(C) 2011 American Institute of Physics [doi: 10 1063/1 3552914]“

(C) 2011 American Institute of Physics. [doi: 10.1063/1.3552914]“
“Mefloquine is an effective and widely used anti-malarial drug; however, some clinical reports suggest that it can cause dizziness, balance,

and vestibular disturbances. To determine if mefloquine might be toxic to the vestibular system, we applied mefloquine to organotypic cultures of the macula of the utricle from postnatal day 3 rats. The macula of the utricle was micro-dissected out as a flat surface preparation and cultured with 10, 50, 100, or 200 mu M mefloquine for 24 h. Specimens were stained with TRITC-conjugated phalloidin to label the actin in hair cell stereocilia and TO-PRO-3 to visualize cell nuclei. Some utricles were also labeled with fluorogenic caspase-3, -8, or -9 selleck chemical indicators to evaluate the mechanism of programmed cell death. Mefloquine treatment caused a dose-dependent loss https://www.selleckchem.com/products/nec-1s-7-cl-o-nec1.html of utricular hair cells. Treatment with 10 mu M caused a slight reduction, 50 mu M caused a significant reduction, and 200 mu M destroyed nearly all the hair cells. Hair cell nuclei in mefloquine-treated utricles were condensed and fragmented, morphological features of apoptosis. Mefloquine-treated utricles were positive for the extrinsic initiator caspase-8 and intrinsic

initiator caspase-9 and downstream executioner caspase-3. These results indicate that mefloquine can induce significant hair cell degeneration in the postnatal rat utricle and that mefloquine-induced hair cell death is initiated by both caspase-8 and caspase-9.”
“The choice of appropriate therapeutic plans for primary endocervical adenocarcinomas (ECA) and endometrial adenocarcinomas (EMA) depend on the tumor’s site of origin. The purpose of this study was to compare the performances of the commonly used three-marker (ER/Vim/CEA), four-marker (ER/Vim/CEA/PR) and five-marker (ER/Vim/CEA/PR/p16(INK4a)) panels in distinguishing between primary ECA

and EMA.

A tissue microarray was constructed using paraffin-embedded, formalin-fixed tissues from 35 hysterectomy specimens, including 14 ECA and 21 EMA. Utilizing the avidin-biotin (ABC) technique, JNJ-64619178 tissue array sections were immunostained with five commercially available antibodies (ER, Vim, CEA, PR and p16(INK4a)) to evaluate the performances of their respective three-, four- and five-marker panels in distinguishing between primary ECA and EMA.

ER, PR and Vim were more likely to be expressed in EMA, while CEA and p16(INK4a) were frequently expressed in ECA. The three-marker (ER/Vim/CEA) panel exhibits the most favorable performance in the distinction between these two gynecologic malignancies (ECA vs. EMA).

The new Papal position has been widely applauded, but made conser

The new Papal position has been widely applauded, but made conservative Catholics unhappy. A dialogue with the Church now seems possible: Does concentrating on condoms hinder the effectiveness of other strategies? What are the respective roles of condoms and other approaches to prevent infection

spread? Does a special CP-690550 molecular weight situation exist in Africa requiring specific and focused interventions? (C) 2011, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.”
“Cardiac rhabdomyoma (CR) is the most common heart tumor in children and is usually associated with tuberous sclerosis complex (TSC). Tuberous sclerosis complex is a genetic disorder caused by a mutation in either of 2 genes (TSC1 or TSC2) and characterized by the formation of hamartomas in multiple organs. The 2 TSC proteins’ hamartin and tuberin, antagonize the mammalian target of rapamycin (mTOR) signaling pathway, thus regulating cell growth and proliferation. Recently, some trials treating TSC with the mTOR inhibitor rapamycin have

been published; however, the impact of such treatment on heart tumors is not known. The aim of the present paper was to study the molecular pathobiology of CRs. Six CR samples were studied. The expression of S6K1, pErk, Erk, Akt, pAkt, 4E-BP1, hamartin, tuberin, mTOR, bcl-2, Bax, and Ki-67 was examined using immunohistochemistry and Western blot methods. Increased expression of Bax, mTOR, pS6K, pErk, and 4E-BP1 was found in all find more CR samples. Hamartin and tuberin expression was decreased in tumors versus normal heart tissues. This is the first study showing mTOR pathway dysregulation and an increased expression of proapoptotic Bax protein in CRs associated with TSC.”
“The number of patients undergoing lumbar learn more spinal fusion procedures (LSF) has risen in recent years, but only few studies have examined different rehabilitation strategies for this patient group.

To evaluate the impact of initiating rehabilitation either 6 or 12 weeks after a LSF based

on the patients’ physical performance using the 6-min walking test (6MWT) and the strand Fitness test (AF-test) as measurement.

A multicentre RCT including 82 patients with degenerative disc diseases undergoing LSF randomly assigned to initiate rehabilitation either 6 or 12 weeks after surgery. Both groups received the same group-based rehabilitation. The main outcome measures were the 6MWT and the AF-test, secondarily questionnaire-based measures. Follow-up at baseline as well as at 3, 6 and 12 months after surgery.

Comparing the two groups no statistically significant difference was found in walking distance or fitness over time. In both groups, the patients achieved an overall increase in walking distance (p < 0.01), but no improvement in fitness. The 6MWT showed significant correlation (-0.37 to -0.

Accordingly, in addition to PFOS-related industries, domestic act

Accordingly, in addition to PFOS-related industries, domestic activities may also considerably contribute to the PFOS emissions in the eastern coastal region of China, which has been characterized by high industrial input. In the present study, domestic emissions of PFOS equivalents derived from

municipal wastewater treatment plants were estimated at the county level, using a regression model of domestic emission density with population density and per capita disposable income as independent variables. The total emission load of PFOS equivalents from domestic sources in the eastern coastal Caspase inhibitor region of China was 381 kg in 2010, and large cities were prominent as the emission centers. Cytoskeletal Signaling inhibitor The domestic emission density averaged 0.37 g/km(2).a for the entire study area. Generally, the Beijing-Tianjin area, Pearl River Delta and Yangtze River Delta, as the most populous and economically developed areas in China, showed significantly higher emission density. Geographical variations

within individual provinces were noteworthy. The average per capita discharge load of PFOS equivalents arising from domestic activities was 1.91 mu g/day per capita in the eastern coastal region of China, which is consistent with previous estimates in Korea, but lower than those calculated for developed countries. In comparison, the spatial distributions of provincial PFOS emissions from domestic and industrial sources were similar to each other; however, the latter was much larger for all the provinces. (C) 2013 Elsevier Ltd. All rights reserved.”
“Background: Extracardiac comorbidities are common in patients with heart failure and a preserved ejection fraction (HFPEF). We sought to evaluate

the relationship between comorbidities and ventricular structure and function in patients with HFPEF through evaluation AZD6094 cost of pressure-volume analysis.

Methods and Results: Two hundred twenty Chinese patients with a preserved ejection fraction who were either healthy (n = 75), hypertensive without heart failure (HTN; n = 89), or hypertensive with HFPEF (HFPEF; n = 56) were studied. Using echocardiographic measures, estimated end-systolic and end-diastolic pressure-volume relationships, and the area between them as a function of EDP, the isovolumic pressure-volume areas (PVA(iso)), were calculated. Ventricular capacitance, as measured by V(30), was larger in patients with HFPEF compared with normal control subjects and tended to be larger compared with hypertensive control subjects. The presence of diabetes and renal insufficiency was independently associated with greater ventricular capacitance in patients with HFPEF. The PVA(iso) was increased in patients with HFPEF compared with HTN and normal control subjects, and in particular, it was increased in HFPEF patients with multiple comorbidities.

approved criteria for susceptibility testing are still lacking T

approved criteria for susceptibility testing are still lacking. The aim of this study was to evaluate tigecycline activity against multidrug resistant A. baumannii clinical isolates, as well as susceptibility testing methods and disk diffusion (DD) breakpoints. Reference Tubastatin A broth microdilution (BMD), Etest and DD methods were used. MIC(50) and MIC(90) by the reference method were 1 and 8 mu g/ml, respectively. Applying the breakpoints for Enterobactericeae, 85.7% of the isolates were sensitive to tigecycline. The Etest resulted in lower susceptibility rates (63.7%). Essential agreement between Etest and BMD was 75.8%. 21.9% of the strains were susceptible by BMD and intermediate by Etest.

Provisional DD breakpoints >= 19/<= 14 mm produced unacceptable minor errors while adjustment to >= 17/<= 13 mm yielded the best results. In conclusion, resistance was not rare against our MDR A. baumannii isolates although tigecycline had not been used previously. Breakpoints >= 17/<= 13 mm may be preferred for DD. We suggest caution with intermediate results by Etest.”
“We present a computational approach for the determination of the equilibrium misfit dislocation density and strain in a semiconductor heterostructure with an arbitrary

compositional profile. We demonstrate that there is good agreement between our computed results and known analytical solutions for heterostructures containing a single linearly graded layer or a single uniform selleck composition layer. We have calculated the dislocation VE-822 density and strain profiles in Si(1-x)Ge(x)/Si(001), In(x)Ga(1-x)As/GaAs(001), and ZnS(y)Se(1-y)/GaAs(001) heterostructures, each containing a uniform composition layer (uniform layer) on a linearly graded buffer layer (graded layer). The density of misfit dislocations in the graded layer is inversely proportional to its grading coefficient and is unchanged by the presence of the uniform layer, but the dislocated thickness increases with the uniform layer thickness. If the uniform layer is sufficiently thick, misfit dislocations will exist throughout the graded layer, but

additional misfit dislocations are not produced in the uniform layer. The biaxial strain in the uniform layer is inversely proportional to its thickness and is unchanged by the graded layer. We have also calculated the equilibrium configuration in a convex, exponentially graded Si(1-x)Ge(x)/Si(001) layer, for which the misfit dislocation density is tapered with distance from the interface. Other nonlinear grading profiles offer opportunities to tailor the misfit dislocation density and strain profile. (C) 2009 American Institute of Physics. [doi:10.1063/1.3243312]“
“Background: Accidental puncture of the vertebral arteries (VAs) can occur through the internal jugular veins (IJVs) during central venous catheterization (CVC).

9 weeks with up to 15 (65 2%) patients presenting in the second t

9 weeks with up to 15 (65.2%) patients presenting in the second trimester. Eighteen (78.3%) patients had histopathologically proven appendicitis giving a negative appendectomy rate of 21.7%. Postoperative complications were noted in eight (34.8%) patients. Half of these occurred within the negative appendectomy group. The negative appendectomy group also contributed significantly to the adverse obstetric outcome: preterm labor, 8.7% of 21.7%, preterm delivery, 4.5% selleck products of 13.6% and a fetal

loss rate of 4.3% of 13%. One maternal death occurred in the group with diseased appendix giving a maternal mortality rate of 4.3%.

Conclusions: While a higher index of suspicion among clinicians will ensure earlier diagnosis and improve the associated maternal and fetal prognosis, the need to reduce the negative laparotomy rate is highlighted by the high rate of adverse obstetric outcomes amongst the negative appendectomy group.”
“Background: Dysphagia is a major complication of stroke, but factors influencing its recovery are incompletely understood. The goal of this study was to identify important prognostic variables affecting swallowing recovery after acute ischemic stroke. Methods: We retrospectively reviewed our patient

database to identify acute ischemic stroke patients who developed dysphagia after stroke but were free of other confounding conditions affecting swallowing. Of the 1774 patients screened, 323 met the study criteria. We assessed ATM inhibitor cancer the effect of age, sex, baseline National Institutes of Health Stroke Scale (NIHSS) score, level of consciousness (LOC),

facial weakness, dysarthria, neglect, bihemispheric Vadimezan infarcts, right hemispheric infarcts, brainstem infarcts, intubation, aspiration, acute stroke therapies, occurrence of symptomatic hemorrhagic transformation, seizures, pneumonia, and length of hospitalization (LOH) on persistence of dysphagia at hospital discharge in a logistic regression analysis. Results: The mean age and NIHSS scores (mean 6 standard deviation) were 75.9 +/- 13.6 years and 13.5 +/- 6.9, respectively; 58.5% were women. In a multivariate analysis, aspiration detected on a clinical swallowing evaluation (odds ratio [OR] 21.83; 95% confidence interval [CI] 8.16-58.42; P < .0001), aspiration on videofluoroscopic swallowing study (OR 10.50; 95% CI 3.35-32.96; P < .0001), bihemispheric infarcts (OR 3.72; 95% CI 1.33-10.43; P = .0123), dysarthria (OR 3.4; 95% CI 1.57-7.35; P = .0019), intubation (OR 2.86; 95% CI 1.10-7.39; P = .0301), NIHSS score >= 12 (OR 2.51; 95% CI 1.19-5.23; P – .0157) were significant predictors of persistent dysphagia. The area under the curve and Somer’s D-xy statistics of the model were 0.8918 and 0.78, respectively, indicating good calibration and discriminative power. Conclusions: Prognostic factors affecting swallowing recovery identified in this study can help advance dysphagia research methodologies and the clinical care of stroke patients.

This novel mechanism may apply to other class C, G protein-couple

This novel mechanism may apply to other class C, G protein-coupled receptors. Am J Clin Nutr 2009;90(suppl):733S-7S.”
“Cellulytic enzymes were used for the isolation and structural characterization of Populus deltoides wood lignin as a fast growing and important species in wood processing technology. The isolation was based on the hydrolysis and partial solubilization of wood

xylan and cellulose using combination of Thricoderma lanuginosus xylanase, Aspergillus sp. plus, A. niger cellulase, and almond glycosidase, followed by lignin purification using Ispinesib supplier Bacillus licheniformis alkaline protease (for hydrolysis of cellulase contamination). The structure of enzymatic

lignin (EL) was elucidated using chemical analysis, Py-GC/MS, FTIR, and quantitative (13)C-NMR techniques. Different lignin structures of acetylated and nonacetylated lignin preparation were calculated. P. deltoides EL has been determined to have an h : g : s ratio of 5 : 60 : 35. Also, P. deltoides EL contained 0.59/Ar of beta-O-4 moieties with small amounts of other structural units such as pino/syringyresinol (0.05/Ar), phenylcoumaran (0.05/Ar), GSK1120212 concentration and spirodienone (0.01/Ar). The degree of condensation was estimated at 20%. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 118: 469-479, 2010″
“Umami taste is elicited by many small molecules, including amino acids ( glutamate and aspartate) and nucleotides (monophosphates Dinaciclib clinical trial of inosinate or guanylate, inosine 5′-monophosphate and guanosine-5′-monophosphate). Mammalian taste buds respond to these diverse compounds via membrane receptors that bind

the umami tastants. Over the past 15 y, several receptors have been proposed to underlie umami detection in taste buds. These receptors include 2 glutamate-selective G protein-coupled receptors, mGluR4 and mGluR1, and the taste bud-expressed heterodimer T1R1+T1R3. Each of these receptors is expressed in small numbers of cells in anterior and posterior taste buds. The mGluRs are activated by glutamate and certain analogs but are not reported to be sensitive to nucleotides. In contrast, T1R1+T1R3 is activated by a broad range of amino acids and displays a strongly potentiated response in the presence of nucleotides. Mice in which the Grm4 gene is knocked out show a greatly enhanced preference for umami tastants. Loss of the Tas1r1 or Tas1R3 genes is reported to depress but not eliminate neural and behavioral responses to umami. When intact mammalian taste buds are apically stimulated with umami tastants, their functional responses to umami tastants do not fully resemble the responses of a single proposed umami receptor.

Conclusion General anesthesia represents a risk factor for BDE,

Conclusion. General anesthesia represents a risk factor for BDE, increasing its prevalence and duration. (Oral Surg Oral

Med Oral Pathol Oral Radiol Endod 2010;110:706-712)”
“Background: Anopheles darlingi is the major vector of malaria in South America, and its behavior and distribution has epidemiological importance to biomedical research. In Brazil, I-BET151 An. darlingi is found in the northern area of the Amazon basin, where 99.5% of the disease is reported.

Methods: The study area, known as Ramal do Granada, is a rural settlement inside the Amazon basin in the state of Acre. Population variations and density have been analysed by species behaviour, and molecular analysis has been measured by ND4 mitochondrial gene sequencing.

Results: The results show higher density in collections near a recent settlement, suggesting that a high level of colonization decreases the vector presence. The biting activity

showed higher activity at twilight and major numbers of mosquitos in the remaining hours of the night in months of high density. From a sample of 110 individual mosquitoes, 18 different haplotypes were presented Raf activation with a diversity index of 0.895, which is higher than that found in other Anopheles studies.

Conclusions: An. darlingi depends on forested regions for their larval and adult survival. In months with higher population density, the presence of mosquitoes persisted Selleck Omipalisib in the second part of the night, increasing the vector capacity of the species. Despite the intra-population variation in the transition to rainy season, the seasonal distribution of haplotypes shows no change in the structure population of An. darlingi.”
“Objective. The aim of this paper was to analyze how healing occurs between onlay bone graft and the mandible cortex.

Study design. Autologous and allogeneic corticocancellous bones, harvested from the ilium wing, were grafted at each mandible

side of 40 rabbits. One side received platelet-rich plasma (PRP). Killings occurred at 3, 7, 14, 28, and 56 days. Tissues were stained by hematoxylin-eosin and toluidine blue. New bone area was measured at different regions of sections stained with toluidine blue. Wilcoxon test was used to analyze differences among regions and Bonferroni test toanalyze the influence of PRP, graft nature, and days.

Results. Osteogenesis was higher at the lateral region (P < .05). PRP tended to improve bone neoformation, which was higher at the allogeneic graft. Statistical significance among the different categories of variables-grafts, use of PRP, and days of observation-did not have a linear behavior. A linear behavior of statistical tests was not detected. Bone new formation increased until the 14th day (P < .05).

Conclusions. Onlay grafts heal due to osteogenesis which occurs at the lateral region and between the cortex and host mandible. Allogeneic grafts and PRP tend to improve bone formation.

They were then asked to rate injection

They were then asked to rate injection GSK3326595 order pain on an 11-point numerical rating scale and to note any bruising. Physician preference was also evaluated.


There were no statistically significant differences in the amount of intra-procedural pain (p=.37) or the level

of post-procedural pain and discomfort (p=.76) experienced. Twenty-seven percent of subjects reported greater bruising with the 32-gauge needle, versus 29.7% with the 30-gauge needle. The physician injector did not have a preference. Lastly, 83.8% of subjects did not detect a difference in BTX-A paralysis effect.


We do not recommend using 32-gauge needles in place of 30-gauge needles for administering BTX-A.

The authors have indicated no significant interest with commercial

“The purpose of this study was to evaluate the relationship between the grades of positivity of the direct antiglobulin test (DAT) and their effects on the duration of phototherapy for neonatal jaundice. DAT reactions of blood samples were graded as (1+), (2+), (3+) and (4+). DAT was positive in 80 neonates who were exposed to phototherapy due to jaundice. Patients with positive DAT reactions are classified in the study as follows: 34 newborns were DAT (1+), 18 newborns were DAT (2+), 16 newborns were DAT (3+) and 12 newborns were DAT (4+). We found that higher grades of positivity of DAT are associated with extended duration of phototherapy (r = 0.436, p<0.05). Additionally, DAT (4+) reactions are more predictive for a prolonged duration of phototherapy requirement than the other grades (p<0.0001).”
“A wide application JNJ-26481585 of carbon nanotubes (CNTs) is on the way owing to their unique structural, optical, mechanical MEK inhibition and electronic properties, high specific surface area, and facile functionalization. As a result, human beings will inevitably be exposed to CNTs, especially when the tubes are utilized as diagnostic and therapeutic tools to better understand, detect, and treat human diseases. Therefore the new subject of nanotoxicology, which is the study of the

toxicity of nanomaterials, is now gaining public concern. This review provides an overview and comments on recent advances (mostly within the last 3 years) in the toxicology of CNTs, including their toxicity targeted to cells, organs, tissues and the whole organism, including mammals and other species (e.g. aquatic species, plants, and bacteria). Not only these traditional subjects of toxicological study but the interaction of CNTs and biomacromolecules is also covered so that the mechanism of their toxicity may be understood and their undesirable properties are more likely to be avoided. (C) 2011 Elsevier Ltd. All rights reserved.”
“The development of industrial microbial processes is gaining unprecedented momentum. Increased concern for environmental issues and the prospect of declining petroleum resources has shifted the industrial focus increasingly to microorganisms as biocatalysts.

p , for one hour prior to ischemia) On the 15th

day foll

p., for one hour prior to ischemia). On the 15th

day following https://www.selleckchem.com/products/dinaciclib-sch727965.html nephrectomy, groups 3 and 4 were subjected to 45 min of renal pedicle occlusion followed by 3 h of reperfusion. At the end of the treatment period, kidney samples were taken for histological examination or determination of the renal malondialdehyde (MDA) and glutathione (GSH) levels. Serum creatinine, blood urea nitrogen (BUN), and lactate dehydrogenase (LDH) concentrations were measured for the evaluation of renal function. I/R caused a significant decrease in GSH level, which was accompanied with a significant increase in MDA level of kidney tissues. Similarly, serum BUN and creatinine levels, as well as LDH, were elevated in the I/R group as compared to the control group. In group four, AA treatment reversed all the changes in these biochemical indices, as well as histopathological alterations normally induced by I/R. The findings imply that reactive oxygen species play a causal role in I/R-induced renal injury, and that AA exerts renoprotective effects, probably by radical scavenging and antioxidant activities.”
“We aim to report the 3-year outcome and complications of the tension-free vaginal tape obturator (TVT-O) in treating female stress urinary incontinence buy BMS-345541 (SUI).

Retrospective analysis for complications and outcome of surgery was performed in 419 women undergoing the TVT-O from 2004 to 2006.

Three patients (0.8%) with an isolated TVT-O had a

blood loss of more than 200 ml.

Two patients (0.5%) had bladder perforation. Out of 11 readmitted patients (2.6%), 10 were due to voiding difficulty. Six patients (1.4%) required tape loosening or division. Persistent pain occurred in 3.6% and erosion in 2.4% of patients. One hundred eighty-five patients (44.2%) came for follow-up at 3 years. The actual subjective and objective success rates were 89.7% and 99.9% at 3 years follow-up, respectively. With imputation, the 3-year subjective and objective PARP inhibitor drugs success rates were 86.9% and 97.4%, respectively.

The TVT-O is effective in treating female SUI with minimal complications.”
“Background: Evidence that links dietary factors to ovarian cancer is conflicting, but several epidemiologic studies suggested that consumption of dietary fat and meat may increase risk of ovarian cancer.

Objective: We studied associations of intakes of total fat and sources and subtypes of fat, fresh meat, processed meat, and fish with ovarian cancer risk within the Netherlands Cohort Study (NLCS).

Design: The NLCS includes 62,573 postmenopausal women, aged 55-69 y at baseline, who completed a baseline questionnaire on dietary habits and other risk factors for cancer in 1986. After 16.3 y of follow-up, 340 ovarian cancer cases and 2161 subcohort members were available for a case-cohort analysis. Multivariable rate ratios (RRs) were adjusted for age at baseline, total energy intake, oral contraceptive use, and parity.

Results: After a mean 8 1 y of follow-up, 215 women in the interv

Results: After a mean 8.1 y of follow-up, 215 women in the intervention group and 285 women in the comparison group (annualized rate: 0.14% and 0.12%, respectively) experienced a hip fracture (hazard ratio: 1.12; 95% CI: 0.94, 1.34; P = 0.21). The intervention group (n = 5423; annualized rate: 3.44%) had a lower rate of reporting >= 2 falls than did the comparison group (n = 8695; annualized rate: 3.67%) (HR: 0.92; 95% CI: 0.89, 0.96; P < 0.01). There was a significant interaction according to hormone therapy use; those in the comparison group receiving hormone therapy had the lowest incidence of hip fracture. In a subset

of 3951 women, hip BMD at years 3, 6, and 9 was 0.4-0.5% lower in the intervention Go 6983 in vivo group than in the comparison group (P – 0.003).

Conclusions: A low-fat and increased fruit, vegetable, and grain diet intervention modestly reduced the risk of multiple falls and slightly lowered hip BMD but did not change the risk of osteoporotic fractures. This trial was registered at clinicaltrials. gov as NCT00000611. Am J Clin Nutr 2009; 89: 1864-76.”
“Methods: We analyzed 787

CRT-defibrillator (CRT-D) recipients with a glomerular filtration rate (GFR) measured prior to implant. Patients were grouped by GFR (in mL/min/1.73 m2): >= 60 (n = 376), 30-59 (n = 347), and < 30 (n = 64). Overall survival, changes in left ventricular (LV) ejection fraction and LV end-systolic diameter, and GFR change at 3-6 months were Elafibranor compared among CRT-D groups and with a control cohort (n = 88), also stratified by GFR, in whom LV lead implant was unsuccessful and a standard defibrillator (SD) was placed. All patients met clinical criteria for CRT-D.

Results: Among CRT-D recipients, overall survival improved incrementally with higher baseline GFR (for each 10 mL/min/1.73 m2 increase, corrected hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.13-1.30, P < 0.0001). Survival among SD and CRT-D patients within GFR < 30

and GFR >= 60 groups was similar, whereas CRT-D recipients with GFR 30-59 had significantly better survival compared click here to SD counterparts (HR 2.23, 95% CI 1.34-3.70; P = 0.002). This survival benefit was associated with improved renal and cardiac function. CRT recipients with GFR >= 60 derived significant echocardiographic benefit but experienced a GFR decline, whereas those with GFR < 30 had no echocardiographic benefit but did improve GFR.

Conclusions: CRT may provide the largest survival benefit in HF patients with moderate RI, perhaps by improving GFR and LV function. Severe baseline RI predicts poor survival and limited echocardiographic improvement despite a modest GFR increase, such that CRT may not benefit those with GFR < 30 mL/min/1.73 m2.