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https://www.readbyqxmd.com/read/29933071/autologous-stem-cell-transplant-for-al-amyloidosis-patients-aged-70-to-75
#1
M Hasib Sidiqi, Mohammed A Aljama, Eli Muchtar, Francis K Buadi, Rahma Warsame, Martha Q Lacy, Angela Dispenzieri, David Dingli, Nelson Leung, Wilson I Gonsalves, Prashant Kapoor, Taxiarchis V Kourelis, William J Hogan, Shaji K Kumar, Morie A Gertz
Autologous stem cell transplantation has been used in treatment for AL amyloidosis for over two decades and generally reserved for patients younger than 70 years of age. Herein we report on outcomes of ASCT in a cohort of patients with AL amyloidosis aged 70 years or older. Between August of 2002 and April of 2017, 34 patients aged 70 years or older, with biopsy proven AL amyloidosis, received an autologous stem cell transplant at the Mayo Clinic Rochester. 70% (n=24) of patients were transplanted within 6 months of diagnosis and 74% (n=25) received reduced intensity conditioning with melphalan <200mg/m2...
June 19, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29931573/optimizing-target-control-of-the-vessel-rich-group-with-volatile-anesthetics
#2
Christopher W Connor
The ability to monitor the inspired and expired concentrations of volatile anesthetic gases in real time makes these drugs implicitly targetable. However, the end-tidal concentration only represents the concentration within the brain and the vessel rich group (VRG) at steady state, and very poorly approximates the VRG concentration during common dynamic situations such as initial uptake and emergence. How should the vaporization of anesthetic gases be controlled in order to optimally target VRG concentration in clinical practice? Using a generally accepted pharmacokinetic model of uptake and redistribution, a transfer function from the vaporizer setting to the VRG is established and transformed to the time domain...
June 21, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29931543/arrhythmia-care-in-africa
#3
Demilade Adedinsewo, Oluwatosin Omole, Oludamilola Oluleye, Itse Ajuyah, Fred Kusumoto
Data on cardiovascular disease, including arrhythmias, in Africa is limited. However, the burden of cardiovascular disease appears to be on the rise. Recent global data suggests an increase in atrial fibrillation rates despite declining rates of rheumatic heart disease. Atrial fibrillation is also associated with increased mortality in Africa. Current management with medical therapy is sub-optimal and ablation procedures, inaccessible. Atrial fibrillation is also an independent risk factor for death in patients with rheumatic heart disease...
June 22, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29931487/update-on-incorporating-biomarkers-with-imaging-findings-for-the-detection-and-management-of-cardiotoxicity
#4
REVIEW
Neha Quatromoni, Marielle Scherrer-Crosbie
PURPOSE OF REVIEW: Modern cancer therapy comes at a cost of increased risk of cardiotoxicity. The purpose of our paper is to provide an updated review highlighting research incorporating biomarkers and imaging findings for the detection of subclinical cardiac dysfunction and management of cancer treatment-related cardiotoxicity. RECENT FINDINGS: Biomarkers, particularly troponin, NTproBNP, and myeloperoxidase, have been shown to have a predictive role in the development of cancer treatment-related cardiotoxicity...
June 22, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29930951/ecg-based-reconstruction-of-heart-position-and-orientation-with-bayesian-optimization
#5
Jaume Coll-Font, Setareh Ariafar, Dana H Brooks
Respiratory motion is known to cause beat-to-beat variation of the ECG. This observation suggests that it may be possible to use this variation to track position and orientation of the heart. Electrocardiographic Imaging (ECGI) would benefit from such a reconstruction since one contribution to errors in its solutions is respiratory motion of the heart. ECGI solutions generally rely on prior computation of a "forward" model that relates cardiac electrical activity to ECGs. However, the ill-posed nature of the inverse solution leads to large errors in ECGI even for small amounts of error in the forward model...
September 2017: Computing in Cardiology
https://www.readbyqxmd.com/read/29930689/unity-in-diversity-a-survey-of-muscular-systems-of-ctenostome-gymnolaemata-lophotrochozoa-bryozoa
#6
Thomas F Schwaha, Andreas Wanninger
Background: Myoanatomical studies of adult bryozoans employing fluorescent staining and confocal laser scanning microscopy (CLSM) have been chiefly conducted on freshwater bryozoans. The diversity of muscular systems in the marine bryozoans is currently not well known with only two species being studied in more detail. The aim of this study is to unravel the diversity of muscle systems of 15 ctenostome bryozoans by phalloidin-coupled fluorescence stainings combined with CLSM. Results: In general, the myoanatomy of the selected ctenostomes shows significant similarities and consists of 1) muscles associated with the body wall, 2) apertural muscles, 3) lophophoral muscles, 4) tentacle sheath muscles, 5) digestive tract muscles and 6) the prominent retractor muscles...
2018: Frontiers in Zoology
https://www.readbyqxmd.com/read/29930186/acute-renal-artery-embolisation-role-of-local-catheter-based-intra-arterial-thrombolysis
#7
Neeraj Ganju, Sachin Sondhi, Arvind Kandoria
A 45-year-old man without previous comorbidity presented to us with acute onset right-sided flank pain for last 14 hours. His general physical and systemic examination was unremarkable, and there were no clinical signs of peritonitis. The ultrasonography did not reveal any evidence of nephrolithiasis or hydronephrosis. His contrast-enhanced CT scan revealed hypoattenuated areas of right kidney and evidence of right renal artery thrombosis. He was immediately shifted to cardiac catheterisation lab, and his renal angiography showed thrombotic occlusion of right renal artery...
June 21, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29929976/metabolic-coordination-of-physiological-and-pathological-cardiac-remodeling
#8
REVIEW
Andrew A Gibb, Bradford G Hill
Metabolic pathways integrate to support tissue homeostasis and to prompt changes in cell phenotype. In particular, the heart consumes relatively large amounts of substrate not only to regenerate ATP for contraction but also to sustain biosynthetic reactions for replacement of cellular building blocks. Metabolic pathways also control intracellular redox state, and metabolic intermediates and end products provide signals that prompt changes in enzymatic activity and gene expression. Mounting evidence suggests that the changes in cardiac metabolism that occur during development, exercise, and pregnancy as well as with pathological stress (eg, myocardial infarction, pressure overload) are causative in cardiac remodeling...
June 22, 2018: Circulation Research
https://www.readbyqxmd.com/read/29929612/angioscopic-evaluation-of-spontaneously-ruptured-aortic-plaques
#9
Sei Komatsu, Chikao Yutani, Tomoki Ohara, Satoru Takahashi, Mitsuhiko Takewa, Atsushi Hirayama, Kazuhisa Kodama
BACKGROUND: Spontaneous ruptured aortic plaques (SRAP), which might cause atheromatous embolization, are thought to be mainly iatrogenic and have not been observed directly. OBJECTIVES: The purpose of this study was to clarify the incidence, types, and dimensions of SRAP using angioscopy. METHODS: In a cross-sectional study, 324 consecutive patients diagnosed with or suspected of having coronary artery disease were subjected to intra-aortic scans with nonobstructive angioscopy...
June 26, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29928647/loss-of-metabolic-flexibility-in-the-failing-heart
#10
REVIEW
Qutuba G Karwi, Golam M Uddin, Kim L Ho, Gary D Lopaschuk
To maintain its high energy demand the heart is equipped with a highly complex and efficient enzymatic machinery that orchestrates ATP production using multiple energy substrates, namely fatty acids, carbohydrates (glucose and lactate), ketones and amino acids. The contribution of these individual substrates to ATP production can dramatically change, depending on such variables as substrate availability, hormonal status and energy demand. This "metabolic flexibility" is a remarkable virtue of the heart, which allows utilization of different energy substrates at different rates to maintain contractile function...
2018: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29926565/-update-on-myocarditis
#11
M Moonen, P Lancellotti
Myocarditis is an illness characterized by myocardial infiltration with inflammatory cells and non-ischemic myocytic necrosis. The clinical presentation of myocarditis varies widely and diagnosis is sometimes difficult to establish. The current incidence of myocarditis is also difficult to determine as endomyocardial biopsy, the diagnostic gold standard, is unfrequently used, or even not justified. The leading causes are infections, immune-mediated injury and toxins. Prognosis is most often good but, in some patients, the disease can be fulminant with progression to cardiogenic shock, or occurrence of sudden cardiac death...
May 2018: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29923941/intensive-care-mortality-prognostic-model-for-pediatric-pulmonary-hypertension
#12
Emily Morell Balkin, Matt S Zinter, Satish K Rajagopal, Roberta L Keller, Jeffrey R Fineman, Martina A Steurer
OBJECTIVES: The disease burden and mortality of children with pulmonary hypertension are significantly higher than for the general PICU population. We aimed to develop a risk-adjustment tool predicting PICU mortality for pediatric pulmonary hypertension patients: the Pediatric Index of Pulmonary Hypertension Intensive Care Mortality score. DESIGN: Retrospective analysis of prospectively collected multicenter pediatric critical care data. SETTING: One-hundred forty-three centers submitting data to Virtual Pediatric Systems database between January 1, 2009, and December 31, 2015...
June 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29923132/pregnancy-among-survivors-of-childhood-cancer-cardiovascular-considerations
#13
REVIEW
Michael C Honigberg, Amy A Sarma
PURPOSE OF REVIEW: To educate clinicians on cardiovascular considerations and management strategies surrounding pregnancy in childhood cancer survivors. RECENT FINDINGS: With advances in oncologic treatment, growing numbers of childhood cancer survivors are now able to consider pregnancy. A significant proportion of survivors have received cardiotoxic therapy, particularly anthracyclines, and/or chest radiation. Cardiomyopathy is the most common cardiac complication of cancer-directed therapy; pericardial disease, valvular disease, premature coronary artery disease, and conduction abnormalities are other potential sequelae...
June 19, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29923127/pregnancy-associated-myocardial-infarction
#14
REVIEW
Michael C Honigberg, Nandita S Scott
PURPOSE OF REVIEW: To educate clinicians about the epidemiology, etiologies, diagnosis, and management of pregnancy-associated myocardial infarction (PAMI). RECENT FINDINGS: The risk of myocardial infarction is increased more than threefold around the time of pregnancy. In the recent series, PAMI is most commonly caused by spontaneous coronary artery dissection, followed by atherosclerosis. Percutaneous coronary intervention or coronary artery bypass grafting may be required, but conservative management with medical therapy is generally advised when possible, particularly in cases of coronary dissection...
June 19, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29922963/endocrine-treatment-of-aging-transgender-people
#15
REVIEW
Louis J Gooren, Guy T'Sjoen
High quality empirical data assessing morbidity and mortality and cancer incidence among transgender people are almost non-existent. Sex hormone treatment of conditions in older non-transgender people might as yet be taken as the best available analogy to hormone administration to aging transgender persons. Testosterone administration to transgender men carries little risk with regard to cardiovascular disease and cancer. A dose adaptation may be needed in men with a high hematocrit or cardiac insufficiency...
June 19, 2018: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/29922047/relationship-between-high-sensitivity-cardiac-troponin-t-and-the-prognosis-of-elderly-inpatients-with-non-acute-coronary-syndromes
#16
Wei Wu, Dong-Xia Li, Qing Wang, Ying Xu, Yun-Jing Cui
Objective: Low-level high-sensitivity cardiac troponin T (hs-cTnT) increases in elderly population. In this study, the relationship between hs-cTnT level and all-cause death of elderly inpatients with non-acute coronary syndrome (non-ACS) after discharge from the hospital was investigated. Materials and methods: Non-ACS patients aged >65 years admitted in the General Practice Wards and Department of Geriatrics of Fuxing Hospital Affiliated to Capital Medical University were enrolled in the study...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29921685/stepped-wedge-cluster-randomised-controlled-trial-to-assess-the-effectiveness-of-an-optimisation-strategy-for-general-anaesthesia-on-postoperative-morbidity-and-mortality-in-elderly-patients-the-opti-aged-study-a-study-protocol
#17
Serge Molliex, Sylvie Passot, Emmanuel Futier, Marlène Bonnefoi, Florence Rancon, Yannick Lemanach, Bruno Pereira
INTRODUCTION: Elderly patients constitute an increasingly large proportion of the high-risk surgical group. In adult patients, several specific intraoperative approaches such as cardiac output-guided haemodynamic therapy, depth of anaesthesia monitoring (DAM) or lung-protective ventilation (LPV) are designed to reduce postoperative mortality and surgical complications. However, none of these approaches has been specifically performed in the elderly, and no evaluation of a multimodal optimisation strategy for general anaesthesia has been achieved in this population...
June 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29921358/in-flight-management-of-a-supraventricular-tachycardia-using-telemedicine
#18
Jessica J Voerman, Mary E Hoffe, Sam Surka, Paulo M Alves
BACKGROUND: Supraventricular tachycardia (SVT) is a common presenting arrhythmia in the general population. Cases of SVT presenting during commercial air travel are always challenging as they might be confused with other conditions requiring different treatment strategies. We present a case of an in-flight SVT that was successfully managed using telemedicine support. CASE REPORT: A 33-yr-old woman developed chest pain and dizziness while on an international commercial flight...
July 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29916842/understanding-survivors-needs-and-outcomes-the-role-of-routinely-collected-data
#19
Liya Lu, Jennifer Deane, Linda Sharp
PURPOSE OF REVIEW: The number of cancer survivors is growing due to population ageing, earlier detection and more effective therapies. Routinely collected data (RCD), generally cancer registry data, has been used to investigate survivors' needs and outcomes. We reviewed uses of RCD since 2017, identifying novel findings and research directions. RECENT FINDINGS: Survival is improving internationally but continues to vary between subgroups. Longitudinal survivor surveys suggest malignancy-specific temporal patterns in unmet needs and health-related quality-of-life (HRQoL)...
June 18, 2018: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29915955/population-pharmacokinetic-modeling-of-remifentanil-in-infants-with-unrepaired-tetralogy-of-fallot
#20
Jing Chang, Yang Shen, Yue Huang, Ying Sun, Mei-Hua Cai, Jing Niu, Li-Ming Zhang, Ji-Jian Zheng, Ma-Zhong Zhang
BACKGROUND: Although there is literature suggesting that pathophysiologic changes in children with congenital heart disease alter the pharmacokinetics of anesthetics and may result in dosage adjustment, limited information exists regarding the pharmacokinetics of remifentanil in infants with unrepaired tetralogy of Fallot (TOF). The objectives of the current analysis were to characterize the population pharmacokinetics of remifentanil in infants, and to evaluate the effects of TOF on remifentanil's pharmacokinetics...
June 19, 2018: European Journal of Drug Metabolism and Pharmacokinetics
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