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https://www.readbyqxmd.com/read/28319954/comparison-of-initial-vasopressors-used-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#1
Bhaskar Roy, Louise D McCullough, Rajat Dhar, James Grady, Yu-Bo Wang, Robert J Brown
BACKGROUND: The main reason for morbidity after aneurysmal subarachnoid hemorrhage (aSAH) is delayed cerebral ischemia (DCI). The mainstay of medical therapy for treating DCI is induced hypertension with vasopressors to restore cerebral perfusion. Both phenylephrine (PE) and norepinephrine (NE) are commonly used for induced hypertension, but the impact of the initial choice of vasopressor on the efficacy, adverse effects, or outcome after hemodynamic therapy for DCI is unknown. METHODS: Sixty-three patients with aSAH between January 2012 and October 2014, who developed DCI (defined as new focal deficit or decline in Glasgow Coma Score) and in which PE (n = 45) or NE (n = 18) treatment was initiated were evaluated in this retrospective study...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319871/autoantibodies-and-immune-complexes-to-oxidation-specific-epitopes-and-progression-of-aortic-stenosis-results-from-the-astronomer-trial
#2
Romain Capoulade, Kwan L Chan, Patrick Mathieu, Yohan Bossé, Jean G Dumesnil, James W Tam, Koon K Teo, Xiaohong Yang, Joseph L Witztum, Benoit J Arsenault, Jean-Pierre Després, Philippe Pibarot, Sotirios Tsimikas
BACKGROUND AND AIMS: Elevated levels of lipoprotein(a) [Lp(a)] and oxidized phospholipids on apolipoprotein B-100 (OxPL-apoB) predict the progression of pre-existing mild-to-moderate calcific aortic valve stenosis (CAVS). Whether indirect markers of oxidation-specific epitopes (OSE) are also predictive is not known. The association between IgG and IgM autoantibodies and malondialdehyde-modified low density lipoprotein (MDA-LDL) and IgG and IgM apolipoprotein B immune complexes (apoB-IC), and the hemodynamic progression rate of CAVS was determined in the ASTRONOMER (Aortic Stenosis Progression Observation: Measuring Effects of Rosuvastatin, NCT00800800) trial...
March 9, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28319589/exercise-improves-v-combining-dot-above-o-2max-and-body-composition-in-adt-treated-prostate-cancer-patients
#3
Bradley A Wall, Daniel A Galvão, Naeem Fatehee, Dennis R Taaffe, Nigel Spry, David Joseph, Jeffrey J Hebert, Robert U Newton
INTRODUCTION: Prostate cancer is the most common cancer in men and patients treated with androgen deprivation therapy (ADT) experience unfavourbale changes in body composition and associated metabolic complications, which can increase the risk of cardiovascular disease. We examined the effect of a 6-month program of aerobic and resistance exercise aimed at improving body composition and cardiorespiratory health in this population. METHODS: Ninety-seven men (43-90 years) with localized prostate cancer receiving ADT were randomized to either exercise (EX, n=50) or usual care (CON, n=47)...
March 18, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28319467/effects-of-iv-acetaminophen-on-core-body-temperature-and-hemodynamic-responses-in-febrile-critically-ill-adults-a-randomized-controlled-trial
#4
Hildy M Schell-Chaple, Kathleen D Liu, Michael A Matthay, Daniel I Sessler, Kathleen A Puntillo
OBJECTIVE: To determine the effects of IV acetaminophen on core body temperature, blood pressure, and heart rate in febrile critically ill patients. DESIGN: Randomized, double-blind, placebo-controlled clinical trial. SETTING: Three adult ICUs at a large, urban, academic medical center. PATIENTS: Forty critically ill adults with fever (core temperature, ≥ 38.3°C). INTERVENTION: An infusion of acetaminophen 1 g or saline placebo over 15 minutes...
March 17, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28318811/st-elevation-myocardial-infarction-after-penetrating-thoracic-trauma
#5
Kiran Faryar, Michael P Flaherty, Martin Huecker
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) may complicate penetrating thoracic trauma. CASE REPORT: This report describes a 42-year-old man who sustained a self-inflicted gunshot wound to the left chest. Electrocardiogram showed ST elevation in the inferior leads. Emergent catheterization was not recommended and conservative management was initiated. Cardiac catheterization 4 days later showed no perturbation of the coronary arteries, neither atherosclerotic nor traumatic...
March 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28318674/organ-donor-management-eight-common-recommendations-and-actions-that-deserve-reflection
#6
C Chamorro-Jambrina, M R Muñoz-Ramírez, J L Martínez-Melgar, M S Pérez-Cornejo
Despite major advances in our understanding of the physiopathology of brain death (BD), there are important controversies as to which protocol is the most appropriate for organ donor management. Many recent reviews on this subject offer recommendations that are sometimes contradictory and in some cases are not applied to other critically ill patients. This article offers a review of the publications (many of them recent) with an impact upon these controversial measures and which can help to confirm, refute or open new areas of research into the most appropriate measures for the management of organ donors in BD, and which should contribute to discard certain established recommendations based on preconceived ideas, that lead to actions lacking a physiopathological basis...
March 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28318517/-intracardiac-myxoma-complicated-by-acute-aortic-occlusion-case-report
#7
O Zizi, B Benfor, H Jiber, A Bouarhroum, S Benlamkaddem, N Kanjaa
We report the case for a 44-year-old patient without medical history, admitted in our department for bilateral acute limb ischemia (H6). The patient was hemodynamically stable and the physical examination shows limb sever ischemia (no femoral arterial pulses, coldness, cyanosis and paralysis). Abdominal CT angiography showed a complete occlusion of the infra renal abdominal aorta compatible with embolus. An embolectomy with Fogarty catheters was performed. Echocardiography showed a mass in the left atrium. Pathological examination of the material embolic confirmed the diagnosis of the cardiac myxoma...
March 16, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28317490/speculative-considerations-about-some-cardiology-enigmas
#8
Paulo Roberto Barbosa Evora, Andre Schmidt, Livia Arcêncio, José Antonio Marin-Neto
Write a review text or point-of-view that takes into account the interests, if not of all, but of most readers of a scientific journal is an arduous task. The editorial can be grounded in published articles, even in a single article of undeniable importance and, it can also represent a trend of specialty. Therefore, especially for the sake of the reader's motivation, the present text was freely designed to discuss some cardiology enigmas in the context of the heart valve and coronary artery disease (CAD). Concerning the CAD five well-known enigmas will be considered: 1) The absence of arteriosclerosis in intramyocardial coronary arteries; 2) The unique and always confirmed superior evolution of the left internal thoracic artery as a coronary graft; 3) The prophylactic left internal thoracic artery graft in mildly-stenosed coronary lesions, and; 4) The high incidence of perioperative atrial fibrillation (AF) in patients with CAD, and; 5) The handling of disease-free saphenous vein graft at the time of reoperation...
March 17, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28317398/cardiac-transplantation-towards-a-new-noninvasive-approach-of-cardiac-allograft-rejection
#9
Sophie I Mavrogeni, George Athanasopoulos, Aggeliki Gouziouta, Evangelos Leontiadis, Stamatis Adamopoulos, Genovefa Kolovou
Cardiac allograft rejection (CAR) may occur after transplantation and remains silent, until hemodynamic deterioration takes place. Endomyocardial biopsy (EMB) is applied to early detect CAR. Although, flexible bioptoms have decreased the incidence of lethal complications, EMB remains an invasive procedure carrying risk of tamponade and permanent heart block. Therefore, a new non-invasive approach is needed. Areas covered: AlloMap molecular expression testing and graft-derived cell-free DNA (GcfDNA) test can be used as blood indices of acute and chronic CAR, respectively...
March 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28317393/structural-analysis-of-two-different-stent-configurations
#10
M Simão, J M Ferreira, J Mora-Rodriguez, H M Ramos
Two different stent configurations (i.e. the well known Palmaz-Schatz (PS) and a new stent configuration) are mechanically investigated. A finite element model was used to study the two geometries under combining loads and a computational fluid dynamic model based on fluid structure interaction was developed investigating the plaque and the artery wall reactions in a stented arterial segment. These models determine the stress and displacement fields of the two stents under internal pressure conditions. Results suggested that stent designs cause alterations in vascular anatomy that adversely affect arterial stress distributions within the wall, which have impact in the vessel responses such as the restenosis...
March 20, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28316980/clinical-and-prognostic-significance-of-positive-hepatojugular-reflux-on-discharge-in-acute-heart-failure-insights-from-the-escape-trial
#11
Hesham R Omar, Maya Guglin
Background. There has been a decline in emphasis of the value of physical examination in heart failure (HF) with increased reliance on cardiac imaging. We aim to study the clinical and prognostic significance of positive hepatojugular reflux (HJR) on discharge in patients hospitalized with HF. Methods. Using the ESCAPE trial data, patients were compared according to the presence or absence of a positive HJR on discharge. The primary study endpoints were all-cause mortality and a composite endpoint of death, rehospitalization, and cardiac transplant during the first 6 months after discharge...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28316963/the-results-of-proximal-femoral-nail-for-intertrochanteric-fracture-in-hemodialysis-patient
#12
Kyung Sub Song, Sang Phil Yoon, Su Keon Lee, Seung Hwan Lee, Bong Seok Yang, Byeong Mun Park, Ick Hwan Yang, Beom Seok Lee, Ji Ung Yeom
PURPOSE: Hip fractures in hemodialysis patients are accompanied by high rates of complications and morbidities. Previous studies have mainly reported on nonunion and avascular necrosis of femoral neck fractures in this patient group. In this study the complication and clinical results of hemodialysis patients with intertrochanteric fractures treated with proximal femoral intramedullary nailing have been investigated through comparison with patients with normal kidney function. MATERIALS AND METHODS: Forty-seven patients were included; the hemodialysis group (n=17) and the control group with normal kidney function (n=30)...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28316127/melatonin-pretreatment-improves-gastric-mucosal-blood-flow-and-maintains-intestinal-barrier-function-during-hemorrhagic-shock-in-dogs
#13
Christian Vollmer, Andreas P M Weber, Martin Wallenfang, Till Hoffmann, Tabea Mettler-Altmann, Richard Truse, Inge Bauer, Olaf Picker, Alexander M Mathes
OBJECTIVE: Melatonin improves hepatic perfusion after hemorrhagic shock and may reduce stress-induced gastric lesions. This study was designed to investigate whether pretreatment with melatonin may influence gastric mucosal microcirculatory perfusion (μflow), oxygenation (μHbO2 ) or intestinal barrier function during physiological and hemorrhagic conditions in dogs. METHODS: In a randomized cross-over study, five anesthetized foxhounds received melatonin 100 μg/kg or vehicle (ethanol 5%) intravenously in the absence or presence of hemorrhagic shock (60 min, -20% blood volume)...
March 18, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/28316038/the-impact-of-the-aortic-valve-impairment-on-the-distant-coronary-arteries-hemodynamics-a-fluid-structure-interaction-study
#14
Hossein Mohammadi, Raymond Cartier, Rosaire Mongrain
Atherosclerosis is still the leading cause of death in the developed world. Although its initiation and progression is a complex multifactorial process, it is well known that blood flow-induced wall shear stress (WSS) is an important factor involved in early atherosclerotic plaque initiation. In recent clinical studies, it was established that the regional pathologies of the aortic valve can be involved in the formation of atherosclerotic plaques. However, the impact of hemodynamic effects is not yet fully elucidated for disease initiation and progression...
March 18, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28316030/a-new-ct-score-as-index-of-hemodynamic-changes-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#15
Maria Barbara Leone, Marica Giannotta, Massimiliano Palazzini, Mariano Cefarelli, Sofia Martìn Suàrez, Enrico Gotti, Maria Letizia Bacchi Reggiani, Maurizio Zompatori, Nazzareno Galiè
PURPOSE: The aim of this study was to retrospectively assess the relationship between radiological and hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We introduced a new CT-score to evaluate hemodynamic changes, only employing CT-pulmonary angiography (CTPA). MATERIALS AND METHODS: 145 patients affected by CTEPH underwent hemodynamic and CTPA evaluation. Among these 145 patients, 69 underwent pulmonary endarterectomy (PEA) and performed a CTPA evaluation even after surgery...
March 18, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28315943/hyperoxia-reduces-oxygen-consumption-in-children-with-pulmonary-hypertension
#16
Long Guo, Prashant Bobhate, Shine Kumar, Karunakar Vadlamudi, Tarek Kaddoura, Mohamed Elgendi, Paula Holinski, James Y Coe, Jennifer Rutledge, Ian Adatia
High inspired oxygen concentration (FiO2 > 0.85) is administered to test pulmonary vascular reactivity in children with pulmonary hypertension (PH). It is difficult to measure oxygen consumption (VO2) if the subject is breathing a hyperoxic gas mixture so the assumption is made that baseline VO2 does not change. We hypothesized that hyperoxia changes VO2. We sought to compare the VO2 measured by a thermodilution catheter in room air and hyperoxia. A retrospective review of the hemodynamic data obtained in children with PH who underwent cardiac catheterization was conducted between 2009 and 2014...
March 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28315568/diurnal-blood-pressure-parameters-in-normal-tension-glaucoma-primary-open-angle-glaucoma-and-healthy-subjects
#17
Tolga Kocatürk, Çağdaş Akgüllü, Gökhan E Evliçoğlu, İmran K Ömürlü, Harun Çakmak, Ufuk Eryılmaz, Volkan Dayanır
OBJECTIVE: The pathophysiology of glaucoma is still undisclosed. Cardiovascular hemodynamic changes are hypothesized to contribute to glaucoma. This study aimed to determine the differences in the diurnal blood pressure (BP) of patients with normal tension glaucoma (NTG), primary open angle glaucoma (POAG), and controls without glaucoma. METHODS: A total of 129 patients were included in this study. The day-night average systolic and diastolic BPs, the day-night average pulse pressures (PPs), the day-night average heart rates, and the percentage of BP decline at night were obtained from the Holter devices and compared...
March 9, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28315502/the-effect-of-left-ventricular-assist-device-therapy-in-patients-with-heart-failure-and-mixed-pulmonary-hypertension
#18
Hoong S Lim, Neil Howell, Aaron Ranasinghe
BACKGROUND: Diastolic pressure gradient (DPG) of ≥7 mmHg has been proposed to distinguish mixed pulmonary hypertension from isolated post-capillary pulmonary hypertension in heart failure (HF). We evaluated the changes in pulmonary hemodynamics with left ventricular assist devices (LVADs) in patients with DPG of ≥7 or <7 mmHg, and effects on peak oxygen uptake (VO2) in patients with advanced HF. METHODS: Pre- and post-LVAD implant pulmonary hemodynamics (including right atrial (RA) pressures, DPG, pulmonary vascular resistance (PVR), pulmonary capacitance (PCap) and cardiac output), echocardiography, cardiopulmonary exercise test were measured in 38 consecutive patients...
March 15, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28315287/elective-primary-or-secondary-delayed-sternal-closure-improves-outcome-in-severely-compromised-patients
#19
Antonio M Calafiore, Azmat A Sheikh, Juan J Alfonso, Tarek Tantawi, Belgeit Maklouf, Ahmed Shawki, Ahmed Allam, Mohammed O Awadi, Ahmed A Osman, Aly M Habib, Michele Di Mauro
Background Delayed sternal closure (DSC) in patients with severely compromised preoperative hemodynamics can be helpful as the chest sometimes cannot be able to contain both lungs and heart. We report our experience to evaluate the midterm results of this strategy in an adult population. Materials and Methods From May 2009 till July 2015, 33 patients had DSC as first treatment of severe hemodynamic deterioration after cardiac surgery. Surgical procedures were valvular (9.27%) or coronary artery bypass grafting + others (24...
March 17, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28315124/multi-modality-imaging-assessment-of-pericardial-masses
#20
REVIEW
Wunan Zhou, Monvadi Barbara Srichai
PURPOSE OF REVIEW: This review will discuss the application of various imaging modalities including their advantages and disadvantages in the evaluation of the most common pericardial masses with a focus on pericardial cysts, tumors, and hematomas. RECENT FINDINGS: Accurate identification of pericardial masses and assessment of potential hemodynamic compromise is imperative for management. Cardiac imaging plays a central role in tissue characterization as well as evaluation of extension into neighboring structures...
April 2017: Current Cardiology Reports
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