex and 38 Vega leads). Mean patient age was 76±13.1 years (66% men). Dual chamber pacemakers were implanted in 162 patients (60%) and single chamber in 109 (40%). Mean threshold at implant was 0.6V/0.5ms (range 0.3–1.2V), mean R wave 13.2 mV (range 1.5–30mV) and mean impedance 816 Ohm (range 469–1639 Ohm). Patients without available follow-up information were excluded (N=18, 6.6%). The remaining 253 patients (93.4%) were analysed. Median follow-up was 1.26 years, IQR [25%=0.91 and 75%=2.24]. We observed a total of 25 lead failures (10%). Lead dislocation occurred in 2 cases (0.8%), lead perforation in 5 cases (2%), electrical abnormalities in 6 cases (2.4%) and excessively high threshold in 12 cases (4.8%; mean voltage 4V, range 2–7.5V; mean pulse width 0.75ms, range 0.35–1ms). Yearly incidence of lead failure per 100 leads was 6.1% (95%-CI [4.09–8.98] with a failure rate of 12.74% at 3 year in Kaplan-Meier analysis (Figure). Figure 1 Conclusion We found an unexpectedly high rate of lead failure of the Microport Beflex and Vega pacing leads at our centre. The two main reasons for premature lead failure were excessively high thresholds as well as electrical abnormalities during follow-up. Comparison of lead performance with other centres and against other leads are needed to further assess the magnitude of the problem.

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REPEAT CHEST CT SCANS IN MODERATE-TO-SEVERE PATIENTS’ MANAGEMENT DURING THE COVID-19 PANDEMIC: OBSERVATIONS FROM A SINGLE CENTRE IN WUHAN, CHINA

Radiation Protection Dosimetry ◽

10.1093/rpd/ncaa106 ◽

2020 ◽

Vol 190 (3) ◽

pp. 269-275

Author(s):

Lang Chen ◽

Qiuxia Wang ◽

Hongyu Wu ◽

Junwu Hu ◽

Jing Zhang

Keyword(s):

Clinical Utility ◽

Disease Duration ◽

Value Added ◽

Healthcare Systems ◽

Chest Ct ◽

High Rate ◽

Single Centre ◽

Computed Tomographic ◽

Repeat Chest

Abstract Objective To observe the rates of repeated computed tomographic scans (CTs) in a cohort of patients with coronavirus disease-2019 (COVID-19) and to assess the validity of repeat CTs. Methods Each CT was recorded, and the validity of the repeated CTs was assessed. Results The 394 patients underwent a total of 1493 CTs. Of the 394 patients, 260 received at least one non-value-added CT. Both the total number of CTs (median, 4; interquartile range (IQR), 3–5) and non-value-added CTs (median, 1; IQR, 0–1) per patient were strongly related to the disease duration (R2 = 0.566 for total CTs, R2 = 0.432 for non-value-added CTs, p < 0.001). The proportion of non-value-added CTs was potentially higher after 3 weeks from symptom onset (>35%). Conclusions There was a high rate of repeat CTs for the COVID-19 patients, and the proportion of non-value-added CTs increased with disease duration. Follow-up CT should be avoided without clinical decline. Advances in Knowledge As COVID-19 is impacting healthcare systems across the globe, we believe in our findings that serial chest CT imaging has limited clinical utility in basically stable COVID-19 patients, will help relieve some of this burden.

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High rate of chronicity in HCV infection determined by antibody confirmatory assay and PCR in 4110 patients during long-term follow-up

Journal of Clinical Virology ◽

10.1016/s1386-6532(99)00005-0 ◽

1999 ◽

Vol 13 (1-2) ◽

pp. 43-51 ◽

Cited By ~ 4

Author(s):

Heinz-Hubert Feucht ◽

Bernhard Zöllner ◽

Matthias Schröter ◽

Susanne Polywka ◽

Peter Buggisch ◽

...

Keyword(s):

Hcv Infection ◽

High Rate ◽

Long Term Follow Up ◽

Confirmatory Assay

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Acute hepatitis C virus (HCV) infection in the setting of HIV coinfection: a single-centre 10-year follow-up

Journal of the International AIDS Society ◽

10.7448/ias.17.4.19638 ◽

2014 ◽

Vol 17 ◽

pp. 19638 ◽

Cited By ~ 2

Author(s):

Patrick Ingiliz ◽

Katharina Steininger ◽

Marcel Schuetze ◽

Stephan Dupke ◽

Andreas Carganico ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Acute Hepatitis ◽

Hcv Infection ◽

Acute Hepatitis C ◽

Single Centre ◽

Hiv Coinfection

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Viral clearance or persistence after acute hepatitis C infection: Interim results from a prospective study

Medicina ◽

10.3390/medicina44070066 ◽

2008 ◽

Vol 44 (7) ◽

pp. 510 ◽

Cited By ~ 9

Author(s):

Aušra Guobužaitė ◽

Shilpa Chokshi ◽

Ligita Balčiūnienė ◽

Alina Voinič ◽

Aušra Stiklerytė ◽

...

Keyword(s):

Hepatitis C ◽

Acute Hepatitis ◽

Alanine Aminotransferase ◽

Viral Clearance ◽

Hcv Infection ◽

High Rate ◽

Hcv Rna ◽

Acute Hepatitis C ◽

G Cell

Objective. Hepatitis C virus infection (HCV) has a high rate of chronic evolution; however, the underlying mechanisms remain to be elucidated. We investigated natural clinical, virological, and immunological course of acute HCV infection in order to identify possible prognostic factors of spontaneous resolution and to gain more understanding of early characteristics responsible for viral clearance or persistence. Materials and methods. Eight patients with acute symptomatic hepatitis C were prospectively followed up for more than 6 months (range, 8–14 months). None of the individuals received antiviral therapy during the study period. We analyzed biochemical, virological, and immunological parameters of these patients detected at different time-points of the follow-up. Plasma HCV RNA was quantitated using TaqManâ real-time polymerase chain reaction. Virusspecific CD4+ T cells were enumerated by interferon-gamma (IFN-g) ELISpot assay. Results. Two of eight individuals resolved HCV spontaneously, while the remaining patients developed chronic HCV infection. HCV RNA became undetectable within 14 days of the study, followed by a rapid alanine aminotransferase normalization in patients with resolved infection. On the contrary, chronically infected subjects demonstrated persistent viremia or intermittently undetectable HCV-RNA, accompanied by polyphasic alanine aminotransferase profile throughout the study. Patients with self-limited hepatitis C displayed the strongest virus-specific CD4+ T (IFN-g) cell reactivity within the first weeks of the follow-up, while persistently infected subjects initially showed a weak antiviral CD4+ T (IFN-g) cell response. Conclusions. In most cases, acute hepatitis C progresses to chronic disease. Viral clearance within the first month after clinical presentation accompanied by monophasic alanine aminotransferase profile could predict recovery. Early and strong CD4+/Th1 immune response against HCV might play an important role in the disease resolution.

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Periprocedural risk and long-term outcome of intracranial angioplasty based on a single-centre experience

VASA ◽

10.1024/0301-1526/a000287 ◽

2013 ◽

Vol 42 (4) ◽

pp. 264-274

Author(s):

Dagmar Krajíčková ◽

Antonín Krajina ◽

Miroslav Lojík ◽

Martina Mulačová ◽

Martin Vališ

Keyword(s):

Death Rate ◽

Long Term Outcomes ◽

Single Centre ◽

Intracranial Atherosclerotic Stenosis ◽

Atherosclerotic Stenosis ◽

Angioplasty And Stenting ◽

Aggressive Medical Management ◽

Stroke Death

Background: Intracranial atherosclerotic stenosis is a major cause of stroke and yet there are currently no proven effective treatments for it. The SAMMPRIS trial, comparing aggressive medical management alone with aggressive medical management combined with intracranial angioplasty and stenting, was prematurely halted when an unexpectedly high rate of periprocedural events was found in the endovascular arm. The goal of our study is to report the immediate and long-term outcomes of patients with ≥ 70 % symptomatic intracranial atherosclerotic stenosis treated with balloon angioplasty and stent placement in a single centre. Patients and methods: This is a retrospective review of 37 consecutive patients with 42 procedures of ballon angioplasty and stenting for intracranial atherosclerotic stenosis (≥ 70 % stenosis) treated between 1999 and 2012. Technical success (residual stenosis ≤ 50 %), periprocedural success (no vascular complications within 72 hours), and long-term outcomes are reported. Results: Technical and periprocedural success was achieved in 90.5 % of patients. The within 72 hours periprocedural stroke/death rate was 7.1 % (4.8 % intracranial haemorrhage), and the 30-day stroke/death rate was 9.5 %. Thirty patients (81 %) had clinical follow-up at ≥ 6 months. During follow-up, 5 patients developed 6 ischemic events; 5 of them (17 %) were ipsilateral. The restenosis rate was 27 %, and the retreatment rate was 12 %. Conclusions: Our outcomes of the balloon angioplasty/stent placement for intracranial atherosclerotic stenosis are better than those in the SAMMPRIS study and compare favourably with those in large registries and observational studies.

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