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https://www.readbyqxmd.com/read/28944931/basic-concepts-of-heart-lung-interactions-during-mechanical-ventilation
#1
Martin R Grübler, Olivier Wigger, David Berger, Stefan Blöchlinger
Critically ill patients with the need for mechanical ventilation show complex interactions between respiratory and cardiovascular physiology. These interactions are important as they may guide the clinician's therapeutic decisions and, possibly, affect patient outcome. The aim of the present review is to provide the practicing physician with an overview of the concepts of heart-lung interactions during mechanical ventilation. We outline the basic cardiac and respiratory physiology during spontaneous breathing and under mechanical ventilation...
September 25, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28944310/metabolic-origins-of-heart-failure
#2
Adam R Wende, Manoja K Brahma, Graham R McGinnis, Martin E Young
For more than half a century, metabolic perturbations have been explored in the failing myocardium, highlighting a reversion to a more fetal-like metabolic profile (characterized by depressed fatty acid oxidation and concomitant increased reliance on glucose utilization). More recently, alterations in ketone body and amino acid/protein metabolism have been described during heart failure, as well as mitochondrial dysfunction and perturbed metabolic signaling (e.g., acetylation, O-GlcNAcylation). Although numerous mechanisms are likely involved, the current review provides recent advances regarding the metabolic origins of heart failure, and their potential contribution toward contractile dysfunction of the heart...
June 2017: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/28944301/intravenous-rehydration-of-malnourished-children-with-acute-gastroenteritis-and-severe-dehydration-a-systematic-review
#3
Kirsty A Houston, Jack G Gibb, Kathryn Maitland
Background: Rehydration strategies in children with severe acute malnutrition (SAM) and severe dehydration are extremely cautious. The World Health Organization (WHO) SAM guidelines advise strongly against intravenous fluids unless the child is shocked or severely dehydrated and unable to tolerate oral fluids. Otherwise, guidelines recommend oral or nasogastric rehydration using low sodium oral rehydration solutions. There is limited evidence to support these recommendations. Methods: We conducted a systematic review of randomised controlled trials (RCTs) and observational studies on 15 (th) June 2017 comparing different strategies of rehydration therapy in children with acute gastroenteritis and severe dehydration, specifically relating to intravenous rehydration, using standard search terms...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28944227/neonatal-enterovirus-myocarditis-with-severe-dystrophic-calcification-novel-treatment-with-pocapavir
#4
Samuel G Wittekind, Catherine C Allen, John L Jefferies, Mantosh S Rattan, Peace C Madueme, BreAnn N Taylor, Ryan A Moore
Dystrophic myocardial calcification occurs in the setting of myocardial injury and normal serum calcium. We present a case of a neonate with prominent dystrophic calcification and severe left ventricular systolic dysfunction in the setting of enterovirus myocarditis. These findings are superbly illustrated by multiple imaging modalities. The patient was treated with the novel antiviral, pocapavir, in addition to a standard heart failure regimen. The dystrophic calcification persisted but the left ventricle remodeled significantly...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28943982/awareness-of-physicians-and-pharmacists-of-aldosterone-antagonists-in-heart-failure-and-myocardial-infarction-in-jordan
#5
Fadia Mayyas, Khalid Ibrahim, Karem H Alzoubi
OBJECTIVE: to evaluate physicians and clinical pharmacists' awareness and practices regarding use of aldosterone antagonists in heart failure (HF) and post-myocardial infarction (MI). METHODS: First, we reviewed the prescription of aldosterone antagonists among 408 patients presenting to the cardiology clinic at a major hospital in Jordan. Second, physicians and pharmacists working in cardiovascular departments completed a questionnaire related to use of aldosterone antagonists in HF and post-MI...
July 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28943106/at2-receptor-agonist-compound-21-a-silver-lining-for-diabetic-nephropathy
#6
REVIEW
Anuradha Pandey, Anil Bhanudas Gaikwad
The currently available therapies for diabetic nephropathy, one of the leading causes of renal failure globally are based on inhibition of renin angiotensin system. However, recently, the focus has shifted towards activation of its protective arm rather than the inhibition of deteriorative axis, using specific agonists. Compound 21 (C21), a novel non-peptide Angiotensin II type 2 receptor (AT2) agonist, recently granted orphan drug status for the treatment of a rare disease, idiopathic pulmonary fibrosis has also shown a potent anti-inflammatory, anti-fibrotic, antioxidant and anti-apoptotic potential in various diseases including heart failure, myocardial infarction, chronic inflammatory diseases, and neurological diseases such as ischemic stroke...
September 21, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28942782/eighth-annual-intermacs-report-special-focus-on-framing-the-impact-of-adverse-events
#7
James K Kirklin, Francis D Pagani, Robert L Kormos, Lynne W Stevenson, Elizabeth D Blume, Susan L Myers, Marissa A Miller, J Timothy Baldwin, James B Young, David C Naftel
BACKGROUND: The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database now includes >20,000 patients from >180 hospitals. METHODS: The eighth annual report of INTERMACS updates the first decade of patient enrollment. RESULTS: In the current era, >95% of implants are continuous flow devices. Overall survival continues to remain >80% at 1 year and 70% at 2 years. Review of major adverse events shows minimal advantage for patients with ambulatory heart failure pre-implant...
October 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28942764/ocular-manifestations-of-obstructive-sleep-apnea
#8
Matthew Santos, R Jeffrey Hofmann
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) incurs a host of systemic side effects. The eyes are particularly susceptible to both mechanical and vascular sequelae of the disease. This paper outlines the ocular manifestations of sleep apnea. The authors hope to increase awareness of the ocular complications of this common disorder and increase communication and co-management between eye-care providers and sleep specialists alike. METHODS: Data were collected from PubMed and the Brown University Library Collection...
September 20, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28942076/assessment-of-commonly-used-frailty-markers-for-high-and-extreme-risk-patients-undergoing-transcatheter-aortic-valve-replacement
#9
Jessica Forcillo, Jose F Condado, Yi-An Ko, Michael Yuan, Jose N Binongo, Nnaemeka M Ndubisi, John J Kelly, Vasilis Babaliaros, Robert A Guyton, Chandan Devireddy, Bradley G Leshnower, James P Stewart, Louis P Perrault, Paul Khairy, Vinod H Thourani
BACKGROUND: The effect of frailty on outcomes after transcatheter aortic valve replacement (TAVR) remains incompletely understood. The objective of this study was to evaluate the performance of four commonly used frailty markers as predictors of early and late outcomes among patients undergoing TAVR. METHODS: A review was performed of 361 high- and extreme-risk patients undergoing TAVR from 2011 to 2015. Four frailty variables were assessed: serum albumin (g/dL), 5-m walk (seconds), grip strength (kg), and Katz index of independence in activities of daily living...
September 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28941606/new-developments-in-hypertrophic-cardiomyopathy
#10
REVIEW
Robert M Cooper, Claire E Raphael, Max Liebregts, Nandan S Anavekar, Josef Veselka
Hypertrophic cardiomyopathy is the leading cause of sudden death in young individuals and an important cause of heart failure at any age. In this review we discuss advances in investigation and management of this heterogenous disease. Improved cardiac imaging has allowed us to detail many of the structural abnormalities whereas the use of new techniques, predominantly in cardiac magnetic resonance imaging, has given us a greater insight in to tissue architecture, mechanism of contractile abnormalities, and function...
October 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28940761/the-cognitive-evolutionary-model-of-surprise-a-review-of-the-evidence
#11
Rainer Reisenzein, Gernot Horstmann, Achim Schützwohl
Research on surprise relevant to the cognitive-evolutionary model of surprise proposed by Meyer, Reisenzein, and Schützwohl (1997) is reviewed. The majority of the assumptions of the model are found empirically supported. Surprise is evoked by unexpected (schema-discrepant) events and its intensity is determined by the degree if schema-discrepancy, whereas the novelty and the valence of the eliciting events probably do not have an independent effect. Unexpected events cause an automatic interruption of ongoing mental processes that is followed by an attentional shift and attentional binding to the events, which is often followed by causal and other event analysis processes and by schema revision...
September 23, 2017: Topics in Cognitive Science
https://www.readbyqxmd.com/read/28940670/deoxygenation-of-inspiratory-muscles-during-cycling-hyperpnoea-and-loaded-breathing-in-health-and-disease-a-systematic-review
#12
REVIEW
Takako Tanaka, Nada Basoudan, Luana T Melo, Lisa Wickerson, Laurent J Brochard, Ewan C Goligher, W Darlene Reid
Assessing inspiratory muscle deoxygenation and blood flow can provide insight into anaerobic stress, recruitment strategies and mechanisms of inspiratory muscle limitation. Therefore, this review aimed to synthesize measurements of inspiratory muscle oxyhaemoglobin (O2 Hb), deoxyhaemoglobin (HHb), blood volume and flow of the inspiratory muscles acquired via near-infrared spectroscopy (NIRS) during cycling, hyperpnoea and loaded breathing in healthy non-athletes, healthy athletes and patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF)...
September 22, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28940440/continuous-infusion-vs-intermittent-bolus-injection-of-furosemide-in-acute-decompensated-heart-failure-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#13
REVIEW
K T Ng, J L L Yap
Loop diuretics remain a fundamental pharmacological therapy to remove excess fluid and improve symptom control in acute decompensated heart failure. Several recent randomised controlled trials have examined the clinical benefit of continuous vs. bolus furosemide in acute decompensated heart failure, but have reported conflicting findings. The aim of this review was to compare the effects of continuous and bolus furosemide with regard to mortality, length of hospital stay and its efficacy profile in acute decompensated heart failure...
September 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28940112/iron-in-kidney-and-heart-failure-from-theory-to-practice
#14
REVIEW
Aslihan Yerlikaya, Mustafa C Bulbul, Baris Afsar, Tuncay Dagel, Gamze Aslan, Luminita Voroneanu, Dimitire Siriopol, Adrian Covic, Mehmet Kanbay
There is evidence that serum iron levels, regardless of the presence of anemia, directly impact outcomes in congestive heart failure (CHF) including quality of life, hospitalization rate and overall survival. Despite modern medical treatments, the prognosis of CHF remains grim. Ironically, simple iron replenishment may serve as a powerful tool in the armamentarium. This review will start from fundamental concepts of iron in oxygen delivery and analyze evidence-based outcomes in CHF iron-directed therapeutic trials...
September 22, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28940102/micrornas-in-heart-failure-cardiac-transplantation-and-myocardial-recovery-biomarkers-with-therapeutic-potential
#15
REVIEW
Palak Shah, Michael R Bristow, J David Port
PURPOSE OF REVIEW: Heart failure is increasing in prevalence with a lack of recently developed therapies that produce major beneficial effects on its associated mortality. MicroRNAs are small non-coding RNA molecules that regulate gene expression, are differentially regulated in heart failure, and are found in the circulation serving as a biomarker of heart failure. RECENT FINDINGS: Data suggests that microRNAs may be used to detect allograft rejection in cardiac transplantation and may predict the degree of myocardial recovery in patients with a left ventricular assist device or treated with beta-blocker therapy...
September 22, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28940089/skeletal-muscle-alterations-in-hfref-vs-hfpef
#16
REVIEW
Volker Adams, Axel Linke, Ephraim Winzer
PURPOSE OF REVIEW: Severe exercise intolerance and early fatigue are hallmarks of heart failure patients either with a reduced (HFrEF) or a still preserved (HFpEF) ejection fraction. This review, therefore, will provide a contemporary summary of the alterations currently known to occur in the skeletal muscles of both HFrEF and HFpEF, and provide some further directions that will be required if we want to improve our current understanding of this area. RECENT FINDINGS: Skeletal muscle alterations are well documented for over 20 years in HFrEF, and during the recent years also data are presented that in HFpEF muscular alterations are present...
September 22, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28939708/the-decisions-interventions-and-goals-in-implantable-cardioverter-defibrillator-therapy-dignity-pilot-study
#17
Daniel B Kramer, Daniel Habtemariam, Yaw Adjei-Poku, Michelle Samuel, Diane Engorn, Matthew R Reynolds, Susan L Mitchell
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are commonly implanted in older patients, including those with multiple comorbidities. There are few prospective studies assessing the clinical course and end-of-life circumstances for these patients. METHODS AND RESULTS: We prospectively followed 51 patients with ICDs for up to 18 months to longitudinally assess in terms of (1) advance care planning, (2) health status, (3) healthcare utilization, and (4) end-of-life circumstances through quarterly phone interviews and electronic medical record review...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28939459/comparative-effectiveness-of-telemonitoring-versus-usual-care-for-heart-failure-a-systematic-review-and-meta-analysis
#18
Ji Eun Yun, Jeong-Eun Park, Hyun-Young Park, Hae-Young Lee, Dong Ah Park
BACKGROUND: This study aimed to evaluate the effectiveness of telemonitoring (TM) in the management of patients with heart failure (HF). METHODS AND RESULTS: We searched Ovid-Medline, Ovid-EMBASE, and the Cochrane Library for randomized controlled trials published through April 2016. Outcomes of interest included clinical effectiveness (mortality, hospitalization, and emergency room visits) and patient-reported outcomes. TM was defined as the transmission of individual biological data such as weight, blood pressure, and heart rate...
September 19, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28939458/mind-body-interventions-for-individuals-with-heart-failure-a-systematic-review-of-randomized-trials
#19
REVIEW
Zehra Gok Metin, Deborah Ejem, J Nicholas Dionne-Odom, Yasemin Turkman, Carolina Salvador, Salpy Pamboukian, Marie Bakitas
BACKGROUND: The effects of mind-body interventions (MBIs) (e.g. Tai Chi, yoga, and meditation) for individuals with heart failure (HF) have not been systematically evaluated. METHODS AND RESULTS: We performed a systematic review of randomized controlled trials (RCTs) examining the effects of MBIs in HF. We extracted participant characteristics, MBI procedure, outcomes assessed, and main results of English language RCTs before October 2016. We identified 24 RCTs (n=1314 participants) of nine MBI types: Tai Chi (n=7), yoga (n =4), relaxation (n =4), meditation (n=2), acupuncture (n=2), biofeedback (n=2), stress management (n=1), Pilates (n=1) and reflexology (n=1)...
September 19, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28938958/pulmonary-hemodynamics-in-heart-failure-patients-with-reduced-or-preserved-ejection-fraction-and-pulmonary-hypertension-similarities-and-disparities
#20
Yochai Adir, Marco Guazzi, Amir Offer, Pier Luigi Temporelli, Antonia Cannito, Stefano Ghio
OBJECTIVE: The current understanding of pulmonary hypertension (PH) due to left ventricular diseases does not distinguish heart failure (HF) with reduced ejection fraction (HFrEF) from HF and preserved ejection fraction (HFpEF), in terms of pulmonary hemodynamics. The value of pulmonary vascular compliance (PCa) and diastolic pulmonary gradient (DPG) as predictors of survival in either HF syndrome is controversial. The aims of our study were to compare the pulmonary hemodynamics in the two HF phenotypes, given similar values of pulmonary artery wedge pressure (PAWP), and to evaluate the impact of PCa and DPG on survival...
October 2017: American Heart Journal
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