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1599 Introduction: The term “spinal cord injury” (SCI) refers to damage to the spinal cord due to trauma, disease, or degeneration. According to the World Health Organization, every year approximately 500,000 people suffer from SCI, with up to 90% of these SCI cases due to trauma. The symptoms of SCI depend upon the severity of the injury and its location in the spinal cord. These symptoms may include partial or complete loss of sensory or motor function. SCI can also affect the system that regulates bowel/bladder control, breathing, heart rate and blood pressure. In this study, we explored the long-term outcomes of a moderate severity SCI in a rat model on glucose uptake throughout the spinal cord. Methods: Adult male Sprague Dawley rats were randomly divided into 2 groups. The injured group received a laminectomy at vertebral level T9 and moderate contusion SCI (150 kdyne force) was induced with Infinite Horizon Impactor (Precision Systems Incorporated, Natick, MA). Sham animals received laminectomy but no impact. PET/CT images were acquired (Siemens Inveon preclinical scanner, Erlangen, Germany) at 4 time points - baseline (prior to injury), 6 hours, 1 month and 3 months post injury for both the groups of animals. FDG uptake was assessed by drawing regions of interest (ROI’s) in the cerebellum, cervical spinal cord (C2-C5, uninjured site) and thoracic spinal cord (injured site), using Siemens Inveon Workplace software (V4.2) [Figure 1]. The Basso-Beattie-Bresnahan (BBB) scale was used to assess neurological function in both the Sham and Injured group at 1, 7, 14, 21, 28 days and 2 and 3 months [Figure 2]. The statistical analysis was done using GraphPad Prism (v8.1), mixed effect model with Sidak’s multiple comparisons tests. Results: The Sham animals showed no significant changes in glucose uptake or motor function at any time point. The Injured group showed impaired functional performance at 1 day and 1-month post injury compared to Sham group. The injured group showed decreased FDG uptake at 1- month and 3- months post injury compared to baseline, not only at the lesion site (thoracic region) but also at the uninjured site (cervical region) [Figure 3 and 4]. Interestingly, the cerebellum also showed decreased FDG uptake at 3- months’ post injury compared to baseline in the injured group of animals but not the shams [Figure 5]. The acute time point (6 hours post injury) did not show any significant alterations. Conclusions: FDG PET can be used to assess moderate spinal cord contusion in rats and indicates decreased glucose uptake up to 3 months post injury at the lesion site and in distal locations possibly suggestive of axonal degeneration. Acknowledgements: This work was supported by the Defense Health Program, Congressionally Directed Medical Research Programs through the Spinal Cord Injury Research Program under Award No. SC170244. Disclaimer: The opinions and assertions expressed herein are those of the author(s) and do not necessarily reflect the official policy or position of the Uniformed Services University or the Department of Defense.

Regadenoson is a selective A2A receptor agonist approved for use as a pharmacologic stress agent for myocardial perfusion imaging after several multicenter trials demonstrated its equivalence in diagnostic accuracy for the detection of coronary artery disease and a decreased incidence of serious side effects as compared to adenosine. Recently, the FDA released a safety announcement advising of the rare but serious risk of heart attack and death associated with regadenoson and adenosine in cardiac stress testing, particularly in patients with unstable angina or cardiovascular instability. We report two cases of asystole with hemodynamic collapse in stable outpatients soon after receiving a standard regadenoson injection. The prevalence of potentially life threatening bradycardia, including asystole, associated with the use of regadenoson may be greater than previously expected. These cases highlight the need for cardiac stress labs to anticipate the potential for serious side effects with all patients during the administration of coronary vasodilators.

Background The acute benefits of platelet glycoprotein IIb/IIIa inhibitors for non-ST–segment elevation acute coronary syndromes (NSTE ACS) remain unclear. Methods In this pilot trial, 311 patients with NSTE ACS were randomly assigned in the emergency department to double-blinded therapy with eptifibatide or placebo for 12 to 24 hours before crossover to open-label eptifibatide. Serial creatine-kinase MB (CK-MB) and quantitative cardiac troponin T levels were collected during the first 24 hours to assess the impact of early platelet glycoprotein IIb/IIIa blockade on infarct size as measured by cardiac markers. Results Median peak CK-MB (10.3 vs 11.8 ng/mL; P = .71) and peak quantitative cardiac troponin T levels (0.2 vs 0.3 ng/mL; P = .95) were similar between treatment groups, respectively. Median calculated peak CK-MB values (41 vs 40 ng/mL; P = .72) and area under the CK-MB curve measurements (980 vs 764 μg/min/L; P = .68) from curve-fitting analyses that could be performed in 106 of 311 patients were also similar. Conclusions In this pilot trial, early administration of eptifibatide in the emergency department did not modulate serologic measurements of infarct size in patients with NSTE ACS.

ACC/AHA guidelines assign a class I indication for use of myocardial perfusion imaging (MPI) for the evaluation of chest pain in patients with acute coronary syndromes and a nondiagnostic ECG. However, MPI is not a widely used modality for the evaluation of patients who present to the ER with chest pain and an intermediate pretest probability for coronary artery disease. We report a case in which resting MPI was pivotal in diagnosing acute myocardial infarction and expedited the appropriate reperfusion strategy. Copyright © 2010 Wiley Periodicals, Inc.

Hypertrophic obstructive cardiomyopathy (HOCM) is a primary myocardial disease with typical echocardiography features of asymmetric septal hypertrophy and evidence of left ventricular outflow tract obstruction. The natural history of HOCM is characterized by a slow progression of symptoms and a significant annual mortality rate. We report an unusual case of transient HOCM during pregnancy with evidence of total resolution postpartum. hypertrophic cardiomyopathy, pregnancy, idiopathic hypertrophic subaortic stenosis, two-dimensional echocardiography, Doppler echocardiography

Acute SPECT imaging with Tc-99m sestamibi is an emerging, cost-effective stratagem for selected patients arriving at the emergency department with chest pain. To date, the cohort of patients studied have included those who arrive at the emergency department with typical chest pain and a normal or nondiagnostic electrocardiogram. This application could be extended to other clinical settings. The current case demonstrates that in an outpatient setting, a severe rest SPECT perfusion defect in a symptomatic patient with a nondiagnostic electrocardiogram prompted timely hospitalization and revascularization. The resting defect was consistent with jeopardized, viable myocardium as it normalized after revascularization.