“
“We examined two aspects of temperamental approach in early infancy, positive reactivity and anger, and their unique and combined influences on maternal reports of child surgency and attention focusing at 4 years of age. One hundred and fourteen infants were observed for their positive reactions to novel stimuli at 4 months, and their anger expressions during arm restraint at 9 months. Child surgency and attention focusing at age 4 years were assessed by maternal report. Infants who expressed more anger to restraint were rated higher in surgency during early childhood relative to infants who expressed less anger. The effects of positive reactivity to novelty on attention focusing were moderated by anger to restraint. These findings

suggest that infant temperamental approach tendencies BGB324 in vivo are multifaceted and have both unique and combined influences on later maternal report of attention and social behavior. “
“Infants

search for an object hidden by an occluder in the light months later than one hidden by darkness. One explanation attributes this décalage to easier action demands in darkness versus occlusion, whereas another attributes it to easier representation demands in darkness versus occlusion. However, search tasks typically confound these two types of demands. This article presents a search task that unconfounds them to better address these two explanations of the “dark advantage.” Objects were hidden by submersion in liquid instead of occlusion with a screen, allowing infants to search with equally simple actions in light versus dark. In Experiment 1, 6-month-olds learn more unexpectedly showed a dark disadvantage by discriminating when an object was hidden in the light but not the dark. Experiment 2 addressed the possibility that representation demands were higher in the dark than the light and showed that infants’ search in the dark increased to match that in the light, but not exceed it. Six-month-olds can thus search for a hidden DOCK10 object both when action demands are simplified and

when a noncohesive substance rather than a cohesive occluder hides the object, supporting aspects of both action-demand and representation-demand explanations of décalage in search behavior. “
“This study examines face-scanning behaviors of infants at 6, 9, and 12 months as they watched videos of a woman describing an object in front of her. The videos were created to vary information in the mouth (speaking vs. smiling) and the eyes (gazing into the camera vs. cueing the infant with head turn or gaze direction to an object being described). Infants tended to divide their attention between the eyes and the mouth, looking less at the eyes with age and more at the mouth than the eyes at 9 and 12 months. Attention to the mouth was greater on speaking trials than on smiling trials at all three ages, and this difference increased between 6 and 9 months. Despite consistent results within subjects, there was considerable variation between subjects.

Another vaccine reported in 2004 links hCGβ with a human anti-DC antibody, B-11, at genetic level.80 This vaccine is reported to elicit cell-mediated immune response to tumor-associated antigen(s) in a human in vitro model. Monocytes of a normal human donor were incubated with B-11-hCGβ, activated with CD40 ligand mixed with autologous lymphocytes and tested for their ability to mount hCGβ-specific proliferative and cytotoxic T-lymphocyte response. The procedure led to the generation of tumor-specific HLA class https://www.selleckchem.com/products/gsk2126458.html I- and class II-restricted T-cell response (including CTLs) capable of killing human cancer cell lines expressing hCGβ.

According to the authors, this is the first time that cellular immune response has been induced by a vaccine in a human in vitro system in contrast to the other vaccines inducing primarily antibody response. Immunological interventions against

hCG, whether by vaccines or by recombinant human/chimeric antibodies, have entered an exciting new phase. They may provide therapeutic options for advanced-stage cancers, which are often metastasized and refractory to available drugs. These would also be useful for the control of fertility for which there is a continuing need of additional more acceptable methods. According to WHO (http://www.who.int/en), more than 120 million couples still have an unmet need for family planning and 45 million Astemizole DAPT pregnancies are terminated each year globally. Two recombinant vaccines have been developed. One employs hCGβ linked to either an antibody homing to Dendrocytes or linked to a mucosal carrier, and the other has β subunit of hCG fused to B subunit of heat labile enterotoxin of E. coli (hCGβ-LTB). The former has been tested in vitro; it induces a cell-mediated immune response against hCG. The second vaccine, hCGβ-LTB, given along with a non-pathogenic human use approved Mycobacterium indicus pranii

generates several fold higher antibody response in mice than titers established by previous clinical trials to prevent pregnancy. The third vaccine employs an engineered hCGβ with glutamic acid replacing arginine at position 68, conjugated to a human antibody for delivery to dendrocytes. It is in clinical trials in bladder cancer patients with encouraging results. Corresponding Author Dr G. P. Talwar Talwar Research Foundation, New Delhi, India. “
“Regulatory T cells play a crucial role in normal gut homeostasis, as well as during infection with microbial or parasitic pathogens. Prior to infection, interactions with the commensal microflora are essential to differentiation of a healthy steady-state level of immunoregulation, mediated through both Toll-like receptor-dependent and -independent pathways.

STATISTICA® StatSoft, Inc. (StatSoft Scandinavia AB, Uppsala, Sweden) 9.0 software package was used MAPK inhibitor for all statistical analyses. Positively skewed variables were logarithmically transformed prior to analysis. Values are presented as mean ± SD. The

study was approved by the Ethics Committee at Huddinge University Hospital, Stockholm, Sweden. The research was performed in accordance with institutional guidelines of the Karolinska Institute and in accordance with the Declaration of Helsinki. All subjects gave their informed consent. As shown in Table 1, the level of ascorbate in plasma increased significantly after treatment with ascorbate. Likewise, the level of α-tocopherol in plasma increased after treatment with vitamin E, whereas measured levels of retinol remained unchanged. As shown in Table 2, inhalation of cigarette smoke induced a significant reduction in capillary blood flow velocity. This effect of smoking was very prompt both before (p < 0.0007) and after treatment with ascorbate (p < 0.0004). However, there was no significant difference in terms of relative reduction in CBV before or after intervention by either of the antioxidants. The reduction was 65% before ascorbate and 60% after ascorbate (ns). At baseline, TtP was significantly prolonged after inhalation of cigarette smoke, an increase in TtP from 7.3 to 10.6 seconds (p < 0.05). When comparing

the response to provocation by PRH before and after two weeks of treatment with ascorbate, there was a highly significant shortening of TtP Atezolizumab datasheet as compared with baseline: 7.3 seconds vs 5.2 seconds (p < 0.002). Furthermore, the TtP in response to smoking after treatment with ascorbate was prolonged from 5.2 to 7.4 seconds (p < 0.002). The relative change in response to smoking did not differ between subjects treated or not treated with ascorbate (ns). The same experimental protocol was repeated in volunteers using vitamin E. Again, there was an effect on resting CBV with a similar effect of acute smoke inhalation on CBV as for ascorbate. The reduction in CBV after smoking was highly significant: from 0.72 ± 0.24 to 0.40 ± 0.22 mm/sec (p < 0.000008). Concordant with the results of treatment

with ascorbate, there was no difference Arachidonate 15-lipoxygenase in the response of CBV to the effects of smoke inhalation before and after treatment with vitamin E, i.e., it was not possible to demonstrate any significant effect on the reduction in CBV in response to smoking before or after the two-week treatment with vitamin E. The baseline TtP before treatment with vitamin E was similar to before ascorbate, 7.0 ± 3.0 seconds compared to 7.3 seconds (ns). However, there was no difference in TtP before or after the two-week treatment with vitamin E, 7.0 ± 3.0 seconds vs 6.8 ± 2.6 seconds (ns). Baseline CBV before either treatment did not differ (ns). In contrast to baseline measurements, the CBV increased significantly after treatment with ascorbate, from 0.64 ± 0.33 to 1.00 ± 0.53 mm/sec (p < 0.

Eligible for enrolment were pregnant women who at the time of sampling, i.e. within 48 h before delivery, expected to give birth by vaginal route. Pregnant women who finally gave birth by caesarean section were still included in the study. The selection of pregnant women was at random order. These 347 pregnant women represented 2% of the total births in the prefecture of Heraklion during the 4-year study period. Candida colonisation was investigated both in mothers selleck products and in their neonates. Demographic and clinical data were collected by the same investigator from hospital registries and mother-retrieved questionnaires. Mothers were informed about the aims of the study

and about the sample collection from both themselves and their offspring. Ethical approval for the study was obtained from the relevant Institutional

Committee. Maternal samples were obtained from vaginal mucosa within 48 h before delivery. Neonatal samples were obtained from oral (cheek, lip, ventral and dorsal surface of tongue) and rectal mucosa within 24–72 h after delivery. In cases of symptomatic neonates colonised by Candida, repeated samples were collected from the same sites on days 14 and 28 after birth. A sterile fibre-tipped swab was used to collect the samples. The specimens were inoculated onto Sabouraud dextrose agar plates (Becton Dickinson Microbiology Systems, Cockeysville, MD) and incubated for 72 h at 36 °C under aerobic conditions. Results were categorised semiquantitatively as 1+, 2+, 3+ and 4+ (yeast colonies limited to quadrant

1, 2 and 3 or extended to all quadrants of Petri plate Tanespimycin molecular weight respectively). Yeast isolates were identified to species level using the API 20 CAUX system (BioMérieux, Marcy L’ Etoile, France). Antifungal susceptibility testing against amphotericin B, 5-fluorocytosine, fluconazole, ketoconazole, itraconazole, voriconazole, caspofungin, anidulafungin and micafungin was performed by the E-test method as recommended by the manufacturer (BioMérieux). The plates were incubated at 35 °C and read at 24 and 48 h. The minimal inhibitory concentration (MIC) was read as the lowest concentration at which the border of the elliptical zone of growth inhibition intersected the scale on the test strip. For the azoles an 80% inhibition in growth was used as the MIC cut-off (microcolonies were ignored), and for 5-fluorocytosine MycoClean Mycoplasma Removal Kit and amphotericin B the MIC endpoint was defined as the lowest concentration with nearly complete (90%) and complete (100%) inhibition respectively. C. krusei ATCC 6258 and C. parapsilosis ATCC 22019 served as quality control strains. For all antifungal agents tested, interpretative breakpoints followed those published as part of the M27-A3 document.[8] The isolates from colonised mother–infant pairs were further analysed for their genetic relatedness. The pulsed-field gel electrophoresis (PFGE) method was conducted as previously described by Chen et al.

oryzae compared to CAS or ABLC monotherapy.[26] Furthermore, based on preclinical studies, Reed et al. showed that patients with rhino-orbital-cerebral mucormycosis treated with CAS and ABLC therapy had superior success and survival time compared with patients who received ABLC monotherapy.[73] The same group of investigators[74] showed that the enhanced efficacy of LAmB with micafungin (MFG) or anidulafungin combination therapy

in treating DKA mice with disseminated mucormycosis is a class effect. Triple therapy for mucormycosis consisting of LAmB, MFG and the iron chelator deferasirox was superior to monotherapy or dual therapy treatments. Triple therapy improved survival of mice by 40% compared to 0–11% for LY2157299 molecular weight all other

treatments.[75] Given the resistant phenotype of Mucorales with conventional drugs, the potential for triple therapy in mucormycosis should be further investigated in preclinical and clinical studies. Although PSC shows good in vitro susceptibilities against Zygomycetes, the in vivo efficacy of PSC in immunosuppressed murine models of disseminated mucormycosis is substantially variable as well as species- and dose-dependent.[44-48] Vismodegib purchase In order to evaluate its role in combination therapy, Rodriguez et al.[76] investigated the efficacy of PSC in combination with AmB. Findings showed that low doses of AmB (0.3 mg/kg, once daily) combined with PSC (40 mg/kg, once daily) prolonged survival, but it was not superior to the high-dose of administered AmB (0.8 mg/kg, once daily), allowing reduction of the AmB dose and similar efficacy levels with AmB monotherapy. A most recent in vivo combination study, using a non-lethal murine model of cutaneous mucormycosis caused by R. oryzae, showed that TAC

combined with PSC reduced significantly cutaneous lesions and fungal burden compared to the animals administered VRC alone.[77] To date, there is no adequate clinical evidence on the use of VRC as a single agent or in combination therapy. For this reason, additional studies are required to explore further the role of VRC to improve the prognosis and outcome of the patients who develop invasive mucormycosis. Beta-glucan is an essential cell wall component of fungi that lies beneath a Glutamate dehydrogenase dense layer of mannan coat. The inner beta-glucan layer is targeted by the dectin-1 receptor of immune cells, mediating the innate immune response, and by the echinocandin class of antifungal drugs. Lamaris et al. [78] showed that the beta-glucan unmasking effect of CAS enhanced the activity of PMN against A. fumigatus and R. oryzae as well as other non-Aspergillus hyphae. The effect of PMN against A. corymbifera, R. microsporus and R. oryzae under the influence of LAmB and ABLC was also investigated in another in vitro study. While LAMB exhibited synergistic activity with PMN in inducing hyphal damage only to R.

22,108 This interesting model raises the possibility of using similar approaches, possibly also exploiting viral miRNAs, to limit the replication of BK virus in renal allograft and cytomegalovirus, EBV viruses in transplant recipients. There are currently sparse data on the pharmacokinetics of these oligonucleotides obtained from animal studies. Observations so far have suggested that these inhibitors are eliminated mainly through the renal route and as a consequence, it will be essential Ibrutinib mw to learn the effect of human renal impairment on the clearance of these molecules.109,110 Silencing

miRNAs with ‘antagomirs’ in kidney disease may take advantage of higher renal concentration after systemic administration compared with other organs or tissues. There are several major challenges in exploring the role of miRNAs in kidney NVP-AUY922 manufacturer diseases. Most importantly many fundamental questions remain regarding miRNA biology. The mechanism of regulation of miRNA production is not completely clear. While many miRNAs are located within introns of host genes, their expression does not always correlate perfectly with that of host genes suggesting further, post-transcriptional, regulation.23,111,112 Examples of such regulation are the influence

of Lin28 proteins on Let-7 production and p53 on the processing of several miRNAs.113,114 Initially, miRNAs were thought to suppress translational inhibition by interfering with the binding of essential translational initiation factors.115 However, other translational repression mechanisms and translational activation and transcriptional effects have been reported.11,115–118 Specific targets for most

miRNAs remain unclear. Bioinformatic analyses have predicted many thousands of miRNA-target pairs but only a small proportion of these has been validated experimentally ifoxetine (Table 1). Furthermore, the use of miRNAs as therapeutic agents is attractive but faces considerable challenges, including development of safe and reliable organ and cell-specific delivery systems, avoidance of toxicity derived from off-target effects and from activation of the innate and adaptive immune response. Given these challenges, the most immediate clinical benefits are likely to emerge from identification of miRNAs that can be used as reliable biomarkers for diagnosis, prognosis and response to therapy, in both kidney and allograft disease. “
“Aim:  Hyaluronan (HA) is an important extracellular matrix (ECM) proteoglycan. The localization of HA and its binding receptors, CD44 and LYVE-1, was evaluated in an experimental model of chronic cyclosporine A (CsA)-induced nephropathy. Methods:  Sprague–Dawley rats maintained on a low-salt diet (0.05% sodium) received an s.c. injection of vehicle (1 mL/kg per day olive oil; VH groups) or CsA (15 mg/kg per day; CsA groups) for 1 or 4 weeks.

Gene Set Enrichment Analysis

revealed 26 Gene Ontology terms including “JAK-STAT cascade” to be significantly positively correlated with the density of NG2-positive OPCs. Immunohistology revealed an increased Ulixertinib amount of activated, phosphorylated STAT3-expressing astrocytes, OPCs, and microglia/macrophages within the lesions. Meteorin-induced activation of STAT3-signalling in BO-1 cells and primary rat OPCs resulted in an enhanced GFAP- and reduced CNPase-expression. In contrast, an oppositional result was observed in BO-1 cells treated with STAT3 inhibitor VII. The STAT3 pathway is a key regulator of OPC-differentiation, suggested to shift their differentiation from an oligodendroglial towards an astrocytic fate, thereby inducing astrogliosis and insufficient remyelination in TME. “
“J. D. F. Wadsworth, E. A. Asante and J. Collinge (2010) Neuropathology and Applied Neurobiology36, 576–597 Contribution of transgenic models to understanding human prion disease Transgenic mice expressing human prion protein in the absence of endogenous mouse prion protein faithfully replicate human prions. These models reproduce all of the key features of human disease, including

long clinically silent incubation periods prior to fatal neurodegeneration with neuropathological phenotypes that mirror human prion strain diversity. Critical contributions to our understanding of human prion disease pathogenesis and aetiology have only been possible through the use of transgenic mice. These models have provided the basis for the selleck chemicals llc conformational selection model of prion transmission barriers and have causally linked bovine spongiform encephalopathy with variant Creutzfeldt-Jakob disease. In the future these models will be essential for evaluating newly identified potentially zoonotic prion strains, for validating effective methods of prion decontamination and for developing effective therapeutic treatments for human prion disease. “
“Immune-mediated necrotizing myopathies (IMNMs) are

now well recognized among the so-called idiopathic inflammatory myopathies Proteases inhibitor (IIMs), which also comprise dermatomyositis (DM), polymyositis (PM), sporadic inclusion body myositis (sIBM) and non-specific myositis. All of these conditions are defined on the basis of distinct clinical symptoms, in combination with results derived from muscle biopsy and additional data, such as measurement of the serum creatine kinase (CK) level as well as myositis-associated and myositis-specific autoantibodies, electromyography (EMG) and modern imaging techniques. Importantly, diagnosis of one of the above mentioned myositis forms implies a specific clinical syndrome or a distinct disease. However, there is considerable clinical heterogeneity, and overlap requiring further diagnostic precision. Classification and subclassification of IIMs are highly debated and the subjects of intense research, especially as clinical trials with anti-inflammatory agents should follow universally defined and accepted criteria.

Further investigations will doubtless reveal new information that will lead to a better understanding of the relationships Opaganib ic50 between these molecules. This work was supported by Grants-in-Aid nos. 23590390 (to Y.T.) and 23240049 (to H.T.) for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology,

Japan. “
“Y. Kawamoto, H. Ito, Y. Kobayashi, Y. Suzuki, I. Akiguchi, H. Fujimura, S. Sakoda, H. Kusaka, A. Hirano and R. Takahashi (2010) Neuropathology and Applied Neurobiology36, 331–344 HtrA2/Omi-immunoreactive intraneuronal inclusions in the anterior horn of patients with sporadic and Cu/Zn superoxide dismutase (SOD1) mutant amyotrophic lateral sclerosis Aims: HtrA2/Omi is a mitochondrial serine protease that promotes the apoptotic processes, but the relationship between HtrA2/Omi and amyotrophic lateral sclerosis (ALS) is still unknown. The purpose of the present study was to determine whether abnormal expression of HtrA2/Omi occurs in patients with ALS. Methods: We prepared autopsied spinal cord tissues from check details 7 control subjects, 11 patients with sporadic ALS (SALS) and 4 patients with Cu/Zn superoxide dismutase (SOD1)-related familial ALS (FALS). We then performed immunohistochemical studies on HtrA2/Omi using formalin-fixed, paraffin-embedded

sections from all of the cases. Results: In the control subjects, the anterior horn cells were mildly to moderately immunostained with HtrA2/Omi. In the patients with SALS, strong HtrA2/Omi immunoreactivity

was found in some skein-like inclusions and round hyaline inclusions as well as many spheroids, but Bunina bodies were immunonegative for HtrA2/Omi. In the patients with SOD1-related FALS, Lewy body-like hyaline inclusions were observed in three cases and conglomerate inclusions were observed in the remaining case, and both types of inclusions were intensely immunopositive for HtrA2/Omi. Conclusions: These results suggest that abnormal accumulations of HtrA2/Omi may occur in several types of motor neuronal inclusions in the anterior horn from SALS and SOD1-linked FALS cases, and that HtrA2/Omi may be associated Liothyronine Sodium with the pathogenesis of both types of ALS. “
“Based on the cerebral tans-activation response DNA protein 43 (TDP-43) immunohistochemistry, frontotemporal lobar degeneration with TDP-43 pathology (FTLD-TDP) is classified into four subtypes: type A has numerous neuronal cytoplasmic inclusions (NCIs) and dystrophic neurites (DNs); type B has numerous NCIs with few DNs; type C is characterized by DNs which are often longer and thicker than DNs in type A, with few NCIs; and type D has numerous neuronal intranuclear inclusions and DNs with few NCIs.

g. the ERVW-1 envelope gene Syncytin-1, essential for placentogenesis, but also deregulated in human tumors. Data concerning ERV expression in the AH and related endocrine tumors are missing. Syncytin-1 protein was analysed in normal AH (n=15) and compared to five PA subtypes (n=117) by immunohistochemistry.

Absolute gene expression of 20 ERV functional envelope genes and ERVW-5 gag was measured. PA tissues were examined for Syncytin-1 and the cAMP signaling marker phospho-CREB-Ser133 using immunohistochemistry. Isolated primary human PA cells were treated with different hormones. Murine embryonic and adult pituitary gland ERV expressions were compared PF-01367338 ic50 to human AH. Syncytin-1 protein co-localised with corticotropic cells of AH. In contrast, all PA demonstrated significant Syncytin-1 protein

overexpression, supporting deregulation. All other ERV genes showed significant up-regulations in different PA subtypes. Phospho-CREB-Ser133 and Syncytin-1 co-localized in PA cells. Cultivated primary PA cells with ACTH or CRH induced their respective receptors and ERV genes. Syncytin-A/-B, murine orthologs to human Syncytin-1/-2, localized to embryonic and adult pituitary glands demonstrating functional mammalian conservation. Deregulated ERV genes may contribute to PA development via cAMP signalling. “
“Autophagy has multiple physiological functions, including protein degradation, organelle KU57788 turnover and the response of cancer cells to chemotherapy. Because autophagy is implicated in a number of diseases, a better understanding of the molecular mechanisms of autophagy is needed for therapeutic purposes, including rational design of drugs. Autophagy is a process that occurs in several steps as follows: formation of phagophores, formation of mature autophagosomes, targeting

and trafficking of autophagosomes to lysosomes, formation of autolysosomes by fusion between second autophagosomes and lysosomes, and finally, degradation of the autophagic bodies within the lysosomes. It has been suggested that autophagosome formation is driven by molecular motor machineries, and, once formed, autophagosomes need to reach lysosomes, enriched perinuclearly around the microtubule-organizing centre. While it is recognized that all these steps require the cytoskeletal network, little is known about the mechanisms involved. Here we assessed the role of cytoplasmic dynein in the autophagic process of human glioma cells to determine the part played by dynein in autophagy. We observed that chemical interference with dynein function led to an accumulation of autophagosomes, suggesting impaired autophagosome-lysosome fusion. In contrast, we found that overexpression of dynamitin, which disrupts the dynein complex, reduced the number of autophagosomes, suggesting the requirement of the dynein-dynactin interaction in the early membrane trafficking step in autophagosome formation.

© 2009 Wiley-Liss, Inc. Microsurgery, 2010. “
“Recidivating pressure sores are a frequent complication in meningomyelocele patients because of their limitation in motility and their scarce ability

to monitor the pressure applied on insensate areas while seated. We report the utilization of the sensate pedicled anterolateral thigh perforator flap for reconstruction of ischiatic sores in meningomyelocele patients. Between May 2011 and September 2013, five patients underwent transfer of a sensate pedicled anterolateral thigh flap, by an intermuscular passageway through the upper thigh, to reach the ischial defect. Flap was properly harvested from the thigh after assessment of the lateral cutaneous femoral nerve sensitive area with the Pressure-Specified Sensory Device. In all cases the flap reached AZD4547 clinical trial the ischial defect harmlessly, healing was uneventful with no immediate nor late complications. Each patient showed persistence of sensitivity at the reconstructed area and no recurrent ischiatic sore was observed at mean follow-up of 26.4 months. The sensate

pedicled anterolateral thigh flap is a valuable solution for coverage of recurrent ischial sores in meningomyelocele patients, in which pressure consciousness is fundamental. The intermuscular passageway allows to reduce the distance between flap’s vascular pedicle origin and the ischial defect, hence to use the more reliable skin from the middle third of the anterolateral thigh. © 2014 Wiley Periodicals, Inc. Microsurgery, 2014. “
“Background: selleck compound No consensus exists among microsurgeons regarding the role of intravenous (IV) heparin in digital replantation/revascularization. The current experience of the Provincial Replantation Center in Quebec was reviewed over a 4-year period. Methods:

An initial retrospective review of all revascularized or reimplanted digits at our Replantation Center from April 2004 to April 2006 was conducted. Then, data of all patients treated at our center from January 08 to September Galeterone 08 were prospectively collected. The two cohorts were compared with regards to demographics, injury characteristics, postoperative thromboprophylaxis medication as well as complication and success rates. Proportions were compared using χ2 tests/Fisher’s exact tests. Multivariate analysis was conducted with logistic regression. Results: 175 digits were treated from April 2004 to April 2006, including 104 revascularizations and 71 amputations. IV heparin was used in 35.1% of the cases and was associated with a 3.59-fold (95% CI, 1.55–8.31) increase risk of developing a complication compared with cases where heparin was not used (P = 0.001). In 2008, 106 digits were treated. IV heparin was used in 14.6% of the cases and was not significantly associated with a higher complication rate compared with cases where heparin was not used (P = 0.612). Both cohorts’ success rates were very similar (P = 0.557).