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https://www.readbyqxmd.com/read/28820798/how-to-better-identify-patients-at-high-risk-of-postoperative-complications
#1
Daniel Talmor, Barry Kelly
PURPOSE OF REVIEW: Preoperative risk assessment and perioperative factors may help identify patients at increased risk of postoperative complications and allow postoperative management strategies that improve patient outcomes. This review summarizes historical and more recent scoring systems for predicting patients with increased morbidity and mortality in the postoperative period. RECENT FINDINGS: Most prediction scores predict postoperative mortality with, at best, moderate accuracy...
August 17, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28820653/fibrous-skeleton-of-the-heart-anatomic-overview-and-evaluation-of-pathologic-conditions-with-ct-and-mr-imaging
#2
Farhood Saremi, Damián Sánchez-Quintana, Shumpei Mori, Horia Muresian, Diane E Spicer, Cameron Hassani, Robert H Anderson
The fibrous skeleton is concentrated at the base of the ventricular mass. It provides electrical insulation at the atrioventricular level and fibrous continuity for the leaflets of the mitral, aortic, and tricuspid valves. Its components include the fibrous trigones, the fibrous area of aortic-mitral continuity, the subvalvar collar of the mitral valve, the membranous septum, the interleaflet triangles, the tendon of Todaro, and likely the conus ligament. The majority of the mitral annulus is fibrous, but the only true fibrous part of the tricuspid annulus is where the valvar leaflets are attached to the central fibrous body...
August 18, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28820609/cardio-pulmonary-interactions-physiologic-basis-and-clinical-applications
#3
Michael R Pinsky
The hemodynamic effects of ventilation can be grouped into three concepts: 1) spontaneous ventilation is exercise; 2) changes in lung volume alter autonomic tone, pulmonary vascular resistance, and can compress the heart in the cardiac fossa; 3) spontaneous inspiratory efforts decrease intrathoracic pressure (ITP) increasing venous return and impeding left ventricular (LV) ejection; whereas positive pressure ventilation decreases venous return and unloads LV ejection. Spontaneous inspiratory efforts may induce acute LV failure and cardiogenic pulmonary edema...
August 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28820549/qishenyiqi-dripping-pill-improves-heart-failure-by-up-regulation-of-%C3%AE-2-adrenergic-receptor-expression
#4
Junfeng Sun, Hua Qian, Xiaoguang Li, Xianling Tang
BACKGROUND: QishenYiqi Dripping Pill (QYDP) is a Chinese herbal medicine that originally was used for the treatment of coronary artery disease. Recently, QYDP was used as a complementary treatment for heart failure (HF) in China. METHODS: An HF rat model was used to clarify the possible therapeutic effects of QYDP on HF. The HF rats were allocated to two groups, HF and HF+QYDP, while normal rats served as a negative control. Cardiac functions were evaluated echocardiographically and hemodynamically...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820296/long-term-hemodynamic-changes-and-blood-pressure-in-atherosclerotic-major-cerebral-artery-disease
#5
Hiroshi Yamauchi, Shinya Kagawa, Masaaki Takahashi, Tatsuya Higashi
In patients with major cerebral artery disease, lower blood pressure might reduce blood flow in the collateral pathways, thereby impairing the growth of cerebral collaterals, inhibiting hemodynamic improvement. We evaluated the hemodynamic status twice using positron emission tomography and (15)O-gas, over time, in 89 medically treated patients with atherosclerotic internal carotid artery or middle cerebral artery disease that had no ischemic episodes during follow-up (mean, 28 ± 23 months). Changes in the mean hemispheric values of hemodynamic parameters in the territory of the diseased artery at follow-up were correlated with the mean blood pressure values at the baseline and follow-up examinations...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28819713/plasma-growth-differentiation-factor-15-is-a-potential-biomarker-for-pediatric-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease
#6
Gang Li, Yan Li, Xiao-Qiu Tan, Peng Jia, Jian Zhao, Dong Liu, Ting Wang, Bin Liu
We aimed to investigate plasma growth differentiation factor-15 (GDF-15) levels in pediatric pulmonary arterial hypertension secondary to congenital heart disease (PAH-CHD), and assess the association with hemodynamic parameters. Plasma GDF-15 levels were measured in children with PAH-CHD (n = 46) and compared to children with CHD without PAH (n = 39). Normal individuals (n = 30) served as health control group. Plasma GDF-15 levels were significantly elevated in patients with PAH-CHD compared with those with CHD without PAH (median 1415 ng/L, interquartile range [IQR] 926...
August 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28819093/non-seminomatous-germ-cell-tumor-presenting-with-superior-vena-cava-syndrome
#7
Paolo K Soriano, Muhammad F Iqbal, Omar M Siddiqui, Jeff F Wang, Meghna R Desai
BACKGROUND Primary mediastinal non-seminomatous germ cell tumors (NSGCTs) are aggressive and carry a poor five-year disease free survival rate even with aggressive treatment. We describe a young adult male with primary mediastinal NSGCT presenting with airway obstruction and superior vena cava syndrome (SVCS). CASE REPORT The patient presented with four weeks of nonproductive cough, weight loss, and right-sided pleuritic chest pain. Chest computed topography (CT) imaging demonstrated a right-sided mediastinal mass determined as a yolk sac tumor on biopsy...
August 18, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28819006/increased-tissue-oxygenation-explains-the-attenuation-of-hyperaemia-upon-repetitive-pneumatic-compression-of-the-lower-leg
#8
Alessandro Messere, Gianluca Ceravolo, Walter Franco, Daniela Maffiodo, Carlo Ferraresi, Silvestro Roatta
Aim The rapid hyperaemia evoked by muscle compression is short-lived and was recently shown to undergo a rapid decrease even in spite of continuing mechanical stimulation. The present study aims at investigating the mechanisms underlying this attenuation which include local metabolic mechanisms, desensitization of mechano-sensitive pathways, and reduced efficacy of the muscle pump. Methods In 10 healthy subjects short sequences of mechanical compressions (n=3-6; 150 mmHg) of the lower leg were delivered at different inter-stimulus intervals (ranging from 20 to 160 s) through a customized pneumatic device...
August 17, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28818693/hybrid-photoacoustic-and-electrophysiological-recording-of-neurovascular-communications-in-freely-moving-rats
#9
Lei Xi, Tian Jin, Junli Zhou, Paul Carney, Hubei Jiang
Uncovering the relationships between neural activities and capillary-level hemodynamics such as blood flow and concentration of hemoglobin in the brain plays an important role in the study of animal behaviors and brain disorders. Here, we developed a miniature probe integrating a photoacoustic sensor and micro-electrodes to simultaneously record the dynamics of blood flow and total hemoglobin inside a single capillary and the activities of surrounding neurons with high spatiotemporal resolution in freely-moving rats...
August 14, 2017: NeuroImage
https://www.readbyqxmd.com/read/28817509/high-intensity-exercise-enhances-conduit-artery-vascular-function-in-older-adults
#10
Erika Iwamoto, Josh M Bock, Darren P Casey
PURPOSE: Modulation of vascular function follows an exercise intensity-dependent pattern in young adults. This study aimed to investigate the potential intensity-dependent effects of an acute bout of exercise on conduit and resistance artery function in healthy older adults. METHODS: Eleven healthy older adults (5 males/6 females, 66±1 years) completed 30 minutes of recumbent cycling at 50-55% (low-intensity) and 75-80% (high-intensity) of their age-predicted maximal heart rate on two separate study visits...
August 16, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28817482/american-college-of-critical-care-medicine-clinical-practice-parameters-for-hemodynamic-support-of-pediatric-and-neonatal-septic-shock-erratum
#11
(no author information available yet)
No abstract text is available yet for this article.
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28817458/noninvasive-derivation-of-fractional-flow-reserve-from-coronary-computed-tomographic-angiography-a-review
#12
Stewart M Benton, Christian Tesche, Carlo N De Cecco, Taylor M Duguay, U Joseph Schoepf, Richard R Bayer
Coronary computed tomographic angiography (CCTA) has evolved as a rapid and highly sensitive method for the exclusion of obstructive coronary artery disease. Unfortunately, as it pertains to moderate and severe lesions, the ability to discriminate between those that are hemodynamically significant and those that are nonobstructive is lacking. Consequently, this deficiency can result in a significant number of unnecessary referrals for invasive angiography that yields nonobstructive results. Fractional flow reserve (FFR), which assesses the hemodynamic significance of a specific lesion, when performed during invasive angiography, results in improved patient outcomes compared with visual stenosis assessment alone...
August 16, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28817218/bmi-nephroangiosclerosis-and-glomerulonephritis-is-there-any-meeting-point
#13
Antonietta Gigante, Konstantinos Giannakakis, Francesca Di Mario, Biagio Barbano, Edoardo Rosato, Riccardo Pofi, Marcello Di Paolo, Anna Rachele Rocca, Rosario Cianci
BACKGROUND: Overweight has been related to renal arteriolosclerosis and is able to modify intrarenal hemodynamics. Increasing evidences suggest an association between weight excess and primary glomerulonephritis (GN). The aim of this study was to evaluate the relationship between nutritional status and intrarenal arterial stiffness in primary GN associated to arteriolosclerosis. We have considered the glomerular diameter (GD) as morphological parameter in overweight and obese patients...
August 17, 2017: Nephrology
https://www.readbyqxmd.com/read/28816881/the-shikani-optical-stylet-as-an-alternative-to-awake-fiberoptic-intubation-in-patients-at-risk-of-secondary-cervical-spine-injury-a-randomized-controlled-trial
#14
Rabab S S Mahrous, Aly M M Ahmed
BACKGROUND: Conventional intubation of the trachea and consequent prone positioning of anesthetized patients with cervical spine instability may result in secondary neurological injury. Historically, flexible fiberoptics used to be the chief choice for patients presenting with cervical spine instability surgery with difficult airway. Recently, the rigid optical stylets have shown promise in assisting difficult intubations. PURPOSE: The aim of the present study was to compare the efficacy of Shikani optical stylet (SOS) with the flexible fiberscope for awake intubation in patients with cervical spine instability...
August 14, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28816745/restoration-of-normal-sympathetic-neural-function-in-heart-failure-following-baroreflex-activation-therapy-final-43-month-study-report
#15
Raffaella Dell'Oro, Edoardo Gronda, Gino Seravalle, Giuseppe Costantino, Luca Alberti, Barbara Baronio, Tiziana Staine, Emilio Vanoli, Giuseppe Mancia, Guido Grassi
BACKGROUND: Baroreflex activation therapy (BAT) exerts in severe heart failure sympathoinhibitory effects, improving clinical variables and reducing hospitalization rate. The current follow-up study was aimed at determining the long-term effects of BAT, assessing whether BAT in heart failure allows to restore physiological levels of sympathetic function. METHODS: Seven patients out of the 11 heart failure patients aged 66.5 ± 3 years (mean ± SEM) in New York Heart Association Class III with left ventricular ejection fraction 40% or less and impaired functional capacity recruited in the study survived at the final follow-up (43...
August 14, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28816594/consensus-statement-on-current-and-emerging-methods-for-the-diagnosis-and-evaluation-of-cerebrovascular-disease
#16
Manus J Donahue, Eric Achten, Petrice M Cogswell, Frank-Erik De Leeuw, Colin P Derdeyn, Rick M Dijkhuizen, Audrey P Fan, Rashid Ghaznawi, Jeremy J Heit, M Arfan Ikram, Peter Jezzard, Lori C Jordan, Eric Jouvent, Linda Knutsson, Richard Leigh, David S Liebeskind, Weili Lin, Thomas W Okell, Adnan I Qureshi, Charlotte J Stagg, Matthias Jp van Osch, Peter Cm van Zijl, Jennifer M Watchmaker, Max Wintermark, Ona Wu, Greg Zaharchuk, Jinyuan Zhou, Jeroen Hendrikse
Cerebrovascular disease (CVD) remains a leading cause of death and the leading cause of adult disability in most developed countries. This work summarizes state-of-the-art, and possible future, diagnostic and evaluation approaches in multiple stages of CVD, including (i) visualization of sub-clinical disease processes, (ii) acute stroke theranostics, and (iii) characterization of post-stroke recovery mechanisms. Underlying pathophysiology as it relates to large vessel steno-occlusive disease and the impact of this macrovascular disease on tissue-level viability, hemodynamics (cerebral blood flow, cerebral blood volume, and mean transit time), and metabolism (cerebral metabolic rate of oxygen consumption and pH) are also discussed in the context of emerging neuroimaging protocols with sensitivity to these factors...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28816352/pulmonary-artery-wave-propagation-and-reservoir-function-in-conscious-man-impact-of-pulmonary-vascular-disease-respiration-and-dynamic-stress-tests
#17
Junjing Su, Charlotte Manisty, Ulf Simonsen, Luke S Howard, Kim H Parker, Alun D Hughes
Detailed hemodynamic analysis may provide novel insights into the pulmonary circulation. Therefore, wave intensity and reservoir-excess pressure analyses were applied in the pulmonary artery to characterise changes in wave propagation and reservoir function during spontaneous respiration and dynamic stress tests. Right heart catheterisation was performed using a pressure and Doppler flow sensor tipped guidewire to obtain simultaneous pressure and flow velocity measurements in the pulmonary artery in control subjects and patients with pulmonary arterial hypertension (PAH) at rest...
August 17, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28815461/drug-induced-kidney-injury-in-the-elderly
#18
REVIEW
Sana Khan, Valentina Loi, Mitchell H Rosner
The incidence of acute kidney injury in the elderly has grown over the past decade. One of the primary drivers is drug-induced nephrotoxicity, which is the result of a combination of the unique susceptibilities to kidney injury and the increased use of medications in the elderly population. Specific drug classes are associated with increased rates of kidney injury including agents that block the renin angiotensin system, antimicrobials, and chemotherapeutic agents. Mechanistically, injury may be due to hemodynamic effects, tubular or glomerular toxicity, and interstitial nephritis...
August 16, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28815378/effect-of-aging-on-mechanical-stresses-deformations-and-hemodynamics-in-human-femoropopliteal-artery-due-to-limb-flexion
#19
Anastasia Desyatova, Jason MacTaggart, Rodrigo Romarowski, William Poulson, Michele Conti, Alexey Kamenskiy
Femoropopliteal artery (FPA) reconstructions are notorious for poor clinical outcomes. Mechanical and flow conditions that occur in the FPA with limb flexion are thought to play a significant role, but are poorly characterized. FPA deformations due to acute limb flexion were quantified using a human cadaver model and used to build a finite element model that simulated surrounding tissue forces associated with limb flexion-induced deformations. Strains and intramural principal mechanical stresses were determined for seven age groups...
August 16, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28815338/prolonged-hypotension-after-carotid-artery-stenting-incidence-predictors-and-consequences
#20
Elif Gökçal, Elvin Niftaliyev, Çiğdem Deniz, Mehmet Ergelen, Vildan Güzel, Ömer Göktekin, Talip Asil
BACKGROUND: Hemodynamic changes frequently occur after carotid artery stenting (CAS), and in some patients these changes, particularly hypotension, may be prolonged. There are discrepant results for predicting patients at high risk for these prolonged hemodynamic changes and identifying the effect on clinical outcome. In this study, we aimed to determine the frequency, predictors and consequences associated with prolonged hypotension (PH) after CAS in our center. METHODS: We retrospectively analyzed the demographics, risk factors, nature of carotid disease, degree of stenosis of both internal carotid arteries, stent diameter and site of dilatation during stenting in 137 CAS procedures...
August 17, 2017: Acta Neurochirurgica
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