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Mechanical assist device

Emanuele Mauri, Alessandro Sacchetti, Filippo Rossi
The use of polymers as biomaterials has provided significant advantages in therapeutic applications. In particular, the possibility to modify and functionalize polymer chains with compounds that are able to improve biocompatibility, mechanical properties, or cell viability allows the design of novel materials to meet new challenges in the biomedical field. With the polymer functionalization strategies, click chemistry is a powerful tool to improve cell-compatibility and drug delivery properties of polymeric devices...
October 7, 2016: Journal of Visualized Experiments: JoVE
Jessica Rimsans, Katelyn W Sylvester, Jean M Connors
Available options for the treatment of advanced heart failure have expanded to include the use of mechanical circulatory assist devices to improve quality of life in those both eligible and ineligible for heart transplant. Although there have been significant advancements in device technologies, anticoagulation protocols, and multidisciplinary team management, bleeding and thrombosis are the most common adverse effects. Management strategies for pump thrombosis and their outcomes vary considerably among mechanical circulatory support centers and include intensification of antithrombotic therapy (medical) and device exchange (surgical)...
October 7, 2016: Clinical and Applied Thrombosis/hemostasis
Ju H Kim, Ramesh Singh, Francis D Pagani, Shashank S Desai, Nicholas A Haglund, Shannon M Dunlay, Simon Maltais, Keith D Aaronson, John M Stulak, Mary E Davis, Christopher T Salerno, Jennifer A Cowger, Palak Shah
BACKGROUND: Limited data exist on outcomes in patients greater than 70 years of age supported with continuous flow left ventricular assist devices (LVAD). METHODS: Data on 1,149 continuous-flow LVAD recipients was queried from the Mechanical Circulatory Support Research Network. Groups were assigned based on age: ≥70 years ("older patients") and <70 years. The primary outcome was survival at one-year based on age grouping. RESULTS: Compared with younger patients, (54...
October 17, 2016: Journal of Cardiac Failure
O P Sanjay
The use of mechanical circulatory support for patients with severe heart failure is on the rist. The poeoperative, intraoperative and postoperative challenges the anaesthesiologists skills. These are discussed in this review.
October 2016: Annals of Cardiac Anaesthesia
S Ten Hoorn, P W Elbers, A R Girbes, P R Tuinman
BACKGROUND: Ventilator-dependent patients in the ICU often experience difficulties with one of the most basic human functions, namely communication, due to intubation. Although various assistive communication tools exist, these are infrequently used in ICU patients. We summarized the current evidence on communication methods with mechanically ventilated patients in the ICU. Secondly, we developed an algorithm for communication with these patients based on current evidence. METHODS: We performed a systematic review...
October 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
Henrik Vase, Steffen Christensen, Aage Christiansen, Christian Juhl Therkelsen, Evald Høj Christiansen, Hans Eiskjær, Steen Hvidtfeldt Poulsen
INTRODUCTION: Mechanical circulatory support may be considered as a therapeutic option in selected patients with refractory cardiac arrest (rCA). Animal studies suggest a potential role for the Impella(®) left ventricular assist device in this setting, but so far no human data have been published. METHODS: Eight patients with rCA were treated with the Impella CP(®) device at our institution from November 2014 to October 2015. The Impella CP(®) was used at the discretion of the treating physicians in patients with rCA and pulseless electrical activity with presumed primary left ventricular failure...
October 14, 2016: Resuscitation
Jesus M Casida, Horng-Shiuann Wu, Martha Abshire, Bidisha Ghosh, James J Yang
BACKGROUND: There is no empirical study about the context and influence of self-management (SM) factors on quality of life (QOL) among adults with left ventricular assist device (LVADs). The purpose of this study was to close this knowledge gap by: (1) differentiating select SM factors (e.g., cognition) and overall QOL based on LVAD implant durations; (2) examining the relationships among SM factors and QOL variables; and (3) identifying which SM factors predict QOL. METHODS: An observational study was employed including 87 LVAD patients, ages 20 to 80 years, with mean implant durations of 18...
September 13, 2016: Journal of Heart and Lung Transplantation
Dominik Wiedemann, Thomas Schlöglhofer, Julia Riebandt, Markus Neuner, Edda Tschernko, Heinrich Schima, Daniel Zimpfer
Peripartum cardiomyopathy requiring mechanical ciruculatory support is rare however it is a lifethreatening disease with recovery rates poorer than expected. Herein we describe a case of successfull recovery of a patient with peripartum cardiomyopathy. Implantation of a biventricular ventricular assist device was performed, additonally the patient's hyperprolactinemia was treated with Cabergoline resulting in a fast complete restoration of ventricular function.
September 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Carlos A Teixeira, Gabriela Furlan Giordano, Maisa B Beltrame, Luis Carlos Silveira Vieira, Angelo Luiz Gobbi, Renato Sousa Lima
The contamination, passivation, or fouling of the detection electrodes is a serious problem undermining the analytical performance of electroanalytical devices. The methods to regenerate the electrochemical activity of the solid electrodes involve mechanical, physical, or chemical surface treatments that usually add operational time, complexity, chemicals, and further instrumental re-quirements to the analysis. In this paper, we describe for the first time a reproducible method for renewing solid electrodes when-ever their morphology or composition are non-specifically changed without any surface treatment...
October 17, 2016: Analytical Chemistry
Xinxin Li, Bryan Ruddy, Andrew Taberner
Hypodermic injections have been the standard for transcutaneous drug delivery for many years. However, needle phobia, pain, and risks of needle-stick injuries have manifested in poor patient compliance. Needle-free jet injections (NFJI) have been developed to address these drawbacks but the reliability of dose and depth of delivery have been limited by a lack of control over jet parameters, and by variability in the skin's mechanical properties among individuals. Moreover, the device size and cost have been restrained by the high pressure (>20MPa) required to penetrate the skin...
October 13, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
Jonathan D Rich, Igor Gosev, Chetan B Patel, Susan Joseph, Jason N Katz, Peter M Eckman, Sangjin Lee, Kartik Sundareswaran, Ahmet Kilic, Brian Bethea, Behzad Soleimani, Brian Lima, Nir Uriel, Michael Kiernan
BACKGROUND: Early right-sided heart failure (RHF) after left ventricular assist device (LVAD) implantation is associated with increased mortality, but little is known about patients who develop late RHF (LRHF). We evaluated the incidence, risk factors, and clinical impact of LRHF in patients supported by axial-flow LVADs. METHODS: Data were analyzed from 537 patients enrolled in the HeartMate II (HM II; Thoratec/St. Jude) destination therapy clinical trial. LRHF was defined as the development of clinical RHF accompanied by the need for inotropic support occurring more than 30 days after discharge from the index LVAD implant hospitalization...
August 20, 2016: Journal of Heart and Lung Transplantation
Snehal R Patel, Shivank Madan, Omar Saeed, Mohammed Algodi, Anne Luke, Marc Gibber, Daniel J Goldstein, Ulrich P Jorde
OBJECTIVES: This study sought to determine whether the nasal mucosa can serve as a surrogate for evaluating arteriovenous malformations (AVMs) related gastrointestinal (GI) bleeding in patients supported by continuous flow left ventricular assist devices (CF LVADs). BACKGROUND: Bleeding from the mucosal surfaces of GI tract, particularly AVMs, is the most common complication of CF LVAD support. The pathophysiology of AVM formation during CF LVAD support is of critical interest yet poorly understood; in large part because of the length and accessibility of the GI tract...
September 29, 2016: JACC. Heart Failure
M Hirschvogel, M Bassilious, L Jagschies, S M Wildhirt, M W Gee
A model for patient-specific cardiac mechanics simulation is introduced, incorporating a 3-dimensional finite element model of the ventricular part of the heart which is coupled to a reduced-order 0-dimensional closed-loop vascular system, heart valve and atrial chamber model.The ventricles are modeled by a nonlinear orthotropic passive material law. The electrical activation is mimicked by a prescribed parametrized active stress acting along a generic muscle fiber orientation. Our activation function is constructed such that the start of ventricular contraction and relaxation as well as the active stress curve's slope are parameterized...
October 15, 2016: International Journal for Numerical Methods in Biomedical Engineering
James Wever-Pinzon, Craig H Selzman, Greg Stoddard, Omar Wever-Pinzon, Anna Catino, Abdallah G Kfoury, Nikolaos A Diakos, Bruce B Reid, Stephen McKellar, Michael Bonios, Antigone Koliopoulou, Deborah Budge, Aaron Kelkhoff, Josef Stehlik, James C Fang, Stavros G Drakos
BACKGROUND: Small-scale studies focused mainly on nonischemic cardiomyopathy (NICM) have shown that a subset of left ventricular assist device (LVAD) patients can achieve significant improvement of their native heart function, but the impact of ischemic cardiomyopathy (ICM) has not been specifically investigated. Many patients with acute myocardial infarction are discharged from their index hospitalization without heart failure (HF), only to return much later with overt HF syndrome, mainly caused by chronic remodeling of the noninfarcted region of the myocardium...
October 18, 2016: Journal of the American College of Cardiology
Matthew Harris, Grigoris V Karamasis, Shayna Chotai, Kare H Tang, Gerald J Clesham, Paul A Kelly
Intra-aortic balloon pump (IABP) is commonly used as a cardiac assist device in various clinical situations: cardiogenic shock, mechanical complications of acute myocardial infarction, high risk percutaneous coronary interventions, coronary artery bypass graft surgery and refractory unstable angina and ventricular arrhythmias as bridge to therapy. Although current data support its safety, there is limited or no support for its efficacy. We present the case of spinal cord infarction after IABP use in a patient who presented with ST elevation myocardial infarction and cardiac arrest and we discuss the potential mechanism of such a devastating complication...
October 13, 2016: Acute Cardiac Care
Kan Zhan, Rui Su, Sihang Bai, Zhenhua Yu, Nian Cheng, Changlei Wang, Sheng Xu, Wei Liu, Shishang Guo, Xing-Zhong Zhao
The properties of nanomaterials are highly dependent on their size, shape and composition. Compared with zero-dimensional nanoparticles, the increased dimension of a one-dimensional silver nanowire (AgNW/Ag NW) leads to extra challenges on synthesizing it with controllable sizes. Here, a convenient way for the synthesis of AgNWs with tunable sizes has been developed simply by adjusting the amount of salt additives, i.e., ferric chloride (FeCl3), or Fe(NO3)3 & KCl. The average diameter and length of nanowires are readily tailored within 45-220 nm and 10-230 μm, respectively...
October 13, 2016: Nanoscale
Ye Ding, Fausto A Panizzolo, Christopher Siviy, Philippe Malcolm, Ignacio Galiana, Kenneth G Holt, Conor J Walsh
BACKGROUND: Recent advances in wearable robotic devices have demonstrated the ability to reduce the metabolic cost of walking by assisting the ankle joint. To achieve greater gains in the future it will be important to determine optimal actuation parameters and explore the effect of assisting other joints. The aim of the present work is to investigate how the timing of hip extension assistance affects the positive mechanical power delivered by an exosuit and its effect on biological joint power and metabolic cost during loaded walking...
October 3, 2016: Journal of Neuroengineering and Rehabilitation
Mingyue Chen, Zhiguo Xia, Quanlin Liu
This paper demonstrates a facile hydrothermal method using ethylenediamine (EDA) as a "shape modifier" for the controlled synthesis of rod bunch, decanedron, spindle, flakiness, and flowerlike NaCaSiO3OH microarchitectures. The set of experimental conditions is important to obtain adjustable shape and size of NaCaSiO3OH particles, as the change in either the amount of EDA/H2O or reaction time, or the amount of NaOH. Accordingly, the crystal growth mechanism during the synthesis process is proposed, and it is found that the EDA, acting as the chelating agent and shape modifier, plays a crucial role in fine-tuning the NaCaSiO3OH morphology...
October 7, 2016: Inorganic Chemistry
C Wallmüller, P Stratil, A Schober
The development of technical assist devices in the context of cardiopulmonary resuscitation (CPR) reaches back to the early roots of modern resuscitation research. This article covers the subjects of extracorporeal CPR (ECPR), including extracorporeal life support (ECLS), emergency ECLS (EECLS) and mechanical resuscitation devices. Specifically, the potential use of active compression-decompression CPR (ACD-CPR), impedance threshold devices (ITD) and capnography as additional measures during resuscitation are described in detail...
October 6, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Osamu Ito
In this account, studies on the photosensitizing electron transfer of nanocarbons, such as fullerenes, single-walled carbon nanotubes (SWCNTs), and carbon nanohorns (CNH), performed in our laboratory for about 15 years in the early 21st century have been briefly reviewed. These novel nanocarbons act as excellent electron acceptors, when they are linked to light-absorbing electron donors, such as porphyrins or phthalocyanines. For such molecule-nanocarbon hybrids, the direct confirmation of fast, transient, electron-transfer phenomena must be performed with time-resolved spectroscopic methods, such as transient absorption spectral measurements, in addition to fluorescence time-profile measurements in the wide-wavelength regions...
October 4, 2016: Chemical Record: An Official Publication of the Chemical Society of Japan ... [et Al.]
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