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https://www.readbyqxmd.com/read/28822745/discordant-perceptions-of-prognosis-and-treatment-options-between-physicians-and-patients-with-advanced-heart-failure
#1
Amrut V Ambardekar, Jennifer T Thibodeau, Adam D DeVore, Michelle M Kittleson, Rhondalyn C Forde-McLean, Maryse Palardy, Maria M Mountis, Linda Cadaret, Jeffrey J Teuteberg, Salpy V Pamboukian, Rongbing Xie, Lynne W Stevenson, Garrick C Stewart
OBJECTIVES: This study assessed patient and physician perceptions of heart failure (HF) disease severity and treatment options. BACKGROUND: The prognosis for ambulatory patients with advanced HF on medical therapy is uncertain, yet has important implications for decision making regarding transplantation and left ventricular assist device (LVAD) placement. METHODS: Ambulatory patients with advanced HF (New York Heart Association functional class III to IV, Interagency Registry for Mechanically Assisted Circulatory Support profiles 4 to 7) on optimized medical therapy were enrolled across 11 centers...
August 3, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28822743/medical-management-of-patients-with-a%C3%A2-left-ventricular-assist-device-for-the%C3%A2-non-left-ventricular-assist-device%C3%A2-specialist
#2
REVIEW
Adam D DeVore, Priyesh A Patel, Chetan B Patel
More than 2,400 continuous-flow left ventricular assist devices (LVADs) are implanted each year in the United States alone. Both the number of patients living with LVADs and the life expectancy of these patients are increasing. As a result, patients with LVADs are increasingly encountered by non-LVAD specialists who do not have training in managing advanced heart failure for general medical care, cardiovascular procedures, and other subspecialty care. An understanding of the initial evaluation and management of patients with LVADs is now an essential skill for many health care providers...
August 3, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28822388/outcomes-following-noncardiac-surgery-in-patients-with-ventricular-assist-devices-a-single-center-experience
#3
Shawna M Kettyle, Nikhil L Chervu, Appajosula Sarada Rao, Salaam Sadi, David Majure, Jack A Sava, Laura S Johnson
the prevalence of ventricular assist devices (VADs) is increasing as advanced cardiac therapies progress. These patients commonly require non-cardiac surgical procedures (NCS), although data are scant regarding the safety, timing, and operations that may safely be performed. We aim to describe our experience with VAD patients undergoing NCS. We retrospectively reviewed records on patients who underwent NCS after VAD implantation between 2013 and 2015 at a single Joint Commission-accredited VAD institution. Data collection included demographics, ischemic cardiomyopathy or nonischemic cardiomyopathy, operative details, and perioperative anticoagulation management and outcomes...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28821963/myocardial-regenerative-therapy-using-a-scaffold-free-skeletal-muscle-derived-cell-sheet-in-patients-with-dilated-cardiomyopathy-even-under-a-left-ventricular-assist-device-a-safety-and-feasibility-study
#4
Yasushi Yoshikawa, Shigeru Miyagawa, Koichi Toda, Atsuhiro Saito, Yasushi Sakata, Yoshiki Sawa
BACKGROUND AND PURPOSE: Despite promising experimental results, clinically, intramyocardial myoblast injection failed to reverse remodeling and it induced arrhythmogenicity. In contrast, scaffold-free skeletal muscle-derived cell (SC) sheets attenuated cardiac dysfunction and arrhythmogenicity via paracrine effects. We report the first clinical trial of SC sheet implantation (SCSI) conducted in four patients with dilated cardiomyopathy (DCM) supported by a left ventricular assist device (LVAD)...
August 18, 2017: Surgery Today
https://www.readbyqxmd.com/read/28821626/current-applications-and-future-perspectives-of-robotics-in-cerebrovascular-and-endovascular-neurosurgery
#5
REVIEW
Simon A Menaker, Sumedh S Shah, Brian M Snelling, Samir Sur, Robert M Starke, Eric C Peterson
Advances in robotic medicine have been adopted by various surgical subspecialties as the benefits of this technology become more readily apparent: precision in narrow operative windows, tremor controlled movements, and modestly improved outcomes, among others. Vascular neurosurgery, in particular, remains open to newer and more cutting edge treatment options for complex pathologies, and robotics may be on the horizon for such advances. We seek to provide a broad overview of these innovations in vascular neurosurgery for both practitioners well acquainted with robotics and those seeking to become more familiar...
August 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28821330/systemic-atrioventricular-valve-excision-and-ventricular-assist-devices-in-pediatric-patients
#6
Deipanjan Nandi, Kelley D Miller, Carley M Bober, Tami M Rosenthal, Lisa M Montenegro, Joseph W Rossano, J William Gaynor, Christopher E Mascio
BACKGROUND: Continuous-flow ventricular assist devices (CF VADs) designed for adults are increasingly used in pediatric patients. However, there is greater risk of device inflow obstruction as a result of size and anatomy. METHODS: We reviewed all cases of systemic atrioventricular valve (AVV) excision with HeartWare HVAD (HeartWare, Framingham, MA) implantation in the systemic ventricle performed at our institution from November 2015 to May 2016. RESULTS: AVV excision with CF VAD implantation was undertaken in 3 patients...
August 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28821135/exploring-pullulan-poly-vinyl-alcohol-interpenetrating-network-microspheres-as-controlled-release-drug-delivery-device
#7
Saundray Raj Soni, Animesh Ghosh
In the present study, interpenetrating polymeric network (IPN) microsphere was prepared using glutaraldehyde assisted water-in-oil emulsion crosslinking method for controlled delivery of pirfenidone, the only chemical entity approved by US FDA for the treatment of Idiopathic Pulmonary Fibrosis (IPF). In our study, the natural biopolymer pullulan was harnessed in combination with synthetic polymer PVA for drug delivery applications. The prepared microspheres were characterized by Fourier transform infrared spectroscopy, Raman spectroscopy, solid state (13)C nuclear magnetic resonance and field emission scanning electron microscopy...
October 15, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/28820968/reduced-activin-receptor-like-kinase-1-activity-promotes-cardiac-fibrosis-in-heart-failure
#8
Kevin J Morine, Xiaoying Qiao, Vikram Paruchuri, Mark J Aronovitz, Emily E Mackey, Lyanne Buiten, Jonathan Levine, Keshan Ughreja, Prerna Nepali, Robert M Blanton, S Paul Oh, Richard H Karas, Navin K Kapur
INTRODUCTION: Activin receptor-like kinase 1 (ALK1) mediates signaling via the transforming growth factor beta-1 (TGFβ1), a pro-fibrogenic cytokine. No studies have defined a role for ALK1 in heart failure. HYPOTHESIS: We tested the hypothesis that reduced ALK1 expression promotes maladaptive cardiac remodeling in heart failure. METHODS AND RESULTS: In patients with advanced heart failure referred for left ventricular (LV) assist device implantation, LV Alk1 mRNA and protein levels were lower than control LV obtained from patients without heart failure...
July 18, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28820651/starting-and-stopping-kinetics-of-a-rear-mounted-power-assist-for-manual-wheelchairs
#9
Stephanie Wong, Ben Mortenson, Bonita Sawatzky
A rear mounted, powered, drive wheel has been developed to assist with mobility for manual wheelchairs in indoor and outdoor modes. To start the wheel, users must initiate handrim propulsion with sufficient force to trigger the motor. To stop the indoor mode, users must apply a braking force through the handrims exceeding the device's deceleration threshold. The objectives of this study were to compare 1) the minimum force required to start a wheelchair with and without the wheel, and 2) the distances and forces needed to stop a wheelchair at different treadmill speeds (3...
August 18, 2017: Assistive Technology: the Official Journal of RESNA
https://www.readbyqxmd.com/read/28820531/phytic-acid-assisted-electrochemically-synthesized-three-dimensional-o-p-functionalized-graphene-monoliths-with-high-capacitive-performance
#10
Han-Yu Li, Lang Liu, Zhi-Wei Zhang, Shu-Shen Wang, Yao Yu, Lin Liu, Yue Wu
Three-dimensional functionalized graphene monoliths (3DFGMs) have attracted intensive attention as energy storage materials due to their unique interconnected porous structure, good electrical conductivity, excellent mechanical strength, and pseudocapacitive characteristic. Herein, we report a facile, green and low-cost strategy through a simple, one-step electrochemical process in a phytic acid solution to fabricate a 3DFGM. The 3D porous structure and functionalization of graphene can be obtained simultaneously...
August 18, 2017: Nanoscale
https://www.readbyqxmd.com/read/28820212/self-rectifying-bipolar-resistive-switching-memory-based-on-an-iron-oxide-and-graphene-oxide-hybrid
#11
Se-I Oh, Janardhanan R Rani, Sung-Min Hong, Jae-Hyung Jang
A resistive random access memory (RRAM) device with self-rectifying I-V characteristics was fabricated by inserting a silicon nitride (Si3N4) layer between the bottom electrode and solution-processed active material of an iron oxide-graphene oxide (FeOx-GO) hybrid. The fabricated Au/Ni/FeOx-GO/Si3N4/n(+)-Si memory device exhibited an excellent resistive switching ratio and a rectification ratio higher than 10(4). In the Au/Ni/FeOx-GO/Si3N4/n(+)-Si device, resistive switching occurs in both the FeOx-GO and Si3N4 layers separately, resulting in a highly uniform and stable switching performance...
August 18, 2017: Nanoscale
https://www.readbyqxmd.com/read/28820030/epidemiology-of-cardiovascular-disease-in-the-united-states-implications-for-the-perfusion-profession-a-2017-update
#12
Joseph J Sistino, David C Fitzgerald
INTRODUCTION: By analyzing epidemiological trends in cardiovascular disease (CVD), key stakeholders can make informed decisions on the future of disease burden and treatment. Accordingly, the cardiovascular perfusion community would benefit from data that would help predict future professional resource utilization. METHODS: In 2003, the changes in the number of hospital discharges for CVD from 1990 to 2000 were published, based on data from the National Center for Health Statistics (NCHS)...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28819611/acute-stress-fracture-of-the-pelvis-after-total-hip-arthroplasty-a-case-report
#13
Oluwaseun Akinbo, Vineet Tyagi
INTRODUCTION: Acute hip pain following total hip arthroplasty (THA) could have numerous causes to include stress fracture of the pelvis. Stress fractures of the pelvis are rare and have been reported to involve the medial wall and the pubic ramus. A unique case is presented demonstrating the clinical presentation and management of an acute stress fracture of ilium and anterior column following a THA. CASE REPORT: A 72-year-old man underwent an uncomplicated right THA...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28819202/mechanism-of-transformation-in-mycobacteria-using-a-novel-shockwave-assisted-technique-driven-by-in-situ-generated-oxyhydrogen
#14
Akshay Datey, Janardhanraj Subburaj, Jagadeesh Gopalan, Dipshikha Chakravortty
We present a novel method for shockwave-assisted bacterial transformation using a miniature oxyhydrogen detonation-driven shock tube. We have obtained transformation efficiencies of about 1.28 × 10(6), 1.7 × 10(6), 5 × 10(6), 1 × 10(5), 1 × 10(5) and 2 × 10(5) transformants/µg of DNA for Escherichia coli, Salmonella Typhimurum, Pseudomonas aeruginosa, Mycobacterium smegmatis, Mycobacterium tuberculosis (Mtb) and Helicobacter pylori respectively using this method which are significantly higher than those obtained using conventional methods...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28817769/a-paper-based-surface-enhanced-raman-scattering-lateral-flow-strip-for-detection-of-neuron-specific-enolase-in-blood-plasma
#15
Xuefei Gao, Peng Zheng, Sujan Kasani, Steven Wu, Feng Yang, Sara Lewis, Sara Nayeem, Elizabeth Engler-Chiurazzi, Jane Wigginton, James W Simpkins, Nianqiang Wu
An inexpensive and disposable paper-based lateral flow strip (PLFS) has been developed as an immunoassay, in which surface-enhanced Raman scattering (SERS) is utilized for sensing signal transduction. The Au nanostar@Raman Reporter@silica sandwich nanoparticles are developed as the SERS probes, which is the key to high sensitivity of device. Compared with a colorimetric PLFS, the SERS-PLFS exhibits superior performance in terms of sensitivity and limit of detection (LOD) in a blood plasma-containing sample matrix...
August 17, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28814060/a-soft-wearable-robot-for-the-shoulder-design-characterization-and-preliminary-testing
#16
Ciaran T O'Neill, Nathan S Phipps, Leonardo Cappello, Sabrina Paganoni, Conor J Walsh
In this paper, we present a soft wearable robot for the shoulder which has the potential to assist individuals suffering from a range of neuromuscular conditions affecting the shoulder to perform activities of daily living. This wearable robot combines two types of soft textile pneumatic actuators which were custom developed for this particular application to support the upper arm through shoulder abduction and horizontal flexion/extension. The advantage of a textile-based approach is that the robot can be lightweight, low-profile, comfortable and non-restrictive to the wearer, and easy to don like an item of clothing...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814056/design-of-a-lightweight-tethered-torque-controlled-knee-exoskeleton
#17
Kirby Ann Witte, Andreas M Fatschel, Steven H Collins
Lower-limb exoskeletons show promise for improving gait rehabilitation for those with chronic gait abnormalities due to injury, stroke or other illness. We designed and built a tethered knee exoskeleton with a strong lightweight frame and comfortable, four-point contact with the leg. The device is structurally compliant in select directions, instrumented to measure joint angle and applied torque, and is lightweight (0.76 kg). The exoskeleton is actuated by two off-board motors. Closed loop torque control is achieved using classical proportional feedback control with damping injection in conjunction with iterative learning...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814050/segmental-contributions-to-sagittal-plane-whole-body-angular-momentum-when-using-powered-compared-to-passive-ankle-foot-prostheses-on-ramps
#18
Nathaniel T Pickle, Anne K Silverman, Jason M Wilken, Nicholas P Fey
Understanding the effects of an assistive device on dynamic balance is crucial, particularly for robotic leg prostheses. Analyses of dynamic balance commonly evaluate the range of whole-body angular momentum (H). However, the contributions of individual body segments to overall H throughout gait may yield futher insights, specifically for people with transtibial amputation using powered prostheses. We evaluated segment contributions to H using Statistical Parametric Mapping to assess the effects of prosthesis type (powered vs passive) and ramp angle on segmental coordination...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814048/a-mechanism-for-elbow-exoskeleton-for-customised-training
#19
Soumya K Manna, Venketesh N Dubey
It is well proven that repetitive extensive training consisting of active and passive therapy is effective for patients suffering from neuromuscular deficits. The level of difficulty in rehabilitation should be increased with time to improve the neurological muscle functions. A portable elbow exoskeleton has been designed that will meet these requirements and potentially offers superior outcomes than human-assisted training. The proposed exoskeleton can provide both active and passive rehabilitation in a single structure without changing its configuration...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814044/a-survey-of-stakeholder-perspectives-on-a-proposed-combined-exoskeleton-wheelchair-technology
#20
Tim Bhatnagar, W Ben Mortensen, Johanne Mattie, Jamie Wolff, Claire Parker, Jaimie Borisoff
BACKGROUND: Exoskeleton technology has potential benefits for wheelchair users' health and mobility. However, there are practical barriers to their everyday use as a mobility device. In particular, challenges related to travelling longer distances and transitioning between using a wheelchair and exoskeleton walking may present significant deterrents to regular exoskeleton use. In an effort to remove these barriers, a combined exoskeleton-wheelchair concept ('COMBO') has been proposed, which aims to achieve the benefits of both these mobility technologies...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
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