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Device therapy

Vlad Cotarlan, Frances Johnson, Jennifer Goerbig-Campbell, KellyAnn Light-McGroary, Chakradhari Inampudi, Jennifer Franzwa, Kyle Jenn, Carol Johnson, Rudhir Tandon, Rizwan Tahir, Yassar Nabeel, Uzodinma Emerenini, Michael Giudici
The benefit of cardiac resynchronization therapy in patients supported by a left ventricular assist device (LVAD) is unknown. There are currently no guidelines regarding the continuation, discontinuation or pacemaker (PM) settings post-LVAD implant. The aim of the study was to assess the hemodynamic benefit of biventricular (BiV) pacing in LVAD patients. We studied 22 patients supported by LVADs (age 62 ± 9, 21 males) who had received a BiV PM before LVAD implant. A total of 123 complete sets of hemodynamics were obtained during BiV pacing (n = 54), right ventricular (RV) pacing (n = 54), and intrinsic rhythm (n = 15)...
January 1, 2019: American Journal of Cardiology
Ashima Pyngottu, Helene Werner, Phaedra Lehmann, Christian Balmer
The absence of cardiac symptoms, the improved exercise tolerance and the increased life expectancy are the advantages of a successful cardiac device therapy. Nevertheless, the fact of a lifelong device dependency, the inherent possibility of device malfunction and the progression of the underlying heart disease may impact the health-related quality of life (HRQoL) and the psychological adjustment of these individuals. To date, an overview of findings on these topics is lacking. The objective of this study was to evaluate and summarize the current evidence on generic and disease-specific HRQoL and psychological adjustment in paediatric patients with a pacemaker (PM) or an implantable cardioverter defibrillator (ICD)...
December 11, 2018: Pediatric Cardiology
Pierce D Nunley, Timothy R Deer, Ramsin M Benyamin, Peter S Staats, Jon E Block
Background: Lumbar spinal stenosis (LSS) causes significant pain and functional impairment, and medical management has increasingly included the prescription of opioid-based analgesics. Interspinous process decompression (IPD) provides a minimally-invasive treatment option for LSS. Methods: This study estimated the type, dosage, and duration of opioid medications through 5 years of follow-up after IPD with the Superion Indirect Decompression System (Vertiflex Inc...
2018: Journal of Pain Research
Frank Rassouli, David Boutellier, Jonas Duss, Stephan Huber, Martin H Brutsche
Background: Concerning COPD, pulmonary rehabilitation (PR) has a positive effect on disease progression and mortality, is cost-effective, and is a part of recommendations of international guidelines. Only a minority of patients profit from conventional PR due to a lack of resources, physicians' guideline adherence, or patients' motivation. Novel digital therapies like Kaia COPD, a smartphone application that digitizes PR in COPD, are promising solutions to fill this void. Methods: Kaia COPD provides a digital version of PR and is certified as a class-I medical device in the European Union...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Hamdy Ma Ahmed, Samar Abohamad, Mohanad Elfishawi, Mohamed Tharwat Hegazy, Kadambari Vijaykumar
Belimumab is a novel add-on therapy that has been approved for patients with active and antibody-mediated systemic lupus erythematosus. It is a monoclonal antibody that decreases the activation of B-cells and consequently decreases antibodies' production. Recently, the US Food and Drug Administration approved subcutaneous belimumab for patients who have received training on using it. Subcutaneous belimumab can be administered using either a prefilled syringe or an auto-injector device. Weekly subcutaneous belimumab seems to be as effective as monthly intravenous belimumab with a similar safety margin...
2018: Patient Preference and Adherence
Karthik N Rao, Mohan Jagade, Vitthal D Kale, Devkumar Rengaraja, Amol Hekare
Tongue is one of the most common subsites involved by oral cancer. Improved surgical care and adjuvant therapy, along with better rehabilitation has significantly improved long-term survival and quality of life in patients with oral cancer. Primary surgical treatment is the preferred modality of treatment in cancers of the oral tongue. Although the surgical techniques have remained unchanged, various devices have been used to aid primary tumour resection, with a view to reduce bleeding and scarring. The purpose of this study is to compare resection of oral tongue tumours using ultrasonic coagulation device with conventional electrodiathermy...
December 2018: Indian Journal of Surgical Oncology
Gabriela R Oates, Irena Stepanikova, Steven M Rowe, Stephanie Gamble, Hector H Gutierrez, William T Harris
BACKGROUND: Historically, studies of adherence to airway clearance therapy in cystic fibrosis (CF) have relied on self-reporting. We compared self-reported airway clearance therapy adherence to actual usage data from home high-frequency chest wall compressions (HFCWC) vests and identified factors associated with overestimation of adherence in self-reports. METHODS: Pediatric patients who perform airway clearance therapy with a HFCWC vest were eligible to participate...
December 11, 2018: Respiratory Care
Joseph A Impellizeri, Alessandra Gavazza, Eliana Greissworth, Anna Crispo, Maurizio Montella, Gennaro Ciliberto, George Lubas, Luigi Aurisicchio
BACKGROUND: we have recently shown that Tel-eVax, a genetic vaccine targeting dog telomerase (dTERT) and based on Adenovirus (Ad)/DNA Electro-Gene-Transfer (DNA-EGT) technology can induce strong immune response and increase overall survival (OS) of dogs affected by multicentric Diffuse Large B cell Lymphoma (DLBCL) when combined to COP therapy in a double-arm study. Here, we have utilized a clinically validated device for veterinary electroporation called Vet-ePorator™, based on Cliniporator™ technology currently utilized and approved in Europe for electrochemotherapy applications and adapted to electrogenetransfer (EGT)...
December 11, 2018: Journal of Translational Medicine
Catherine N Marti, Gregg C Fonarow, Stefan D Anker, Clyde Yancy, Muthiah Vaduganathan, Stephen J Greene, Ali Ahmed, James L Januzzi, Mihai Gheorghiade, Gerasimos Filippatos, Javed Butler
Multiple drug classes have shown incremental benefits in heart failure with reduced ejection fraction. Most of these trials were designed to achieve specific doses of the investigational agent. Clinical practice guidelines recommend using the same target dosing of therapies, as tolerated. However, with the increasing number of available therapies, clinicians face the challenge of simultaneously using several drugs, achieving target doses, and managing side effects that are often overlapping. Blood pressure, renal function, hyperkalaemia, and other factors may impede achieving target doses of all medications, leaving clinicians with dilemmas as to how to sequence and dose these various classes of drugs...
December 10, 2018: European Journal of Heart Failure
Mohamad El Moheb, Johny Nicolas, Assem M Khamis, Ghida Iskandarani, Elie A Akl, Marwan Refaat
BACKGROUND: There is evidence that implantable cardioverter-defibrillator (ICD) for primary prevention in people with an ischaemic cardiomyopathy improves survival rate. The evidence supporting this intervention in people with non-ischaemic cardiomyopathy is not as definitive, with the recently published DANISH trial finding no improvement in survival rate. A systematic review of all eligible studies was needed to evaluate the benefits and harms of using ICDs for primary prevention in people with non-ischaemic cardiomyopathy...
December 8, 2018: Cochrane Database of Systematic Reviews
William H Nailon, Daniel Welsh, Kim McDonald, Donna Burns, Julie Forsyth, Gillian Cooke, Francisco Cutanda, Linda J Carruthers, Duncan B McLaren, Josep Puxeu Vaqué, Terence Kehoe, Sankar Andiappa
BACKGROUND: Independent verification of the dose delivered by complex radiotherapy can be performed by electronic portal imaging device (EPID) dosimetry. This paper presents 5-yr EPID in vivo dosimetry (IVD) data obtained using the Dosimetry Check (DC) software on a large cohort including breast, lung, prostate, and head and neck (H&N) cancer patients. MATERIAL AND METHODS: The difference between in vivo dose measurements obtained by DC and point doses calculated by the Eclipse treatment planning system was obtained on 3795 radiotherapy patients treated with volumetric modulated arc therapy (VMAT) (n = 842) and three-dimensional conformal radiotherapy (3DCRT) (n = 2953) at 6, 10, and 15 MV...
December 7, 2018: Journal of Applied Clinical Medical Physics
(no author information available yet)
OBJECTIVE: To provide healthcare professionals with updated guidance in the use of novel preventive and acute treatments for migraine in adults. BACKGROUND: The principles of preventive and acute pharmacotherapy for patients with migraine have been outlined previously, but the emergence of new technologies and treatments, as well as new formulations of previously established treatments, has created a need for an updated guidance on the preventive and acute treatment of migraine...
December 10, 2018: Headache
Conor Teljeur, Patricia Harrington, Ronan W Glynn, Máirín Ryan
PURPOSE: Although good evidence exists regarding the clinical effectiveness of mechanical thrombectomy for people with acute ischaemic stroke, cost-effectiveness should also be considered. The aim of this study was to systematically review the evidence of cost-effectiveness of emergency endovascular therapy using mechanical thrombectomy in the management of acute ischaemic stroke. METHODS: The search was carried out in PubMed, EMBASE, Cochrane Library, and a grey literature search...
December 8, 2018: Irish Journal of Medical Science
Joanna Osmanska, Pardeep S Jhund
The foundation of the treatment of heart failure with reduced ejection fraction is a number of pharmacotherapies shown to reduce morbidity and mortality in large randomised multinational clinical trials. These include angiotensin converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, mineralocorticoid receptor antagonists, and more recently, a combined angiotensin receptor blocker neprilysin inhibitor, sacubitril/valsartan. In select cases, digoxin, ivabradine and hydralazine with isosorbide dinitrate have a role to play in the treatment of heart failure with reduced ejection fraction...
December 11, 2018: Drugs & Aging
Yulia A Panina, Anton S Yakimov, Yulia K Komleva, Andrey V Morgun, Olga L Lopatina, Natalia A Malinovskaya, Anton N Shuvaev, Vladimir V Salmin, Tatiana E Taranushenko, Alla B Salmina
Adipose tissue is recognized as an important organ with metabolic, regulatory, and plastic roles. Adipose tissue-derived stem cells (ASCs) with self-renewal properties localize in the stromal vascular fraction (SVF) being present in a vascular niche, thereby, contributing to local regulation of angiogenesis and vessel remodeling. In the past decades, ASCs have attracted much attention from biologists and bioengineers, particularly, because of their multilineage differentiation potential, strong proliferation, and migration abilities in vitro and high resistance to oxidative stress and senescence...
2018: Frontiers in Physiology
Sourabh Jain, Vivek K Dey, Nihit Agrawal
Introduction and Objectives: Tap water iontophoresis is a promising therapy for palmoplantar hyperhidrosis. Non-affordability and nonavailability of the marketed device restrict its usage for many patients hailing from villages or small cities. Materials and Methods: In an article named "A simple user-made iontophoresis device for palmoplantar hyperhidrosis" published previously in this journal, a simple inexpensive homemade device that runs on 12 V direct current battery was described...
July 2018: Journal of Cutaneous and Aesthetic Surgery
Alexandra Kreps, Karen Paltoo, Isabel McFarlane
Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with a wide range of clinical features and variable clinical course. SLE tends to affect women during childbearing years and is characterized by multi-organ involvement. Cardiac complications in SLE, which have been described to occur in about 50% of the cases, contributes to significant morbidity and mortality in this population. We describe a patient with SLE and established lupus nephritis who subsequently developed cardiac manifestations including valvular abnormalities, arrythmia and end stage heart failure...
2018: American journal of medical case reports
Mary D Adu, Usman H Malabu, Aduli E O Malau-Aduli, Bunmi S Malau-Aduli
BACKGROUND: Mobile phone applications (apps) offer motivation and support for self-management of diabetes mellitus (DM), but their use is limited by high attrition due to insufficient consideration of end-users perspectives and usability requirements. This study aimed to examine app usage and feature preferences among people with DM, and explore their recommendations for future inclusions to foster engagement with diabetes apps. METHODS: The study was conducted internationally on adults with type 1 or type 2 DM using online questionnaire (quantitative) to investigate usage and preferences for app features that support diabetes self-management and semi structured telephone interview (qualitative) to explore suggestions on fostering engagement and specific educational information for inclusion into diabetes apps...
2018: PloS One
Julia Vogler, Anne Geisler, Nils Gosau, Samer Hakmi, Stephan Willems, Tienush Rassaf, Reza Wakili, Elif Kaya
Cardiac resynchronization therapy (CRT) device implantation is associated with severe complications including pneumo- and hemothorax. Data on a sole cephalic vein approach (sCV), potentially preventing these complications, are limited. The aim of our study was to compare a sole cSV with a subclavian vein approach (SV) in CRT implantations with respect to feasibility and safety. We performed a prospective cohort study enrolling twenty-four consecutive de-novo CRT implantations (group A) using a sCV at two centers...
December 7, 2018: Scientific Reports
V D Skripko, I K Churpiy, I Ya Mykhailoiko, A L Kovalenko, E V Talikova
The aim of this study was to evaluate the effect of cytoflavin inclusion in therapy regimens of patients with diabetic foot syndrome and medicalcinosis on the microcirculation of the lower limb blood vessels. For this purpose, 64 patients with type II diabetes mellitus (subcompensated form), diabetic foot syndrome and signs of medicalcinosis foot blood vessels of various severity were examined. All patients were divided into 2 groups depending on the therapy scheme: patients of group I (33 people) received insulin, antibiotics, disaggregants, statins, anti-inflammatory drugs, painkillers, detoxification therapy...
2018: Khirurgiia
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