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https://www.readbyqxmd.com/read/29334615/hemodynamic-and-metabolic-responses-to-self-paced-and-ramp-graded-exercise-testing-protocols
#1
Nicholas M Beltz, Fabiano Amorim, Ann L Gibson, Jeffrey M Janot, Len Kravitz, Christine M Mermier, Nathan Cole, Terence A Moriarty, Tony P Nunez, Sam Trigg, Lance Dalleck
PURPOSE: Recent examinations have shown lower maximal oxygen uptake (VO2max) during traditional ramp (RAMP) compared to self-paced (SPV) graded exercise testing (GXT) attributed to differences in cardiac ouput. The current study examined the differences in hemodyamic and metabolic responses between RAMP and SPV during treadmill exercise. METHODS: Sixteen recreationally trained men (23.7±3.0 yrs) completed two separate treadmill GXT protocols. SPV consisted of five 2-min stages (10 min total) of increasing speed clamped by the Borg RPE6-20 scale...
January 15, 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/29334489/association-between-arterial-stiffness-and-wave-reflection-with-subsequent-development-of-placental-mediated-diseases-during-pregnancy-findings-of-a-systematic-review-and-meta-analysis
#2
Mohamed Waseem Osman, Mintu Nath, Eamonn Breslin, Asma Khalil, David R Webb, Thompson G Robinson, Hatem A Mousa
OBJECTIVE: We present a comprehensive systematic review of published literature to examine, whether arterial stiffness and wave reflection measurements during pregnancy differed between healthy patients and patients with placental-mediated diseases including preeclampsia (PET), small for gestational age (SGA), fetal death, and placental abruption, and a quantitative assessment of the findings using the meta-analysis approach. METHODS: We searched Medline, Embase, and The Cochrane Library for studies of arterial stiffness in pregnancy, analyzed pregnancy outcomes and conducted the meta-analysis of data evaluated by trimesters of pregnancy...
January 13, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29334078/high-prf-ultrafast-sliding-compound-doppler-imaging-fully-qualitative-and-quantitative-analysis-of-blood-flow
#3
Jinbum Kang, Won Seuk Jang, Yangmo Yoo
Ultrafast compound Doppler imaging based on plane-wave excitation (UCDI) can be used to evaluate cardiovascular diseases using high frame rates. In particular, it provides a fully quantifiable flow analysis over a large region of interest with high spatio-temporal resolution. However, the pulse-repetition frequency (PRF) in the UCDI method is limited for high-velocity flow imaging since it leverages between the number of plane-wave angles (<i>N</i>) and acquisition time. In this paper, we present high PRF ultrafast sliding compound Doppler imaging method (HUSDI) to improve quantitative flow analysis...
January 15, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29333425/outcomes-of-selective-surgery-in-patients-with-suspected-small-bowel-injury-from-blunt-trauma
#4
Hyoung-Chul Park, Jong Whan Kim, Min Jeong Kim, Bong Hwa Lee
Purpose: The role of initial conservative therapy with selective surgery for patients with suspected blunt bowel injury by radiologic evaluation is less clear. The aim of the study is to assess the outcomes of patients who received initial conservative therapy with selective delayed surgery, compared to emergency surgery. Methods: During this 8-year study, a total of 77 patients who were hemodynamically stable were enrolled, in which computed tomography verified suspected bowel injury from blunt trauma (mesenteric hematoma, mesenteric fat infiltration, bowel wall thickening, and free fluid without solid organ injury) was managed with either initial conservative therapy with selective delayed surgery (group A; n = 42) or emergency surgery (group B; n = 35)...
January 2018: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29333220/outcomes-of-left-ventricular-function-according-to-treatment-response-for-a-patent-ductus-arteriosus-in-preterm-infants
#5
Soo Jung Kang, Young Sun Cho, Seo Jung Hwang, Hyo Jin Kim
Background: To evaluate the outcomes of left ventricular (LV) function according to treatment response for a hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Methods: Echocardiograms of 21 preterm infants born at gestational age < 31 weeks obtained at term-equivalent age were retrospectively studied. Among preterm infants with a hsPDA, 9 underwent ligation after failure of pharmacological closure (ligation group) and 6 experienced successful pharmacological closure (medication group)...
December 2017: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29332912/impairment-of-iodine-123-metaiodobenzylguanidine-123i-mibg-uptake-in-patients-with-pulmonary-artery-hypertension
#6
Kenjuro Higo, Kayoko Kubota, Sunao Miyanaga, Masaaki Miyata, Masatoyo Nakajo, Megumi Jinguji, Mitsuru Ohishi
According to recent studies, lung uptake of iodine-123-metaiodobenzylguanidine (123I-MIBG) is impaired in many lung diseases and low lung uptake of 123I-MIBG suggests endothelial dysfunction of the pulmonary artery. 123I-MIBG scintigraphy in patients with pulmonary hypertension (PH) has not yet been clinically evaluated. We hypothesized that the lung uptake of 123I-MIBG is reduced in patients with PH and differs among PH subtypes. The purpose of the present study was to analyze the lung uptake of 123I-MIBG in patients with PH and compare it with the data obtained by echocardiography or right heart catheterization...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29332910/successful-infant-pneumonectomy-with-unilateral-pulmonary-artery-occlusion-test
#7
Koji Kato, Taichi Kato, Satoshi Hayano, Yoshie Fukasawa, Atsushi Numaguchi, Tetsuo Hattori, Akiko Saito, Yoshiaki Sato, Masahiro Hayakawa
The use of unilateral pulmonary artery occlusion (UPAO) test for the preoperative evaluation of pneumonectomy was reported in adult patients. On the contrary, in infants, no strategies have yet been recommended to predict hemodynamics after pneumonectomy, nor has use of the UPAO test been reported. We describe the first case of infant with abnormal pulmonary circulation in whom successful pneumonectomy was performed after preoperative evaluation using UPAO test. Right pneumonectomy was planned for an 8-month-old girl, because of decreased right pulmonary function, high risk of pneumothorax, and impaired left lung expansion due to overexpansion caused by severe left bronchial stenosis and bronchomalacia...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29331957/mitral-valve-anatomic-predictors-of-hemodynamic-success-with-transcatheter-mitral-valve-repair
#8
Jeremy J Thaden, Joseph F Malouf, Vuyisile T Nkomo, Sorin V Pislaru, David R Holmes, Guy S Reeder, Charanjit S Rihal, Mackram F Eleid
BACKGROUND: Mitral regurgitation is a heterogeneous disease. Determining which patients derive optimal outcomes from transcatheter edge-to-edge mitral valve repair (TMVR) remains challenging. We sought to determine whether baseline mitral valve anatomic characteristics are predictive of left atrial pressure (LAP) changes during TMVR with MitraClip. METHODS AND RESULTS: Consecutive patients with severe mitral regurgitation undergoing TMVR (n=112) underwent continuous intraprocedural LAP monitoring and retrospective echocardiographic analysis for specific mitral anatomic characteristics...
January 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29331874/thyroid-hormone-resuscitation-after-brain-death-in-potential-organ-donors-a-primer-for-neurocritical-care-providers-and-narrative-review-of-the-literature
#9
REVIEW
Ian A Buchanan, Vivek A Mehta
Solid organ transplantation has become a mainstay in the contemporary management of end-stage organ failures fueled by advances in immunosuppression, intensive care and surgical technology. Every year, a vast number of transplantable organs is lost on account of hemodynamic instability in potential brain-dead organ donors. Because of a growing organ shortage, measures that increase total donor supply pools are desperately needed. Thyroid hormone has been identified as an adjunctive therapy in donor management due to its potential for increasing organ supply and is currently endorsed by transplant organizations such as United Network for Organ Sharing (UNOS)...
January 8, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29331435/complications-of-chronic-total-occlusion-percutaneous-coronary-intervention-subepicardial-hematoma
#10
Punag Divanji, Kendrick Shunk
A 67-year-old man with coronary artery disease and previous coronary underwent successful Guideliner reverse CART percutaneous coronary intervention of a chronic total occlusion of the right coronary artery. He later developed evidence of myocardial ischemia, and imaging, including angiogram, echocardiogram, and cardiac computed tomography revealing active dye extravasation from the previously normal RV marginal branches, in addition to a large subepicardial hematoma. Despite these dramatic findings, the patient remained hemodynamically stable and pain-free, with resolving ECG changes...
December 30, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29331339/cardiopulmonary-hemodynamics-and-c-reactive-protein-as-prognostic-indicators-in-compensated-and-decompensated-cirrhosis
#11
Laura Turco, Guadalupe Garcia-Tsao, Ilenia Magnani, Marcello Bianchini, Martina Costetti, Cristian Caporali, Stefano Colopi, Emilio Simonini, Nicola De Maria, Federico Banchelli, Rosario Rossi, Erica Villa, Filippo Schepis
BACKGROUND AND AIMS: The main stages of cirrhosis (compensated and decompensated) have been substaged based on clinical, endoscopic, and portal pressure (determined by the hepatic venous pressure gradient, HVPG) features. Vasodilatation leading to a hyperdynamic circulatory state is central in the development of a late decompensated stage with inflammation being currently considered a key driver. We aimed to assess hepatic/systemic hemodynamics and inflammation (by C reactive protein, CRP) among the different substages of cirrhosis and to investigate their interrelationship and prognostic relevance...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29331270/severe-beta-blocker-and-calcium-channel-blocker-overdose-role-of-high-dose-insulin
#12
Karan Seegobin, Satish Maharaj, Ansuya Deosaran, Pramod Reddy
A 54-year-old female presented after taking an overdose of an unknown amount of hydrochlorothiazide, doxazocin, atenolol and amlodipine. She was initially refractory to treatment with conventional therapy (intravenous fluids, activated charcoal, glucagon 5 mg followed with glucagon drip, calcium gluconate 10%, and atropine). Furthermore, insulin at 4 U/kg was not effective in improving her hemodynamics. Shortly after high dose insulin was achieved with 10 U/kg, there was dramatic improvement in hemodynamics resulting in three of five vasopressors being weaned off in 8 h...
January 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29331056/exploring-the-advantages-of-multiband-fmri-with-simultaneous-eeg-to-investigate-coupling-between-gamma-frequency-neural-activity-and-the-bold-response-in-humans
#13
Makoto Uji, Ross Wilson, Susan T Francis, Karen J Mullinger, Stephen D Mayhew
We established an optimal combination of EEG recording during sparse multiband (MB) fMRI that preserves high-resolution, whole-brain fMRI coverage while enabling broad-band EEG recordings which are uncorrupted by MRI gradient artefacts (GAs). We first determined the safety of simultaneous EEG recording during MB fMRI. Application of MB factor = 4 produced <1°C peak heating of electrode/hardware during 20 min of GE-EPI data acquisition. However, higher SAR sequences require specific safety testing, with greater heating observed using PCASL with MB factor = 4...
January 13, 2018: Human Brain Mapping
https://www.readbyqxmd.com/read/29330892/ophthalmic-artery-doppler-prediction-of-preeclampsia-a-systematic-review-and-meta-analysis
#14
REVIEW
Erkan Kalafat, Ariana Laoreti, Asma Khalil, Fabricio Da Silva Costa, Basky Thilaganathan
OBJECTIVE: To determine the accuracy of ophthalmic artery Doppler in pregnancy for the prediction of preeclampsia. METHODS: MEDLINE (1947-2017), EMBASE (1974-2017), CINAHL (inception-2017) and the Cochrane Library (inception-2017) were searched for relevant citations without language restrictions. Two reviewers independently selected studies that evaluated the accuracy of ophthalmic artery Doppler to predict the development of preeclampsia and performed data extraction to construct 2 × 2 tables...
January 12, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29330874/safety-of-high-current-stimulation-for-intermittent-intraoperative-neural-monitoring-in-thyroid-surgery-a-porcine-model
#15
I-Cheng Lu, Pi-Ying Chang, Gregory W Randolph, Hsiu-Ya Chen, Kuang-Yi Tseng, Yi-Chu Lin, Feng-Yu Chiang, Che-Wei Wu
OBJECTIVES: During monitored thyroidectomy, displacement of the recurrent laryngeal nerve (RLN) or vagus nerve (VN) in some complicated cases can increase the risk of injury. Although increasing the stimulus current can facilitate nerve mapping and localization, the safety of a high-current stimulus remains unknown. Therefore, this study evaluated the safety of a high-current stimulus in a porcine model. METHODS: Short-duration (1 minute), high-current (3, 5, 10, 15, 20, 25, and 30 mA at 4Hz) stimulus pulses were repeatedly applied to the RLN or VN in six anesthetized piglets...
January 13, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29330639/changes-in-tissue-and-cerebral-oxygenation-following-spinal-anesthesia-in-infants-a-prospective-study
#16
Alexander B Froyshteter, Dmitry Tumin, Emmett E Whitaker, David P Martin, Mumin Hakim, Hina Walia, Tarun Bhalla, Joseph D Tobias
Use of spinal anesthesia (SA) in children may address concerns about potential neurocognitive effects of general anesthesia. We used near-infrared spectroscopy (NIRS) to assess the effects of SA on cerebral and tissue oxygenation in 19 patients aged 7 ± 3 months. Prior to SA placement, NIRS monitors were placed on the forehead (cerebral) and the thigh (tissue). Intraoperative cerebral and tissue saturation were 73 ± 7 and 80 ± 11%, respectively, before SA placement. NIRS measurements were monitored every minute for 30 min after SA placement and modeled using mixed-effects linear regression...
January 12, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29330589/impact-of-valve-less-vs-standard-insufflation-on-pneumoperitoneum-volume-inflammation-and-peritoneal-physiology-in-a-laparoscopic-sigmoid-resection-experimental-model
#17
Michele Diana, Eric Noll, Andras Legnèr, Seong-Ho Kong, Yu-Yin Liu, Luigi Schiraldi, Francesco Marchegiani, Jordan Bano, Bernard Geny, Anne-Laure Charles, Bernard Dallemagne, Véronique Lindner, Didier Mutter, Pierre Diemunsch, Jacques Marescaux
BACKGROUND: Standard insufflators compensate for intra-abdominal pressure variations with pressure spikes. Our aim was to evaluate the impact of a stable, low-pressure pneumoperitoneum induced by a valve-less insufflator, on working space, hemodynamics, inflammation, and peritoneal physiology, in a model of laparoscopic sigmoid resection. MATERIALS AND METHODS: Twelve pigs (47 ± 3.3 kg) were equipped for invasive hemodynamic monitoring and randomly assigned to Standard (n = 6) vs...
January 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29330514/a-comparison-of-static-and-dynamic-cerebral-autoregulation-during-mild-whole-body-cold-stress-in-individuals-with-and-without-cervical-spinal-cord-injury-a-pilot-study
#18
Jan W van der Scheer, Yoshi-Ichiro Kamijo, Christof A Leicht, Philip J Millar, Manabu Shibasaki, Victoria L Goosey-Tolfrey, Fumihiro Tajima
STUDY DESIGN: Experimental study. OBJECTIVES: To characterize static and dynamic cerebral autoregulation (CA) of individuals with cervical spinal cord injury (SCI) compared to able-bodied controls in response to moderate increases in mean arterial pressure (MAP) caused by mild whole-body cold stress. SETTING: Japan METHODS: Five men with complete autonomic cervical SCI (sustained > 5 y) and six age-matched able-bodied men participated in hemodynamic, temperature, catecholamine and respiratory measurements for 60 min during three consecutive stages: baseline (10 min; 33 °C water through a thin-tubed whole-body suit), mild cold stress (20 min; 25 °C water), and post-cold recovery (30 min; 33 °C water)...
January 12, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29330133/the-evaluation-of-drug-induced-changes-in-left-ventricular-function-in-pentobarbital-anesthetized-dogs
#19
Yevgeniya E Koshman, Brett R Herzberg, Terese R Seifert, James S Polakowski, Scott W Mittelstadt
INTRODUCTION: The goal of this study was to determine whether assessment of myocardial contractility and hemodynamics in an anesthetized dog model, could consistently detect drug-induced changes in the inotropic state of the heart using drugs known to have clinically relevant positive and negative effects on myocardial contractility. METHODS: Derived parameters included: diastolic, systolic and mean arterial BP, peak systolic LVP, HR, end-diastolic LVP, and LVdP/dtmax as the primary contractility index...
January 9, 2018: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/29329828/frequency-and-prognostic-significance-of-acute-kidney-recovery-in-patients-who-underwent-transcatheter-aortic-valve-implantation
#20
Amir Azarbal, Kevin L Leadholm, Takamaru Ashikaga, Richard J Solomon, Harold L Dauerman
Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is associated with increased mortality. As significant hemodynamic improvement may occur with relief of aortic stenosis, we hypothesized that TAVI patients may demonstrate the opposite phenomena: acute kidney recovery (AKR). We studied the incidence and predictors of AKR in post-TAVI patients. A total of 366 consecutive patients underwent TAVI (January 2012 to January 2017) at a single center. We defined AKR as a 25% improvement in glomerular filtration rate (GFR) at 48 hours after TAVI...
December 13, 2017: American Journal of Cardiology
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