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https://www.readbyqxmd.com/read/28333785/improving-decision-making-for-advanced-heart-failure-patients-and-caregivers
#1
Colleen K McIlvennan
In this month's Magnet® Perspectives column, Colleen K. McIlvennan, DNP, ANP, lead nurse practitioner, Advanced Heart Failure and Transplantation at the University of Colorado, discusses her groundbreaking research encompassing patients' and caregivers' emotional, rational, and fundamental beliefs when considering a left ventricular assist device (LVAD). Results have led to the development of 2 innovative decision aids that are currently in use by LVAD programs across the United States and Canada. Dr McIlvennan's efforts led to a $2 million grant from the Patient-Centered Outcomes Research Institute, as well as national recognition from the American Heart Association and the Heart Failure Society of America...
April 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28333642/endomicroscopy-for-computer-and-robot-assisted-intervention
#2
Siyang Zuo, Guang-Zhong Yang
Endomicroscopy is a new technique that allows human tissue to be characterized in vivo, and in situ, circumventing the need for conventional biopsy and histology. Despite increased application and growing research interests in this area, the clinical application of endomicroscopy, however, is limited by difficulties in ergonomic control, consistent probe-tissue contact, large area surveillance and retargeting. Recently, advances in high-speed imaging, mosaicing and robotics have aimed to address these difficulties...
March 22, 2017: IEEE Reviews in Biomedical Engineering
https://www.readbyqxmd.com/read/28333441/direct-chemical-vapor-deposition-growth-and-band-gap-characterization-of-mos2-h-bn-van-der-waals-heterostructures-on-au-foils
#3
Zhepeng Zhang, Xujing Ji, Jianping Shi, Xiebo Zhou, Shuai Zhang, Yue Hou, Yue Qi, Qiyi Fang, Qingqing Ji, Yu Zhang, Min Hong, Pengfei Yang, Xinfeng Liu, Qing Zhang, Lei Liao, Chuanhong Jin, Zhongfan Liu, Yanfeng Zhang
Stacked transition-metal dichalcogenides on hexagonal boron nitride (h-BN) are platforms for high-performance electronic devices. However, such vertical stacks are usually constructed by the layer-by-layer polymer-assisted transfer of mechanically exfoliated layers. This inevitably causes interfacial contamination and device performance degradation. Herein, we develop a two-step, low-pressure chemical vapor deposition synthetic strategy incorporating the direct growth of monolayer h-BN on Au foil with the subsequent growth of MoS2...
March 23, 2017: ACS Nano
https://www.readbyqxmd.com/read/28333037/cerebral-hemodynamic-with-intra-aortic-balloon-pump-business-as-usual
#4
Juliana Caldas, Ronney B Panerai, Edson Bor-Seng-Shu, Juliano Almeida, Graziela Ferreira, Ligia Cunha, Ricardo Nogueira, Marcelo Oliveira, Fabio Jatene, Thompson Robinson, Ludhmila Hajjar
Intra-aortic balloon pump (IABP) is commonly used as mechanical support after cardiac surgery or cardiac shock. Although its benefits for cardiac function have been well documented, its effects on cerebral circulation are still controversial. We hypothesized that transfer function analysis (TFA) and continuous estimates of dynamic cerebral autoregulation (CA) provide consistent results in the assessment of cerebral autoregulation in patients with IABP. Continuous recordings of blood pressure (BP, intra-arterial line), end-tidal CO2, heart rate and cerebral blood flow velocity (CBFV, transcranial Doppler) were obtained i) 5 minutes with IABP ratio 1:3, ii) 5 minutes, starting 1 minute with the IABP-ON, and continuing for another 4 minutes without pump assistance (IABP-OFF)...
March 23, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28332444/a-functional-electrical-stimulation-system-for-human-walking-inspired-by-reflexive-control-principles
#5
Lin Meng, Bernd Porr, Catherine A Macleod, Henrik Gollee
This study presents an innovative multichannel functional electrical stimulation gait-assist system which employs a well-established purely reflexive control algorithm, previously tested in a series of bipedal walking robots. In these robots, ground contact information was used to activate motors in the legs, generating a gait cycle similar to that of humans. Rather than developing a sophisticated closed-loop functional electrical stimulation control strategy for stepping, we have instead utilised our simple reflexive model where muscle activation is induced through transfer functions which translate sensory signals, predominantly ground contact information, into motor actions...
April 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28332395/electrolyte-gated-red-green-and-blue-organic-light-emitting-diodes
#6
Jiang Liu, Dustin Yuan Chen, Xinning Luan, Kwing Tong, Fangchao Zhao, Chao Liu, Qibing Pei, Huaping Li
We report vertical, electrolyte-gated, red, green and blue phosphorescent small molecule organic light emitting diodes (OLED), in which light emission was modified by tuning the electron injection via electrochemical doping of the electron injection layer 4,4-bis(N-carbazolyl)-1,1-biphenyl (CBP) under the assistance of a polymer electrolyte. These devices comprise an electrolyte capacitor on top of a conventional OLED, with the interfacial contact between the electrolyte and electron injection layer CBP of OLEDs achieved through a porous cathode...
March 23, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28331371/vacuum-assisted-cesarean-section
#7
REVIEW
Ross W McQuivey, Jon E Block
There has been a dramatic rise in the frequency of cesarean sections, surpassing 30% of all deliveries in the US. This upsurge, coupled with a decreasing willingness to allow vaginal birth after cesarean section, has resulted in an expansion of the use of vacuum assistance to safely extract the fetal head. By avoiding the use of a delivering hand or forceps blade, the volume being delivered through the uterine incision can be decreased when the vacuum is used properly. Reducing uterine extensions with their associated complications (eg, excessive blood loss) in difficult cases is also a theoretical advantage of vacuum delivery...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28331275/the-use-of-the-endograb%C3%A2-port-free-endocavity-retractor-in-single-incision-laparoscopic-right-hemicolectomy
#8
Yasumitsu Hirano, Masakazu Hattori, Kenji Douden, Yasuo Hashizume
The EndoGrab™ Port-Free Endocavity Retractor is an internally anchored retracting device that enables surgeons to reduce not only the number of ports and incisions but also the number of assistant surgeons. Our institution performs single-incision laparoscopic colectomy (SILC) as a routine procedure. Forty-nine patients underwent a single-incision laparoscopic right hemicolectomy. In this procedure, we use this retractor to the mesenteric tissue, including the ileocolic vessels and the mesentery of the transverse colon, and overcame the technical problems related to SILC and showed excellent short-term outcomes...
February 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28331240/minimally-invasive-breast-fibroadenoma-excision-using-an-ultrasound-guided-vacuum-assisted-biopsy-device
#9
Thomas Papathemelis, Stefanie Heim, Michael P Lux, Ines Erhardt, Anton Scharl, Sophia Scharl
Introduction We studied the extent to which an ultrasound-guided vacuum-assisted biopsy device ("hand-held Mammotome") could be used not only as a valuable tool for investigation of suspicious breast lesions, but also therapeutically for the complete removal of breast fibroadenomas. Materials and Methods 132 aspiration biopsies showing fibroadenoma on histology were collected retrospectively. We ascertained whether there were residual findings on breast ultrasound at a median follow-up of approx. 9 months following biopsy...
February 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/28331172/an-anti-coagulation-conundrum-implantation-of-total-artificial-heart-in-a-patient-with-heparin-induced-thrombocytopenia-type-ii
#10
Theodore J Cios, Yuliana Salamanca-Padilla, Dmitri Guvakov
BACKGROUND Heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication of heparin administration. It can present a major clinical dilemma for physicians caring for patients requiring life-saving urgent or emergent cardiac surgery. Studies have been published examining the use of alternative anticoagulants for patients undergoing cardiopulmonary bypass (CPB), however, evidence does not clearly support any particular approach. Presently, there are no large-scale, prospective randomized studies examining the impact of alternative anticoagulants on clinical outcomes for HIT-positive patients requiring cardiac surgery...
March 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28330991/limb-flexion-induced-twist-and-associated-intramural-stresses-in-the-human-femoropopliteal-artery
#11
Anastasia Desyatova, William Poulson, Paul Deegan, Carol Lomneth, Andreas Seas, Kaspars Maleckis, Jason MacTaggart, Alexey Kamenskiy
High failure rates of femoropopliteal artery (FPA) interventions are often attributed to severe mechanical deformations that occur with limb movement. Torsion of the FPA likely plays a significant role, but is poorly characterized and the associated intramural stresses are currently unknown. FPA torsion in the walking, sitting and gardening postures was characterized in n = 28 in situ FPAs using intra-arterial markers. Principal mechanical stresses and strains were quantified in the superficial femoral artery (SFA), adductor hiatus segment (AH) and the popliteal artery (PA) using analytical modelling...
March 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28330751/reduction-in-heart-failure-hospitalizations-with-ambulatory-hemodynamic-monitoring-seen-in-clinical-trials-is-maintained-in-the-real-world
#12
Akshay S Desai, Arvind Bhimaraj, Rupinder Bharmi, Rita Jermyn, Kunjan Bhatt, David Shavelle, Margaret M Redfield, Robert Hull, Jamie A Pelzel, Kevin Davis, Nirav Dalal, Philip B Adamson, J Thomas Heywood
BACKGROUND: In the CHAMPION trial, heart failure hospitalization (HFH) rates were lower in patients managed with guidance from an implantable pulmonary artery pressure (PAP) sensor compared to usual care. OBJECTIVES: To examine the effectiveness of ambulatory hemodynamic monitoring in reducing HFH outside the clinical trial setting. METHODS: We conducted a retrospective cohort study using US Medicare claims data from patients undergoing PAP sensor implantation between 6/1/2014 and 12/31/2015...
March 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28329284/contemporary-outcome-of-unplanned-right-ventricular-assist-device-for-severe-right-heart-failure-after-continuous-flow-left-ventricular-assist-device-insertion
#13
Daisuke Yoshioka, Hiroo Takayama, Reshad A Garan, Veli K Topkara, Jiho Han, Paul Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Koji Takeda
OBJECTIVES: The timely use of a right ventricular assist device (RVAD) becomes necessary for severe right heart failure (RHF) after left ventricular assist device (LVAD) insertion. This study evaluates outcomes in patients who required unplanned RVAD support early after continuous-flow (CF) LVAD insertion. METHODS: We retrospectively reviewed 305 patients who underwent HeartMate II/HeartWare CF-LVAD insertion between 2009 and 2014. Twenty-seven (9%) patients required unplanned RVAD for severe RHF early after LVAD insertion...
March 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329269/proteomics-highlights-decrease-of-matricellular-proteins-in-left-ventricular-assist-device-therapy%C3%A2
#14
Jasmin Hasmik Shahinian, Bettina Mayer, Stefan Tholen, Kerstin Brehm, Martin L Biniossek, Hannah Füllgraf, Selina Kiefer, Ulrike Heizmann, Claudia Heilmann, Florian Rüter, Martin Grapow, Oliver Thomas Reuthebuch, Friedrich Eckstein, Friedhelm Beyersdorf, Oliver Schilling, Matthias Siepe
OBJECTIVES: We investigated the impact of mechanical unloading with a left ventricular assist device (LVAD) on the myocardial proteome. METHODS: We collected 11 patient-matched samples of myocardial left ventricular tissue of patients with non-ischaemic dilate cardiomyopathy, harvested at time of LVAD implant ('pre-LVAD') and heart transplant ('post-LVAD'). Samples were studied by quantitative proteomics. Further we performed histological assessment of deposited collagens and immune infiltration in both pre- and post-LVAD samples...
February 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329164/large-animal-model-of-functional-tricuspid-regurgitation-in-pacing-induced-end-stage-heart-failure
#15
Marcin Malinowski, Alistair G Proudfoot, David Langholz, Lenora Eberhart, Michael Brown, Hans Schubert, Jeremy Wodarek, Tomasz A Timek
OBJECTIVES: Functional tricuspid regurgitation (FTR) is common in patients with advanced heart failure and frequently complicates left ventricular assist device implantation yet remains poorly understood. We set out to establish large animal model of FTR that could serve as a research platform to investigate the pathogenesis of FTR associated with end-stage heart failure. METHODS: : Through right thoracotomy, ten adult sheep underwent implantation of pacemaker with epicardial LV lead, five sonomicrometry crystals on the right ventricle, and left and right ventricular telemetry pressure sensors during a beating heart off-pump procedure...
February 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329162/the-value-of-fluorine-18-deoxyglucose-positron-emission-tomography-scans-in-patients-with-ventricular-assist-device-specific-infections%C3%A2
#16
Alexander M Bernhardt, Mustafa A Pamirsad, Chantal Brand, Daniel Reichart, Milena Tienken, Markus J Barten, Andreas Schaefer, Hanno Grahn, Meike Rybczynski, Tobias Deuse, Hermann Reichenspurner, Florian M Wagner
BACKGROUND: Infections are major complications in patients with ventricular assist devices (VAD). Positron emission tomography with deoxyglucose marked by fluorine-18 ( 18 F-FDG PET/CT) is a diagnostic tool to scan for tissue with high metabolism as present in infections. The specificity of 18 F-FDG PET/CT to discriminate between infection and an aseptic reaction of the implanted device is not defined and its evaluation is the aim of this retrospective analysis. METHODS: Until September 2015 a total of 100 patients underwent VAD implantations in our institution...
February 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329112/comparison-of-paracorporeal-and-continuous-flow-ventricular-assist-devices-in-children-preliminary-results%C3%A2
#17
Mohamed S Nassar, Asif Hasan, Teresa Chila, Stephan Schueler, Carola Pergolizzi, Zdenka Reinhardt, Stephen Lord, Fabrizio De Rita, Lee Ferguson, Jon Smith, Simon Haynes, John O'Sullivan, Bari Murtuza
OBJECTIVES: With the scarcity of organs, a durable, reliable ventricular assist device (VAD) is required. The Berlin Heart EXCOR ® (BH) remains the most established VAD in the paediatric population. Implantable continuous flow (CF) VADs have been introduced to the paediatric field with encouraging early results. In this study, we compared the results of a newly introduced CF VAD (HeartWare VAD [HVAD] ® ) to results in a matched group of BH recipients. METHODS: The study included patients aged <16 years who received mechanical left VAD (LVAD) support between December 2005 and January 2016...
February 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329105/medical-three-dimensional-printing-opens-up-new-opportunities-in-cardiology-and-cardiac-surgery
#18
Thomas Bartel, Andrew Rivard, Alejandro Jimenez, Carlos A Mestres, Silvana Müller
Advanced percutaneous and surgical procedures in structural and congenital heart disease require precise pre-procedural planning and continuous quality control. Although current imaging modalities and post-processing software assists with peri-procedural guidance, their capabilities for spatial conceptualization remain limited in two- and three-dimensional representations. In contrast, 3D printing offers not only improved visualization for procedural planning, but provides substantial information on the accuracy of surgical reconstruction and device implantations...
February 16, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329060/first-series-of-left-ventricular-assist-device-exchanges-to-heartmate-3
#19
Jasmin S Hanke, Sebastian V Rojas, Günes Dogan, Christina Feldmann, Erik Beckmann, Ezin Deniz, Bettina Wiegmann, Jana-Elena Michaelis, L Christian Napp, Dominik Berliner, Malakh Shrestha, Johann Bauersachs, Axel Haverich, Jan D Schmitto
OBJECTIVES: Left ventricular assist device (LVAD) exchange is becoming a standard surgical procedure. The exchange procedure is an opportunity to upgrade patients to a new generation pump that offers advanced reduction of adverse events or longer battery hours. METHODS: We performed an analysis of 6 consecutive patients who underwent LVAD exchange to HeartMate 3 either from a HeartWare or HeartMate (HM) II device. Minimally invasive operations were performed through a lateral thoracotomy...
March 13, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328585/mechanical-support-with-impella-during-malignant-arrhythmia-ablation-a-case-report-on-the-growing-trend-in-the-electrophysiology-laboratory
#20
Adam C Adler, Ramesh Kodavatiganti
Congenitally corrected transposition of the great arteries is a rare form of congenital heart disease in which the persistence of the right ventricle as the systemic ventricle leads to heart failure, tricuspid valve insufficiency, and arrhythmia. Supraventricular arrhythmias are especially common in these patients. We discuss the anesthetic management of a 33-year-old patient with congenitally corrected transposition of the great arteries who required a ventricular assist device to maintain cardiac output during ablation of supraventricular tachyarrythmia...
March 17, 2017: A & A Case Reports
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