Ball Medeiros (lathelentil82)
To quantify the impact of cardiac motion on stent length measurements with Optical Coherence Tomography (OCT) and to demonstrate in vivo OCT imaging of implanted stents, without motion artefacts. The study consists of clinical data evaluation, simulations and in vivo tests. A comparison between OCT-measured and nominal stent lengths in 101 clinically acquired pullbacks was carried out, followed by a simulation of the effect of cardiac motion on stent length measurements, experimentally and computationally. Both a commercial system and a custom OCT, capable of completing a pullback between two consecutive ventricular contractions, were employed. A 13 mm long stent was implanted in the left anterior descending branch of two atherosclerotic swine and imaged with both OCT systems. The analysis of the clinical OCT images yielded an average difference of 1.1 ± 1.6 mm, with a maximum difference of 7.8 mm and the simulations replicated the statistics observed in clinical data. Imaging with the custom OCT, yielded an RMS error of 0.14 mm at 60 BPM with the start of the acquisition synchronized to the cardiac cycle. In vivo imaging with conventional OCT yielded a deviation of 1.2 mm, relative to the length measured on ex-vivo micro-CT, while the length measured in the pullback acquired by the custom OCT differed by 0.20 mm. We demonstrated motion artefact-free OCT-imaging of implanted stents, using ECG triggering and a rapid pullback.INTRODUCTION When a new drug or biologic product enters the market, its full spectrum of side effects is not yet fully understood, as use in the real world often uncovers nuances not suggested within the relatively narrow confines of preapproval preclinical and trial work. OBJECTIVE We describe a new, phenome-wide association study (PheWAS)- and evidence-based approach for detection of potential adverse drug effects. METHODS We leveraged our established platform, which integrates human genetic data with associated phenotypes in electronic health records from 29,722 patients of European ancestry, to identify gene-phenotype associations that may represent known safety issues. We examined PheWAS data and the published literature for 16 genes, each of which encodes a protein targeted by at least one drug or biologic product. RESULTS Initial data demonstrated that our novel approach (safety ascertainment using PheWAS [SA-PheWAS]) can replicate published safety information across multiple drug classes, with validated findings for 13 of 16 gene-drug class pairs. CONCLUSIONS By connecting and integrating in vivo and in silico data, SA-PheWAS offers an opportunity to supplement current methods for predicting or confirming safety signals associated with therapeutic agents.BACKGROUND The purpose of this study was to provide a practicable and contemporary classification system that is reliable and pragmatic with respect to perioperative evaluation, planning, scientific comparison and analysis. MATERIAL AND METHODS This was a retrospective study of 160 patients who underwent acetabular revision surgery after THR due to loosening of the acetabular cup. The assessment of the acetabular defect was based on intraoperative description of the bony configuration of the acetabulum as well as on standardized preoperative planning images (pelvic overview and axial view of the hip joint). click here Preoperative computed tomography (CT) was carried out in individual cases. RESULTS Acetabular bone defects were classified into 4 types based on whether or not a 3-point fixation of the acetabular cup within the boundaries of the acetabular cavity was possible. Minor segmental defects or cup loosening without bone loss can be treated with standard hemispherical acetabular components. Bone loss can be filled with bone grafts and/or treated by the appropriate acetabular component in order to ensure stable anchorage. When conventional revision cups are no longer suitable a custom