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A meta-analysis of 1-year outcomes of transcatheter versus surgical aortic valve replacement in low-risk patients with severe aortic stenosis

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Journal of Geriatric Cardiology 2020年第1期17卷 43-50,I0008-I0010页

作者： Aaqib H Malik syed Zaid Hasan Ahmad Joshua Goldberg Tanya Dutta Cenap Undemir Martin Cohen wilbert s aronow steven L Lansman Department of Medicine Westchester Medical Center and New York Medical CollegeValhallaNYUSA Department of Cardiology Westchester Medical Center and New York Medical CollegeValhallaNYUSA section of Cardiothoracic surgery Department of SurgeryWestchester Medical CenterValhallaNew YorkUSA

Background Transcatheter aortic valve replacement(TAVR)for the treatment symptomatic severe aortic stenosis(As)is indicated in patients with intermediate or higher surgical *** trials showed TAVR,and surgical aortic valve replacement(sAVR)perform similarly at 1-year for the composite outcomes of mortality,stroke and *** performed a comprehensive meta-analysis to compare individual outcomes at 1-year for TAVR compared to sAVR in low-risk *** Pub Med,Embase,and Cochrane central were searched for all the randomized controlled trials(RCTs)that reported 1-year comparative outcomes of TAVR and surgical aortic valve replacement(sAVR).Our conclusions are based upon the random-effects model using Der simonian-Laird *** Data from 4 trials and 2887 randomized patients showed that TAVR had lower rates of all-cause mortality,cardiovascular mortality,and atrial fibrillation compared to sAVR at 1-year follow-up(Pso,TAVR was also associated with a significantly higher risk of permanent pacemaker implantation and moderate-severe paravalvular leak(Psions The latest randomised trial data demonstrates that in short-term,TAVR is safe and effective in reducing all-cause mortality or *** follow-up of RCTs is needed to determine the durability of clinical benefits in TAVR over sAVR in low-risk patients.

关键词： Aortic stenosis Low surgical risk Meta-analysis Transcatheter aortic valve replacement

Cardiac papillary fibroelastoma:The need for a timely diagnosis

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World Journal of Clinical Cases 2017年第1期5卷 9-13页

作者： srikanth Yandrapalli Bella Mehta Pratik Mondal Tanush Gupta Pallavi Khattar John Fallon Randy Goldberg sachin sule wilbert s aronow Department of Internal Medicine New York Medical College at Westchester Medical Center Department of Pathology New York Medical College at Westchester Medical Center Department of Cardiology New York Medical College at Westchester Medical Center

Cardiac papillary fibroelastomas(CPFs) are the second most common primary cardiac tumors and the most common cardiac valvular tumors. Although they are histologically benign and usually asymptomatic, CPFs can lead to serious and life-threatening complications like myocardial infarction, stroke, pulmonary embolus, cardiac arrest etc. CPFs represent a rare entity in clinical medicine and literature regarding their management is limited. We report two cases which illustrate such complications arising from undiagnosed CPFs on the aortic valve. We further stress on the importance of identifying CPFs early so that they can be managed appropriately based on recommendations from the available literature.

关键词： Lambl’s excrescences Aortic valve Cardiac tumors Cardiac papillary fibroelastoma sudden cardiac death

Assessment of neovascularization within carotid plaques in patients with ischemic stroke

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World Journal of Cardiology 2010年第4期2卷 89-97页

作者： wilbert s aronow Chandra K Nair David Cosgrove Division of Cardiology New York Medical CollegeValhalla Center of Creighton University OmahaNE 68131United States Department of Imaging sciences Imperial CollegeHammersmith Hospital

AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic ***:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero-sclerotic plaques in the internal carotid artery were *** thickest soft plaque in each patient was examined using contrast-enhanced ***-intensity curves were collected from 5 s to 3 min after contrast *** neovascularization within the plaques in the internal carotid artery was evaluated using the ACQ software built into the scanner by 2 of the experienced investigators who were blinded to the clinical history of the ***:Ischemic stroke was present in 7 of 33 patients(21%) with grade Ⅰ plaque,in 14 of 51 pa-tients(28%) with grade Ⅱ plaque,in 26 of 43 patients(61%) with grade Ⅲ plaque,and in 34 of 49 patients(69%) with grade Ⅳ plaque(P sis of the time intensity curves revealed that patients with ischemic stroke had a significantly higher intensity of enhancement(IE) than those without ischemic stroke(P sh-in time(WT) of plaque was signifi-cantly shorter in stroke patients(P sensi-tivity and specificity for IE in the plaque were 82% and 80%,respectively,and for WT were 68% and 74%,*** was no significant difference in the peak intensity or time to peak between the 2 ***:This study shows that the higher the grade of plaque enhancement,the higher the risk of ischemic *** data suggest that the presence of neovascularization is a marker for unstable plaque.

关键词： Carotid artery plaques Cerebral infarction Contrast-enhanced ultrasonography Ischemic stroke Neovascularization

Ambulatory pulmonary artery pressure monitoring in advanced heart failure patients

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World Journal of Cardiology 2017年第1期9卷 21-26页

作者： srikanth Yandrapalli Anoshia Raza sohaib Tariq wilbert s aronow Department of Cardiology New York Medical College at Westchester Medical CenterValhallaNY 10595United States

Heart failure (HF) is an emerging epidemic associate with significant morbidity, mortality, and health care expenditure. Although there were major advances in pharmacologic and device based therapies for the management of HF, mortality of this condition remains high. Accurate monitoring of HF patients for exacerbations is very important to reduce recurrent hospitalizations and its associated complications. With the failure of clinical signs, tele-monitoring, and laboratory bio-markers to function as early markers of HF exacerbations, more sophisticated techniques were sought to accurately predict the circulatory status in HF patients in order to execute timely pharmacological intervention to reduce frequent hospitalizations. CardioMEMssup>TMsup> (st. Jude Medical, Inc., saint Paul, Minnesota) is an implantable, wireless pulmonary arterial pressure (PAP) monitoring system which transmits the patient’s continuous PAPs to the treating health care provider in the ambulatory setting. PAP-guided medical therapy modification has been shown to significantly reduce HF-related hospitalization and overall mortality. In advanced stages of HF, wireless access to hemodynamic information correlated with earlier left ventricular assist device implantation and shorter time to heart transplantation.

关键词： CardioMEMs Heart failure Remote heart failure monitoring Pulmonary arterial pressure monitoring Left ventricular assist device

Editorial on hemoglobin A1c, blood pressure, and lowdensity lipoprotein cholesterol goals in diabetics

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World Journal of Cardiology 2013年第5期5卷 119-123页

作者： wilbert s aronow Division of Cardiology Department of Medicine Westchester Medical Center/New York Medical College Valhalla NY 10595 United States

The American Diabetes Association (ADA) 2013 guidelines state that a reasonable hemoglobin A1c goal for many nonpregnant adults with diabetes is less than 7.0% a hemoglobin A1c level of less than 6.5% may be considered in adults with short duration of diabetes, long life expectancy, and no significant cardiovascular disease if this can be achieved without significant hypoglycemia or other adverse effects of treatment. A hemoglobin A1c level less than 8.0% may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced macrovascular and microvascular complications, extensive comorbidities, and long-standing diabetes in whom the hemoglobin A1c goal is difficult to attain despite multiple glucoselowering drugs including insulin. The ADA 2013 guidelines recommend that the systolic blood pressure in most diabetics with hypertension should be reduced to less than 140 mmHg. These guidelines also recommend use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in the treatment of hypertension in diabetics unless they are pregnant. Diabetics at high risk for cardiovascular events should have theirserum low-density lipoprotein (LDL) cholesterol lowered to less than 70 mg/dL with statins. Lower-risk diabetics should have their serum LDL cholesterol reduced to less than 100 mg/dL. Combination therapy of a statin with either a fibrate or niacin has not been shown to provide additional cardiovascular benefit above statin therapy alone and is not recommended. Hypertriglyceridemia should be treated with dietary and lifestyle changes. severe hypertriglyceridemia should be treated with drug therapy to reduce the risk of acute pancreatitis.

关键词： Diabetes mellitus Blood pressure Hemoglobin A1c serum low-density lipoprotein cholesterol statins Lipid-lowering drugs

Re-evaluation of the phylogenetic position of the genus Dexiotrichides (Protozoa, Ciliophora, scuticociliatida) inferred from stomatogenetic and molecular information for Dexiotrichides pangi

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Progress in Natural science:Materials International 2005年第8期15卷 700-707页

作者： Alan WARREN,David ROBERTs,Norbert wilbert London sW7 5BD UK Zoologisches Institut Universitt Bonn 53115 Bonn Germany Department of Zoology Natural History of Museum Cromwell Road London sW7 5BD UK Department of Zoology Natural History of Museum Cromwell Road

The divisional process and systematic position of the marine scuticociliate Dexiotrichides pangi are studied. Based on both stomatogenetic data and 18s rDNA gene sequences, the phylogeny and morphogenetic characteristics of this taxon, and of other related genera, are analyzed and discussed. Both the divisionary events and the molecular biological data indicate that this species/genus, together with certain other genera in the Dexiotricha-complex, occupies an intermediate position between the tetrahymenids and the “typical” scuticociliate, which suggests that the Dexiotricha-like taxa should be excluded from the “true” scuticociliates. As a further contribution, the process of stomatogenesis in D. pangi can be summarized as follows: (1) The oral primordia in the opisthe are formed only by the proliferation of basal bodies in the scutica field, which subsequently develop into three membranelles, while the new paroral membrane seems to be generated by the sub-anterior portion of somatic kinety 1 (the 1st postoral intercalary kinety). The latter character exhibits a mode similar to Tetrahymena. (2) In the proter the parental membranelles are retained and remain unchanged throughout the entire division process; only the old paroral membrane is disassembled and differentiated into the anlage, which then gives rise to the new paroral membrane and the scutica of the proter. The 18s rRNA gene sequence reported here is the first one for a ciliate in the Dexiotricha-complex.

关键词： marine ciliate systematic position stomatogenesis 18s rRNA gene sequences Dexiotrichides pangi.

High sensitivity and high selectivity terahertz biomedical imaging

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Chinese Optics Letters 2011年第11期9卷 46-49页

作者： seongsin M.Kim William Baughman David s.wilbert Lee Butler Michael Bolus soner Balci Patrick Kung Department of Electrical and Computer Engineering University of AlabamaTuscaloosa

We demonstrate two distinct emerging terahertz （THz） biomedical imaging *** is based on the use of a new single frequency THz quantum cascade laser and the other is based on broadband THz time domain *** first method is employed to derive a metastasis lung tissue imaging at 3.7 THz with clear contrast between cancerous and healthy *** second approach is used to study an osseous tissue under several imaging modalities and achieve full THz spectroscopic imaging based on the frequency domain or on a fixed THz propagation *** contrast is achieved which facilitated the identification of regions with different cellular types and density compositions.

关键词： THz High sensitivity and high selectivity terahertz biomedical imaging high

study on stability of Ion-exchange Resin Catalysts:Ⅱ. Desulfonation during Isobutylene Dimerization

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China Petroleum Processing & Petrochemical Technology 2011年第1期13卷 52-57页

作者： Tan songwei Wang Hongjun Jiang Hongliang Wang Liqun wilbert Tsao Lin Xiangzhou MOE Key Laboratory of Macromolecular synthesis and Functionalization Department of Polymer Science and Engineering Zhejiang University Hangzhou 310027 China The Purolite Company 150 Monument Road Bala Cynwyd PA 19004 USA

The performance of ion-exchange resin catalysts during isobutene (IB) dimerization was investigated under different IB contents,temperatures and liquid-volume hourly space velocity (LHsV) using a plug flow reactor in the absence of any selectivity enhancing *** IB content and temperature resulted in a high conversion and C12 selectivity bu low C8 *** influence of LHsV was related with the IB content:LHsV had great effect at high IB content,while the performance of ion-exchange resin changed little with LHsV if IB content was *** effect of water on the stability of resins was also *** was observed during the C4 dimerization reaction when water was added to the *** resin was more stable than conventional polystyrene-based resins during the test.

关键词： ion-exchange resin catalysts flow reactor dimmer desulfonation

NETosis,complement,and coagulation:a triangular relationship

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Cellular & Molecular Immunology 2019年第1期16卷 19-27页

作者： Cynthia M.de Bont wilbert C.Boelens Ger J.M.Pruijn Department of Biomolecular Chemistry Institute for Molecules and Materials(IMM)Radboud UniversityNijmegenThe Netherlands

NETosis is a regulated form of neutrophil cell death that contributes to the host defense against pathogens and was linked to various diseases soon after its first description in *** NETosis,neutrophils release neutrophil extracellular traps(NETs),which can capture and kill bacteria and other pathogens to prevent them from *** substantial progress has been made in our understanding of NETosis,the precise mechanism underlying NETosis is still a matter of *** continues to elucidate the molecular pathways involved in *** recent years,interactions with the complement and coagulation systems have become increasingly *** complement proteins can stimulate NET formation,and NETs,in turn,can serve as a platform for complement *** addition,NETs can act as a scaffold for thrombus formation during *** crosstalk between the coagulation and complement systems has been previously described,NETosis appears to be a third important player in this consortium to protect the host against *** review summarizes our current knowledge on the mutual interactions between NETosis,the complement system and the coagulation system,with an emerging description of their complex triangular relationship.

关键词： coagulation complement NETosis neutrophils thrombosis