BACKGROUND: Calcium deposits in the aortic valve and mitral annulus have been associated with cardiovascular events and mortality. However, there is no accepted standard method for scoring such cardiac calcifications, and most existing methods are simplistic. The aim of this study was to test the hypothesis that a semiquantitative score, one that accounts for all visible calcium on echocardiography, could predict all-cause mortality and stroke in a graded fashion. METHODS: This was a retrospective study of 443 unselected subjects derived from a general echocardiography database. A global cardiac calcium score (GCCS) was applied that assigned points for calcification in the aortic root and valve, mitral annulus and valve, and submitral apparatus, and points for restricted leaflet mobility. The primary outcome was all-cause mortality, and the secondary outcome was stroke. RESULTS: Over a mean 3.8 ± 1.7 years of follow-up, there were 116 deaths and 34 strokes. Crude mortality increased in a graded fashion with increasing GCCS. In unadjusted proportional hazard analysis, the GCCS was significantly associated with total mortality (hazard ratio, 1.26; 95% CI, 1.17-1.35; P < .0001) and stroke (hazard ratio, 1.23; 95% CI, 1.07-1.40; P = .003). After adjusting for demographic and clinical factors (age, gender, body mass index, diabetes, hypertension, dyslipidemia, smoking, family history of coronary disease, chronic kidney disease, history of atrial fibrillation, and history of stroke), these associations remained significant. CONCLUSIONS: The GCCS is easily applied to routinely acquired echocardiograms and has clinically significant associations with total mortality and stroke.

• MeSH
• cévní mozková příhoda diagnostické zobrazování   mortalita   MeSH
• echokardiografie metody   statistika a číselné údaje   MeSH
• incidence MeSH
• kardiomyopatie diagnostické zobrazování   mortalita   MeSH
• kauzalita MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• odchylka pozorovatele MeSH
• reprodukovatelnost výsledků MeSH
• rizikové faktory MeSH
• rozložení podle pohlaví MeSH
• senzitivita a specificita MeSH
• vaskulární kalcifikace diagnostické zobrazování   mortalita   MeSH
• věkové rozložení MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Pennsylvania epidemiologie   MeSH

• MeSH
• funkce levé komory srdeční MeSH
• lidé MeSH
• mimotělní membránová oxygenace škodlivé účinky   přístrojové vybavení   metody   MeSH
• pulzatilní průtok MeSH
• respirační insuficience terapie   MeSH
• srdeční selhání terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• úvodníky MeSH
• Geografické názvy
• Pennsylvania MeSH

Microscopic investigations were undertaken to decipher the diversity in the lotic algal communities from acidic waters (pH 2.4-3.2) flowing overland in sheets and channels at an acid mine drainage (AMD) barrens near Kylertown, PA, USA. Microscopic observations, supplemented with taxonomic keys, aided in identification of the dominant algae, and measurement of carbon from adjacent soils was undertaken. The unicellular protist Euglena sp. was most abundant in slower flowing waters (i.e., pool near point of emergence and surficial flow sheets), while Ulothrix sp. was most abundant in faster flowing water from the central stream channel. A diverse range of unicellular microalgae such as Chlorella, Cylindrocystis, Botryococcus, and Navicula and several filamentous forms identified as Microspora, Cladophora, and Binuclearia were also recorded. The observed high algal diversity may be related to the long duration of AMD flow at this site which has led to the development of adapted algal communities. The comparatively higher carbon content in soil materials adjacent to slower flowing water sampling locations provides evidence for the important role of algae as primary producers in this extreme environment.

• MeSH
• biodiverzita MeSH
• Chlorophyta klasifikace   cytologie   MeSH
• hornictví MeSH
• mikrořasy klasifikace   cytologie   izolace a purifikace   MeSH
• půda chemie   MeSH
• voda chemie   MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Pennsylvania MeSH

We describe the feasibility, safety, and clinical outcomes of percutaneous lead extraction in patients at a tertiary care center who had intracardiac vegetations identified by transesophageal echocardiogram. BACKGROUND: Infection in the presence of intracardiac devices is a problem of considerable morbidity and mortality. Patients with intracardiac vegetations are at high risk for complications related to extraction and protracted clinical courses. Historically, lead extraction in this cohort has been managed by surgical thoracotomy. METHODS: We analyzed percutaneous lead extractions performed from January 1991 to September 2007 in infected patients with echocardiographic evidence of intracardiac vegetations, followed by a descriptive and statistical analysis. RESULTS: A total of 984 patients underwent extraction of 1,838 leads; local or systemic infection occurred in 480 patients. One hundred patients had intracardiac vegetations identified by transesophageal echocardiogram, and all underwent percutaneous lead extraction (215 leads). Mean age was 67 years. Median extraction time was 3 min per lead; median implant duration was 34 months. During the index hospitalization, a new device was implanted in 54 patients at a median of 7 days after extraction. Post-operative 30-day mortality was 10%; no deaths were related directly to the extraction procedure. CONCLUSIONS: Patients with intracardiac vegetations identified on transesophageal echocardiogram can safely undergo complete device extraction using standard percutaneous lead extraction techniques. Permanent devices can safely be reimplanted provided blood cultures remain sterile. The presence of intracardiac vegetations identifies a subset of patients at increased risk for complications and early mortality from systemic infection despite device extraction and appropriate antimicrobial therapy. Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

• MeSH
• defibrilátory implantabilní škodlivé účinky   MeSH
• dospělí MeSH
• echokardiografie transezofageální MeSH
• elektrokardiografie MeSH
• incidence MeSH
• infekce spojené s protézou diagnóza   epidemiologie   chirurgie   MeSH
• kardiostimulátor škodlivé účinky   MeSH
• katetrizace metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• mladiství MeSH
• mladý dospělý MeSH
• následné studie MeSH
• odstranění implantátu metody   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• tachykardie terapie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• srovnávací studie MeSH
• Geografické názvy
• Pennsylvania MeSH

• MeSH
• lidé MeSH
• mezinárodní spolupráce MeSH
• nemocnice MeSH
• řízení nemocnice MeSH
• univerzity organizace a řízení   MeSH
• výzkum MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Pennsylvania MeSH

• MeSH
• lidé MeSH
• mezinárodní spolupráce MeSH
• nemocnice MeSH
• řízení nemocnice MeSH
• univerzity MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Pennsylvania MeSH