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https://www.readbyqxmd.com/read/29688916/gastrointestinal-bleeding-with-left-ventricular-assist-devices-lvad-locating-the-leak-and-identifying-outcomes
#1
Sarah Malik, Shahbaz A Malik, Laura L Ulmer, Lokesh K Jha, Michael S Strupp, Eugenia Raichlin, Elizabeth R Lyden, Alexander T Hewlett
BACKGROUND AND GOALS: Gastrointestinal bleeding (GIB) is a significant complication following left ventricular assist device (LVAD) implantation. We evaluated the incidence, predictors, endoscopic findings, and outcomes of GIB in LVAD recipients. STUDY: Retrospective review of 205 adult patients undergoing HeartMate II LVAD implantation from January 2012 to June 2016. Patients were reviewed and separated into GIB (n=57; 28%) and non-GIB (n=148; 72%) groups. RESULTS: Median time to GIB was 55 (range, 3 to 730) days...
April 23, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29686556/usefulness-of-a-left-ventricular-assist-device-in-patients-with-left-ventricular-noncompaction
#2
Helen Hashemi, Fayez S Raza, David M Harmon, Tony Alias, Joost Felius, Melody J Sherwood
Left ventricular noncompaction (LVNC) is a multifactorial structural abnormality of the myocardial wall characterized by prominent trabeculae and deep trabecular recesses. LVNC may present as a congenital or acquired defect characterized by 2 distinct tissue layers: a spongy, noncompacted inner myocardium and a thin, compacted outer myocardium. Patients with LVNC are prone to thromboembolic events, either due to deep trabeculations in the noncompacted myocardium or due to arrhythmias accompanying the defect...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29686162/-characteristics-of-headache-and-neck-pain-in-spontaneous-vertebral-artery-dissections
#3
Emiko Hori, Satoshi Hori, Soshi Okamoto, Takashi Shibata, Kimiko Oya Umemura, Michiya Kubo, Eisuke Furui, Yukio Horie, Satoshi Kuroda
PURPOSE: Sudden onset severe occipital/nuchal pain is believed to be a typical symptom of vertebral artery dissection(VAD). However, recent developments in diagnostic imaging have suggested that VAD is not always associated with such pain. This study aimed to analyze the clinical features of initial symptoms in patients with VAD. METHODS: In total, this study included 29 consecutive patients who were referred to our hospital because of only headache and/or nuchal pain due to VAD between 2011 and 2016...
April 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29686029/initial-right-ventricular-dysfunction-severity-identifies-severe-peripartum-cardiomyopathy-phenotype-with-worse-early-and-overall-outcomes-a-24-year-cohort-study
#4
Andrew Peters, Mara Caroline, Huaqing Zhao, Matthew R Baldwin, Paul R Forfia, Emily J Tsai
BACKGROUND: Outcomes in peripartum cardiomyopathy (PPCM) vary. We sought to determine whether severity of left or right ventricular dysfunction (RVD) at PPCM diagnosis differentially associates with adverse outcomes. METHODS AND RESULTS: We conducted a single-center retrospective cohort study of 53 patients with PPCM. The primary outcome was a composite of left ventricular assist device implantation, cardiac transplantation, or death. We used Kaplan-Meier curves to examine event-free survival and Cox proportional hazards models to examine associations of left ventricular (LV) ejection fraction <30%, LV end-diastolic diameter ≥60 mm, and moderate-to-severe RVD at PPCM diagnosis with the primary outcome...
April 23, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29683872/social-support-moderates-the-relationship-between-perceived-stress-and-quality-of-life-in-patients-with-a-left-ventricular-assist-device
#5
Martha Abshire, Stuart D Russell, Patricia M Davidson, Chakra Budhathoki, Hae-Ra Han, Kathleen L Grady, Shashank Desai, Cheryl Dennison Himmelfarb
BACKGROUND: Living with a left ventricular assist device has significant psychosocial sequelae that affect health-related quality of life (HRQOL). OBJECTIVE: The purpose of this study was to (1) describe psychosocial indicators of stress including perceived stress, depression, fatigue, and coping; (2) examine relationships among stress indicators by level of perceived stress; (3) examine relationships among indicators of stress and clinical outcomes; and (4) test the moderation of social support on the relationship between stress and clinical outcomes...
April 20, 2018: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29682239/diagnostic-relevance-of-spatial-orientation-for-vascular-dementia-a-case-study
#6
Gillian Coughlan, Emma Flanagan, Stephen Jeffs, Maxime Bertoux, Hugo Spiers, Eneida Mioshi, Michael Hornberger
Spatial orientation is emerging as an early and reliable cognitive biomarker of Alzheimer's disease (AD) pathophysiology. However, no evidence exists as to whether spatial orientation is also affected in vascular dementia (VaD). Objective: To examine allocentric (map-based) and egocentric (viewpoint-based) spatial orientation in an early stage VaD case. Methods: A spatial test battery was administered following clinical and neuropsychological cognitive evaluation...
January 2018: Dementia & Neuropsychologia
https://www.readbyqxmd.com/read/29678608/clinical-and-hemodynamic-effects-of-intra-aortic-balloon-pump-therapy-in-chronic-heart-failure-patients-with-cardiogenic-shock
#7
Justin A Fried, Abhinav Nair, Koji Takeda, Kevin Clerkin, Veli K Topkara, Amirali Masoumi, Melana Yuzefpolskaya, Hiroo Takayama, Yoshifumi Naka, Daniel Burkhoff, Ajay Kirtane, S M Dimitrios Karmpaliotis, Jeffrey Moses, Paolo C Colombo, A Reshad Garan
BACKGROUND: The role of the intra-aortic balloon pump (IABP) in acute decompensated heart failure (HF) with cardiogenic shock (CS) is largely undefined. In this study we sought to assess the hemodynamic and clinical response to IABP in chronic HF patients with CS and identify predictors of response to this device. METHODS: We retrospectively reviewed all patients undergoing IABP implantation from 2011 to 2016 at our institution to identify chronic HF patients with acute decompensation and CS (cardiac index <2...
March 20, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29677212/pulsatile-operation-of-a-continuous-flow-right-ventricular-assist-device-rvad-to-improve-vascular-pulsatility
#8
Boon C Ng, Matthias Kleinheyer, Peter A Smith, Daniel Timms, William E Cohn, Einly Lim
Despite the widespread acceptance of rotary blood pump (RBP) in clinical use over the past decades, the diminished flow pulsatility generated by a fixed speed RBP has been regarded as a potential factor that may lead to adverse events such as vasculature stiffening and hemorrhagic strokes. In this study, we investigate the feasibility of generating physiological pulse pressure in the pulmonary circulation by modulating the speed of a right ventricular assist device (RVAD) in a mock circulation loop. A rectangular pulse profile with predetermined pulse width has been implemented as the pump speed pattern with two different phase shifts (0% and 50%) with respect to the ventricular contraction...
2018: PloS One
https://www.readbyqxmd.com/read/29677081/changes-in-pediatric-heart-transplant-hospitalization-costs-over-time
#9
Justin Godown, Cary Thurm, Matt Hall, Jonathan H Soslow, Brian Feingold, Bret A Mettler, Andrew H Smith, David W Bearl, Debra A Dodd
BACKGROUND: Despite significant changes in the past decade for children undergoing heart-transplantation, including the evolution of mechanical circulatory support and increasing patient complexity, costs and resource utilization have not been reassessed. We sought to utilize a novel linkage of clinical-registry and administrative data to examine changes in hospitalization costs over time in this population. METHODS: We identified all pediatric heart transplant recipients in a unique linked PHIS/SRTR dataset (2002-2016)...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29677038/postoperative-b-type-natriuretic-peptide-as-predictor-for-postoperative-outcomes-in-patients-implanted-with-left-ventricular-assist-devices
#10
Gardner Yost, Geetha Bhat, Patroklos Pappas, Antone Tatooles
Brain natriuretic peptide (BNP) is a cardiac neurohormone known to correlate with left ventricular (LV) dilation, decreased contractility, and increased stiffness. Consequently, BNP has been used as a prognostic tool to assess the degree of LV unloading for patients supported by continuous-flow LV assist devices (LVADs). We assessed the prognostic value of changes in BNP in the 2 weeks after LVAD implantation. This retrospective study analyzed laboratory findings and outcomes of 189 LVAD patients. Patients were separated into two groups based on whether serum BNP levels had improved from preoperative levels by postoperative day 14...
April 18, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29677037/small-left-ventricular-size-is-an-independent-risk-factor-for-ventricular-assist-device-thrombosis
#11
Venkat Keshav Chivukula, Jennifer A Beckman, Anthony R Prisco, Shin Lin, Todd F Dardas, Richard K Cheng, Stephen D Farris, Jason W Smith, Nahush A Mokadam, Claudius Mahr, Alberto Aliseda
The prevalence of ventricular assist device (VAD) therapy has continued to increase due to a stagnant donor supply and growing advanced heart failure (HF) population. We hypothesize that left ventricular (LV) size strongly influences biocompatibility and risk of thrombosis. Unsteady computational fluid dynamics (CFD) was used in conjunction with patient-derived computational modeling and virtual surgery with a standard, apically implanted inflow cannula. A dual-focus approach of evaluating thrombogenicity was employed: platelet-based metrics to characterize the platelet environment and flow-based metrics to investigate hemodynamics...
April 18, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29677035/outflow-cannula-systolic-slope-in-patients-with-left-ventricular-assist-devices-a-novel-marker-of-myocardial-contractility
#12
Jonathan Grinstein, Eric Kruse, Gabriel Sayer, Gene H Kim, Jayant Raikhelkar, Sara Kalantari, Nitasha Sarswat, Sirtaz Adatya, Takeyoshi Ota, Valluvan Jeevanandam, Victor Mor-Avi, Roberto M Lang, Nir Uriel
Left ventricular (LV) unloading with a LV assist device (LVAD) reverse remodels the heart and may lead to favorable changes in cellular architecture and LV geometry promoting myocardial recovery. Currently, there are no standardized methods for evaluating myocardial recovery. This study assesses the systolic slope of the LVAD outflow cannula as a marker for myocardial contractility. Doppler echocardiography (transthoracic echocardiogram [TTE]) of the LVAD outflow cannula and TTE of the LV cavity were prospectively collected in 57 patients with LVADs...
April 18, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29676814/potential-of-carnosine-a-histamine-precursor-in-rat-model-of-bilateral-common-carotid-artery-occlusion-induced-vascular-dementia
#13
Nidhi Tiwari, Pankaj Bhatia, Amit Kumar, Amteshwar S Jaggi, Nirmal Singh
The present study investigates the potential of Carnosine a histamine precursor, in rat model of bilateral common carotid artery occlusion (BCCAo) induced vascular dementia (VaD). Wistar rats were subjected to BCCAo procedure under anesthesia to induce VaD. The rats were subjected to Morris water-maze (MWM) test (6th day onwards post-surgery). MWM test was employed to assess learning and memory of the animals whereby ELT (escape latency time), TSTQ (time spent in target quadrant) and Path length (distance travelled) taken as important parameters...
April 20, 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29676339/prevalence-of-vitamin-a-deficiency-among-under-five-children-in-south-western-nigeria
#14
Olufunmilola O Abolurin, Adebanjo J Adegbola, Oyeku A Oyelami, Samuel A Adegoke, Oluseye O Bolaji
Background and Aim: Vitamin A deficiency (VAD) constitutes a major nutritional concern in developing countries. It contributes significantly to the morbidity and mortality of under-five children and can result in impaired resistance to infection as well as increased risk of death. The aim of this study was to determine the prevalence of VAD among Southwestern Nigerian children. Methods: Apparently healthy children aged between 6 months and 5 years were recruited for the study...
January 2018: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29675919/therapy-and-outcome-of-staphylococcus-aureus-infections-of-intracorporeal-ventricular-assist-devices
#15
Miquel B Ekkelenkamp, Mats T Vervoorn, Jumamurat R Bayjanov, Ad C Fluit, Barry J Benaissa-Trouw, Faiz Z Ramjankhan
Infection of the driveline or pump pocket is a common complication in patients with ventricular assist devices (VADs) and Staphylococcus aureus is the main pathogen causing such infections. Limited evidence is currently available to guide the choice of antibiotic therapy and the duration of treatment in these patients. Patients at the University Medical Center Utrecht who developed a VAD-related S. aureus infection between 2007 and 2016 were retrospectively assessed. Blood culture isolates were typed by whole genome sequencing to differentiate between relapses and reinfections, and to determine whether antibiotic therapy had led to acquisition of resistance mutations...
April 19, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29674236/sub-lethal-ultraviolet-b-irradiation-and-poly-i-c-treatment-synergistically-induced-apoptosis-of-hacat-cells-through-nf-%C3%AE%C2%BAb-pathway
#16
Wuxiyar Otkur, Weiwei Liu, Jinda Wang, Xingfan Jia, Dianchao Huang, Fang Wang, Toshihiko Hayashi, Shin-Ichi Tashiro, Satoshi Onodera, Takashi Ikejima
Ultraviolet B (UVB) irradiation exerts multiple effects on skin cells, inducing apoptosis, senescence and carcinogenesis. Toll-like receptor 3, a member of pattern recognition receptors, is reported to initiate inflammation by recognizing double-strand RNA (dsRNA) released from UVB-irradiated cells. It has not been studied, however, whether apoptosis induction in UVB irradiation is attributed to TLR3 activation. Here, we report on the pro-apoptotic role of TLR3 in UVB-irradiated epidermal cells. Poly I:C, an analogue of dsRNA that activates TLR3, was used in combination with sub-lethal UVB (4...
April 16, 2018: Molecular Immunology
https://www.readbyqxmd.com/read/29674141/trends-in-utilization-of-mechanical-circulatory-support-in-patients-hospitalized-after-out-of-hospital-cardiac-arrest
#17
Nileshkumar J Patel, Nish Patel, Bhaskar Bhardwaj, Harsh Golwala, Varun Kumar, Varunsiri Atti, Shilpkumar Arora, Smit Patel, Nilay Patel, Gabriel A Hernandez, Apurva Badheka, Carlos E Alfonso, Mauricio G Cohen, Deepak L Bhatt, Navin K Kapur
OBJECTIVE: This study sought to examine the trends and predictors of mechanical circulatory support (MCS) use in patients hospitalized after out-of-hospital cardiac arrest (OHCA). BACKGROUND: There is a paucity of data regarding MCS use in patients hospitalized after OHCA. METHODS: We conducted an observational analysis of MCS use in 960,428 patients hospitalized after OHCA between January 2008 and December 2014 in the Nationwide Inpatient Sample database...
April 16, 2018: Resuscitation
https://www.readbyqxmd.com/read/29673504/usefulness-of-tricuspid-annular-diameter-to-predict-late-right-sided-heart-failure-in-patients-with-left-ventricular-assist-device
#18
Koki Nakanishi, Shunichi Homma, Jiho Han, Hiroo Takayama, Paolo C Colombo, Melana Yuzefpolskaya, Arthur R Garan, Maryjane A Farr, Paul Kurlansky, Marco R Di Tullio, Yoshifumi Naka, Koji Takeda
Although late-onset right-sided heart failure is recognized as a clinical problem in the treatment of patients with left ventricular assist devices (LVADs), the mechanism and predictors are unknown. Tricuspid valve (TV) deformation leads to the restriction of the leaflet motion and decreased coaptation, resulting in a functional tricuspid regurgitation that may act as a surrogate marker of late right-sided heart failure. This study aimed to investigate the association of preoperative TV deformation (annulus dilatation and leaflet tethering) with late right-sided heart failure development after continuous-flow LVAD implantation...
March 28, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29671831/the-potential-of-integrating-provitamin-a-biofortified-maize-in-smallholder-farming-systems-to-reduce-malnourishment-in-south-africa
#19
REVIEW
Mthokozisi K Zuma, Unathi Kolanisi, Albert T Modi
Biofortification interventions have the potential to combat malnutrition. This review explored the use of provitamin A-biofortified maize (PVABM) as a vitamin A deficiency (VAD) reduction agricultural-based strategy. Maize has been identified as one of the key staple crops for biofortification to reduce hidden hunger in Africa. Most nutrition interventions have not been successful in reducing hunger because rural communities, who mainly rely on agriculture, have been indirectly excluded. The biofortification intervention proposed here aims to be an inclusive strategy, based on smallholder farming systems...
April 19, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29671764/evaluation-of-factors-associated-with-hypermetabolism-and-hypometabolism-in-critically-ill-aki-patients
#20
Cassiana R de Góes, André Luis Balbi, Daniela Ponce
Acute kidney injury (AKI) is a frequent and serious condition with high mortality. The presence of hypermetabolism may be a factor related to poorer prognosis. This study evaluated the resting energy expenditure (REE) of intensive care unit (ICU) patients with severe AKI using indirect calorimetry (IC) and identified factors associated with metabolism categories. Patients were evaluated through measurement of REE and estimation of basal energy expenditure (BEE) using the Harris⁻Benedict equation. Metabolism categories were as follows: hypermetabolism (REE/BEE > 1...
April 19, 2018: Nutrients
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