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https://www.readbyqxmd.com/read/28632653/imaging-adults-with-congenital-heart-disease-part-ii-advanced-cmr-techniques
#1
Anurag Sahu, Timothy C Slesnick
Because of great strides in medical care, survival into adulthood has become a common expectation in patients suffering from nearly all forms of congenital heart disease. As this aging population expands, the utilization of cardiac magnetic resonance imaging in their care continues to grow. Magnetic resonance technology has developed exponentially over the last 2 decades, and several advanced techniques for imaging adults with congenital heart disease have moved from the purely research arena into routine clinical care...
July 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28631767/-conservative-treatment-of-a-pseudoaneurysm-of-the-mitral-aortic-intervalvular-fibrosa-9-years-of-follow-up
#2
Domenico Riccardo Rosario Chieppa, Antonio Davide Scardigno, Giovanni Deluca, Saverio Capodivento, Nicola Quinto, Mariangela Cicala
Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (MAIVF-P) is one of the rare complications of endocarditis or, more rarely, of surgical trauma. This condition is characterized by a pseudoaneurysm in the intra-annular area between the mitral valve and the aortic valve communicating with the outflow tract of the left ventricle, between the coronary or noncoronary left aortic valve and the front flap of the mitral valve. Nowadays, surgery is recommended to avoid further growth and complications. We hereby describe the case of a patient with MAIVF-P as a consequence of a surgical trauma and early appearance of MAIVF-P...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28629292/increased-blood-pressures-in-veterans-with-post-traumatic-stress-disorder
#3
Ehsan Moazen-Zadeh, Alireza Khoshdel, Farhad Avakh, Arash Rahmani
Objective Veterans of war affected by posttraumatic stress disorder (PTSD) are at increased risk for cardiovascular diseases. We aimed to compare brachial and central blood pressures between veterans with PTSD and controls. Method In this case-control study on veterans of Iran-Iraq war, 50 veterans with PTSD and 50 veterans as controls were selected from an outpatient clinic and matched for age ±3 years. Exclusion criteria were malignancies, severe anatomical defects such as amputated extremities, history of PTSD before serving in war, comorbid psychiatric disorders other than anxiety or depressive disorders...
August 2016: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28617684/non-infarct-related-artery-revascularization-in-st-segment-elevation-myocardial-infarction-patients-with-multivessel-disease
#4
Asim N Cheema, Shamir R Mehta, Subodh Verma, Akshay Bagai
PURPOSE OF REVIEW: Multivessel disease (MVD) is common in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) and is associated with significant risk of future cardiovascular (CV) events including short and longer-term mortality. In this review, we examine the pathophysiologic construct contributing to adverse prognosis of MVD in STEMI, relevant available evidence that currently guides the management of the noninfarct-related artery (IRA) stenosis and define the remaining knowledge gaps for future studies...
June 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28612958/clinical-characteristics-and-salvage-management-of-persistent-cesarean-scar-pregnancy
#5
Xue Ying, Wei Zheng, Li Zhao, Mi Zhou, Zhengyun Chen
AIM: The study was conducted to illustrate the clinical characteristics and treatment outcomes of patients with persistent cesarean scar pregnancy (PCSP). METHODS: During a six-year period, 38 cases of PCSP were diagnosed and treated conservatively to preserve fertility. The clinical presentations, imaging findings and treatment outcomes of these patients were reviewed. RESULTS: Fourteen out of 38 women (37%) presenting with PCSP suffered heavy vaginal bleeding...
June 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28609532/effect-of-abdominal-ultrasound-on-clinical-care-outcomes-and-resource-use-among-children-with-blunt-torso-trauma-a-randomized-clinical-trial
#6
James F Holmes, Kenneth M Kelley, Sandra L Wootton-Gorges, Garth H Utter, Lisa P Abramson, John S Rose, Daniel J Tancredi, Nathan Kuppermann
Importance: The utility of the focused assessment with sonography for trauma (FAST) examination in children is unknown. Objective: To determine if the FAST examination during initial evaluation of injured children improves clinical care. Design, Setting, and Participants: A randomized clinical trial (April 2012-May 2015) that involved 975 hemodynamically stable children and adolescents younger than 18 years treated for blunt torso trauma at the University of California, Davis Medical Center, a level I trauma center...
June 13, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28607783/intramural-hematoma-of-the-esophagus-complicating-severe-preeclampsia
#7
Simone Garzon, Giovanni Zanconato, Nicoletta Zatti, Giuseppe Chiarioni, Massimo Franchi
Intramural hematoma of the esophagus is a rare injury causing esophageal mucosal dissection. Forceful vomiting and coagulopathy are common underlying causes in the elderly population taking antiplatelets or anticoagulation agents. Acute retrosternal pain followed by hematemesis and dysphagia differentiates the hematoma from other cardiac or thoracic emergencies, including acute myocardial infarction or aortic dissection. Direct inspection by endoscopy is useful, but chest computed tomography best assesses the degree of obliteration of the lumen and excludes other differential diagnoses...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28600098/prioritizing-and-combining-therapies-for-heart-failure-in-the-era-of-mechanical-support-devices
#8
REVIEW
George S Hanzel, Simon Dixon, James A Goldstein
Technological advances have promoted challenges to prioritizing and combining therapies for heart failure. The concept of prioritization implies distinct but inextricably linked considerations. They may be viewed from pathophysiologic, clinical, and procedural perspectives, encompassing analysis of hemodynamic status, anatomic considerations, and technical challenges. It is essential to consider factors, including conduction disease, renal and pulmonary function, hematological derangements, and so forth. These considerations allow determination of clinical goals, which determine prioritization and interventional strategies...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28598912/cardiac-output-measurements-based-on-the-pulse-wave-transit-time-and-thoracic-impedance-exhibit-limited-agreement-with-thermodilution-method-during-orthotopic-liver-transplantation
#9
Aurora Magliocca, Emanuele Rezoagli, Thomas Anthony Anderson, Sara Maria Burns, Fumito Ichinose, Hovig Vatche Chitilian
BACKGROUND: Orthotopic liver transplantation (OLT) is characterized by significant intraoperative hemodynamic variability. Accurate and real-time cardiac output (CO) monitoring aids clinical decision making during OLT. The purpose of this study is to compare accuracy, precision, and trending ability of CO estimation obtained noninvasively using pulse wave transit time (estimated continuous cardiac output [esCCO; Nihon Kohden, Tokyo, Japan]) or thoracic bioimpedance (ICON; Osypka Medical GmbH, Berlin, Germany) to thermodilution cardiac output (TDCO) measured with a pulmonary artery catheter...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28598799/clinical-outcomes-of-an-inpatient-pediatric-obesity-treatment-program-in-the-usa
#10
Sharonda J Alston Taylor, Kimberly Rennie, Cindy Jon
Background When treating recalcitrant and severe childhood obesity, pharmaceutical options are limited and few patients qualify for bariatric surgery. A prolonged inpatient program serves as an alternative treatment. The purpose of this project was to describe the development of a medically supervised inpatient weight management program and evaluate its effectiveness. Methods This is a retrospective chart review of 18 patients [4-18 years, mean body mass index (BMI) 50.2 kg/m2] admitted to an inpatient pediatric weight management program from October 2011 through December 31, 2012 to evaluate the biometric, laboratory, sleep and behavioral changes that occurred from admission to discharge from the program...
June 9, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/28597769/a-systematic-review-of-transition-studies-of-pulmonary-arterial-hypertension-specific-medications
#11
Avraham Sofer, Michael J Ryan, Ryan J Tedford, Joel A Wirth, Wassim H Fares
Pulmonary arterial hypertension (PAH) is a progressive potentially fatal disease. Multiple pharmacologic options are now available, which facilitated transitions between different therapeutic options, although the evidence for such transitions has not been well described. We sought to review the evidence supporting the safety and/or efficacy of transitioning between PAH-specific medications. We performed a systematic review of all published studies in the Medline database between 1 January 2000 and 30 June 2016 reporting on any transition between the currently Food and Drug Administration (FDA)-approved PAH-specific medications...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597766/identifying-super-responders-in-pulmonary-arterial-hypertension
#12
Stephen J Halliday, Anna R Hemnes
Pharmacotherapeutic options for pulmonary arterial hypertension (PAH) have increased dramatically in the last two decades and along with this have been substantial improvements in survival. Despite these advances, however, PAH remains a progressive and ultimately fatal disease for most patients and only epoprostenol has been shown to improve survival in a randomized control trial. Clinical observations of the heterogeneity of treatment response to different classes of medications across the phenotypically diverse PAH population has led to the identification of patients who derive significantly more benefit from certain medications than the population mean, the so-called "super responders...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597758/longitudinal-change-in-pulmonary-arterial-capacitance-as-an-indicator-of-prognosis-and-response-to-therapy-and-in-pulmonary-arterial-hypertension
#13
Sarah K Medrek, Chad Kloefkorn, Duc T M Nguyen, Edward A Graviss, Adaani E Frost, Zeenat Safdar
Pulmonary arterial hypertension (PAH) is a chronic progressive disease that leads to right heart failure and death. Pulmonary arterial capacitance (PAC), defined as stroke volume divided by the pulmonary pulse pressure, has been identified as a prognostic factor in PAH. The impact of changes in PAC over time, however, is unclear. We evaluated changes in PAC over time to determine if such changes predicted transplant-free survival. A single-center retrospective study of consecutive group 1 PAH patients who had two or more right heart catheterizations (RHC) between January 2007 and June 2016 was undertaken...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28593469/a-patient-specific-aortic-valve-model-based-on-moving-resistive-immersed-implicit-surfaces
#14
Marco Fedele, Elena Faggiano, Luca Dedè, Alfio Quarteroni
In this paper, we propose a full computational framework to simulate the hemodynamics in the aorta including the valve. Closed and open valve surfaces, as well as the lumen aorta, are reconstructed directly from medical images using new ad hoc algorithms, allowing a patient-specific simulation. The fluid dynamics problem that accounts from the movement of the valve is solved by a new 3D-0D fluid-structure interaction model in which the valve surface is implicitly represented through level set functions, yielding, in the Navier-Stokes equations, a resistive penalization term enforcing the blood to adhere to the valve leaflets...
June 7, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28593159/delayed-repair-of-ventricular-septal-rupture-following-preoperative-awake-extracorporeal-membrane-oxygenation-support
#15
Bong Suk Park, Weon Yong Lee, Jung Hyeon Lim, Yong Joon Ra, Yong Han Kim, Hyoung Soo Kim
Outcomes of ventricular septal rupture (VSR) as a complication of acute myocardial infarction are extremely poor, with an in-hospital mortality rate of 45% in surgically treated patients and 90% in patients managed with medication. Delaying surgery for VSR is a strategy for reducing mortality. However, hemodynamic instability is the main problem with this strategy. In the present case, venoarterial extracorporeal membrane oxygenation (ECMO) was used to provide stable hemodynamic support before the delayed surgery...
June 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28592080/-complete-revascularization-for-multi-vessel-coronary-diseases-through-lower-ministernotomy-on-beating-heart-off-pump-surgery
#16
Z B Xiao, Y Zhang, J Z Guo, Y Y Li, Y P Zhang
Objective: To discuss a novel method of complete revascularization for multi-vessel coronary diseases on beating heart off-pump surgery through lower ministernotomy. Methods: Clinical data of 79 patients underwent ministernotomy off-pump coronary artery bypass from January 2015 to May 2016 at Department of Cardiac Surgery, Heart Center, Beijing Friendship Hospital, Capital Medical University were analyzed retrospectively. There were 62 male and 17 female patients, with an average age of (65±9) years. All the patients were multi-vessel coronary diseases and planned to receive coronary artery bypass grafting...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28590829/aging-and-sexual-health-getting-to-the-problem
#17
Ecem Kaya, Suresh C Sikka, Philip J Kadowitz, Serap Gur
Erectile dysfunction (ED) is one of the most common disorders in male and is often associated with other age-related comorbidities. The aging process affects the structural organization and function of penile erectile components such as smooth muscle cell and vascular architecture. These modifications affect penile hemodynamics by impairing cavernosal smooth muscle cell relaxation, reducing penile elasticity, compliance and promoting fibrosis. This review aims to identify the mechanisms of ED in the penile aging process in experimental and clinical data...
June 2017: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
https://www.readbyqxmd.com/read/28585915/hemodynamic-changes-are-predictive-of-coagulopathic-hemorrhage-after-living-donor-liver-transplant
#18
Chia-En Hsieh, Chen-Te Chou, Chia-Cheng Lin, Kuo-Hua Lin, Ping-Yi Lin, Hui-Chuan Lin, Chih-Jan Ko, Ya-Yin Chang, Su-Han Wang, Yao-Li Chen
OBJECTIVES: Our goal was to evaluate the predictors of coagulopathic hemorrhage after living-donor liver transplant. MATERIALS AND METHODS: We retrospectively evaluated 161 patients who had undergone living-donor liver transplant from July 2005 to April 2014 at a single medical institution. Of these patients, 32 developed hemorrhage after transplant. Patients were separated into those with coagulopathy-related hemorrhage (n=15) or noncoagulopathy-related hemorrhage (n=17) based on the results of computed tomography images...
June 5, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28584505/management-and-outcome-of-patients-with-pancreatic-trauma
#19
Ravinder Pal Singh, Anuj Mahajan, Jaspal Singh Selhi, Nikhil Garg, Honey Chahal, Manjyot Bajwa
INTRODUCTION: Pancreatic trauma is a rare entity occurring in 0.2% of patients with blunt trauma abdomen. Once the diagnosis is made, the management of patients is dependent on multiple variables. Conservative management, suture repair, drainage, and resection have been utilized with varying degree of success. This study is aimed to evaluate the management of patients with pancreatic trauma. MATERIALS AND METHODS: This was a prospective study done in the Department of Surgery in Dayanand Medical College and Hospital where forty hemodynamically stable patients diagnosed to have pancreatic trauma on contrast-enhanced computed tomography abdomen were included in the study...
January 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/28584428/a-pilot-randomized-controlled-trial-of-comparison-between-extended-daily-hemodialysis-and-continuous-veno-venous-hemodialysis-in-patients-of-acute-kidney-injury-with-septic-shock
#20
Shakti Bedanta Mishra, Afzal Azim, Narayan Prasad, Ratendra Kumar Singh, Banani Poddar, Mohan Gurjar, Arvind Kumar Baronia
AIM OF STUDY: Acute kidney injury (AKI) is common in patients of septic shock. There is sparse data comparing sustained low-efficiency dialysis (SLED) and continuous renal replacement therapy (CRRT) in patients with septic shock. MATERIALS AND METHODS: This is a prospective randomized study in a 12-bedded medical intensive care unit. After clearance from institute's ethics committee and obtaining informed consent from the relatives, sixty adult patients with septic shock who were to undergo dialysis for AKI were included in the study...
May 2017: Indian Journal of Critical Care Medicine
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