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https://www.readbyqxmd.com/read/28345431/collaterals-2016-translating-the-collaterome-around-the-globe
#1
David S Liebeskind, Graham W Woolf, Ashfaq Shuaib
Collaterals 2016 (third International Symposium on Collaterals to the Brain) was a multidisciplinary scientific conference focused on collateral circulation in acute ischemic stroke. Decisive challenges include generalizability of optimal triage and selection paradigms based on collateral status for definitive treatment of acute ischemic stroke, rapid dissemination of expert methods, and the urgent need to leverage networking opportunities for stroke science related to the hemodynamics of collaterals. The collaterome, or individual capacity to offset ischemia in the brain, and determination of a favorable collateral profile have become pivotal factors in consideration of the precision medicine of stroke decision-making...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28340895/post-operative-consequences-of-hemodynamic-optimization
#2
A Lazkani, G Lebuffe
Hemodynamic optimization begins with a medical assessment to identify the high-risk patients. This stratification is needed to customize the choice of hemodynamic support that is best adapted to the patient's level of risk, integrating the use of the least invasive procedures. The macro-circulatory hemodynamic approach aims to maintain a balance between oxygen supply (DO2) and oxygen demand (VO2). Volume replacement plays a crucial role based on the titration of fluid boluses according to their effect on measured stroke volume or indices of preload dependency...
December 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28333373/ventricular-arrhythmias-in-patients-with-newly-diagnosed-nonischemic-cardiomyopathy-insights-from-the-prolong-study
#3
David Duncker, Thorben König, Stephan Hohmann, Johann Bauersachs, Christian Veltmann
BACKGROUND: Patients with nonischemic cardiomyopathy (NICM) reportedly have low incidence of appropriate shocks from wearable cardioverter-defibrillators (WCDs). A recent study questions the benefit from primary preventive implantation of implantable cardioverter-defibrillators in NICM. We therefore analyzed a subgroup of patients with NICM from the PROLONG study. HYPOTHESIS: Patients with newly diagnosed NICM show a risk for ventricular tachyarrhythmia. METHODS: The PROLONG study included 167 patients with newly diagnosed heart failure and left ventricular ejection fraction (LVEF) ≤35% with a WCD...
March 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28332221/right-ventricular-free-wall-longitudinal-speckle-tracking-strain-in-patients-with-pulmonary-arterial-hypertension-under-specific-treatment
#4
Hatice S Kemal, Meral Kayikcioglu, Hakan Kultursay, Ozcan Vuran, Sanem Nalbantgil, Nesrin Mogulkoc, Levent Can
BACKGROUND: Right ventricular (RV) dysfunction is a major determinant of outcomes in patients with pulmonary arterial hypertension (PAH), although the optimal measure of RV function is poorly defined. We evaluated the utility of RV free-wall speckle tracking strain as an assessment tool for RV function in patients with PAH who are already under specific treatment compared with conventional echocardiographic parameters and investigated the relationship of RV free-wall strain with clinical hemodynamic parameters of RV performance...
March 23, 2017: Echocardiography
https://www.readbyqxmd.com/read/28332137/correction-of-dilutional-anemia-induces-renal-dysfunction-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-a-consequence-of-microcirculatory-alterations
#5
Güçlü Aykut, Meltem Kilercik, Cem Arıtürk, Halim Ulugöl, Uğur Aksu, Türkan Kudsioğlu, Nazan Atalan, Nihan Yapıcı, Hasan Karabulut, Fevzi Toraman
BACKGROUND: In this study we aimed to evaluate the effects of dilutional anemia resulting from cardiopulmonary bypass (CPB) and its correction with red blood cell (RBC) transfusion on tissue oxygenation and renal function in diabetic patients undergoing coronary artery bypass grafting (CABG). METHOD: 70 diabetic patients who underwent elective CABG and whose hematocrit values had been between 24-28% at any time during CBP were prospectively randomized and equally allocated to two groups: patients who received RBC during CPB (group I, n = 35) vs...
March 22, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28330737/optimizing-the-assessment-of-pediatric-injury-severity-in-low-resource-settings-consensus-generation-through-a-modified-delphi-analysis
#6
Etienne St-Louis, Dan Leon Deckelbaum, Robert Baird, Tarek Razek
INTRODUCTION: Although a plethora of pediatric injury severity scoring systems is available, many of them present important challenges and limitations in the low resource setting. Our aim is to generate consensus among a group of experts regarding the optimal parameters, outcomes, and methods of estimating injury severity for pediatric trauma patients in low resource settings. MATERIALS AND METHODS: A systematic review of the literature was conducted to identify and compare existing injury scores used in pediatric patients...
March 15, 2017: Injury
https://www.readbyqxmd.com/read/28327167/optimal-release-timing-of-temporary-drain-clamping-after-total-knee-arthroplasty
#7
Yoon Sang Jeon, Jun Sung Park, Myung Ku Kim
BACKGROUND: Bleeding control is critical after total knee arthroplasty (TKA). The purpose of this study was to evaluate the optimal time to release the clamped drain after TKA. METHODS: We performed unilateral TKA in 120 patients using three methods of drainage. Group A (N = 40) had a 3-hour clamp applied, and group B (N = 40) had a 4-hour clamp applied. Group C (N = 40) underwent conventional negative drainage. We evaluated the drainage volume, as well as the hemodynamic markers, transfusion volume, visual analog scale (VAS) scores, and range of motion (ROM)...
March 21, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28325140/vitamins-in-heart-failure-friend-or-enemy
#8
George Georgiopoulos, Christina Chrysohoou, Georgia Vogiatzi, Nikolaos Magkas, Ippokratis Bournelis, Sofia Bampali, Damien Gruson, Dimitris Tousoulis
BACKGROUND: The failing heart is characterized by a depleted metabolic energy reserve and the up-regulation of several molecular mechanisms leading to cardiac hypertrophy, inflammation, fibrosis, angiogenesis, and apoptosis. Dietary or non-dietary supplementation of vitamins could potentially benefit energy balance. OBJECTIVE: The objective of the present study was to evaluate all available information on vitamins supplementation in patients with chronic HF for possible beneficial effect on metabolic, inotropic, chronotropic and hemodynamic indices...
March 20, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28323662/hvad-flow-waveform-morphologies-theoretical-foundation-and-implications-for-clinical-practice
#9
Jonathan D Rich, Daniel Burkhoff
Continuous flow ventricular assist device (cfVAD) performance and patient hemodynamic conditions are intimately interrelated and dynamic, changing frequently with alterations in physiologic conditions, particularly pre- and after-loading conditions. The Heartware cfVAD (HVAD) provides a unique feature among currently approved VADs of providing an estimated instantaneous flow waveform, the characteristics of which can provide significant insights into patient and device properties. Despite being readily available, HVAD waveforms are poorly understood, underutilized and insufficiently leveraged, even by clinicians who regularly manage HVAD patients...
March 16, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28321965/robust-presurgical-functional-mri-at-7-t-using-response-consistency
#10
Pedro Lima Cardoso, Florian Ph S Fischmeister, Barbara Dymerska, Alexander Geißler, Moritz Wurnig, Siegfried Trattnig, Roland Beisteiner, Simon Daniel Robinson
Functional MRI is valuable in presurgical planning due to its non-invasive nature, repeatability, and broad availability. Using ultra-high field MRI increases the specificity and sensitivity, increasing the localization reliability and reducing scan time. Ideally, fMRI analysis for this application should identify unreliable runs and work even if the patient deviates from the prescribed task timing or if there are changes to the hemodynamic response due to pathology. In this study, a model-free analysis method-UNBIASED-based on the consistency of fMRI responses over runs was applied, to ultra-high field fMRI localizations of the hand area...
March 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28314673/can-we-perform-rotational-atherectomy-in-patients-with-severe-aortic-stenosis-substudy-from-the-ocean-tavi-registry
#11
Toru Naganuma, Hiroyoshi Kawamoto, Kensuke Takagi, Hiroto Yabushita, Satoru Mitomo, Yusuke Watanabe, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Masanori Yamamoto, Hirokazu Onishi, Sunao Nakamura, Akihiro Higashimori, Minoru Tabata, Kazuki Mizutani, Hiroshi Ueno, Kentaro Hayashida
PURPOSE: The aim of this study was to report the safety of coronary rotational atherectomy (RA) in patients with severe aortic stenosis (AS). RA in the clinical setting seems challenging because coronary slow flow leads to hemodynamic instability. METHODS: Between October 2013 and May 2016, 1401 patients in the Optimized transCathEter vAlvular iNtervention (OCEAN) registry in Japan underwent transcatheter aortic valve implantation (TAVI). The primary study endpoint was procedural success, defined as residual stenosis <20% with final Thrombolysis in Myocardial Infarction flow 3...
February 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28298766/comparison-of-perioperative-thoracic-epidural-fentanyl-with-bupivacaine-and-intravenous-fentanyl-for-analgesia-in-patients-undergoing-coronary-artery-bypass-grafting-surgery
#12
Amitabh Chanchal Sen, Sunil Rajan, Rakhi Balachandran, Lakshmi Kumar, Suresh Gangadharan Nair
CONTEXT: Two-thirds of patients undergoing coronary artery bypass grafting (CABG) surgery report moderate to severe pain, particularly with ambulatory or respiratory effort. AIMS: The aim of this study is to compare the analgesic effect of perioperative thoracic epidural fentanyl with bupivacaine and intravenous fentanyl in patients undergoing CABG surgery. SETTINGS AND DESIGN: The study was a prospective, randomized, nonblinded comparative study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298034/a-protocol-for-postoperative-admission-of-elective-craniotomy-patients-to-a-non-icu-or-step-down-setting
#13
Jeffrey E Florman, Deborah Cushing, Lynne A Keller, Anand I Rughani
OBJECTIVE Selecting the appropriate patients undergoing craniotomy who can safely forgo postoperative intensive care unit (ICU) monitoring remains a source of debate. Through a multidisciplinary work group, the authors redefined their institutional care process for postoperative monitoring of patients undergoing elective craniotomy to include transfer from the postanesthesia care unit (PACU) to the neurosurgical floor. The hypothesis was that an appropriately selected group of patients undergoing craniotomy could be safely managed outside the ICU in the postoperative period...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28297064/endovascular-treatment-of-swing-segment-stenosis-in-vascular-access-current-status-and-future-directions
#14
Rick de Graaf
Swing-segment lesions are a fairly common reason for access failure and predispose to repeated interventions. The pathophysiology, hemodynamic circumstances and the primary intervention might all play a role in early recurrence. Mainly, percutaneous transluminal angioplasty (PTA), bare metal stenting and stent graft implantation have been performed to prolong lesion patency and access circuit patency. The available data on endovascular treatment of swing-segment lesions are scarce, heterogeneous and of poor quality...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28296732/optimal-dose-of-intravenous-oxycodone-for-attenuating-hemodynamic-changes-after-endotracheal-intubation-in-healthy-patients-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Yong-Hee Park, Seung-Hyuk Lee, Oh Haeng Lee, Hyun Kang, Hwa-Yong Shin, Chong-Wha Baek, Yong Hun Jung, Young Cheol Woo
BACKGROUND: Intravenous oxycodone has been used as an adjunct to anesthetic agents. This study aimed to assess the optimal dose of intravenous oxycodone for the attenuation of the hemodynamic responses to laryngoscopy and endotracheal intubation. METHODS: A prospective, randomized, double-blind study was conducted. Ninety-five patients were randomly divided into 5 groups based on the oxycodone dose: 0, 0.05, 0.1, 0.15, 0.2 mg/kg. After administering the assigned dose of intravenous oxycodone, anesthesia was induced with thiopental...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28293976/evolution-of-hybrid-interventions-for-congenital-heart-disease
#16
Hitesh Agrawal, Wail Alkashkari, Damien Kenny
Surgical and transcatheter interventions have seen a tremendous evolution in last three decades. Hybrid technology combines the achievements of both disciplines to bring substantial hemodynamic benefit to patients with congenital heart disease (CHD) in a minimally invasive manner. This collaboration between surgeons and interventionalists will continue to grow as the technology evolves to meet the demands of CHD patients, potentially avoiding cardiopulmonary bypass and vascular access complications as well as optimizing immediate technical outcomes with exit angiography...
March 23, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28292655/a-one-dimensional-arterial-network-model-for-bypass-graft-assessment
#17
A R Ghigo, S Abou Taam, X Wang, P-Y Lagrée, J-M Fullana
We propose an arterial network model based on one-dimensional hemodynamic equations to study the behavior of different vascular surgical bypass grafts in the case of an arterial occlusive pathology: a stenosis of the Right Iliac artery. We investigate the performances of three different bypass grafts (Aorto-Femoral, Axillo-Femoral and cross-over Femoral) depending on the degree of obstruction of the stenosis. Numerical simulations show that all bypass grafts are efficient since we retrieve in each case the healthy hemodynamics downstream of the stenosed region while ensuring at the same time a global healthy circulation...
March 11, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28292391/endovascular-treatment-of-carotid-internal-jugular-venous-fistula-in-a-bomb-blast-victim
#18
Tariq Ashraf, Navedullah Khan, K M Yousaf, Maha Zainab Z. Yaqub
Carotid-internal jugular venous fistula is one of the rarest presentations among victims of bomb blast injuries. Treatment of such fistula is open surgery with high mortality and morbidity. Endovascular treatment with covered stent seems to have an optimal result with low complications. We present a case report of a bomb blast victim having carotid-jugular venous fistula with hemodynamic compromise. The patient was successfully managed with endovascular graft stent. There was an optimal result with no immediate and long-term complications...
February 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28290895/-hemodynamic-predictors-of-clinical-deterioration-in-patients-with-pulmonary-arterial-hypertension-associated-with-systemic-scleroderma
#19
E V Nikolaeva, I A Kurmukov, N N Yudkina, S I Glukhova, A V Volkov
OBJECTIVE: to elucidate hemodynamic predictors of clinical deterioration (CD) in patients with pulmonary arterial hypertension (PAH) associated with systemic scleroderma (SSD). MATERIAL AND METHODS: We included into this study 48 patients with PAH-SSD consecutively admitted in 2004-2014. At inclusion all patients underwent right heart catheterization (RHC) and thereafter were under dynamic observation. CD deterioration was diagnosed in the presence of the following: >15% decline in 6-minute walk test distance; worsening of PAH functional class; intensification of symptoms of right ventricular failure; necessity in administration of parenteral diuretics...
October 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290794/-hemodynamic-derangements-in-patients-with-functional-univentricular-heart-mechanisms-of-development-possibilities-of-treatment
#20
I A Kovalev, S Ovroutski, I V Plotnikova, A A Tupikina
Heart failure (HF) is a predictable outcome of nearly all cardiovascular diseases including congenital heart diseases (CHD). A special category comprises patients with functional single ventricle (FSV) of the heart because of extreme diversity of anatomical changes of the heart and great vessels, complex mechanisms of development of HF, multistage surgical correction of the defect, presence of arrhythmias, progressive rise of pulmonary vascular resistance, etc. Prevention and treatment of HF in patients with FSV includes surgical optimization of pulmonary blood flow during neonatal period, timely staged surgical correction of the defect, pharmacotherapy, cardiac resynchronization therapy, and in severe cases mechanical cardiac support and heart transplantation...
February 2017: Kardiologiia
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