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https://www.readbyqxmd.com/read/28214482/catheter-directed-ultrasound-assisted-thrombolysis-is-a-safe-and-effective-treatment-for-pulmonary-embolism-even-in-high-risk-patients
#1
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28213945/optimization-of-initial-propofol-bolus-dose-for-eeg-narcotrend-index-guided-transition-from-sevoflurane-induction-to-intravenous-anesthesia-in-children
#2
Nils Dennhardt, Dietmar Boethig, Christiane Beck, Sebastian Heiderich, Martin Boehne, Andreas Leffler, Barbara Schultz, Robert Sümpelmann
BACKGROUND: Sevoflurane induction followed by intravenous anesthesia is a widely used technique to combine the benefits of an easier and less traumatic venipuncture after sevoflurane inhalation with a recovery with less agitation, nausea, and vomiting after total intravenous anesthesia (TIVA). Combination of two different anesthetics may lead to unwanted burst suppression in the electroencephalogram (EEG) during the transition phase. OBJECTIVE: The objective of this prospective clinical observational study was to identify the optimal initial propofol bolus dose for a smooth transition from sevoflurane induction to TIVA using the EEG Narcotrend Index (NI)...
February 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28212401/preload-based-starling-like-control-of-rotary-blood-pumps-an-in-vitro-evaluation
#3
Mahdi Mansouri, Shaun D Gregory, Robert F Salamonsen, Nigel H Lovell, Michael C Stevens, Jo P Pauls, Rini Akmeliawati, Einly Lim
Due to a shortage of donor hearts, rotary left ventricular assist devices (LVADs) are used to provide mechanical circulatory support. To address the preload insensitivity of the constant speed controller (CSC) used in conventional LVADs, we developed a preload-based Starling-like controller (SLC). The SLC emulates the Starling law of the heart to maintain mean pump flow ([Formula: see text]) with respect to mean left ventricular end diastolic pressure (PLVEDm) as the feedback signal. The SLC and CSC were compared using a mock circulation loop to assess their capacity to increase cardiac output during mild exercise while avoiding ventricular suction (marked by a negative PLVEDm) and maintaining circulatory stability during blood loss and severe reductions in left ventricular contractility (LVC)...
2017: PloS One
https://www.readbyqxmd.com/read/28212333/the%C3%A2-cardiovascular%C3%A2-and%C3%A2-neurotoxic%C3%A2-effects%C3%A2-of%C3%A2-the%C3%A2-venoms%C3%A2-of%C3%A2-six%C3%A2-bony%C3%A2-and%C3%A2-cartilaginous%C3%A2-fish%C3%A2-species
#4
Han Han, Kate Baumann, Nicholas R Casewell, Syed A Ali, James Dobson, Ivan Koludarov, Jordan Debono, Scott C Cutmore, Niwanthi W Rajapakse, Timothy N W Jackson, Rob Jones, Wayne C Hodgson, Bryan G Fry, Sanjaya Kuruppu
Fish venoms are often poorly studied, in part due to the difficulty in obtaining, extracting, and storing them. In this study, we characterize the cardiovascular and neurotoxic effects of the venoms from the following six species of fish: the cartilaginous stingrays Neotrygon kuhlii and Himantura toshi, and the bony fish Platycephalus fucus, Girella tricuspidata, Mugil cephalus, and Dentex tumifrons. All venoms (10-100 μg/kg, i.v.), except G. tricuspidata and P. fuscus, induced a biphasic response on mean arterial pressure (MAP) in the anesthetised rat...
February 16, 2017: Toxins
https://www.readbyqxmd.com/read/28211094/comparison-of-procedural-sequences-in-same-day-painless-bidirectional-endoscopy-a-single-center-prospective-randomized-study
#5
Yan Cao, Jun Yang, Jiao Li, Xin Ao, Kai-Yuan Zhang, Xiao-Chun Shen, Dong-Feng Chen, Chun-Hui Lan
AIMS: To compare the efficacy and safety of esophagogastroduodenoscopy (EGD)-colonoscopy and colonoscopy-EGD sequences for patients subjected to same-day bidirectional endoscopy under remifentanil and propofol sedation. METHOD: A total of 209 eligible outpatients scheduled for diagnostic same-day bidirectional endoscopy between February 16, 2016 and April 30, 2016 were randomly assigned to the EGD-colonoscopy (n=106) and colonoscopy-EGD (n=103) sequence groups. The primary endpoint was the total dose of propofol required for the procedure...
February 17, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28210489/arterial-ventricular-coupling-and-parameters-of-vascular-stiffness-in-hypertensive-patients-role-of-gender
#6
Luca Faconti, Rosa Maria Bruno, Simona Buralli, Marta Barzacchi, Elisa Dal Canto, Lorenzo Ghiadoni, Stefano Taddei
OBJECTIVE: Non-invasive estimation of arterial-ventricular coupling has been extensively used for the evaluation of cardiovascular performance, however, a relative small amount of data is available regarding arterial-ventricular coupling and its components in hypertension. The present study was designed to investigate the relationship between left ventricular elastance, arterial elastance, parameters of vascular stiffness and the influence of gender in a population of hypertensive individuals...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/28208977/comparison-of-levosimendan-milrinone-and-dobutamine-in-treating-low-cardiac-output-syndrome-following-valve-replacement-surgeries-with-cardiopulmonary-bypass
#7
Sunny, Mohd Yunus, Habib Md Reazaul Karim, Manuj Kumar Saikia, Prithwis Bhattacharyya, Samarjit Dey
INTRODUCTION: Low Cardiac Output Syndrome (LCOS) following Cardiopulmonary Bypass (CPB) is common and associated with increased mortality. Maintenance of adequate cardiac output is one of the primary objectives in management of such patients. AIM: To compare Levosimendan, Milrinone and Dobutamine for the treatment of LCOS after CPB in patients who underwent valve replacement surgeries. MATERIALS AND METHODS: Sixty eligible patients meeting LCOS were allocated into three treatment groups: Group A-Levosimendan (loading dose 10μg/kg over 10 minutes, followed by 0...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207907/argon-does-not-affect-cerebral-circulation-or-metabolism-in-male-humans
#8
Frank Grüne, Stephan Kazmaier, Sanne Elisabeth Hoeks, Robert Jan Stolker, Marc Coburn, Andreas Weyland
OBJECTIVE: Accumulating data have recently underlined argon´s neuroprotective potential. However, to the best of our knowledge, no data are available on the cerebrovascular effects of argon (Ar) in humans. We hypothesized that argon inhalation does not affect mean blood flow velocity of the middle cerebral artery (Vmca), cerebral flow index (FI), zero flow pressure (ZFP), effective cerebral perfusion pressure (CPPe), resistance area product (RAP) and the arterio-jugular venous content differences of oxygen (AJVDO2), glucose (AJVDG), and lactate (AJVDL) in anesthetized patients...
2017: PloS One
https://www.readbyqxmd.com/read/28207868/acetylcholine-versus-cold-pressor-testing-for-evaluation-of-coronary-endothelial-function
#9
Ahmed AlBadri, Janet Wei, Puja K Mehta, Sofy Landes, John W Petersen, R David Anderson, Bruce Samuels, Babak Azarbal, Eileen M Handberg, Quanlin Li, Margo Minissian, Chrisandra Shufelt, Carl J Pepine, C Noel Bairey Merz
BACKGROUND: Assessment of coronary endothelial function with intracoronary acetylcholine (IC-Ach) provides diagnostic and prognostic data in patients with suspected coronary microvascular dysfunction (CMD), but is often not feasible due in part to the time and expertise needed for pharmacologic mixing. Cold pressor testing (CPT) is a simple and safe stimulus useful for either invasive or non-invasive endothelial function testing and myocardial perfusion imaging but has not been specifically evaluated among symptomatic women with signs of ischemic heart disease (IHD) who have no obstructive coronary artery disease (CAD)...
2017: PloS One
https://www.readbyqxmd.com/read/28207639/predictors-of-waitlist-mortality-in-portopulmonary-hypertension
#10
Hilary M DuBrock, David S Goldberg, Norman L Sussman, Sonja D Bartolome, Zakiyah Kadry, Reena J Salgia, David C Mulligan, Walter K Kremers, Steven M Kawut, Michael J Krowka, Richard N Channick
BACKGROUND: The current Organ Procurement Transplantation Network (OPTN) policy grants Model for End Stage Liver Disease (MELD) exception points to patients with portopulmonary hypertension (POPH), but potentially important factors, such as severity of liver disease and pulmonary hypertension, are not included in the exception score, and may affect survival. The purpose of this study was to identify significant predictors of waitlist mortality in patients with POPH. METHODS: We performed a retrospective cohort study of patients in the OPTN database with hemodynamics consistent with POPH [defined as mean pulmonary arterial pressure (mPAP) >25mmHg and pulmonary vascular resistance (PVR) ≥240 dynes-s-cm] who were approved for a POPH MELD exception between 2006 and 2014...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28207536/cervical-plexus-anesthesia-versus-general-anesthesia-for-anterior-cervical-discectomy-and-fusion-surgery-a-randomized-clinical-trial
#11
Hui Wang, Lei Ma, Dalong Yang, Tao Wang, Qian Wang, Lijun Zhang, Wenyuan Ding
Both general anesthesia (GA) and cervical plexus anesthesia (CPA) can be used for anterior cervical discectomy and fusion (ACDF) surgery. The aim of this study was to evaluate the influence of anesthetic techniques on perioperative mortality and morbidity in patients undergoing cervical surgery.From January 2008 to December 2015, 356 patients who underwent 1-level ACDF for cervical spinal myelopathy were prospectively reviewed. They were assigned to receive GA (group A) and CPA (group B). The analgesic efficacy of the block was assessed by anesthesia preparation time, the maximum heart rate, and mean arterial blood pressure changes compared with the baseline, time of postoperative revival, and duration of recovery stay...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205455/commentary
#12
Christopher A Droege, Neil E Ernst
Obesity presents a growing challenge in critically ill patients because of variable medication pharmacokinetics and pharmacodynamics. Vasopressors used in the treatment of septic shock, including norepinephrine, are dosed using weight-based (WB) or non-weight-based (NWB) strategies. Retrospective research has evaluated the effect of total body weight and body mass index on vasopressor requirements, consequently finding that obese patients require less total vasopressor per kilogram to obtain clinical end points such as mean arterial pressure...
February 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28203328/blood-pressure-profile-in-the-7th-and-11th-year-of-life-in-children-born-prematurely
#13
Maja Gilarska, Malgorzata Klimek, Dorota Drozdz, Andrzej Grudzien, Przemko Kwinta
BACKGROUND: Several research trials have analyzed the impact of prematurity on the prevalence of hypertension (HT). However, prospective long-term studies are lacking. OBJECTIVES: The aim of this study was to evaluate the prevalence of HT at the age of 7 and 11 years in a regional cohort of preterm infants with a birth weight of ≤ 1000 g. PATIENTS AND METHODS: This study included 67 children with a birth weight of ≤ 1000 g who were born in Malopolska between September 2002 and August 2004...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28203025/-trigemino-cardiac-reflex-in-skull-base-surgery
#14
H Z Duan, Y Zhang, L Li, J Y Zhang, Z Q Yi, S D Bao
OBJECTIVE: To explore the mechanism, clinical features, and prognosis of Trigemino-cardiac reflex (TCR) during skull base operations. METHODS: A retrospective analysis was performed on 291 patients with skull base disease from Jan. 2009 to Oct. 2015 in Peking University First Hospital. By reviewing the patients' operative data and anaesthetic electrical record, and we picked out all the patients who suffered from TCR during the operation and analyzed their surgical procedures, clinical features, influence factors, and prognosis...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28202944/controversies-in-the-association-of-cardiorespiratory-fitness-and-arterial-stiffness-in-children-and-adolescents
#15
Joanna Meyer, Julia Elmenhorst, Tobias Giegerich, Renate Oberhoffer, Jan Müller
The relationship between cardiorespiratory fitness and arterial compliance in children and adolescents remains controversial. The aim of this study was to assess this association with a quantitative approach. A total of 646 healthy children and adolescents (316 females, age 13.9±2.1 years) were cross-sectionally investigated in seven school settings in and around Munich for their cardiorespiratory fitness and demographic, anthropometric and hemodynamic parameters. Surrogates of arterial stiffness, such as pulse wave velocity (PWV), Augmentation Index normalized to a heart rate of 75 (AI@75), and peripheral and central systolic blood pressures were measured in a supine position using the oscillometric Mobil-O-Graph...
February 16, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28202943/arterial-pressure-lability-is-improved-by-sodium-glucose-cotransporter-2-inhibitor-in-streptozotocin-induced-diabetic-rats
#16
Tomoko Yoshikawa, Takuya Kishi, Keisuke Shinohara, Ko Takesue, Risa Shibata, Noriyuki Sonoda, Toyoshi Inoguchi, Kenji Sunagawa, Hiroyuki Tsutsui, Yoshitaka Hirooka
To prevent cardiovascular events in patients with diabetes mellitus (DM), it is essential to reduce arterial pressure (AP). Sodium-glucose cotransporter 2 inhibitor (SGLT2i) prevents cardiovascular events via the depressor response in patients with DM. In the present study, we examined whether SGLT2i ameliorates AP lability in DM rats. Ten-week-old male Sprague-Dawley rats were administered a single intravenous injection of streptozotocin (50 mg kg(-1)) and were divided into three groups treated with low-dose SGLT2i, vehicle (VEH) or subcutaneously implanted insulin pellets (SGLT2i, VEH and Insulin group, respectively) for 14 days...
February 16, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28202896/effect-of-mild-hypercapnia-on-lung-oxygenation-in-sitting-position-during-shoulder-arthroscopy-under-general-anesthesia
#17
Hyun Jeong Kwak, Ji Yeon Lee, Jong Wha Lee, Hong Soon Kim, Ho Jin Hur, Ji Young Kim
BACKGROUND Mild hypercapnia is permitted during surgeries in sitting position under general anesthesia to maintain cerebral regional oxygen saturation (rSO2). However, since hypoventilation may cause gas exchange impairment, we evaluated effects of mild hypercapnia on lung oxygenation during shoulder arthroscopy in sitting position. MATERIAL AND METHODS Forty patients were randomly allocated to a normocapnia group (ETCO2 35 mmHg, n=20) or a hypercapnia group (45 mmHg, n=20). The mean arterial pressure (MAP), heart rate (HR), and rSO2 were measured 5 min after intubation in supine position (T0), and at 2, 4, 6, 8, 10, 20, 30, 40, 50, and 60 min of remaining in sitting position (T1-10)...
February 16, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28202855/early-and-late-atrial-arrhythmias-after-lung-transplantation%C3%A3-incidence-predictive-factors-and-impact-on-mortality
#18
Laurence Jesel, Jérémie Barraud, Han S Lim, Halim Marzak, Nathan Messas, Sandrine Hirschi, Nicola Santelmo, Anne Olland, Pierre Emmanuel Falcoz, Gilbert Massard, Michel Kindo, Patrick Ohlmann, Michel Chauvin, Olivier Morel, Romain Kessler
BACKGROUND: Atrial arrhythmias (AAs) are frequent after lung transplantation (LT) and late postoperatively. Several predictive factors of early postoperative AAs after LT have been identified but those of late AAs remain unknown. Whether AA after LT affects mortality is still being debated. This study assessed in a large cohort of LT patients the incidence of AAs early and late after surgery, their predictive factors and their effect on mortality.Methods and Results:We studied 271 consecutive LT patients over 9 years...
February 15, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28202852/association-of-serum-uric-acid-levels-with-leg-ischemia-in-patients-with-peripheral-arterial-disease-after-treatment
#19
Yoko Sotoda, Shigeki Hirooka, Hiroyuki Orita, Ichiro Wakabayashi
AIM: We investigated the relationships of serum uric acid levels with the progression of atherosclerosis in patients with peripheral arterial disease (PAD) after treatment. METHODS: Subjects were male patients diagnosed with PAD. Atherosclerosis at the common carotid artery was evaluated based on its intima-media thickness (IMT). Leg arterial flow was evaluated by measuring ankle-brachial index (ABI) and exercise-induced decrease in ABI. RESULTS: Among various risk factors including age, blood pressure, adiposity, estimated glomerular filtration rate, and blood lipid, blood glucose, uric acid, fibrinogen and C-reactive protein levels, only uric acid levels showed significant correlations with ABI [Pearson's correlation coefficient, -0...
February 15, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28202440/exposure-to-placental-ischemia-impairs-postpartum-maternal-renal-and-cardiac-function-in-rats
#20
Nina D Paauw, Jaap A Joles, Frank T Spradley, Bhavisha Bakrania, Zsuzsanna K Zellenger, Arie Franx, Marianne C Verhaar, Joey P Granger, A Titia Lely
INTRODUCTION: Women with a history of preeclampsia (PE) have an increased risk to develop cardiovascular and renal diseases later in life, but the mechanisms underlying this effect are unknown. In rats, we assessed whether placental ischemia results in long-term effects on the maternal cardiovascular and renal systems using the Reduced Uterine Perfusion Pressure (RUPP) model for PE. METHODS: Sprague-Dawley rats received either a SHAM or RUPP operation at gestational day 14...
February 15, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
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