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1

Kapoor, Mukul. ""TEE OR NOT TO TEE?"." Annals of Cardiac Anaesthesia 19, no. 5 (2016): 1. http://dx.doi.org/10.4103/0971-9784.192571.

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2

Song, Haibo. "TEE: Simulator-Based TEE Training." Ultrasound in Medicine & Biology 43 (2017): S54. http://dx.doi.org/10.1016/j.ultrasmedbio.2017.08.1120.

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3

Frank, Bruno. "Tee." Zeitschrift für Phytotherapie 40, no. 06 (December 2019): 244–53. http://dx.doi.org/10.1055/a-0879-8785.

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4

Albrecht, Clelia, and Anna Kraut. "Tea Time: Vernetzung über einer Tasse Tee." Mitteilungen der Deutschen Mathematiker-Vereinigung 29, no. 2 (June 1, 2021): 77–79. http://dx.doi.org/10.1515/dmvm-2021-0029.

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5

Sampaio, CS, PG Pizarro, PJ Atria, R. Hirata, M. Giannini, and E. Mahn. "Effect of Shortened Light-Curing Modes on Bulk-Fill Resin Composites." Operative Dentistry 45, no. 5 (February 26, 2020): 496–505. http://dx.doi.org/10.2341/19-101-l.

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Clinical Relevance Shortened light curing does not affect volumetric polymerization shrinkage or cohesive tensile strength but negatively affects the shear bond strength of some bulk-fill resin composites. When performing shortened light curing, clinicians should be aware of the light output of their light-curing units. SUMMARY Purpose: To evaluate volumetric polymerization shrinkage (VPS), shear bond strength (SBS) to dentin, and cohesive tensile strength (CTS) of bulk-fill resin composites (BFRCs) light activated by different modes. Methods and Materials: Six groups were evaluated: Tetric EvoCeram bulk fill + high mode (10 seconds; TEC H10), Tetric EvoFlow bulk fill + high mode (TEF H10), experimental bulk fill + high mode (TEE H10), Tetric EvoCeram bulk fill + turbo mode (five seconds; TEC T5), Tetric EvoFlow bulk fill + turbo mode (TEF T5), and experimental bulk fill + turbo mode (TEE T5). Bluephase Style 20i and Adhese Universal Vivapen were used for all groups. All BFRC samples were built up on human molar bur-prepared occlusal cavities. VPS% and location were evaluated through micro–computed tomography. SBS and CTS tests were performed 24 hours after storage or after 5000 thermal cycles; fracture mode was analyzed for SBS. Results: Both TEC H10 and TEE H10 presented lower VPS% than TEF H10. However, no significant differences were observed with the turbo-curing mode. No differences were observed for the same BFRC within curing modes. Occlusal shrinkage was mostly observed. Regarding SBS, thermal cycling (TC) affected all groups. Without TC, all groups showed higher SBS values for high mode than turbo mode, while with TC, only TEC showed decreased SBS from high mode to turbo modes; modes of fracture were predominantly adhesive. For CTS, TC affected all groups except TEE H10. In general, no differences were observed between groups when comparing the curing modes. Conclusions: Increased light output with a shortened curing time did not jeopardize the VPS and SBS properties of the BFRCs, although a decreased SBS was observed in some groups. TEE generally showed similar or improved values for the tested properties in a shortened light-curing time. The VPS was mostly affected by the materials tested, whereas the SBS was affected by the materials, curing modes, and TC. The CTS was not affected by the curing modes.
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6

Ernits, Margus, Johannes Tammekänd, and Olaf Maennel. "i-tee." ACM SIGCOMM Computer Communication Review 45, no. 4 (September 22, 2015): 113–14. http://dx.doi.org/10.1145/2829988.2790033.

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7

Béïque, François A., and Josée Lavoie. "TEE Monitoring." Canadian Journal of Anaesthesia 45, no. 10 (October 1998): 919–24. http://dx.doi.org/10.1007/bf03012297.

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8

Bianchini, Amedeo, Cristiana Laici, Martina Bordini, Matteo Bianchin, Catalin Iustin Ioan Silvas, Matteo Cescon, Matteo Ravaioli, Giovanni Vitale, and Antonio Siniscalchi. "Using Transesophageal Echocardiography in Liver Transplantation with Veno-Venous Bypass Is a Tool with Many Applications: A Case Series from an Italian Transplant Center." Journal of Cardiovascular Development and Disease 10, no. 1 (January 16, 2023): 32. http://dx.doi.org/10.3390/jcdd10010032.

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Background: Hemodynamic instability (HDI) is common during liver transplantation (LT); veno-venous bypass (VVB) is a tool used in selected cases to ensure hemodynamic stability and for surgical needs. Transesophageal echocardiography (TEE) allows the transplant team to identify the causes of HDI and to guide therapies. We present a case series of four patients showing the valuable role of TEE during LT in VVB. Methods: We report four explicative cases of TEE use in LT with VVB performed at IRCCS Azienda Ospedaliero–Universitaria di Bologna. Four transplants were performed between 2016 and 2022. Results: Many authors have highlighted the diagnostic value of TEE during LT in the case of HDI. However, its specific role during LT with VVB is poorly described. This paper illustrates multiple potential uses of TEE in LT with VVB: TEE as a guide for catheterization and optimal cannula positioning, TEE as a tool for intraoperative Patent Foramen Ovale management, TEE as help for anticoagulation therapy and finally, TEE as support when evaluating bypass efficiency and correcting hypovolemia. Conclusion: TEE is a useful instrument during LT with VVB. However, further studies are needed to assess the suitable applications of TEE during LT in patients with HDI requiring VVB. TEE should be part of the anesthetist’s cultural background.
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9

Snijder, Roel J. R., Laura E. Renes, Martin J. Swaans, Maarten Jan Suttorp, Jurrien M. Ten Berg, and Martijn C. Post. "Microtransesophageal Echocardiographic Guidance during Percutaneous Interatrial Septal Closure without General Anaesthesia." Journal of Interventional Cardiology 2020 (September 7, 2020): 1–7. http://dx.doi.org/10.1155/2020/1462140.

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Objective. To study the safety and efficacy of microtransesophageal echocardiography (micro-TEE) and TEE during percutaneous atrial septal defect (ASD) and patent foramen ovale (PFO) closure. Background. TEE has proven to be safe during ASD and PFO closure under general anaesthesia. Micro-TEE makes it possible to perform these procedures under local anaesthesia. We are the first to describe the safety and efficacy of micro-TEE for percutaneous closure. Methods. All consecutive patients who underwent ASD and PFO closure between 2013 and 2018 were included. The periprocedural complications were registered. Residual shunts were diagnosed using transthoracic contrast echocardiography (TTCE). All data were compared between the use of TEE or micro-TEE within the ASD and PFO groups separately. Results. In total, 82 patients underwent ASD closure, 46 patients (49.1 ± 15.0 years) with TEE and 36 patients (47.8 ± 12.1 years) using micro-TEE guidance. Median device diameter was, respectively, 26 mm (range 10–40 mm) and 27 mm (range 10–35 mm). PFO closure was performed in 120 patients, 55 patients (48.6 ± 9.2 years, median device diameter 25 mm, range 23–35 mm) with TEE and 65 patients (mean age 51.0 ± 11.8 years, median device diameter 27 mm, range 23–35 mm) using micro-TEE. There were no major periprocedural complications, especially no device embolizations within all groups. Six months after closure, there was no significant difference in left-to-right shunt after ASD closure and no significant difference in right-to-left shunt after PFO closure using TEE or micro-TEE. Conclusion. Micro-TEE guidance without general anaesthesia during percutaneous ASD and PFO closure is as safe as TEE, without a significant difference in the residual shunt rate after closure.
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10

Iliuta, Luminita, Madalina-Elena Rac-Albu, Eugenia Panaitescu, Andreea Gabriella Andronesi, Horatiu Moldovan, Florentina Ligia Furtunescu, Alexandru Scafa-Udriște, et al. "Challenges Regarding the Value of Routine Perioperative Transesophageal Echocardiography in Mitral Valve Surgery." Diagnostics 14, no. 11 (May 24, 2024): 1095. http://dx.doi.org/10.3390/diagnostics14111095.

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Background and Objectives: Transesophageal echocardiography (TEE) is considered an indispensable tool for perioperative evaluation in mitral valve (MV) surgery. TEE is routinely performed by anesthesiologists competent in TEE; however, in certain situations, the expertise of a senior cardiologist specializing in TEE is required, which incurs additional costs. The purpose of this study is to determine the indications for specialized perioperative TEE based on its utility and the correlation between intraoperative TEE diagnoses and surgical findings, compared with routine TEE performed by an anesthesiologist. Materials and Methods: We conducted a three-year prospective study involving 499 patients with MV disease undergoing cardiac surgery. Patients underwent intraoperative and early postoperative TEE and at least one other perioperative echocardiographic evaluation. A computer application was dedicated to calculating the utility of each type of specialized TEE indication depending on the type of MV disease and surgical intervention. Results: The indications for performing specialized perioperative TEE identified in our study can be categorized into three groups: standard, relative, and uncertain. Standard indications for specialized intraoperative TEE included establishing the mechanism and severity of MR (mitral regurgitation), guiding MV valvuloplasty, diagnosing associated valvular lesions post MVR (mitral valve replacement), routine evaluations in triple-valve replacements, and identifying the causes of acute, intraoperative, life-threatening hemodynamic dysfunction. Early postoperative specialized TEE in the intensive care unit (ICU) is indicated for the suspicion of pericardial or pleural effusions, establishing the etiology of acute hemodynamic dysfunction, and assessing the severity of residual MR post valvuloplasty. Conclusions: Perioperative TEE in MV surgery can generally be performed by a trained anesthesiologist for standard measurements and evaluations. In certain cases, however, a specialized TEE examination by a trained senior cardiologist is necessary, as it is indirectly associated with a decrease in postoperative complications and early postoperative mortality rates, as well as an improvement in immediate and long-term prognoses. Also, for standard indications, the correlation between surgical and TEE diagnoses was superior when specialized TEE was used.
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11

Edwardson, Graham, Cecilia Volk, Victor Nizet, George Sakoulas, and Warren Rose. "2243. Using Host Biomarkers and Time to Blood Culture Positivity to Predict Necessity for Echocardiogram in Patients with Staphylococcus aureus Endocarditis." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S767. http://dx.doi.org/10.1093/ofid/ofz360.1921.

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Abstract Background Patients with complicated S. aureus bacteremia (SaB) require a transesophageal echocardiogram (TEE) to rule out endocarditis. Risks of TEE may exceed benefits in patients with a low pretest probability of endocarditis. Given our prior findings that endovascular bacterial burden drives elevated serum IL-10 concentrations, we hypothesize that time to positive blood culture and IL-10 serum concentrations may be used to risk stratify patients for selection of TEE. We compared time to positive blood culture and serum IL-10 in patients with negative and positive TEE. Methods Patients with SaB were included if they had a diagnosis of primary, endovascular infection source of bacteremia identified by an infectious diseases consult team and a TEE performed. A retrospective chart review was done to identify the time to positivity (hours) of patient blood cultures grown aerobically or anaerobically and TEE results. Sera collected at clinical presentation of these patients were tested for biomarkers IL-10 and IL-1β. Mann–Whitney U test compared the data between the two groups. Results This study included 66 patients with SaB: 17 with negative TEE and 49 with positive TEE. Patients with a positive TEE confirming endocarditis had a faster time to positive blood cultures compared with patients with negative TEE (P = 0.031; figure). IL-10 serum concentrations were significantly higher in patients with positive TEE (26.2 pg/mL) vs. negative TEE (14.39 pg/mL). Time-to-positivity in blood culture was linearly associated serum IL-10 concentrations (P = 0.044; figure). Serum IL-1β concentrations were also higher in TEE positive vs. TEE negative patients (32.1 vs. 14.7 pg/mL, P = 0.067) Conclusion These data lend further evidence to link high endovascular bacterial burden (measured by shorter time to positive blood culture) and serum IL-10 concentrations. As anticipated, patients with positive TEE had significantly shorter time to blood culture positivity and higher IL-10 serum concentrations than those with negative TEE. With further study on a larger number of patients, time to positive blood cultures and serum biomarkers like IL-10 may be used to risk stratify patients for performance of TEE, as well as to select antimicrobial therapy and to adjust treatment duration. Disclosures All authors: No reported disclosures.
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Hoai, Nguyen Thi Thu, and Ta Thi Dinh. "Two and three-dimensional transesophageal echocardiography for pre-operative assessment of mitral valve morphology and regurgitation severity." Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam 40 (January 18, 2023): 92–101. http://dx.doi.org/10.47972/vjcts.v40i.837.

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Background: Two-dimensional (2D) transthoracic (TTE) and transesophageal echocardiography (TEE) are the two main diagnostic modalities used to assess valvular heart diseases, particularly for mitral valve injury. In patients who have the indication of mitral valve surgery, 2D TEE & TTE have some limitations in identifying valve lesions. Three-dimensional transesophageal echocardiography (3D TEE) is more accurate than 2DTTE and 2DTEE in the qualitative assessment of mitral valve. Objectives. Evaluating valve morphology and the severity of mitral valve regurgitation using 2DTTE and 2D/3D TEE in patients who required surgical intervention, compared to surgical and left ventricular angiography findings. Subjects: 44 patients with surgical indication from September 2017 to June 2018 were enrolled in this study. Methods: A cross-sectional study conducted at Vietnam National Heart Institute from September 2017 to June 2018. 44 patients with mitral regurgitation who had indication for mitral valve surgery underwent 2D TEE and 2D/3D TEE before opened heart surgery for mitral valve, 17/44 had left ventriculogram during coronary angiogram before surgery. Results: Men/women ratio = 2/1. Mean age: 54.14 ± 13.066 years old. Most of patients (93,2%) had symptoms of heart failure with mean NYHA classification of 2.55 ± 0.504. 3D TEE showed higher diagnostic accuracy and better agreement with surgical findings compared to 2D TEE and 2D TTE in A2 prolapse, A3 prolapse, P3 prolapse, Kappa =1,1,0.65 respectively. For anterior leaflet perforation, 3D TEE had positive predictive value of 100% and better agreement (Kappa =1) in comparison with 2D TEE and 2D TTE with positive predictive value of 96,5 %, Kappa = 0,65. In identifying valve vegetation, 3D TEE had positive predictive value of 93%, kappa =0,82 which were higher than those of 2D TEE and 2D TTE (positive predictive value of 89,6 % and Kappa = 0,73). In evaluating mitral valve regurgitation, 3D TEE had positive predictive value of 100%, kappa =1 compared with positive predictive value of 76,5%, kappa of 0,47 of 2D TEE and 2D TTE. Conclusions: 3D TEE is valuable in localizing prolapse valve segments, especially for A2, A3 and P3 prolapse, as well as in diagnosing anterior leaflet perforation and vegetation of mitral valve. 3D TEE is also more valuable than 2D TEE and 2D TTE in assessing mitral regurgitation severity.
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13

Lu, Yunfei, Bing Li, Ningtao Liu, Jia-Wei Chen, Li Xiao, Shuiping Gou, Linlin Chen, Meiping Huang, and Jian Zhuang. "CT-TEE Image Registration for Surgical Navigation of Congenital Heart Disease Based on a Cycle Adversarial Network." Computational and Mathematical Methods in Medicine 2020 (July 2, 2020): 1–8. http://dx.doi.org/10.1155/2020/4942121.

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Transesophageal echocardiography (TEE) has become an essential tool in interventional cardiologist’s daily toolbox which allows a continuous visualization of the movement of the visceral organ without trauma and the observation of the heartbeat in real time, due to the sensor’s location at the esophagus directly behind the heart and it becomes useful for navigation during the surgery. However, TEE images provide very limited data on clear anatomically cardiac structures. Instead, computed tomography (CT) images can provide anatomical information of cardiac structures, which can be used as guidance to interpret TEE images. In this paper, we will focus on how to transfer the anatomical information from CT images to TEE images via registration, which is quite challenging but significant to physicians and clinicians due to the extreme morphological deformation and different appearance between CT and TEE images of the same person. In this paper, we proposed a learning-based method to register cardiac CT images to TEE images. In the proposed method, to reduce the deformation between two images, we introduce the Cycle Generative Adversarial Network (CycleGAN) into our method simulating TEE-like images from CT images to reduce their appearance gap. Then, we perform nongrid registration to align TEE-like images with TEE images. The experimental results on both children’ and adults’ CT and TEE images show that our proposed method outperforms other compared methods. It is quite noted that reducing the appearance gap between CT and TEE images can benefit physicians and clinicians to get the anatomical information of ROIs in TEE images during the cardiac surgical operation.
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Vrublevsky, A. V., and V. V. Saushkin. "Role of Imaging Modalities in the Quantitative Assessment of Atherosclerotic Plaques in the Thoracic Aorta." Kardiologiia 64, no. 3 (March 31, 2024): 40–45. http://dx.doi.org/10.18087/cardio.2024.3.n2457.

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Aim. Comparative analysis of the height of atherosclerotic plaques (AP) in the descending thoracic aorta (TA) according to two-dimensional (2D) and three-dimensional (3D) transesophageal echocardiography (TEE), and contrast-enhanced multislice computed tomography (MSCT).Material and methods. The TA was examined using 2D, 3D TEE and contrast-enhanced MSCT in 34 patients (20 men and 14 women aged 68 [62; 71] years). AP heights were compared using the Bland-Altman method and the Spearman correlation analysis. This was a blinded comparative study which assessed the AP morphometry using each of the radiation modalities without knowing the results of the method being compared.Results. 100 APs were examined in the descending TA. The mean height of all analyzed APs in the descending TA was 2.2 mm [2; 2.7] for 2D TEE, 3.1 mm [2.7; 3.55] for 3D TEE, and 3.05 mm [2.55; 3.55] for MSCT. The AP heights measured with 2D TEE was statistically significantly smaller than the heights of similar APs measured either with 3D TEE or MSCT. The mean difference (bias) was 0.88±0.34 mm between 2D and 3D TEE, and 0.83±0.41 mm between 2D TEE and MSCT. The correlation coefficients for the AP heights were r=0.87 (p<0.001) between 2D and 3D TEE and r=0.86 (p<0.001) between 2D TEE and MSCT. There were no differences in the height of similar APs between 3D TEE and MSCT.Conclusion. The three-dimensional reconstruction of AP in the TA by TEE is more accurate for quantitative assessment of AP than a two-dimensional study.
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박성근 and Min,Chan Kyoo. "TEE certified teachers’ perceptions and attitudes towards TEE/TEK." English Language Teaching 26, no. 1 (March 2014): 171–92. http://dx.doi.org/10.17936/pkelt.2014.26.1.009.

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Lee, Mun Woo. "TEE uncertified teachers’ perceptions regarding the TEE certificate program." British and American Language and Literature Association of Korea 126 (September 30, 2017): 195–214. http://dx.doi.org/10.21297/ballak.2017.126.195.

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17

San Román, José Alberto, Juan Antonio Castillo, Isidre Vilacosta, Maria Jesús Rollán, and Luis Sánchez-Harguindey. "Right-Sided Endocarditis: To TEE or Not to TEE?" American Journal of Noninvasive Cardiology 8, no. 3 (1994): 162–66. http://dx.doi.org/10.1159/000470185.

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18

Khandheria, Bijoy K. "Suspected bacterial endocarditis: To TEE or not to TEE." Journal of the American College of Cardiology 21, no. 1 (January 1993): 222–24. http://dx.doi.org/10.1016/0735-1097(93)90740-r.

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19

Hegde, Aparna Madhukeshwar, Chipman Robert Geoffrey Stroud, Cynthia R. Cherry, Meera Yogarajah, Sulochana Devi Cherukuri, and Paul R. Walker. "Incidence and impact of thromboembolic events in lung cancer patients treated with nivolumab." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e20624-e20624. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e20624.

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e20624 Background: Lung cancer has one of the highest incidences of thromboembolic events (TEE) ranging from 8.4 to13.2%. Cisplatin-based chemotherapy in lung cancer is a well-established risk factor for TEE (11.8%). The incidence of TEE in lung cancer patients (pts) treated with nivolumab (nivo) is unclear. The objective of this study was to evaluate the incidence of TEE, risk factors and its impact on overall survival in lung cancer pts treated with nivo. Methods: This was a retrospective cohort study that included all lung cancer pts treated with nivo from April 2015 to October 2016 at our institution. Medical records were reviewed for incidence, timing, CTCAE grade, type and site of TEE, risk factors and patient demographics. Cox proportional hazard model was used to identify independent predictive factors for TEE. Risk factors with p <0.15 in univariate analysis were included in multivariate model using a stepwise approach. Kaplan-Meier method was used to estimate overall survival (OS). Results: The cumulative incidence (CI) of TEE over a median follow up of 10.8 months after starting nivo was 18.4% (14/76 pts). Of the 14 pts who had TEE, 8 had deep vein thrombosis (DVT), 7 had pulmonary embolism (PE), 1 had concurrent DVT/PE and 2 had arterial thrombosis (AT). 28.6% (4/14) of pts experienced recurrent TEE resulting in 18 total episodes. Median time to TEE after starting nivo was 2.9 months (95% CI 1.9 - 8.4). Gender was the only covariate included in multivariate analysis that showed a significant association with TEE (Female vs Male HR 3.1, 95% CI 1.02 – 9.5, p= 0.045). At a median follow up of 31.8 months since diagnosis of lung cancer, pts who had TEE before receiving nivo had worse OS. TEE occurring after nivo had no impact on OS. Conclusions: The CI of TEE is significantly high at 18.4% in lung cancer pts treated with nivo. However, it had no impact on OS. Further studies are needed to determine the role of prophylactic anticoagulation in this high-risk population. [Table: see text]
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Goncalves, Alexandra, Charles Nyman, David R. Okada, Avinainder Singh, Jeffrey Swanson, Michael Cheezum, Michael Steigner, et al. "Transthoracic Echocardiography to Assess Aortic Regurgitation after TAVR: A Comparison with Periprocedural Transesophageal Echocardiography." Cardiology 137, no. 1 (December 8, 2016): 1–8. http://dx.doi.org/10.1159/000452617.

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Background: We aimed to compare periprocedural transesophageal echocardiography (TEE) with postprocedural transthoracic echocardiography (TTE) for the diagnosis of aortic regurgitation (AR). Methods and Results: TEE and TTE images of 163 transcatheter aortic valve replacement (TAVR) patients (mean age 81 ± 8 years; 56% men) were reviewed separately and blinded to each other as well as to all clinical data. The median time between TEE during TAVR (TEE/TAVR) and TTE was 4 days (IQR 2-10 days). After TAVR, 48% of the patients had at least trace AR by TEE, 56% by angiography and 67% by TTE. The majority of AR was paravalvular (78%). More patients were classified with mild-to-moderate AR by TTE than by TEE (44 vs. 22%, p < 0.01). When examining the 46 patients with AR by TTE which was not at TEE/TAVR, both systolic and diastolic blood pressure (SBP and DBP) were significantly higher during TTE than during TEE (mean ΔSBP = 9 ± 4 mm Hg and mean ΔDBP = 6 ± 2 mm Hg, p < 0.01 for both). No differences in BP between TEE and TTE were found among patients with no AR or among those who had AR in both studies. At a median follow-up of 185 days (IQR 39-424 days), the overall mortality was 17%, but this was not associated with the presence of AR on TTE or TEE. Conclusions: Patients' hemodynamic conditions may result in underdiagnosis of paravalvular regurgitation in periprocedural TEE. Our findings suggest that a postprocedural evaluation for AR by TTE could serve as a reasonable alternative to TEE for the evaluation of AR.
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Arntfield, Robert, Vincent Lau, Yves Landry, Fran Priestap, and Ian Ball. "Impact of Critical Care Transesophageal Echocardiography in Medical–Surgical ICU Patients: Characteristics and Results From 274 Consecutive Examinations." Journal of Intensive Care Medicine 35, no. 9 (September 6, 2018): 896–902. http://dx.doi.org/10.1177/0885066618797271.

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Objective: Critical care echocardiography has become an integral tool in the assessment and management of critically ill patients. Critical care transesophageal echocardiography (TEE) offers diagnostic reliability, superior image quality, and an expanded diagnostic scope to transthoracic echocardiography. Despite its favorable attributes, TEE use in North American intensive care units (ICUs) remains relatively undescribed. In this article, we seek to characterize the feasibility, indications, and clinical impact of a critical care TEE program. Design: Retrospective, observational study. Setting: Tertiary care, academic critical care program consisting of 2 hospitals in Ontario, Canada. Participants: Consecutive critical care TEE examinations on ICU patients performed between December 2012 and December 2016 Interventions: None. Measurements and Main Results: Consecutive critical care TEE studies on ICU patients from December 1, 2012, to December 31, 2016, were reviewed. The TEEs performed on cardiac surgery patients and those without reports were excluded. Examination details, including indications, complications, examination complexity (number of views, Doppler techniques), and clinical recommendations were aggregated and analyzed. Two hundred seventy-four TEE studies were performed by 38 operators. Common indications for TEE studies were hemodynamic instability (45.2%), assessment for infective endocarditis (22.2%), and cardiac arrest (20.1%). A change in patient management was proposed following 79.5% of TEE studies. Thirty-eight percent of TEE studies were performed during evening hours or on weekends. There were no mechanical complications. Conclusions: Our observational data support intensivist-performed TEE as being safe and therapeutically influential across a broad range of indications. Our program’s demonstrated feasibility and impact may act as a model for TEE adoption in other North American ICUs.
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Luttmann, Kelly F., Tre J. Headington, Alicia M. Hochanadel, Caytlin A. Deering, and Tara L. Harpenau. "280. Description of Transesophageal Echocardiography Prescribing Practices in non-Staphylococcus aureus Bacteremia with Application of Scoring Systems." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S140. http://dx.doi.org/10.1093/ofid/ofaa439.324.

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Abstract Background In non-S. aureus gram-positive bacteremia (non-SAB), practices of obtaining transesophageal echocardiography (TEE) are mixed despite the availability of scoring systems in certain organisms (DENOVA for E. faecalis, HANDOC for non-beta hemolytic streptococci) that provide recommendations for TEE with scores 3 or higher. This study aimed to analyze the application of DENOVA and HANDOC scoring systems to coagulase-negative Staphylococci (CoNS), Enterococcus spp. and Streptococcus spp. in relation to TEE prescribing practices. Methods A retrospective, observational study was conducted at two tertiary care hospitals including patients with ≥1 positive blood culture for Enterococcus spp. or Streptococcus spp., or ≥2 positive blood cultures for CoNS with matching susceptibilities between November 2017 and November 2019. The primary outcome compared DENOVA and HANDOC scores in patients who received TEE vs. those who did not. Secondary outcomes included DENOVA and HANDOC scores in subgroup populations, adherence to DENOVA/HANDOC scoring systems, treatment characteristics, and patient outcomes. Results Of the 310 patients included, 96 (31%) underwent TEE and 214 (69%) did not. Fewer patients in the TEE group underwent transthoracic echocardiography: 29.2% vs. 69.9%, p&lt; 0.01. Infectious Diseases providers were involved in all patients that underwent TEE. Median scores were significantly higher in all patients who underwent TEE; DENOVA: 2 (1–3) vs. 1 (1–2), p&lt; 0.01; HANDOC: 3 (3–4) vs. 3 (2–3), p&lt; 0.01. DENOVA and HANDOC scores were significantly higher in the TEE group in Enterococcus spp. and Streptococcus spp., respectively; overall adherence to scoring system recommendations in these groups was less than 60%. HANDOC score was higher in the TEE group for patients with CoNS and 87.5% of these patients with score ≥3 had endocarditis (versus 50% with DENOVA score). More patients in the TEE group had endocarditis 46.9% vs. 6.5%, p&lt; 0.01. Conclusion DENOVA and HANDOC scores were significantly higher among TEE patients, but areas of improvement exist in relation to overutilization of TEE and development of scoring system for CoNS. Efforts to improve TEE utilization should be coordinated with Infectious Disease providers. Disclosures All Authors: No reported disclosures
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Nowosielecka, Dorota, Wojciech Jacheć, Anna Polewczyk, Łukasz Tułecki, Konrad Tomków, Paweł Stefańczyk, Andrzej Tomaszewski, et al. "Transesophageal Echocardiography as a Monitoring Tool during Transvenous Lead Extraction—Does It Improve Procedure Effectiveness?" Journal of Clinical Medicine 9, no. 5 (May 8, 2020): 1382. http://dx.doi.org/10.3390/jcm9051382.

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Background: Transesophageal echocardiography (TEE) is a valuable tool for monitoring the patient during transvenous lead extraction (TLE), but the direct impact of TEE on the effectiveness and safety of TLE has not yet been documented. Methods: The effectiveness of TLE and short-term survival were compared between two groups of patients: 2106 patients in whom TEE was performed before and after TLE and 1079 individuals in whom continuous TEE monitoring was used. The procedure-related risk of major complications was assessed using a predictive SAFeTY TLE score. Results: The patients monitored by TEE were characterized by older age, more comorbidities and higher SAFeTY TLE scores (6.143 ± 4.395 vs. 5.593 ± 4.127; p = 0.004). Complete procedural success was significantly higher in the TEE-guided group (97.683% vs. 95.442%, p < 0.01). The rate of serious complications in the TEE-guided group was lower than the predictive SAFeTY TLE score—a reduction of 28.75% (p < 0.05). Periprocedural mortality in the TEE-guided and non-TEE-guided groups was zero vs. six deaths (p = 0.186). Short-term survival was comparable between the groups. Conclusions: Transesophageal echocardiography as a monitoring tool during transvenous lead extraction provides valuable results—higher rates of complete procedural success and a reduced risk of the most severe complications, thus preventing periprocedural deaths.
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Anaissie, James, Dominique Monlezun, A. Seelochan, James E. Siegler, Maria Chavez-Keatts, Jonathan Tiu, Denise Pineda, et al. "Left Atrial Enlargement on Transthoracic Echocardiography Predicts Left Atrial Thrombus on Transesophageal Echocardiography in Ischemic Stroke Patients." BioMed Research International 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/7194676.

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Background.Transesophageal echocardiogram (TEE) is superior to transthoracic echocardiogram (TTE) in detecting left atrial thrombus (LAT), a risk factor for stroke, but is costly and invasive, carrying a higher risk for complications.Aims.To determine the utility of using left atrial enlargement (LAE) on TTE to predict LAT on TEE.Methods.AIS patients who presented in06/2008–7/2013and underwent both TTE and TEE were identified from our prospective stroke registry. Analysis consisted of multivariate logistic regression with propensity score adjustment and receiver operating characteristic (ROC) area under the curve (AUC) analyses.Results.219 AIS patients underwent both TTE and TEE. LAE on TTE was detected in 113 (51.6%) of AIS patients. Patients with LAE on TTE had higher proportion of LAT on TEE (8.4% versus 1.0%,p=0.018). LAE on TTE predicted increased odds of LAT on TEE (OR=8.83, 95% CI 1.04–74.83,p=0.046). The sensitivity and specificity for LAT on TEE by LAE on TEE were 88.89% and 52.20%, respectively (AUC=0.7054, 95% CI 0.5906–0.8202).Conclusions.LAE on TTE can predict LAT detected on TEE in nearly 90% of patients. This demonstrates the utility of LAE on TTE as a potential screening tool for LAT, potentially limiting unneeded costs and complications associated with TEE.
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Maxwell, Cory, Ryan Konoske, and Jonathan Mark. "Emerging Concepts in Transesophageal Echocardiography." F1000Research 5 (March 14, 2016): 340. http://dx.doi.org/10.12688/f1000research.7169.1.

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Introduced in 1977, transesophageal echocardiography (TEE) offered imaging through a new acoustic window sitting directly behind the heart, allowing improved evaluation of many cardiac conditions. Shortly thereafter, TEE was applied to the intraoperative environment, as investigators quickly recognized that continuous cardiac evaluation and monitoring during surgery, particularly cardiac operations, were now possible. Among the many applications for perioperative TEE, this review will focus on four recent advances: three-dimensional TEE imaging, continuous TEE monitoring in the intensive care unit, strain imaging, and assessment of diastolic ventricular function.
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Tan, Sze Yen, Marijka Batterham, and Linda Tapsell. "Activity Counts From Accelerometers Do Not Add Value to Energy Expenditure Predictions in Sedentary Overweight Individuals During Weight Loss Interventions." Journal of Physical Activity and Health 8, no. 5 (July 2011): 675–81. http://dx.doi.org/10.1123/jpah.8.5.675.

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Background:Knowing the total energy expenditure (TEE) of overweight adults is important for prescribing weight loss interventions. However, objective measurements of TEE may not always be readily available and can be expensive. This study aimed to investigate the validity of RT3 accelerometers in predicting the TEE of sedentary overweight adults, and to identify any sensitivity to anthropometric changes.Methods:The analysis used data from a 12-week weight loss study. At baseline and 12-week, TEE was predicted using RT3 accelerometers during whole room calorimeter stays. Bias between 2 methods was compared at and between the baseline and 12-week measurement points. Multiple regression analyses of TEE data were conducted.Results:Predicted and measured values for TEE were not different at baseline (P = .677) but were significantly different after weight loss (P = .007). However, the mean bias between methods was small (<100 kcal/d) and was not significantly different between 2 time-points. RT3 activity counts explained an additional 2% of the variation in TEE at 12-week but not at baseline.Conclusion:RT3 accelerometers are not sensitive to body composition changes and do not explain variation in TEE of overweight and obese individuals in a sedentary environment.
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Martinez, Jay A., Fares Qeadan, and Mark R. Burge. "Hypothyroidism, Sex, and Age Predict Future Thromboembolic Events Among Younger People." Journal of Clinical Endocrinology & Metabolism 105, no. 4 (December 21, 2019): e1593-e1600. http://dx.doi.org/10.1210/clinem/dgz291.

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Abstract Purpose Aberrant thyroid function causes dysregulated metabolic homeostasis. Literature has demonstrated hypercoagulability in hypothyroidism, suggesting a risk for thromboembolic events (TEE). We hypothesize that individuals with hypothyroidism will experience more clinically-diagnosed TEE than euthyroid individuals. Methods De-identified patient data from the University of New Mexico Health Sciences Center were retrieved using thyrotropin (TSH; thyroid-stimulating hormone) for case-finding from 2005 to 2007 and ICD billing codes to identify TEE during the follow-up period of 10 to 12 years. Diagnoses affecting coagulation were excluded and 12 109 unique enrollees were categorized according to TSH concentration as Hyperthyroid (n = 510), Euthyroid (n = 9867), Subclinical Hypothyroid (n = 1405), or Overtly Hypothyroid (n = 327). Analysis with multiple logistic regression provided the odds of TEE while adjusting for covariates. Results There were 228 TEEs in the cohort over 5.1 ± 4.3 years of follow-up. Risk of TEE varied significantly across study groups while adjusting for sex, race/ethnicity, levothyroxine, oral contraceptive therapy, and visit status (outpatient vs non-outpatient), and this risk was modified by age. Overt Hypothyroidism conferred a significantly higher risk of TEE than Euthyroidism below age 35, and Hyperthyroidism conferred an increased risk for TEE at age 20. Analysis also demonstrated a higher age-controlled risk for a subsequent TEE in men compared with women (odds ratio [OR] = 1.36; 95% confidence interval [CI], 1.02–1.81). Subanalysis of smoking status (n = 5068, 86 TEE) demonstrated that smokers have 2.21-fold higher odds of TEE relative to nonsmokers (95% CI, 1.41–3.45). Conclusions In this retrospective cohort study, Overt Hypothyroidism conferred increased risk of TEE over the next decade for individuals younger than 35 years of age, as compared with Euthyroidism.
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Steemson, John D., Nicole J. Moreland, Deborah Williamson, Julie Morgan, Philip E. Carter, and Thomas Proft. "Survey of the bp/tee genes from clinical group A streptococcus isolates in New Zealand – implications for vaccine development." Journal of Medical Microbiology 63, no. 12 (December 1, 2014): 1670–78. http://dx.doi.org/10.1099/jmm.0.080804-0.

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Group A streptococcus (GAS) is responsible for a wide range of diseases ranging from superficial infections, such as pharyngitis and impetigo, to life-threatening diseases, such as toxic shock syndrome and acute rheumatic fever (ARF). GAS pili are hair-like extensions protruding from the cell surface and consist of highly immunogenic structural proteins: the backbone pilin (BP) and one or two accessory pilins (AP1 and AP2). The protease-resistant BP builds the pilus shaft and has been recognized as the T-antigen, which forms the basis of a major serological typing scheme that is often used as a supplement to M typing. A previous sequence analysis of the bp gene (tee gene) in 39 GAS isolates revealed 15 different bp/tee types. In this study, we sequenced the bp/tee gene from 100 GAS isolates obtained from patients with pharyngitis, ARF or invasive disease in New Zealand. We found 20 new bp/tee alleles and four new bp/tee types/subtypes. No association between bp/tee type and clinical outcome was observed. We confirmed earlier reports that the emm type and tee type are associated strongly, but we also found exceptions, where multiple tee types could be found in certain M/emm type strains, such as M/emm89. We also reported, for the first time, the existence of a chimeric bp/tee allele, which was assigned into a new subclade (bp/tee3.1). A strong sequence conservation of the bp/tee gene was observed within the individual bp/tee types/subtypes (>97 % sequence identity), as well as between historical and contemporary New Zealand and international GAS strains. This temporal and geographical sequence stability provided further evidence for the potential use of the BP/T-antigen as a vaccine target.
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Livesay, James, William Lorson, R. Eric Heidel, and Mahmoud Shorman. "154. Do I Really Need a Transesophageal Echo? Comparing Echocardiographic Modalities in Native Valve Infective Endocarditis due to Methicillin-Resistant Staphylococcus aureus." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S103. http://dx.doi.org/10.1093/ofid/ofz360.229.

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Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) infective endocarditis (IE) is associated with high morbidity and mortality. Management commonly includes six-weeks of antibiotics and surgical intervention, if the patient has complications. Current guidelines recommend obtaining an echocardiogram. Transesophageal echocardiogram (TEE) is preferred over transthoracic echocardiogram (TTE). We wanted to evaluate the role of a TEE in changing management of MRSA IE. Methods A retrospective cohort of patients with MRSA IE was analyzed between January 2013 and July 2017 at a tertiary care facility in East Tennessee. Patients with prosthetic valves or cardiac devices were excluded. Demographic, echocardiographic, antibiotic, blood culture, mortality, and intravenous drug use data were collected (Figure 1). Results Seventy-eight patients met the inclusion criteria. TTE was performed on 73 patients while five patients proceeded directly to TEE. Of the 73 patients that had a TTE, 33 (45.2%) detected the presence of vegetation and 40 (54.8%) did not. Of the 33 patients with a positive TTE, 15 subsequently underwent TEE, confirming IE. Out of the 40 patients with a negative TTE, 34 underwent TEE, of which 22 (64.7%) showed a vegetation. (Figure 2). A total of ten patients (12.8%) from the study underwent surgery. Of these ten, three (30%) had a positive TTE only, with no subsequent TEE. Five (50%) had both a positive TTE and TEE, and two (20%) had a negative TTE but positive TEE. Conclusion Transthoracic echocardiogram was adequate to visualize vegetations in 45.2% of patients. Completing a TEE increased the sensitivity of visualizing a vegetation, but management was most often not altered. Only two patients (5%) with a negative TTE, but positive TEE proceeded to surgery because of the findings. This causes us to question whether a subsequent TEE needs to be pursued when a TTE is negative in the setting of definite or possible IE by the modified Duke criteria. Even if a vegetation is seen on TEE the patient would most likely receive the same treatment, 6 weeks of intravenous antibiotics, as if no vegetation was seen. Forgoing a TEE reduces risk to the patient of undergoing a procedure, and reduces costs to the healthcare system. Disclosures All authors: No reported disclosures.
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30

Malone, Aubrey, Sean Desmond, Pat Ingoldsby, and George Ryan. "Funny Tee Hee." Books Ireland, no. 203 (1997): 97. http://dx.doi.org/10.2307/20631682.

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31

Kanchi, Muralidhar. "Interesting TEE image." Annals of Cardiac Anaesthesia 13, no. 3 (2010): 260. http://dx.doi.org/10.4103/0971-9784.69055.

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Markó, Á., and N. Morgan-Hughes. "TEE Pocket Manual." British Journal of Anaesthesia 108, no. 3 (March 2012): 535. http://dx.doi.org/10.1093/bja/aer508.

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33

Bender, T., and F. Martens. "Kein grüner Tee." Der Notarzt 33, no. 05 (March 16, 2017): 220–23. http://dx.doi.org/10.1055/s-0043-104874.

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34

Hiscox, Rhoda. "TEE in Britain." British Journal of Theological Education 1, no. 1 (June 1987): 17–27. http://dx.doi.org/10.1080/1352741x.1987.11673926.

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Maus, Timothy, and Dalia A. Banks. "Interactive TEE Review." Journal of Cardiothoracic and Vascular Anesthesia 22, no. 5 (October 2008): 796. http://dx.doi.org/10.1053/j.jvca.2008.07.001.

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36

Onishi, Toshinari. "TEE in TAVI." Ultrasound in Medicine & Biology 43 (2017): S54. http://dx.doi.org/10.1016/j.ultrasmedbio.2017.08.1122.

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37

Eichholzer, M. "Tee und Gesundheit." Aktuelle Ernährungsmedizin 31, no. 01 (2006): 18–22. http://dx.doi.org/10.1055/s-2005-915377.

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Klimkina, Oksana. "Board Stiff TEE." Anesthesia & Analgesia 120, no. 4 (April 2015): 951–53. http://dx.doi.org/10.1213/ane.0000000000000586.

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39

&NA;. ""Q-Tee"™." Gastroenterology Nursing 19, no. 4 (July 1996): 157. http://dx.doi.org/10.1097/00001610-199607000-00014.

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Mügge, A. "Transösophageale Echokardiographie (TEE)." Zeitschrift f�r Kardiologie 89, no. 13 (January 1, 2000): S110—S118. http://dx.doi.org/10.1007/s003920070132.

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Konstadt, Steven N., and David L. Reich. "A normal TEE?" Journal of Cardiothoracic and Vascular Anesthesia 8, no. 1 (February 1994): 123–24. http://dx.doi.org/10.1016/1053-0770(94)90025-6.

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42

Uibo, R. "TEE TEKIB KÄIES." EESTI VABARIIGI PREEMIAD 28, no. 1 (2024): 46. http://dx.doi.org/10.3176/evp.2024.02.

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43

Ellis, Christopher R. "To TEE, or Not to TEE, That Is the Question." JACC: Clinical Electrophysiology 5, no. 12 (December 2019): 1415–17. http://dx.doi.org/10.1016/j.jacep.2019.08.022.

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Ehrman, Robert R., Mark J. Favot, Thomas Hartley, and Ashley N. Sullivan. "To TEE or Not to TEE? That Is the Question." Annals of Emergency Medicine 74, no. 4 (October 2019): 608–9. http://dx.doi.org/10.1016/j.annemergmed.2019.05.029.

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45

Comunale, Mark E., Simon C. Body, Catherine Ley, Colleen Koch, Gary Roach, Joseph P. Mathew, Ahvie Herskowitz, and Dennis T. Mangano. "The Concordance of Intraoperative Left Ventricular Wall-motion Abnormalities and Electrocardiographic S-T Segment Changes." Anesthesiology 88, no. 4 (April 1, 1998): 945–54. http://dx.doi.org/10.1097/00000542-199804000-00014.

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Background Transesophageal echocardiography (TEE) and Holter electrocardiography (ECG) are used to detect intraoperative ischemia during coronary artery bypass graft surgery (CABG). Concordance of these modalities and sensitivity as indicators of adverse perioperative cardiac outcomes are poorly defined. The authors tried to determine whether routine use of Holter ECG and TEE in patients with CABGs has clinical value in identifying those patients in whom myocardial infarction (MI) is likely to develop. Methods A total of 351 patients with CABG and both ECG- and TEE-evaluable data were examined for the occurrence of ischemia and infarction. The TEE and five-lead Holter ECGs were performed continuously during cardiac surgery. The incidence of MI (creatine kinase-MB &gt; or = 100 ng/ml) within 12 h of arrival in the intensive care [ICU] unit, new ECG Q wave on ICU admission or on the morning of postoperative day 1, or both, were recorded. Results Electrocardiographic or TEE evidence of intraoperative ischemia was present in 126 (36%) patients. The concordance between modalities was poor (positive concordance = 17%; Kappa statistic = 0.13). Myocardial infarction occurred in 62 (17%) patients, and 32 (52%) of them had previous intraoperative ischemia. Of these, 28 (88%) were identified by TEE, whereas 13 (41%) were identified by ECG. Prediction of MI was greater for TEE compared with ECG. Conclusions Wall-motion abnormalities detected by TEE are more common than S-T segment changes detected by ECG, and concordance between the two modalities is low. One half of patients with MI had preceding ECG or TEE ischemia. Logistic regression revealed that TEE is twice as predictive as ECG in identifying patients who have MI.
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Qureshi, Muneeb, Ahmed Rehan, Wai Kit Mok, Abdulazeez Salawu, Sabin Goktas Aydin, Jessica Tay, Rachel Hubbard, James W. F. Catto, and Syed A. Hussain. "Thromboembolic events associated with neoadjuvant chemotherapy for muscle invasive cancer of the bladder." Journal of Clinical Oncology 42, no. 4_suppl (February 1, 2024): 586. http://dx.doi.org/10.1200/jco.2024.42.4_suppl.586.

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586 Background: Patients with muscle invasive bladder cancer who undergo platinum-based neoadjuvant chemotherapy (NAC) followed by radical cystectomy or radiotherapy are at high risk of venous and arterial thromboembolic events (TEE). TEE is associated with delay to radical cancer treatment, significant morbidity and even mortality. This study aimed to document the incidence and characteristics of TEE during NAC and prior to radical treatment. Methods: Retrospective data was collected on all patients in our centre who underwent NAC prior to radical treatment. TEE events were identified based on routine imaging to assess for response to NAC; or imaging based on clinical symptoms developed during (or within 28 days) of NAC but prior to radical treatment. Results: Data was collected on 148 patients between January 2015 and September 2023. Age range: 44 - 82 years, the majority (73.6%) of whom were male. All patients received platinum-based chemotherapy (median 4 cycles). A total of 31 patients (20.9%) developed 35 TEE, including 27 venous events (24 pulmonary emboli and 3 deep venous thromboses), and 8 arterial events (3 aortic thrombus, 4 limb ischaemia, 1 ischemic stroke). Four patients had a venous and arterial TEE. The majority of pulmonary venous TEE were subclinical. Conclusions: Our single-centre study demonstrates that the incidence of TEE during NAC prior to radical treatment for bladder cancer is high. Improved imaging techniques and routine scans post-NAC led to identification of subclinical TEE that require treatment as they are likely to become clinically significant. The high rate of TEE in this patient population is likely to benefit from prophylactic anticoagulation during NAC and should be investigated in future prospective clinical trials.
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47

Goran, M. I., W. H. Carpenter, and E. T. Poehlman. "Total energy expenditure in 4- to 6-yr-old children." American Journal of Physiology-Endocrinology and Metabolism 264, no. 5 (May 1, 1993): E706—E711. http://dx.doi.org/10.1152/ajpendo.1993.264.5.e706.

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There is a sparsity of data on energy expenditure in young children. We therefore examined the components of daily energy expenditure in a group of 30 children (16 boys, 14 girls; age 4–6 yr) characterized for body weight, height, heart rate, and body composition from bioelectrical resistance. Total energy expenditure (TEE) was measured over 14 days under free living conditions by doubly labeled water, resting energy expenditure (REE) from indirect calorimetry, and activity energy expenditure was estimated from the difference between TEE and REE. Mean TEE was 1,379 +/- 290 kcal/day, which was 475 +/- 202 kcal/day lower than energy intake recommendations for this age group. Activity-related energy expenditure was estimated to be 267 +/- 203 kcal/day. TEE was most significantly related to fat-free mass (FFM; r = 0.86; P < 0.001), body weight (r = 0.83; P < 0.001), and REE (r = 0.80; P < 0.001). When TEE was adjusted for FFM, a significant correlation with heart rate was observed (partial r = 0.54; P = 0.002). Collectively, 86% of interindividual variation in TEE was accounted for by FFM, heart rate, and REE. We conclude that, in young 4- to 6-yr-old children, 1) TEE is approximately 25% lower than current recommendations for energy intake and 2) combined measurement of FFM, heart rate, and REE explain 86% of interindividual variation in TEE, thus providing a possible alternative method to estimate TEE in young children.
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Wang, Shi Gang, Dan Wang, and Fu Sheng Gao. "Analysis of Tee Pipe Hydroforming Process Parameters." Applied Mechanics and Materials 651-653 (September 2014): 643–46. http://dx.doi.org/10.4028/www.scientific.net/amm.651-653.643.

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By using the finite element software Dynaform, the process of tee pipe hydroforming is obtained with the analysis of forming force, the extrusion speed, die radius, friction conditions and the initial length of tube rounds, which are key process parameters on the influence of tee pipe. Obtained by analyzing the tee pipe hydroforming law, to the actual production of tee pipe hydroforming process design provides the reference data and related guidance.
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49

Guimarães, Mariana P., Eduardo Ferriolli, Karina Pfrimer, and Anderson M. Navarro. "Doubly Labeled Water Method and Accelerometer for the Measurement of Energy Expenditure in Human Immunodeficiency Virus-Infected Patients." Annals of Nutrition and Metabolism 70, no. 1 (2017): 66–73. http://dx.doi.org/10.1159/000458766.

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Background: Several studies have reported increased resting energy expenditure (REE) in human immunodeficiency virus (HIV)-infected patients with HIV-associated lipodystrophy syndrome (HALS). However, limited data exist on the total energy expenditure (TEE). This study was aimed at evaluating the REE and TEE of HIV-infected patients with and without HALS by using the doubly labeled water (DLW) technique and the activity monitor based on accelerometry system (AM), and comparing the results obtained using both methods. Methods: Evaluated total of 45 HIV+ men undergoing antiretroviral therapy, including 18 LIPO- (without lipodystrophy) and 27 LIPO+ (with lipodystrophy) individuals were evaluated. Habitual physical activity patterns were measured by using the ActivPAL™ AM system, REE by indirect calorimetry, and TEE by DLW and AM. Results: No significant differences were found between LIPO- and LIPO+ in REE (1,433 ± 196 vs. 1,510 ± 203 kcal), TEE-DLW (2,691 ± 856 vs. 2,618 ± 415 kcal) and TEE-AM (2,560 ± 458 vs. 2,594 ± 456 kcal), respectively. RQ was a predictor of REE in LIPO+. TEE estimated by the AM had a moderate correlation with DLW, but there was a wide variance in the intra-subject results. Conclusions: TEE is not increased in HIV-infected patients with HALS. AM should be used with caution for TEE evaluation during clinical practice.
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Durak, Koray, Alexander Kersten, Oliver Grottke, Rashad Zayat, Michael Dreher, Rüdiger Autschbach, Gernot Marx, Nikolaus Marx, Jan Spillner, and Sebastian Kalverkamp. "Thromboembolic and Bleeding Events in COVID-19 Patients receiving Extracorporeal Membrane Oxygenation." Thoracic and Cardiovascular Surgeon, April 16, 2021. http://dx.doi.org/10.1055/s-0041-1725180.

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Abstract Background Extracorporeal membrane oxygenation (ECMO) is a potential treatment option in critically ill COVID-19 patients suffering from acute respiratory distress syndrome (ARDS) if mechanical ventilation (MV) is insufficient; however, thromboembolic and bleeding events (TEBE) during ECMO treatment still need to be investigated. Methods We conducted a retrospective, single-center study including COVID-19 patients treated with ECMO. Additionally, we performed a univariate analysis of 85 pre-ECMO variables to identify factors influencing incidences of thromboembolic events (TEE) and bleeding events (BE), respectively. Results Seventeen patients were included; the median age was 57 years (interquartile range [IQR]: 51.5–62), 11 patients were males (65%), median ECMO duration was 16 days (IQR: 10.5–22), and the overall survival was 53%. Twelve patients (71%) developed TEBE. We observed 7 patients (41%) who developed TEE and 10 patients (59%) with BE. Upper respiratory tract (URT) bleeding was the most frequent BE with eight cases (47%). Regarding TEE, pulmonary artery embolism (PAE) had the highest incidence with five cases (29%). The comparison of diverse pre-ECMO variables between patients with and without TEBE detected one statistically significant value. The platelet count was significantly lower in the BE group (n = 10) than in the non-BE group (n = 7) with 209 (IQR: 145–238) versus 452 G/L (IQR: 240–560), with p = 0.007. Conclusion This study describes the incidences of TEE and BE in critically ill COVID-19 patients treated with ECMO. The most common adverse event during ECMO support was bleeding, which occurred at a comparable rate to non-COVID-19 patients treated with ECMO.
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