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https://www.readbyqxmd.com/read/29162679/safety-of-peritoneal-dialysis-after-nonrenal-solid-organ-transplantation
#1
Anne Buffet, Sonia Guillouët, Thierry Lobbedez, Maxence Ficheux, Antoine Lanot, Clemence Bechade
BACKGROUND: End-stage renal disease is a well-known complication after solid-organ transplantation, mostly as a result of calcineurin-inhibitor therapy. Among recipients of solid-organ transplants other than kidneys, peritoneal dialysis (PD) has been considered an accessory technique as an increased risk of infectious complications has been reported. The aim of our study was to evaluate the outcome of patients with a liver, heart, or lung transplant who underwent PD for replacement therapy...
November 21, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29161956/percutaneous-repair-of-mitral-valve-regurgitation-in-patients-with-severe-heart-failure-comparison-with-optimal-medical-treatment
#2
Nicolas Geis, Philip Raake, Markus Lewening, Derliz Mereles, Emmanuel Chorianopoulos, Lutz Frankenstein, Hugo A Katus, Raffi Bekeredjian, Sven T Pleger
BACKGROUND: Occurrence of severe mitral valve (MV) regurgitation (MR) is an independent negative predictor of mortality in patients with severe systolic heart failure (HF). This study examines clinical effects and cardiac reverse remodelling in patients with severe systolic HF receiving percutaneous mitral valve repair (PMVR) using MitraClip in comparison to patients receiving optimal medical therapy only. METHODS: Between 2010 and 2014, 86 patients (Society of Thoracic Surgeons score: 10...
November 21, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29159187/the-role-of-costimulation-blockade-in-solid-organ-and-islet-xenotransplantation
#3
REVIEW
Kannan P Samy, James R Butler, Ping Li, David K C Cooper, Burcin Ekser
Pig-to-human xenotransplantation offers a potential bridge to the growing disparity between patients with end-stage organ failure and graft availability. Early studies attempting to overcome cross-species barriers demonstrated robust humoral immune responses to discordant xenoantigens. Recent advances have led to highly efficient and targeted genomic editing, drastically altering the playing field towards rapid production of less immunogenic porcine tissues and even the discussion of human xenotransplantation trials...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/29156176/management-of-patients-with-left-ventricular-assist-devices-requiring-teeth-extraction-is-halting-anticoagulation-appropriate
#4
Visakha Suresh, Muath Bishawi, Michael W Manning, Chetan Patel, Joseph Rogers, Carmelo Milano, Jacob Schroder, Mani Daneshmand, David Powers
PURPOSE: An increasing number of patients with end-stage heart failure are supported with left ventricular assist device (LVAD) implantation and must be maintained on a consistent anticoagulation regimen. Pre-emptive extraction of carious teeth in these patients is necessary to prevent seeding of the implanted device and endocarditis. Thus, the objective of this study was to evaluate bleeding complications after minor oral surgery, specifically teeth extractions, in this unique patient population requiring long-term anticoagulation...
October 31, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29153994/incident-atrial-fibrillation-and-the-risk-of-congestive-heart-failure-myocardial-infarction-end-stage-kidney-disease-and-mortality-among-patients-with-a-decreased%C3%A2-estimated-gfr
#5
David Massicotte-Azarniouch, John Paul Kuwornu, Juan-Jesus Carrero, Ngan N Lam, Amber O Molnar, Deborah Zimmerman, Megan K McCallum, Amit X Garg, Manish M Sood
BACKGROUND: The association of atrial fibrillation (AF), estimated glomerular filtration rate (eGFR), and adverse events. STUDY DESIGN: Population-based retrospective cohort study from Ontario, Canada. SETTING & PARTICIPANTS: 1,422,978 million adult residents with eGFRs < 90mL/min/1.73m(2) from April 1, 2006, through March 31, 2015. FACTOR: A diagnosis of AF at hospitalization. OUTCOMES: Congestive heart failure (CHF), myocardial infarction (MI), end-stage kidney disease, all-cause mortality...
November 16, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29153214/-psychological-support-for-patients-with-a-ventricular-assist-device
#6
Laurence Le Helias
In the case of end-stage heart failure, the medical-surgical team can suggest the use of an external circulatory assist device as a definitive therapy. Living with this assistance requires a certain amount of adaptation on the part of the patients and their family, but can significantly improve quality of life. Support groups give them the opportunity to talk about their new life and receive psychological support.
November 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29153213/-circulatory-assistance-an-alternative-to-heart-transplantation
#7
Jean-Christian Roussel, Thomas Sénage
Circulatory assistance is developing as a treatment for patients with end-stage heart failure. There are two alternative devices: a univentricular circulatory assist pump, or a total artificial heart. It is used to bridge the time to transplantation and, increasingly, as a definitive alternative to a heart transplant.
November 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29151496/cost-effectiveness-analysis-of-cardiovascular-disease-treatment-in-japan
#8
Satoshi Kodera, Arihiro Kiyosue, Jiro Ando, Hiroshi Akazawa, Hiroyuki Morita, Masafumi Watanabe, Issei Komuro
The quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER) are important concepts in cost-effectiveness analysis, which is becoming increasingly important in Japan. QALY is used to estimate quality of life (QOL) and life years, and can be used to compare the efficacies of cancer and cardiovascular treatments. ICER is defined as the difference in cost between treatments divided by the difference in their effects, with a smaller ICER indicating better cost-effectiveness. Here, we present a review of cost-effectiveness analyses in Japan as well other countries...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29148856/novel-applications-for-serum-procalcitonin-testing-in-clinical-practice
#9
Justin J Choi, Matthew W McCarthy
Procalcitonin has emerged as a reliable marker of acute bacterial infection in hospitalized patients and the assay has recently been incorporated into several clinical algorithms to reduce antimicrobial overuse, but its use in patients with end-organ dysfunction is controversial. Areas covered: In this review, the authors examine what is known about procalcitonin testing in patients with organ dysfunction, including those with end-stage renal disease, congestive heart failure, chronic obstructive pulmonary disease, and cirrhosis, and explore how the assay is now being used in the management of non-infectious diseases...
November 17, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29142986/cardiac-autonomic-neuropathy-predicts-all-cause-and-cardiovascular-mortality-in-patients-with-end-stage-renal-failure-a%C3%A2-5-year-prospective-study
#10
Dimitrios Doulgerakis, Ioannis Moyssakis, Chris J Kapelios, Ioanna Eleftheriadou, Stamatia Chorepsima, Spyridon Michail, Nikolaos Tentolouris
Introduction: Chronic renal disease is associated with increased cardiovascular (CV) mortality. Cardiac autonomic neuropathy (CAN) is predictive of mortality for diseases that affect the autonomic nervous system. We prospectively evaluated the prognostic value of indexes of left ventricular (LV) function and CAN in all-cause and CV mortality of patients with end-stage renal failure (ESRF). Methods: A total of 133 patients with ESRF were recruited. LV function was evaluated by echocardiography, whereas cardiac autonomic function was assessed using the battery of the 4 standardized tests proposed by Ewing...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29131895/association-of-blood-pressure-lowering-with-mortality-and-cardiovascular-disease-across-blood-pressure-levels-a-systematic-review-and-meta-analysis
#11
Mattias Brunström, Bo Carlberg
Importance: High blood pressure (BP) is the most important risk factor for death and cardiovascular disease (CVD) worldwide. The optimal cutoff for treatment of high BP is debated. Objective: To assess the association between BP lowering treatment and death and CVD at different BP levels. Data Sources: Previous systematic reviews were identified from PubMed, the Cochrane Database of Systematic Reviews, and the Database of Abstracts of Reviews of Effect...
November 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29131882/time-course-response-of-the-heart-and-circulatory-system-to-active-postural-changes
#12
Jo P Pauls, Llion Roberts, Tom Burgess, John/F Fraser, Shaun/D Gregory, Geoff Tansley
Rotary blood pumps (RBPs) used for mechanical circulatory support of heart failure patients cannot passively change pump flow sufficiently in response to frequent variations in preload induced by active postural changes. A physiological control system that mimics the response of the healthy heart is needed to adjust pump flow according to patient demand. Thus, baseline data is required on how the healthy heart (i.e. heart rate (HR) and cardiac output (CO)) and circulatory system (i.e. systemic vascular resistance (SVR)) respond...
November 13, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29129575/cardiovascular-events-and-target-organ-damage-in-primary-aldosteronism-compared-with-essential-hypertension-a-systematic-review-and-meta-analysis
#13
Silvia Monticone, Fabrizio D'Ascenzo, Claudio Moretti, Tracy Ann Williams, Franco Veglio, Fiorenzo Gaita, Paolo Mulatero
BACKGROUND: There is conflicting evidence, relying on heterogeneous studies, as to whether aldosterone excess is responsible for an increased risk of cardiovascular and cerebrovascular complications in patients with primary aldosteronism. We aimed to assess the association between primary aldosteronism and adverse cardiac and cerebrovascular events, target organ damage, diabetes, and metabolic syndrome, compared with the association of essential hypertension and these cardiovascular and end organ events, by integrating results of previous studies...
November 9, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29123005/percutaneous-ablation-for-hepatocellular-carcinoma-and-peritoneal-dialysis
#14
Annabel Boyer, Marc-Antoine Jegonday, Antoine Lanot, Maxence Ficheux, Thierry Lobbedez, Clémence Bechade
Hepatocellular carcinoma (HCC) is the second leading cause of death by cancer worldwide. Resection and liver transplantation are the gold standards, but only a minority of people are eligible. Percutaneous ablation therapies, such as microwave ablation (MWA), have consequently been developed. There is a lack of guidelines regarding the treatment of HCCs in end-stage renal disease (ESRD) patients. Here, we report the case of a 67-year-old patient who was undergoing peritoneal dialysis (PD) for chronic congestive heart failure and who presented with an HCC while undergoing PD...
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29122578/a-carvedilol-responsive-microrna-mir-125b-5p-protects-the-heart-from-acute-myocardial-infarction-by-repressing-pro-apoptotic-bak1-and-klf13-in-cardiomyocytes
#15
Ahmed S Bayoumi, Kyoung-Mi Park, Yongchao Wang, Jian-Peng Teoh, Tatsuya Aonuma, Yaoliang Tang, Huabo Su, Neal L Weintraub, Il-Man Kim
BACKGROUND: Cardiac injury is accompanied by dynamic changes in the expression of microRNAs (miRs), small non-coding RNAs that post-transcriptionally regulate target genes. MiR-125b-5p is downregulated in patients with end-stage dilated and ischemic cardiomyopathy, and has been proposed as a biomarker of heart failure. We previously reported that the β-blocker carvedilol promotes cardioprotection via β-arrestin-biased agonism of β1-adrenergic receptor while stimulating miR-125b-5p processing in the mouse heart...
November 7, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/29119801/serum-levels-of-growth-arrest-specific-6-protein-and-soluble-axl-in-patients-with-st-segment-elevation-myocardial-infarction
#16
Guillem Caldentey, Pablo García De Frutos, Helena Cristóbal, Manel Garabito, Antonio Berruezo, Xavier Bosch, Rodolfo San Antonio, Eduardo Flores-Umanzor, Rosario J Perea, Teresa M De Caralt, Jany Rodríguez, José T Ortiz-Pérez
BACKGROUND: Serum soluble AXL (sAXL) and its ligand, Growth Arrest-Specific 6 protein (GAS6), intervene in tissue repair processes. AXL is increased in end-stage heart failure, but the role of GAS6 and sAXL in ST-segment elevation myocardial infarction (STEMI) is unknown. OBJECTIVES: To study the association of sAXL and GAS6 acutely and six months following STEMI with heart failure and left ventricular remodelling. METHODS: GAS6 and sAXL were measured by enzyme-linked immunosorbent assay at one day, seven days and six months in 227 STEMI patients and 20 controls...
November 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29112104/cardiogenic-shock-due-to-end-stage-heart-failure-and-acute-myocardial-infarction-characteristics-and-outcome-of-temporary-mechanical-circulatory-support
#17
Hoong Sern Lim, Neil Howell
BACKGROUND: Mechanical circulatory support (MCS) is increasingly used in cardiogenic shock, but outcomes may differ between patients with acute myocardial infarction (AMI) or end-stage heart failure (ESHF). This study aimed to describe the characteristics of patients with cardiogenic shock due to AMI and ESHF. METHODS: Single centre study of consecutive patients with cardiogenic shock due to AMI (n = 26) and ESHF (n = 42) who underwent MCS (extracorporeal life support, Impella or temporary ventricular assist devices)...
November 3, 2017: Shock
https://www.readbyqxmd.com/read/29110792/anesthetic-management-of-the-patient-undergoing-heart-transplantation
#18
REVIEW
Liem Nguyen, Dalia A Banks
Cardiac transplantation is the treatment of choice for patients with end-stage heart failure. Over the years, significant advances in patient selection, donor optimization and selection, and optimization of immunosuppression strategies have markedly improved outcomes. In this review, we highlight patient selection, donor management and procurement, heart transplantation procedure, and intraoperative and postoperative management of heart transplants.
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29110791/preanesthetic-evaluation-of-the-patient-with-end-stage-heart-failure
#19
REVIEW
Michele Sumler, Ratna Vadlamudi
Heart failure (HF) currently affects more than 5 million patients in the United States [1]. Advanced HF is associated with high mortality and poor quality of life. It is estimated that between 5% and 10% of all patients with HF have an advanced form of the disease [1]. Orthotopic heart transplantation (OHT) is an accepted therapy for stage D HF [3] (Fig. 1). Unfortunately, the number of patients with the disease exceeds the number of available organs. This makes appropriate patient selection vital in the field of heart transplantation...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29110789/long-term-management-of-end-stage-heart-failure
#20
REVIEW
Marlena V Habal, A Reshad Garan
End-stage heart failure manifests as severe and often relentless symptoms that define the clinical syndrome of heart failure, namely congestion and hypoperfusion. These patients suffer from dyspnea, fatigue, abdominal discomfort, and ultimately cardiac cachexia. Renal and hepatic dysfunction frequently further complicates the process. Recurrent hospitalizations, cardiac arrhythmias, and intolerance to standard heart failure therapies are common as the disease progresses. Management focuses on controlling symptoms, correcting precipitants, avoiding triggers, and maximizing therapies with demonstrable survival benefit...
June 2017: Best Practice & Research. Clinical Anaesthesiology
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