41-0.95)/0.76 (0.49-1.03) in the intention-to-treat

group and 0.77 (0.42-1.10)/0.84 (0.49-1.18) in completers. Older age at baseline, late onset, and lower severity of SAD were significantly associated with good outcomes as a result of mixed-model analyses.\n\nConclusions: CBT for patients with generalized SAD in Japan is effective for up to 1 year after HSP phosphorylation treatment. The effect sizes were as large as those in previous studies conducted in Western countries. Older age at baseline, late onset, and lower severity of SAD were predictors for a good outcome from group CBT.”
“Objective To assesses the safety and rationale of antibacterial fixed-dose combinations in the private sector in Latin America and determine the extent of their use. Methods Analysis of FDCs was based on retail sales data for eight Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru, Uruguay and Venezuela) between 1999 and 2009. FDCs were classified according to the pre-defined criteria. Use was expressed as daily defined

doses per 1000 inhabitants per day (DDD/TID). Results A total of 175 antibacterial FDCs contained a mean of 1.3 antibacterial substances and 3.2 other active substances. Thirty-seven (21%) FDCs were classified as unsafe, 124 (70%) as lacking sufficient HSP990 evidence for efficacy and only 14 (9%) of all FDCs AZ 628 nmr were considered rational, for example amoxicillin and clavulanic acid. Consumption of unsafe FDCs decreased by 0.011 DDD/TID (95% CI: 0.012 to 0.009) annually, from 0.173 DDD/TID in 1999 to 0.070 DDD/TID

in 2009 (overall decrease, 59.7%). Consumption of FDCs lacking sufficient evidence decreased by 30.3% (0.018 DDD/TID [95% CI: 0.028 to 0.008] annually), while use of rational FDCs increased by 17.1% (from 1.283 DDD/TID to 1.497 DDD/TID annually). Conclusion The majority of antibacterial FDCs in the private sector lack therapeutic benefit. Despite the decrease in the consumption of unsafe antibacterials and those lacking sufficient evidence, their use remains high and their marketing does not fit into strategies of prudent use of antibiotics to contain antibacterial resistance. ObjectifEvaluer la securite et la justification des combinaisons d’antibacteriens a dose fixe (CADF) dans le secteur prive en Amerique latine et determiner l’etendue de leur utilisation. MethodesL’analyse des CADF a ete basee sur les donnees des ventes en detail dans huit pays d’Amerique latine (Argentine, Bresil, Chili, Colombie, Mexique, Perou, Uruguay et Venezuela) entre 1999 et 2009. Les CADF ont ete classees selon des criteres predefinis. L’utilisation a ete exprimee en Doses Journaliere Definies pour 1000 habitants par jour (DDD/TID). ResultatsUn total de 175 CADF contenaient en moyenne 1,3 substances antibacteriennes et 3,2 autres substances actives.

However, most of the observational studies do not support a significant association between higher nutritional

vitamin D store and increased risk of 5-Fluoracil solubility dmso stone formation. Short-term nutritional vitamin D repletion in stone formers with vitamin D deficiency also does not appear to increase urinary calcium excretion.SummaryThe effect of nutritional vitamin D use in stone formers is still not clear. As vitamin D deficiency is highly prevalent among stone formers, future prospective studies are needed to establish the biological effect, as well as the safety and efficacy of nutritional vitamin D therapy in this unique patient population.”
“The mechanism of increased MTb disease susceptibility in HIV+ persons remains poorly understood. Apoptosis of macrophages in response to MTb represents a critical host defense response, and decreased apoptosis may represent a mechanism of increased susceptibility to MTb in HIV. In the current study,

MTb-mediated apoptosis of human AM was reduced in HIV+ subjects compared with healthy subjects in a TNF-alpha-dependent manner. IL-10 levels in BALF from HIV+ persons were significantly elevated compared with HIV-persons, and exogenous IL-10 reduced MTb-mediated apoptosis in healthy AM, suggesting that IL-10 could mediate decreased apoptosis observed in HIV. Further study showed that IL-10 reduced TNF release in response to MTb in AM through a reduction in TNF mRNA levels, and exogenous TNF could partially reverse

Adriamycin inhibitor IL-10-associated effects on AM apoptosis. IL-10 did not influence p-IRAK, I kappa B degradation, or NF-kappa B p65 nuclear translocation in response to MTb, but IL-10 did increase levels of AM BCL-3, an inhibitor of NF-kappa B nuclear activity. BCL-3 knockdown in human macrophages increased MTb-mediated TNF release. Importantly, BCL-3 levels in AM from HIV+ subjects were higher compared with healthy Panobinostat subjects. Taken together, these data suggest that elevated lung levels of IL-10 may impair MTb-mediated AM apoptosis in HIV through a BCL-3-dependent mechanism. BCL-3 may represent a potential therapeutic target to treat or prevent MTb disease in HIV+ persons. J. Leukoc. Biol. 86: 53-60; 2009.”
“The microbes residing in and on the human body influence human physiology in many ways, particularly through their impact on the metabolism of xenobiotic compounds, including therapeutic drugs, antibiotics, and diet-derived bioactive compounds. Despite the importance of these interactions and the many possibilities for intervention, microbial xenobiotic metabolism remains a largely underexplored component of pharmacology. Here, we discuss the emerging evidence for both direct and indirect effects of the human gut microbiota on xenobiotic metabolism, and the initial links that have been made between specific compounds, diverse members of this complex community, and the microbial genes responsible.

Genetic ablation of tau prevents neuronal overexcitation and axonal transport deficits caused by recombinant A beta oligomers. Relevance of these findings to naturally secreted A beta and mechanisms underlying tau’s enabling effect are unknown. Here we demonstrate deficits in anterograde axonal transport of mitochondria in primary neurons from transgenic mice expressing familial AD-linked forms of human amyloid precursor protein. We show that these deficits depend on A beta(1-42) production and are

prevented by tau reduction. The copathogenic effect of tau did not depend on its microtubule binding, interactions with Fyn, or potential role in neuronal development. Inhibition of neuronal activity, N-methyl-D-aspartate receptor function, BB-94 purchase or glycogen synthase kinase 3 beta (GSK3.) LY3023414 cell line activity or expression also abolished A beta-induced transport deficits. Tau ablation prevented A beta-induced GSK3 beta activation. Thus, tau allows A beta oligomers to inhibit axonal transport through activation of GSK3 beta, possibly by facilitating aberrant neuronal activity.”
“Rosemary (Rosmarinus officinalis L.) extracts (RE) are natural antioxidants that are used in food, food supplements and cosmetic applications; exert anti-inflammatory and anti-hyperglycaemic

effects; and promote weight loss, which can be exploited to develop new preventive strategies against metabolic disorders. Therefore, the aim of the present study was to evaluate the preventive effects of rosemary leaf extract that was standardised to 20% carnosic acid (RE) on weight gain, glucose levels and lipid homeostasis in mice that had begun a high-fat diet (HFD) as juveniles. The animals were given a low-fat diet, a HFD or a HFD that was supplemented with 500 mg RE/kg body weight per d (mpk). Physiological and biochemical parameters were monitored for 16 weeks. Body and epididymal fat weight in animals on the HFD that was supplemented with RE increased 69 and 79% less than those in the HFD group. Treatment with RE was associated with increased faecal fat excretion but not with decreased food intake. The extract also reduced fasting glycaemia and plasma

cholesterol levels. In addition, we evaluated the inhibitory effects of RE in vitro on pancreatic lipase and PPAR-gamma Geneticin purchase agonist activity; the in vitro findings correlated with our observations in the animal experiments. Thus, the present results suggest that RE that is rich in carnosic acid can be used as a preventive treatment against metabolic disorders, which merits further examination at physiological doses in randomised controlled trials.”
“PURPOSE. To characterize the age dependence of shape, refractive power, and refractive index of isolated lenses from nonhuman primates.\n\nMETHODS. Measurements were performed on ex vivo lenses from cynomolgus monkeys (cyno: n = 120; age, 2.7-14.3 years), rhesus monkeys (n = 61; age, 0.7-13.3 years), and hamadryas baboons (baboon: n = 16; age, 1.7-27.3 years).

05). A three-fold increase in severe trauma was reported in the group of patients with perinatal mortality than in the group with perinatal survivors (25% versus 7%, respectively, p smaller than 0.05). Conclusions: In patients admitted to hospital for placental abruption delivery prior to 30 weeks of gestation and a history of abdominal trauma are independent risk factors for perinatal death.”
“Hemoglobin (Hb) Lepore is

a variant consisting of two alpha-globin and two delta beta-globin chains. In heterozygote, it is associated with Barasertib clinical findings of thalassemia minor but interactions with other hemoglobinopathies can lead to various clinical phenotypes. Using a combination of Hb-HPLC, Hb-capillary electrophoresis and DNA analyses, we have identified 14 patients with Hb Lepore-Hollandia including eight heterozygotes, two double heterozygotes with alpha(+)-thalassemia, two

compound heterozygotes with Hb E (initially diagnosed as Hb E-beta-thalassemia) and two previously undescribed conditions of double heterozygote for Hb Lepore/Hb Constant Spring NSC23766 cell line and Hb Lepore/alpha(0)-thalassemia, both associated with higher levels of Hb F and lower levels of Hb Lepore. Hematological and molecular features of these patients are presented along with those observed in four other Thai individuals encountered with heterozygous Hb Lepore-Washington-Boston. Haplotype analysis of the beta-globin gene cluster showed that all Hb Lepore-Hollandia genes were associated with a single haplotype not described previously in other populations, (- + – + + – +) whereas the four Hb Lepore-Washington-Boston genes were associated with haplotypes (+ – - – - + – +) (N = 1) and (+ – - – - – +) (N = 3), data indicating multiple origins of these two variants. Hb Lepore may not be uncommon in the Thai and other Asian populations and both hematological and molecular studies are required for accurate diagnosis. To facilitate rapid epidemiological, diagnostic

screening and differentiation of the two Hb Lepore defects, a simple assay based on multiplex PCR has been developed. (C) 2009 Elsevier Inc. All rights reserved.”
“The cytotoxicities Z-DEVD-FMK of various strains of Mycoplasma mycoides subsp. mycoides small colony type (SC), the agent of contagious bovine pleuropneumonia (CBPP), were measured in vitro using embryonic calf nasal epithellial (ECaNEp) cells. Strains isolated from acute cases of CBPP induced high cytotoxicity in the presence of glycerol, concomitant with the release of large amounts of toxic H2O2 that were found to be translocated into the cytoplasms of the host cells by close contact of the Mycoplasma strains with the host cells. Currently used vaccine strains also showed high cytotoxicity and high H2O2 release, indicating that they are attenuated in another virulence attribute.

Besides, its antithrombotic activity also prevents thrombogenic events, which may contribute to reduce the risk of ischemic stroke. In addition, after ischemia insult, ACE2-Ang-(1-7)-Mas has been shown to reduce the cerebral infarct size and improve neurological deficits through its antioxidative PD98059 and anti-inflammatory effects. Taken together, activation of the ACE2-Ang-(1-7)-Mas axis may become a novel therapeutic target in prevention and treatment of ischemia stroke, which deserves further investigations.”
“OBJECTIVES To review our experience with radical nephrectomy and

inferior vena cava thrombectomy (RNIVCT) to determine the utility of preoperative embolization. Preoperative embolization has been used as an adjunctive procedure to facilitate surgical resection of complex renal tumors.\n\nMETHODS From 1990 to 2007, 225 patients with renal tumors and inferior vena cava thrombus underwent RNIVCT, including 135 patients who had undergone preoperative renal artery embolization and 90 patients who

had not. The effect of embolization on perioperative morbidity PS-095760 and mortality, transfusion requirements, blood loss, and operative time was analyzed by comparing the 2 groups.\n\nRESULTS The mean primary tumor size was similar in both groups; however, 67% of the RNIVCT embolization group vs 48% of the nonembolization group had retrohepatic (level III) or supradiaphragmatic (level IV) thrombus extension Anlotinib research buy (P = .032). The RNIVCT embolization patients had a greater median number of perioperative units transfused (8 vs 4; P = .001), a longer operative time (390 vs 313 minutes; P < .001), more postoperative complications (43% vs 29%; P < .001), a longer intensive care unit stay (2 vs 0.5 days), and increased perioperative mortality (13% vs 3%; P = .017). No differences were found in intraoperative complications or length of hospitalization. Multivariate analysis showed

a fivefold greater risk of perioperative death (adjusted odds ratio 5.5; P = .029) and a trend toward increased blood transfusion (regression coefficient 3.9; P = .08) with preoperative embolization.\n\nCONCLUSIONS The results of our study have shown that routine preoperative renal artery embolization in patients undergoing RNIVCT does not provide any measurable benefit in reducing blood loss or complications and was associated with increased major perioperative complications and mortality. UROLOGY 74: 154-160, 2009. (c) 2009 Elsevier Inc.”
“Despite minimal fundamental works, there is an increasing use of meshes in urogynecology. The concept is mainly based on experiences with abdominal wall surgery. We aimed to compare the biomechanical properties of vaginal tissue, abdominal aponeurosis, and skin.\n\nSamples from 11 fresh women cadavers without prolapse were collected. Uniaxial tension tests were performed and stress-strain curves were obtained.

\n\nResults: Most endorsed the entire question prompt list, though a minority queried the utility/appropriateness of some questions. Analysis identified four global themes: (1) reinforcement of known benefits of question prompt lists, (2) appraisal of content buy R406 and suggestions for further developments, (3) perceived benefits and challenges in using the question prompt list and (4) contrasts in Australian/US feedback. These contrasts necessitated distinct Australian/US final versions of the question prompt list.\n\nConclusions: Participants endorsed the question prompt list as acceptable and useful. Feedback resulted in two distinct versions of the question prompt list, accommodating

differences between Australian and US approaches to end-of-life discussions, highlighting the appropriateness of tailoring communication aides to individual learn more populations.”
“The whole metabolism of a sponge holobiont and the respective contributions of prokaryotic and eukaryotic symbionts and their

associations with the sponge host remain largely unclear. Meanwhile, compared with shallow water sponges, deep-sea sponges are rarely understood. Here we report the metagenomic exploration of deep-sea sponge Lamellomorpha sp. at the whole community level. Metagenomic data showed phylogenetically diverse prokaryotes and eukaryotes in Galardin solubility dmso Lamellomorpha sp.. MEGAN and gene enrichment analyses indicated different metabolic potentials of prokaryotic symbionts from eukaryotic symbionts, especially in nitrogen and carbon metabolisms, and their molecular interactions with the sponge host. These results supported the hypothesis that prokaryotic and eukaryotic symbionts have different ecological roles and relationships with sponge host. Moreover, vigorous denitrification, and CO2 fixation by chemoautotrophic prokaryotes were suggested for this deep-sea sponge. The study provided novel insights into the respective potentials of prokaryotic and eukaryotic symbionts and their associations with deep-sea sponge Lamellomorpha sp..”
“The

formation of any complex phenotype involves a web of metabolic pathways in which one chemical is transformed through the catalysis of enzymes into another. Traditional approaches for mapping quantitative trait loci (QTLs) are based on a direct association analysis between DNA marker genotypes and end-point phenotypes, neglecting the mechanistic processes of how a phenotype is formed biochemically. Here, we propose a new dynamic framework for mapping metabolic QTLs (mQTLs) responsible for phenotypic formation. By treating metabolic pathways as a biological system, robust differential equations have proven to be a powerful means of studying and predicting the dynamic behavior of biochemical reactions that cause a high-order phenotype.

Molecularly, our goals were to characterise and determine the genetic variability using Inter-Simple

Sequence Repeats (ISSRs). All individuals were euploid (2n = 2x = 24), and presented a maximum number of four Ag-NORs and four nucleoli per mitotic cell. FISH confirmed the Ag-NORs localisation, and evidenced that all 45S rDNA loci are being actively expressed. Two additional 5S rDNA loci were also detected. Cytogenetic analyses did not allow us to distinguish the oak species. Inversely, ISSR data revealed that the oak species under study presented genetic variability, and showed unique bands which could be putative species-diagnostic markers. The UPGMA phenogram reflected the reliability of the ISSR markers since most individuals belonging to the same species selleck screening library were clustered together.”
“Satellite RNAs (satRNAs) depend on cognate helper viruses for replication, encapsidation, movement and transmission. Many satRNAs with different symptom modulation effects have been reported. The pathogenicity of satRNAs is thought to be the result of a direct interaction among the satRNA, helper viruses and host factors by unknown mechanisms. To understand the effect of satRNA of Cucumber mosaic virus (a severe field Shan-Dong strain, SD-CMV) on pathogenicity, and the possible involvement of host RNA silencing pathways in pathogenicity,

we constructed biologically active CMV cDNA clones and a CMV-Delta 2b mutant lacking the open reading frame of 2b, a silencing suppressor protein, in order to infect Nicotiana benthamiana and Arabidopsis with or without SD-satRNA. We found that SD-satRNA reduced the accumulation of the 2b protein and its Captisol cost coding RNA4A and attenuated the yellowing caused by SD-CMV infection. Small RNA analysis indicated that the 2b protein interfered with RNA silencing, specifically in the synthesis of CMV RNA3-derived small interfering RNAs (R3-siRNAs). The

accumulation of R3-siRNAs in CMV-Delta 2b infection was reduced in the presence of satRNA, for which greater accumulation of satRNA-derived siRNAs (satsiRNAs) was detected. Our results suggest that abundant SD-satRNA serving as target for RNA silencing may play a role in protecting helper CMV RNA, especially, sub-genomic RNA4, from being targeted by RNA silencing. This compensates for the increase in RNA silencing PF-2341066 resulting from the reduction in expression of the 2b suppressor in the presence of satRNA. Our data provide evidence that a plant silencing mechanism is involved in the pathogenicity of satRNA.”
“Serine protease inhibitors (serpin) play essential roles in many organisms. Mammalian serpins regulate the blood coagulation, fibrinolysis, inflammation and complement activation pathways. In parasitic helminths, serpins are less well characterized, but may also be involved in evasion of the host immune response. In this study, a Schistosoma japonicum serpin (SjB10), containing a 1212 bp open reading frame (ORF), was cloned, expressed and functionally characterized.

For the continuous grazing system, sheep grazed the same plots each year, and for the alternating system, grazing and hay making were

alternated annually between two adjacent plots. In July, August, and September 2009 and 2010, feed intake and live weight of sheep were Selleckchem MI-503 determined. The GS did not affect dOM (P=0.101), OMI (P=0.381), and LWG of sheep (P=0.701). Across both GS LWG decreased from 98 g . d(-1) for GI1 to 62 g . d(-1) for GI6 (P smaller than 0.001; R-2=0.42). There were no interactions between GS and GI for all measured parameters (P bigger than = 0.061), indicating that alternating grazing did not compensate for negative effects of heavy grazing even after 4 yr of grassland use. In summary, our study showed that irrespective of GI, alternating grassland use does not improve dOM, OMI, and hence, LWG of sheep. However, it BAY 57-1293 DNA Damage inhibitor might enhance revenues and ecological sustainability in the long term when compared to the common practice of continuous grazing at very high stocking rates.”
“Assortative mating, an ubiquitous form of nonrandom mating, strongly impacts Darwinian fitness and can drive biological diversification. Despite its ecological and evolutionary importance, the behavioural processes underlying assortative mating are often unknown, and in particular, mechanisms not involving mate choice

have been largely ignored so far. Here, we propose that assortative mating can arise from prudent habitat choice’, a general mechanism that acts under natural selection, and that it can occur despite a complete mixing of phenotypes. We show that in the

cichlid Eretmodus cyanostictus size-assortative mating ensues, because individuals of weaker competitive ability AZD6094 Protein Tyrosine Kinase inhibitor ignore high-quality but strongly competed habitat patches. Previous studies showed that in E.cyanostictus, size-based mate preferences are absent. By field and laboratory experiments, here we showed that (i) habitat quality and body size are correlated in this species; (ii) territories with more stone cover are preferred by both sexes in the absence of competition; and (iii) smaller fish prudently occupy vacant territories of worse quality than do larger fish. Prudent habitat choice is likely to be a widespread mechanism of assortative mating, as both preferences for and dominance-based access to high-quality habitats are generic phenomena in animals.”
“INTRODUCTION: Activation of renal sympathetic nerves is associated with the development of hypertension. Catheter-based renal sympathetic denervation with radiofrequency energy ablation is a new promising treatment option for resistant hypertension. We here report the first Danish experiences and results with this technique.\n\nMATERIAL AND METHODS: Nine patients with resistant hypertension and a day-time 24-hour ambulatory blood pressure (BP) of 152/89 mmHg +/- 10/10 (standard deviation) mmHg despite treatment with 5.4 +/- 1.

White race and male sex were significant predictors of need for erythropoietin therapy. We found peritoneal dialysis patients to exhibit significantly increased Hb-var independent of treatment with exogenous erythropoietin (0.99 gm/dL vs. 1.17 gm/dL, p-value smaller than 0.001). We found age to be a significant determinant of Hb-var in the ESA treated group. Hb-var in younger patients ( smaller than 30 years) was increased by 50% compared to young healthy adults. The Hb-var in elderly ( bigger than 60 years) peritoneal dialysis patients was similar to that seen in healthy elders, suggesting similarity with anemia of aging. Fosbretabulin mouse We conclude that exogenous

ESA administration does not explain Hb-var entirely but may enhance it. Intrinsic factors affecting erythropoiesis including age may be the major determinants of Hb-var.”
“Iconic

memory is a high-capacity low-duration visual memory store that allows the persistence of a visual stimulus after its offset. The categorical nature of this store has been extensively debated. This study provides functional magnetic ZD1839 mouse resonance imaging evidence for brain regions underlying the persistence of postcategorical representations of visual stimuli. In a partial report paradigm, subjects matched a cued row of a 3 x 3 array of letters (postcategorical stimuli) or false fonts (precategorical stimuli) with a subsequent triplet of stimuli. The cued row was indicated by two visual flankers presented at the onset (physical stimulus readout) or after the offset of the array (iconic memory readout). The left planum temporale showed a greater modulation of the source of readout (iconic memory vs. physical stimulus) when letters were presented

compared to false fonts. This is a multimodal brain region responsible for matching incoming acoustic and visual patterns with acoustic pattern templates. These findings suggest that letters persist after their physical offset in an abstract postcategorical representation. A targeted region of interest analysis revealed a similar pattern of activation in the Visual Cell Cycle inhibitor Word Form Area. These results suggest that multiple higher-order visual areas mediate iconic memory for postcategorical stimuli. Hum Brain Mapp, 2013. (c) 2012 Wiley Periodicals, Inc.”
“The aim of this study was to examine coherence between surface electromyographic (EMG) signals from two index finger flexor muscles, the first dorsal interosseous (FDI) and flexor digitorum superficialis (FDS), during and immediately following sustained, fatiguing isometric contraction. Coherence was observed between the FDI and FDS EMG signals in the tremor (8-12 Hz), beta (15-35 Hz) and gamma (35-60 Hz) bands in all subjects. A significant increase in EMG-EMG coherence in the beta and gamma frequency bands was observed immediately following the fatiguing contraction. No significant difference was observed in the tremor band coherence before and after fatigue.

With thorough surgery, RLND lymph node (LN) retrieval numbers have a predictable distribution. Whether patients have inguinal or ilioinguinal dissection varies between institutions. This study was designed to provide LN retrieval parameters for inguinal and ilioinguinal LN dissections, and secondarily, to analyze known predictors for survival outcomes, including LN ratio, i.e., involved/total number LN removed.\n\nA prospective database was used to identify 189 patients who had 200 groin dissections between July 2002 and February 2008 to derive parameters

of LN retrieval. A subgroup of 177 patients who had one RLND was assessed for predictors of survival outcome.\n\nInguinal buy 3-deazaneplanocin A dissection had median LN retrieval of 11 (interquartile range, 10-14); 8 LN or more were retrieved in 90% of cases, and 38% of cases had 10 LN or less. Ilioinguinal dissection had median LN retrieval of 21.5 (interquartile range, 17-25); 14 LN or more were retrieved in 90% of cases, and 0 cases had 10 LN or less. The strongest predictors of survival on multivariate analysis were LN ratio, macroscopic LN disease, and ulceration of the primary

melanoma. Overall 39% of ilioinguinal dissections had positive pelvic LNs, but only 9.3% of those completed after positive sentinel node biopsy.\n\nThorough groin RLNDs have a predictable LN yield. LN ratio is the strongest predictor of outcome. Because pelvic LNs are frequently positive ilioinguinal dissection should be considered for all patients, especially those with macroscopic metastases to groin LNs.”
“BACKGROUND Vorinostat mw Bcl-2 apoptosis pathway Recent studies suggest that cardiac resynchronization therapy (CRT) with a quadripolar left ventricular (LV) lead results in low rates of dislocation and phrenic nerve stimulation (PNS) acutely and at short-term follow-up. Confirmation of these results by long-term observational studies is needed.\n\nOBJECTIVE

To evaluate the long-term procedural and clinical outcomes of CRT patients implanted with a quadripolar LV lead.\n\nMETHODS A total of 154 consecutive heart failure patients (79% men, age 68 +/- 10 years) having CRT implantation attempts with a quadripolar LV lead were included in this observational registry. Demographic and clinical data were preoperatively collected, and patients were followed up for at least 6 months.\n\nRESULTS The overall implant success rate after coronary sinus cannulation was 97.4%. Mean overall duration and fluoroscopy time of successful procedures was 112 +/- 22 and 16 +/- 8 minutes, respectively, while 17 +/- 13 minutes were necessary for the LV lead placement. After implant, the conventional bipolar configuration was used as the final pacing configuration in 33.3% of the patients. Four lead dislodgments (requiring reoperation) and 9 clinical PNS were reported during follow-up; reprogramming of the device was sufficient to prevent PNS in all patients.