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heart period delay

Rachel Levene, Elza Pollak-Christian, Ashish Garg, Michael Keenaghan
Coarctation of the aorta (CoA) is a congenital cardiac malformation that is well understood. Despite being well characterized, CoA is a commonly missed congenital heart disease (CHD) during the newborn period. We report a full-term nine-day-old male who presented to the pediatric emergency department (ED) with isolated tachypnea. After an initial sepsis workup, subsequent investigations revealed critical CoA. Because the primary workup focused on sepsis, there was a significant delay in prostaglandin E1 (PGE1 ) initiation...
2018: Case Reports in Pediatrics
Yuanli Lei, Ming-Hua Zheng, Weijian Huang, Jie Zhang, Yingru Lu
RATIONALE: Circulatory failure, especially with low systemic vascular resistance (SVR), as observed in septic shock, thyrotoxicosis, and anemia, is a particular pattern that should suggest thiamine (vitamin B1) deficiency. The clinical picture of wet beriberi secondary to thiamine deficiency only demonstrates non-specific clinical manifestations. For a diagnosis of wet beriberi, medical history is very important. Interestingly, imprisonment was also found to be related to thiamine deficiency...
March 2018: Medicine (Baltimore)
S R Shunmugam, Conn Sugihara, Nick Freemantle, Patrick Round, Steve Furniss, Neil Sulke
PURPOSE: The ultrarapid delayed rectifier current (IKur ) carried by Kv1.5 channels, which are solely expressed in the atrium, is a potential target for safer treatment of paroxysmal atrial fibrillation (PAF). XEN-D0103 is a nanomolar ion channel blocker that selectively inhibits potassium ion flux through the Kv1.5 ion channel. The efficacy of XEN-D0103 in reducing AF burden was assessed in patients with DDDRp permanent pacemakers (PPMs) and PAF. METHODS: A double-blind, placebo-controlled, cross-over study was performed in patients with PAF and DDDRp PPMs with advanced atrial and ventricular Holters allowing beat-to-beat arrhythmia follow-up...
February 19, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Scott Michael, Ollie Jay, Kenneth S Graham, Glen M Davis
OBJECTIVES: This study investigated indirect measures of post-exercise parasympathetic reactivation (using heart-rate-variability, HRV) and sympathetic withdrawal (using systolic-time-intervals, STI) following upper- and lower-body exercise. DESIGN: Randomized, counter-balanced, crossover. METHODS: 13 males (age 26.4±4.7years) performed maximal arm-cranking (MAX-ARM) and leg-cycling (MAX-LEG). Subsequently, participants undertook separate 8-min bouts of submaximal HR-matched exercise of each mode (ARM and LEG)...
February 12, 2018: Journal of Science and Medicine in Sport
K Terziyski, A Draganova
Characterized by periodic crescendo-decrescendo pattern of breathing alternating with central apneas, Central sleep apnea (CSA) with Cheyne-Stokes Breathing represents a highly prevalent, yet underdiagnosed comorbidity in chronic heart failure (CHF). A diverse body of evidence demonstrates increased morbidity and mortality in the presence of CSB. CSB has been described in both CHF patients with preserved and reduced ejection fraction, regardless of drug treatment. Risk factors for CSB are older age, male gender, high BMI, atrial fibrillation and hypocapnia...
February 7, 2018: Advances in Experimental Medicine and Biology
Jacinta Waack, Matthew Shepherd, Emily Andrew, Stephen Bernard, Karen Smith
OBJECTIVE: Delayed sequence intubation (DSI) involves the administration of ketamine to facilitate adequate preoxygenation in the agitated patient. DSI was introduced into the Clinical Practice Guideline for Intensive Care Flight Paramedics in Victoria in late 2013. We aimed to describe the clinical characteristics of patients receiving DSI. METHODS: A retrospective analysis was undertaken of patients who received DSI between January 1, 2014, and December 31, 2016, during both primary response and retrieval missions...
February 6, 2018: Prehospital Emergency Care
Ningke Wang, Yangwen Ou, Wenxiang Qing
This study investigated the effects of acupuncture combined with general anesthesia on postoperative immune and cognitive functions in elderly patients undergoing subtotal gastrectomy. We recruited 96 elderly patients who received anesthesia for subtotal gastrectomy and randomly divided them into control (n=48) and experimental (n=48) groups. The control group received general anesthesia and the experimental group received combined acupuncture and general anesthesia. We measured hemodynamic immediately before and after anesthesia induction, and immune observations before and after surgery...
January 2018: Oncology Letters
Rob C I Wüst, Ger J M Stienen
The rate of oxidative phosphorylation depends on the contractile activity of the heart. Cardiac mitochondrial oxidative phosphorylation is determined by free ADP concentration, mitochondrial Ca2+ accumulation, mitochondrial enzyme activities and Krebs cycle intermediates. The purpose of the present study was to examine the factors that limit oxidative phosphorylation upon rapid changes in contractile activity in cardiac muscle. We tested the hypotheses that prior contractile performance enhances the changes in NAD(P)H and FAD concentration upon an increase in contractile activity, and that this mitochondrial "priming" depends on pyruvate dehydrogenase activity...
January 11, 2018: Journal of Applied Physiology
Philip J Aston, Mark I Christie, Ying H Huang, Manasi Nandi
Advances in monitoring technology allow blood pressure waveforms to be collected at sampling frequencies of 250-1000Hz for long time periods. However, much of the raw data are under analysed. Heart rate variability (HRV) methods, in which beat-to-beat interval lengths are extracted and analysed, have been extensively studied, However, this approach discards the majority of the raw data. OBJECTIVE: Our aim is to detect changes in the shape of the waveform in long streams of blood pressure data...
January 19, 2018: Physiological Measurement
Susan Ross, Melissa Cheung, Ching-In Lau, Neil Sebire, Michael Burch, Peter Kilbride, Barry Fuller, G John Morris, E Graham Davies, Tessa Crompton
Here we show that slices of human thymus tissue that have been frozen and thawed can induce and support T-cell development when transplanted into nude mice. Babies born without a thymus require urgent treatment to reconstitute T-cell immunity. Thymus tissue is removed from infants during cardiac surgery, to allow access to the heart. This discarded thymus tissue can be transplanted into athymic infants to reconstitute T-cell immunity. Slices of thymus tissue are transplanted into the thigh, after a two-three week culture period to deplete thymocytes...
January 10, 2018: European Journal of Immunology
Chaitanya Panchangam, Eric Dean Merrill, Geetha Raghuveer
Atherosclerotic cardiovascular disease is a leading cause of death and disability worldwide, and the atherosclerotic process begins in childhood. Prevention or containment of risk factors that accelerate atherosclerosis can delay the development of atherosclerotic cardiovascular disease. Although current recommendations are to periodically screen for commonly prevailing risk factors for atherosclerosis in children, a single test that could quantify the cumulative effect of all risk factors on the vasculature, thus assessing arterial health, would be helpful in further stratifying risk...
March 2018: Cardiology in the Young
Amit Pawale, Yosef Schwartz, Shinobu Itagaki, Sean Pinney, David H Adams, Anelechi C Anyanwu
OBJECTIVE: Surgical therapy for refractory primary cardiogenic shock is largely based on emergent placement of extracorporeal membrane oxygenation or short-term ventricular assist devices. We have adopted a strategy of routine implantation of durable left ventricular assist devices (LVAD) as initial therapy for refractory cardiogenic shock, in patients who are potential candidates for heart transplantation, and report our experience. METHODS: Retrospective review of 43 consecutive patients with refractory shock caused by acute myocardial infarction (n = 21) or acute decompensated heart failure (n = 22) who were treated with primary implantation of a durable LVAD in a single institution...
March 2018: Journal of Thoracic and Cardiovascular Surgery
Mircea Cătălin ForŢofoiu, Dragoş Marian Popescu, Vlad Pădureanu, Aurelian Constantin Dobrinescu, Adrian Gabriel Dobrinescu, Adrian Mită, Maria Camelia Foarfă, Violeta Serenada Bălă, Anca Emanuela Muşetescu, Nina Ionovici, Maria ForŢofoiu
Ascites is the most frequent complication of cirrhosis and occurs only when the portal hypertension has already installed but ascites is caused by neoplasms, heart failure, tuberculosis, pancreatic illnesses, as well as other kind of affections. We describe the case of a 67-year-old patient, a retired person, without significant personal or familial history, nonsmoker, infrequent alcohol and coffee consumer with following chief complaints at onset: loss of appetite, weight loss, serious physical asthenia, delayed intestinal transit, diffuse abdominal pain and increase of abdominal circumference...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Zengbing Lu, Man P Ngan, Ge Lin, David T W Yew, Xiaodan Fan, Paul L R Andrews, John A Rudd
Preclinical studies show that the glucagon-like peptide-1 (GLP-1) receptor antagonist, exendin (9-39), can reduce acute emesis induced by cisplatin. In the present study, we investigate the effect of exendin (9-39) (100 nmol/24 h, i.c.v), on cisplatin (5 mg/kg, i.p.)-induced acute and delayed emesis and changes indicative of 'nausea' in ferrets. Cisplatin induced 37.2 ± 2.3 and 59.0 ± 7.7 retches + vomits during the 0-24 (acute) and 24-72 h (delayed) periods, respectively. Cisplatin also increased ( P <0...
November 17, 2017: Oncotarget
Hao Su, Hongzhi Liu, Kang Sun, Xin Wang
PURPOSE: Old shoulder dislocations are usually treated by a variety of surgical approaches. Closed reduction of chronic unreduced dislocation is less widely reported. This study was to evaluate the outcome of reduction of old anterior shoulder dislocations using the Hippocratic method. METHODS: Between January 2008 and July 2016, patients with unilateral old shoulder dislocations included 10 women and three men with an average age of 60.00 ± 2.83 years. Eight dislocations involved the right shoulder and five the left shoulder...
January 2018: Der Orthopäde
Barry L Friedberg
Friedberg's Triad is (1) measure the brain; (2) preempt the pain; (3) emetic drugs abstain. Persistent anesthesia problems include over- and under-medication, postoperative pain management, and postoperative nausea and vomiting. Inspired by Vinnik's diazepam-ketamine paradigm, Friedberg's propofol ketamine paradigm was first published in 1993. The 1997 addition of the bispectral (BIS) index brain monitor made the propofol ketamine paradigm numerically reproducible. The 1998 addition of the frontalis electromyogram (EMG) as a secondary trend to the BIS transformed the time-delayed BIS monitor into a real-time, extremely useful device...
October 2017: Plastic and Reconstructive Surgery. Global Open
Jordi Pérez-Rodon, Enrique Galve, Carmen Pérez-Bocanegra, Teresa Soriano-Sánchez, Jesús Recio-Iglesias, Eva Domingo-Baldrich, Mila Alzola-Guevara, Ignacio Ferreira-González, Josep Ramon Marsal, Aida Ribera-Solé, Laura Gutierrez García-Moreno, Luz María Cruz-Carlos, Nuria Rivas-Gandara, Ivo Roca-Luque, Jaume Francisco-Pascual, Artur Evangelista-Masip, Àngel Moya-Mitjans, David García-Dorado
BACKGROUND: A prophylactic implantable cardioverter defibrillator (ICD) in patients with heart failure and reduced left ventricular ejection fraction (HFrEF) is only indicated when left ventricular ejection fraction (LVEF) reassessment remains ≤35% after 3-6 months on optimal pharmacological therapy. However, LVEF may not improve during this period and the patient may be exposed to an unnecessary risk of sudden cardiac death. This study aimed to determine the incidence and predictors of the absence of left ventricular reverse remodeling (LVRR) after pharmacological treatment optimization in patients with HFrEF to design a risk score of absence of LVRR...
November 25, 2017: Journal of Cardiology
M Umar Qureshi, Mitchel J Colebank, David A Schreier, Diana M Tabima, Mansoor A Haider, Naomi C Chesler, Mette S Olufsen
OBJECTIVE: Characteristic impedance (Zc) is an important component in the theory of hemodynamics. It is a commonly used metric of proximal arterial stiffness and pulse wave velocity. Calculated using simultaneously measured dynamic pressure and flow data, estimates of characteristic impedance can be obtained using methods based on frequency or time domain analysis. Applications of these methods under different physiological and pathological conditions in species with different body sizes and heart rates show that the two approaches do not always agree...
January 31, 2018: Physiological Measurement
Masato Furui, Takeshi Yoshida, Bunpachi Kakii, Gaku Uchino, Hiroaki Nishioka
BACKGROUND: The timing of surgical repair for ventricular septal perforation (VSP) is important because patients are susceptible to bleeding from fragile myocardial tissue or residual shunt during the acute phase of acute myocardial infarction (AMI). This study aimed to assess the results of delayed surgery for VSP performed 2 weeks after AMI. METHODS: In total, 24 consecutive postinfarction patients with VSP (mean age: 72.6±10.4 years; 13 males) underwent operation between May 2003 and June 2016...
November 22, 2017: Journal of Cardiology
M Rossignol, E Morau, M Dreyfus
Pregnancy and postpartum are very high-risk periods for venous thromboembolism events (TEE), which seems to extend far beyond the classical 6-8 weeks after childbirth. Pulmonary embolism (PE) is one of the 3 main causes of direct maternal death in western countries. Between 2010 an 2012 in France, 24 deaths were related to PE giving a maternal mortality ratio of 1/100,000, which is not different from the former report (2007-2009). PE is responsible of 9% of maternal deaths, in equal position with postpartum hemorrhage and amniotic fluid embolism...
December 2017: Gynecologie, Obstetrique, Fertilite & Senologie
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