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Trisha V Vigneswaran, Ranjit Akolekar, Argyro Syngelaki, Marietta Charakida, Lindsey D Allan, Kypros H Nicolaides, Vita Zidere, John M Simpson
BACKGROUND: Assessment of the outflow tract views is an integral part of routine fetal cardiac scanning. For some congenital heart defects, notably coarctation of the aorta, pulmonary valve stenosis, and aortic valve stenosis, the size of vessels is important both for diagnosis and prognosis. Existing reference ranges of fetal outflow tracts are derived from a small number of cases. METHODS AND RESULTS: The study population comprised 7945 fetuses at 13 to 36 weeks' gestation with no detectable abnormalities from pregnancies resulting in normal live births...
July 2018: Circulation. Cardiovascular Imaging
Brijesh Patel, George Prousi, Mahek Shah, Paul Secheresiu, Lohit Garg, Manyoo Agarwal, Shantanu Patil, Rahul Gupta, Bruce Feldman
OBJECTIVE: To determine the readmission rate in patients with acute heart failure (AHF) discharged against medical advice (AMA). METHODS: We performed a retrospective analysis using the 2014 National Readmission Database. Patients admitted with a primary diagnosis of AHF were selected. Only those discharged to home and who left AMA were included in the study. The primary outcome was 30-day readmission. We compared the readmission rates among those discharged AMA vs routinely discharged patients using propensity score matching (PSM) to address imbalance in variables between the 2 groups...
July 10, 2018: Mayo Clinic Proceedings
Andrea D Annoni, Daniele Andreini, Maria Elisabetta Mancini, Alberto Formenti, Gianluca Pontone, Saima Mushtaq, Andrea Baggiano, Edoardo Conte, Marco Guglielmo, Giuseppe Muscogiuri, Manuela Muratori, Laura Fusini, Daniela Trabattoni, Giovanni Teruzzi, Ana I Coutinho Santos, Marco Agrifoglio, Mauro Pepi
OBJECTIVES: To evaluate feasibility, image quality and accuracy of a reduced contrast volume protocol for pre-procedural CT imaging in transcatheter aortic valve implantation (TAVI) using a third generation wide array CT scanner. METHODS: 115 consecutive patients (51F, mean age 82.5 ± 6.2y, mean BMI 26.7 ± 3.6) referred for TAVI were examined with wide-array CT scanner with a combined scan protocol and a total amount of 50 ml contrast agent. A 4 point visual scale (4-1) was used to assess image quality ...
July 13, 2018: British Journal of Radiology
Levi M Teigen, Adam J Kuchnia, Emily Nagel, Christopher Deuth, David M Vock, Urvashi Mulasi, Carrie P Earthman
BACKGROUND: There is growing interest in computed tomography (CT) measures of skeletal muscle cross-sectional area (CSA) for nutrition assessment. Multiple software programs are available, but little work has been done comparing programs. We aimed to determine if CT-derived measures of skeletal muscle CSA at the level of the L3 are influenced by the software program used. We also demonstrate the importance of the ImageJ corrigendum published in this journal. METHODS: Two software programs, National Institutes of Health ImageJ and Tomovision sliceOmatic, were compared...
July 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Jin-Tao Fu, Mohammad Sharif Popal, Yu-Qing Jiao, Hai-Bo Zhang, Shuai Zheng, Qiu-Ming Hu, Wei Han, Xu Meng
Background: Mobility and flexibility of anterior mitral leaflet (AML) are considered to be the important factor for mitral valve (MV) repair in rheumatic population, we try to use the bending angle of AML to quantify its' mobility and flexibility and investigate whether it can predict the success of rheumatic MV repair or not. Methods: Total 54 patients underwent rheumatic MV surgeries with mild lesions of subvalvular apparatus from August, 2017 to November, 2017 at the author institution, we divided the patients into MV repair and MV replacement groups which included directly MV replacement and repair attempt but failed repairing transfer to replacement intraoperatively...
May 2018: Journal of Thoracic Disease
Ho Jin Kim, You Na Oh, Min Ho Ju, Joon Bum Kim, Sung-Ho Jung, Cheol Hyun Chung, Jae Won Lee, Suk Jung Choo
Background: We reviewed our experience with on-pump beating (OPB) heart coronary artery bypass grafting (CABG) to evaluate the impacts of obviating aortic cross-clamping and cardioplegic arrest on clinical outcomes compared with conventional CABG (C-CABG). Methods: Between 2006 and 2012, elective isolated cardiopulmonary bypass (CPB)-assisted CABG was consecutively performed in 645 patients (mean patient age 63.3±9.1 years, 471 women) with 254 (39.4%) undergoing OPB-CABG and 391 (60...
May 2018: Journal of Thoracic Disease
María A Domínguez-Sanchéz, Rosa H Bustos-Cruz, Gina P Velasco-Orjuela, Andrea P Quintero, Alejandra Tordecilla-Sanders, Jorge E Correa-Bautista, Héctor R Triana-Reina, Antonio García-Hermoso, Katherine González-Ruíz, Carlos A Peña-Guzmán, Enrique Hernández, Jhonatan C Peña-Ibagon, Luis A Téllez-T, Mikel Izquierdo, Robinson Ramírez-Vélez
The purpose of this study was to compare the neurotrophic factor response following one session of high-intensity exercise, resistance training or both in a cohort of physically inactive overweight adults aged 18-30 years old. A randomized, parallel-group clinical trial of 51 men (23.6 ± 3.5 years; 83.5 ± 7.8 kg; 28.0 ± 1.9 kg/m2 ) who are physically inactive (i.e., < 150 min of moderate-intensity exercise per week or IPAQ score of <600 MET min/week for >6 months) and are either abdominally obese (waist circumference ≥90 cm) or have a body mass index, BMI ≥25 and ≤ 30 kg/m2 were randomized to the following four exercise protocols: high-intensity exercise (4 × 4 min intervals at 85-95% maximum heart rate [HRmax] interspersed with 4 min of recovery at 75-85% HRmax) ( n = 14), resistance training (12-15 repetitions per set, at 50-70% of one repetition maximum with 60 s of recovery) ( n = 12), combined high-intensity and resistance exercise ( n = 13), or non-exercising control ( n = 12)...
2018: Frontiers in Physiology
Murat Gök, Alparslan Kurtul, Murat Harman, Meryem Kara, Muhammed Süleymanoglu, Ender Ornek
In this study, the association between the right ventricular dysfunction (RVD) and CHA2DS2-VASc (C: congestive heart failure or left ventricular systolic dysfunction, H: hypertension, A: age of ≥ 75 years, D: diabetes mellitus, S: previous stroke, V: vascular disease, A: age between 65 and 74 years, Sc: female gender) scores was investigated in patients with acute pulmonary thromboembolism (PTE). The patients have been assigned to 3 subgroups as massive, submassive, and nonmassive PTE. The CHA2DS2-VASc scores were calculated for all of the patients, and the scores have been classified into 3 groups as the scores between 0 and 1, the scores of 2, and the scores of 3 and over...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
Patrick W Serruys, Rodrigo Modolo, Michael Reardon, Yosuke Miyazaki, Stephan Windecker, Jeffrey Popma, Yanping Chang, Neal S Kleiman, Scott Lilly, Hafid Amrane, Piet W Boonstra, Arie Pieter Kappetein, Yoshinobu Onuma, Lars Sondegaard, Nicolas van Mieghem
AIMS: The indication for transcatheter valve implantation (TAVI) has evolved from inoperable patients to patients at increased surgical risk. In low risk patients, surgical aortic valve replacement (SAVR) remains the standard of care. To explore the outcomes of TAVI and SAVR in patients with a Society of Thoracic Surgery (STS) predicted risk of mortality (PROM) score below 3% in the SURTAVI trial. METHODS AND RESULTS: In SURTAVI, patients at intermediate surgical risk based on heart team consensus were randomized to TAVI or SAVR...
July 10, 2018: EuroIntervention
P J Hug, V H Cap, J Honegger, G Schüpbach-Regula, A Schwarz, R Bettschart-Wolfensberger
This blinded prospective study investigated analgesic effects of intramuscular (IM) butorphanol, meloxicam or intratesticular (IT) lidocaine for castration of 7-14 days old piglets under isoflurane anaesthesia. 66 piglets were randomly injected with: meloxicam IM (0.4 mg/kg; group M), butorphanol IM (0.2 mg/kg; group B), or both (group BM) 20 minutes prior to castration, or lidocaine IT (4 mg/kg (group ML4) or 8 mg/kg (group ML8)) together with meloxicam IM (0.4 mg/kg) under anaesthesia with 1.8% end-tidal isoflurane...
July 2018: Schweizer Archiv Für Tierheilkunde
S A Haberlen, L P Jacobson, F J Palella, A Dobs, M Plankey, J E Lake, L A Kingsley, R Stall, W S Post, T T Brown
OBJECTIVES: The aim of the study was to characterize contemporary patterns and correlates of testosterone therapy (TTh) use and discontinuation by HIV serostatus among men in the Multicenter AIDS Cohort Study (MACS). METHODS: Self-reported testosterone use data were collected semiannually from 2400 (1286 HIV-infected and 1114 HIV-uninfected) men who have sex with men. Multivariable Poisson regression was used to estimate prevalence ratios for TTh use and predictors of TTh discontinuation (2012-2015)...
July 10, 2018: HIV Medicine
Itai Gueta, Noa Markovits, Havatzelet Yarden-Bilavsky, Eugenia Raichlin, Dov Freimark, Jacob Lavee, Ronen Loebstein, Yael Peled
Tacrolimus, the major immunosuppressant after heart transplantation therapy is a narrow therapeutic index drug. Hence, achieving stable therapeutic steady state plasma concentrations is essential to ensure efficacy while avoiding toxicity. Whether high variability in steady state concentrations is associated with poor outcomes is unknown. We investigated the association between tacrolimus trough level variability during the first year post-heart transplantation and outcomes during and beyond the first postoperative year...
July 10, 2018: American Journal of Transplantation
Sahar El Shedoudy, Eman El-Doklah
Objectives: To evaluate the safety of using the stiff end of a coronary wire to perforate an atretic pulmonary valve (PV) in patients with pulmonary atresia with intact ventricular septum (PAIVS). Background: Radiofrequency perforation is an accepted modality to perforate the PV in patients PAIVS. However, the high cost precludes its widespread use. Patients and methods: This is a single-center experience that spanned from March 2013 to January 2016 and involved 13 neonates who were severely cyanotic with PAIVS and with ductal-dependent pulmonary circulation...
July 2018: Journal of the Saudi Heart Association
Shih-Ching Yeh, Yuan-Yuan Li, Chu Zhou, Pin-Hua Chiu, Jun-Wei Chen
To explore the effects of virtual reality (VR) and augmented reality (AR) in the treatment of claustrophobia, the potential effects of VR and AR on induced anxiety were investigated in this paper. During the experiment, 34 subjects were randomly selected and distributed in AR and VR scenes in a sequence. The skin conductance and heart rates of the subjects were measured throughout the entire process, and the anxiety scale was used to assess the subjective anxiety when the task in each scene was completed. The results showed the following: (1) AR and VR scenes led to feelings of discomfort, but the subjective anxiety scores obtained in the two scenes were not significantly different; (2) the skin conductance level of the subjects significantly increased from the baseline when the subjects entered the experimental scene but remained active in the two scenes without showing significant difference between the scenes; and (3) the heart rate index significantly increased from the baseline after the subjects entered the scene and then gradually decreased...
July 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Yuko Ono, Takeyasu Kakamu, Hiroaki Kikuchi, Yusuke Mori, Yui Watanabe, Kazuaki Shinohara
The aim of this study was to determine complication rates and possible risk factors of expert-performed endotracheal intubation (ETI) in patients with trauma, in both the prehospital setting and the emergency department. We also investigated how the occurrence of ETI-related complications affected the survival of trauma patients. This single-center retrospective observational study included all injured patients who underwent anesthesiologist-performed ETI from 2007 to 2017. ETI-related complications were defined as hypoxemia, unrecognized esophageal intubation, regurgitation, cardiac arrest, ETI failure rescued by emergency surgical airway, dental trauma, cuff leak, and mainstem bronchus intubation...
2018: Emergency Medicine International
Bana Agha Nasser, Abdu Rahman Mesned, Tageldein Mohamad, Mohamed S Kabbani
Introduction: Trisomy 21 is the most common syndrome in children with a 30-50% association with congenital heart disease (CHD). Cardiac surgeries are required in the majority of Down syndrome (DS) with CHD cases. Because of the distinctive abnormalities in their respiratory system, children with DS may require longer positive pressure ventilation after cardiac surgery. The aim of this study is to investigate the incidence and possible risk factors for prolonged mechanical ventilation (PMV) need in DS patients undergoing cardiac surgery...
July 2018: Journal of the Saudi Heart Association
Yejin Mok, Shoshana H Ballew, Lori D Bash, Deepak L Bhatt, William E Boden, Marc P Bonaca, Juan Jesus Carrero, Josef Coresh, Ralph B D'Agostino, C Raina Elley, F Gerry R Fowkes, Sun Ha Jee, Csaba P Kovesdy, Kenneth W Mahaffey, Girish Nadkarni, Eric D Peterson, Yingying Sang, Kunihiro Matsushita
BACKGROUND: The Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS2°P), a 0-to-9-point system based on the presence/absence of 9 clinical factors, was developed to classify the risk of major adverse cardiovascular events (MACE) (a composite of cardiovascular death, recurrent myocardial infarction, or ischemic stroke) among patients with a recent myocardial infarction. Its performance has not been examined internationally outside of a clinical trial setting...
July 7, 2018: Journal of the American Heart Association
Kuan Li, Wanrong Fu, Yacong Bo, Yongjian Zhu
OBJECTIVE: To investigate the combined effect of albumin (ALB) and globulin (GLB) on the overall survival (OS) of patients with heart failure (HF). DESIGN: Retrospective cohort study. SETTING: A hospital. PARTICIPANTS: 404 patients first diagnosed with HF. MEASUREMENTS: Serum ALB and GLB were measured within 3 days after admission. The albumin to globulin ratio (AGR) was calculated as the ALB divided by the GLB...
July 6, 2018: BMJ Open
Elisa Gervasoni, Marco Bove, Mattia Sinatra, Cristina Grosso, Marco Rovaris, Davide Cattaneo, Giampiero Merati
BACKGROUND: People with multiple sclerosis (PwMS) often develop an autonomic dysfunction (AD), which onset should be assessed early at a subclinical level, as it may interfere with pharmacological treatments and exercise. OBJECTIVE: To evaluate basal cardiac autonomic tone, its modulations during sit-to-stand, sub-maximal exercise and recovery in PwMS without clinical overt AD and its relationships with fatigue perception. METHODS: Twenty-three PwMS (55 ± 8 yrs [mean ± SD]; EDSS score 5...
June 27, 2018: Multiple Sclerosis and related Disorders
Timothy R Romanauski, Erin E Martin, Juraj Sprung, David P Martin, Darrell R Schroeder, Toby N Weingarten
Postoperative delirium (POD) is common among surgical patients admitted to the intensive care unit (ICU) and is associated with increased resource utilization, morbidity, and death. Our primary aim was to compare rates of POD using administrative International Classification of Diseases, Ninth Revision, records and automated interrogation of electronic health records from Confusion Assessment Method for the ICU (CAM-ICU) screening. The secondary aim was to assess POD risk associated with patient and perioperative characteristics...
June 1, 2018: American Surgeon
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