Background and aims
Takotsubo syndrome (TTS) is a conundrum without consensus about the cause. In a murine model of coronary microvascular dysfunction (CMD), abnormalities in myocardial perfusion played a key role in the development of TTS.
Methods and results
Vascular Kv1.5 channels connect coronary blood flow to myocardial metabolism and their deletion mimics the phenotype of CMD. To determine if TTS is related to CMD, wild-type (WT), Kv1.5−/−, and TgKv1.5−/− (Kv1.5−/− with smooth muscle-specific expression Kv1.5 channels) mice were studied following transaortic constriction (TAC). Measurements of left ventricular (LV) fractional shortening (FS) in base and apex, and myocardial blood flow (MBF) were completed with standard and contrast echocardiography. Ribonucleic Acid deep sequencing was performed on LV apex and base from WT and Kv1.5−/− (control and TAC). Changes in gene expression were confirmed by real-time-polymerase chain reaction. MBF was increased with chromonar or by smooth muscle expression of Kv1.5 channels in the TgKv1.5−/−. TAC-induced systolic apical ballooning in Kv1.5−/−, shown as negative FS (P < 0.05 vs. base), which was not observed in WT, Kv1.5−/− with chromonar, or TgKv1.5−/−. Following TAC in Kv1.5−/−, MBF was lower in LV apex than in base. Increasing MBF with either chromonar or in TgKv1.5−/− normalized perfusion and function between LV apex and base (P = NS). Some genetic changes during TTS were reversed by chromonar, suggesting these were independent of TAC and more related to TTS.
Conclusion
Abnormalities in flow regulation between the LV apex and base cause TTS. When perfusion is normalized between the two regions, normal ventricular function is restored.
Retinoblastoma (RB) is a common intraocular cancer in pediatric patients worldwide, and screening is routinely performed throughout the first few years of life. The diagnosis is often made clinically; however, the diagnosis can be delayed due to undetectable leukocoria because of small tumor size at the time of examination, missed appointments, non-compliance with eye examinations, or failure to perform the exam.As mobile devices continue to gain in both popularity and functionality, their use via applications and smartphone attachments for ocular examination introduces a new avenue for screening, detection, and staging of RB both inside and outside the clinical setting. Currently, research regarding mobile device use is still in its infancy, and further research is required to determine whether mobile devices could play a significant role in assisting with the diagnosis of RB.The purpose of this systematic review was to determine whether the existing literature supports the use of mobile devices by healthcare providers, specifically ophthalmologists and non-ophthalmologists, as well as by parents for the early detection of RB. A comprehensive literature search was conducted via PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science with a total of 10 studies included in the final analysis.
Figure 1. Bowel cleansing performance of 1L PEG1ASC: (A) Rates of segmental-level adequate-cleansing (BBPS score $2); (B) Mean BBPS score for the overall colon and per colon segment; (C) Effect of time to colonoscopy on mean BBPS score in patients receiving same-day or split dose regimens.
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