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https://www.readbyqxmd.com/read/28316980/clinical-and-prognostic-significance-of-positive-hepatojugular-reflux-on-discharge-in-acute-heart-failure-insights-from-the-escape-trial
#1
Hesham R Omar, Maya Guglin
Background. There has been a decline in emphasis of the value of physical examination in heart failure (HF) with increased reliance on cardiac imaging. We aim to study the clinical and prognostic significance of positive hepatojugular reflux (HJR) on discharge in patients hospitalized with HF. Methods. Using the ESCAPE trial data, patients were compared according to the presence or absence of a positive HJR on discharge. The primary study endpoints were all-cause mortality and a composite endpoint of death, rehospitalization, and cardiac transplant during the first 6 months after discharge...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28315943/hyperoxia-reduces-oxygen-consumption-in-children-with-pulmonary-hypertension
#2
Long Guo, Prashant Bobhate, Shine Kumar, Karunakar Vadlamudi, Tarek Kaddoura, Mohamed Elgendi, Paula Holinski, James Y Coe, Jennifer Rutledge, Ian Adatia
High inspired oxygen concentration (FiO2 > 0.85) is administered to test pulmonary vascular reactivity in children with pulmonary hypertension (PH). It is difficult to measure oxygen consumption (VO2) if the subject is breathing a hyperoxic gas mixture so the assumption is made that baseline VO2 does not change. We hypothesized that hyperoxia changes VO2. We sought to compare the VO2 measured by a thermodilution catheter in room air and hyperoxia. A retrospective review of the hemodynamic data obtained in children with PH who underwent cardiac catheterization was conducted between 2009 and 2014...
March 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28302292/short-term-effects-of-tolvaptan-in-patients%C3%A2-with-acute-heart-failure-and%C3%A2-volume-overload
#3
Marvin A Konstam, Michael Kiernan, Arthur Chandler, Ravi Dhingra, Freny Vaghaiwalla Mody, Howard Eisen, W Herbert Haught, Lynne Wagoner, Divya Gupta, Richard Patten, Paul Gordon, Kenneth Korr, Russell Fileccia, Susan J Pressler, Douglas Gregory, Patricia Wedge, Douglas Dowling, Matthew Romeling, Jeremy M Konstam, Joseph M Massaro, James E Udelson
BACKGROUND: In patients with acute heart failure (AHF), dyspnea relief is the most immediate goal. Renal dysfunction, diuretic resistance, and hyponatremia represent treatment impediments. OBJECTIVES: It was hypothesized that the addition of tolvaptan to a background diuretic improved dyspnea early in patients selected for an enhanced vasopressin antagonism response. METHODS: In a double-blind trial, patients were randomized to tolvaptan 30 mg/day or placebo...
March 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28302132/long-term-results-and-comparison-of-the-three-different-high-tibial-osteotomy-and-fixation-techniques-in-medial-compartment-arthrosis
#4
Gökhan Polat, Halil İbrahim Balcı, Mehmet Fevzi Çakmak, Mehmet Demirel, Cengiz Şen, Mehmet Aşık
BACKGROUND: The purpose of this study is to report and analyze the long-term outcomes of the patients who underwent high tibial osteotomy (HTO) with three different techniques for the treatment of medial compartment arthrosis. METHODS: A total of 187 patients (195 knees) who underwent HTO between 1990 and 2010 were retrospectively evaluated. Eighty-eight knees, opening-wedge osteotomy with Puddu plate (group A); 51 knees, transverse osteotomy below the tubercle with external fixator (group B); and 29 knees, closing-wedge osteotomy with staple fixation (group C) were included in the study...
March 16, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28295946/feasibility-and-interpretation-of-global-longitudinal-strain-imaging-in-pediatric-heart-transplant-recipients
#5
Bethany L Wisotzkey, Neal W Jorgensen, Erin L Albers, Mariska S Kemna, Robert J Boucek, Richard A Kronmal, Yuk M Law, Aarti H Bhat
Evaluation of myocardial mechanics after heart transplant is important in monitoring allograft function and identifying rejection. Speckle tracking global longitudinal strain (GLS) may be more sensitive to early regional changes from rejection. This study aimed to determine feasibility of GLS in pediatric hearts during surveillance echocardiograms, compare their GLS to published norms (-18% to -22%), and assess association of GLS with other indices of graft function. Retrospective review of transplant echocardiograms from 2013 to 2014...
March 10, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28274560/antithrombin-iii-is-associated-with-acute-liver-failure-in-patients-with-end-stage-heart-failure-undergoing-mechanical-circulatory-support
#6
Judith Hoefer, Hanno Ulmer, Juliane Kilo, Raimund Margreiter, Michael Grimm, Peter Mair, Elfriede Ruttmann
OBJECTIVE: There are few data on the role of liver dysfunction in patients with end-stage heart failure supported by mechanical circulatory support. The aim of our study was to investigate predictors for acute liver failure in patients with end-stage heart failure undergoing mechanical circulatory support. METHODS: A consecutive 164 patients with heart failure with New York Heart Association class IV undergoing mechanical circulatory support were investigated for acute liver failure using the King's College criteria...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28272013/when-traditional-offloading-is-not-an-option-could-an-external-fixator-be-a-solution-a-case-report
#7
Abdulaziz A Kimawi, Robert J Snyder, Mario A Cala, Cherison Cuffy
Offloading is a cornerstone in managing diabetic plantar foot ulcers; however, it often represents one of the most challenging aspects of treatment for clinician and patient alike. The authors present a case of a 61-year-old African American man with type 2 diabetes and a limb-threatening plantar foot ulcer that required aggressive wound and surgical management. Due to the heavy drainage and patient adherence issues, traditional offloading techniques such as total contact cast, DH Pressure Relief Walker (Össur, Foothill Ranch, CA), and wedge shoes, among others, were not viable options...
February 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28270838/clinical-and-hemodynamic-profiles-of-elderly-patients-with-pulmonary-arterial-hypertension-a-single-center-prospective-study
#8
Ebru Ozpelit, Bahri Akdeniz, Dilek Sezgin, Can Sevinc, Kemal Can Tertemiz, Mehmet Emre Ozpelit, Mustafa Baris, Nezihi Baris
BACKGROUNDS: Pulmonary arterial hypertension (PAH) was previously considered an illness that affects mostly the young, but now it is also increasingly recognized in the elderly. The aim of this study was to compare the features of elderly versus younger patients diagnosed with PAH, and to define the prognostic factors which affect their long-term survival. METHODS: In this prospective, single center study, the clinical, echocardiographic, hemodynamic characteristics, and the outcomes of younger (18-65 years) and elderly (≥ 65 years) patients with definitive diagnosis of precapillary PAH were compared...
January 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28267190/changes-in-joint-contact-mechanics-in-a-large-quadrupedal-animal-model-after-focal-and-whole-joint-soft-tissue-injury
#9
David J Heckelsmiller, M James Rudert, Thomas E Baer, Douglas R Pedersen, Douglas C Fredericks, Jessica E Goetz
Acute mechanical damage and the resulting joint contact abnormalities are central to the initiation and progression of post-traumatic osteoarthritis (PTOA). Study of PTOA is typically performed in vivo with replicate animals using artificially induced injury features. The goal of this work was to measure changes in joint contact stress in the knee of a large quadruped after creation of a clinically realistic overload injury and a focal cartilage defect. Whole-joint overload was achieved by excising a 5-mm wedge of the anterior medial meniscus...
March 7, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28264194/rheological-separation-of-the-megathrust-seismogenic-zone-and-episodic-tremor-and-slip
#10
Xiang Gao, Kelin Wang
Episodic tremor and accompanying slow slip, together called ETS, is most often observed in subduction zones of young and warm subducting slabs. ETS should help us to understand the mechanics of subduction megathrusts, but its mechanism is still unclear. It is commonly assumed that ETS represents a transition from seismic to aseismic behaviour of the megathrust with increasing depth, but this assumption is in contradiction with an observed spatial separation between the seismogenic zone and the ETS zone. Here we propose a unifying model for the necessary geological condition of ETS that explains the relationship between the two zones...
March 6, 2017: Nature
https://www.readbyqxmd.com/read/28262399/impacts-of-pressure-bonding-fixation-on-a-bone-flap-depression-and-resorption-in-patients-with-craniotomy
#11
Hidetoshi Matsukawa, Masataka Miyama, Takanori Miyazaki, Genki Uemori, Yu Kinoshita, Fumihiro Sakakibara, Norihiro Saito, Toshiyuki Tsuboi, Kosumo Noda, Nakao Ota, Sadahisa Tokuda, Hiroyasu Kamiyama, Rokuya Tanikawa
Fixation of bone flaps after craniotomy is a routine part of every neurosurgical procedure. Common problems encountered are bone flap depression and resorption. Authors performed the pressure-bonding bone flap fixation (PBFF) using absorbable craniofix (AC) and hydroxyapatite wedge (HW). The aim of the present study is to evaluate the efficacy of PBFF to prevent a bone flap depression and resorption in patients treated with craniotomy. Four-hundred fifty-four patients underwent craniotomies. Authors collected the following data: age, sex, type of craniotomy, what kind of surgery, whether bypass surgery was performed, whether surgery was the initial, whether AC and the HW were used, bone flap depression and resorption at 6-month after the craniotomy...
March 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28256342/usefulness-of-the-continuous-wave-doppler-derived-pulmonary-arterial-right-ventricular-pressure-gradient-just-before-atrial-contraction-for-the-estimation-of-pulmonary-arterial-diastolic-and-wedge-pressures
#12
Michito Murayama, Taisei Mikami, Sanae Kaga, Kazunori Okada, Takuma Hioka, Nobuo Masauzi, Masahiro Nakabachi, Hisao Nishino, Shinobu Yokoyama, Mutsumi Nishida, Hiroyuki Iwano, Mamoru Sakakibara, Satoshi Yamada, Hiroyuki Tsutsui
In our new echocardiographic method, pulmonary regurgitant velocity immediately before right atrial (RA) contraction is used to estimate pulmonary artery diastolic pressure (PADP) and mean PA wedge pressure (MPAWP). Our aim here was to compare the usefulness of this new method with that of the conventional method, which uses pulmonary regurgitant velocity at end diastole. We studied 55 consecutive patients who underwent echocardiography and right-sided heart catheterization. The pulmonary regurgitant velocities just before RA contraction and at end diastole were measured to obtain echocardiographic estimates of PADP (EPADPpreA and EPADPED, respectively) by adding the pressure gradients to the echocardiographically estimated RA pressure...
February 27, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28238244/nt-probnp-as-a-potential-marker-of-left-atrial-dysfunction-in-rheumatic-mitral-stenosis-correlation-with-left-atrial-function-after-pbmv
#13
Rashi Khare, Sudhanshu Dwivedi
BACKGROUND: Rheumatic heart disease is a common reason for cardiovascular morbidity and mortality. Plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are known to rise in patients with MS, but the role of this compound as a non-invasive marker of left atrial (LA) dysfunction is yet to be established. The study aim was to correlate levels of NT-proBNP in patients with rheumatic mitral stenosis (MS), with echocardiographic parameters of LA function including tissue Doppler-derived strain/strain rate (S/Sr) indices, hemodynamic parameters of LA function, before and after percutaneous balloon mitral valvotomy (PBMV) for a follow up of one year...
September 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28219811/stress-echocardiography-in-patients-who-experienced-mechanical-ventilation-weaning-failure
#14
Manuel Ruiz-Bailén, Jesús Cobo-Molinos, Ana Castillo-Rivera, María Dolores Pola-Gallego-de-Guzmán, Antonio Cárdenas-Cruz, Antonio Martínez-Amat, María Sevilla-Martínez, Clara Hernández-Caballero
INTRODUCTION: Critically ill patients may suffer varying degrees of temporary myocardial dysfunction during respiratory weaning that could play an important role in weaning failure. OBJECTIVES: In this study, we tried to assess the existence of temporary diastolic dysfunction during respiratory weaning. METHODS: Inclusion period is from 2006 to 2015. In this study, we included 181 ventilated patients with cardiogenic shock that were being weaned from mechanical ventilation...
January 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28197694/relaxation-of-the-mcl-after-an-open-wedge-high-tibial-osteotomy-results-in-decreasing-contact-pressures-of-the-knee-over-time
#15
N van Egmond, G Hannink, D Janssen, A C Vrancken, N Verdonschot, A van Kampen
PURPOSE: The objective of this study was to investigate the effect of a medial open-wedge osteotomy (OWO) and the release of the superficial medial collateral ligament (MCL) on the tibiofemoral cartilage pressure, the MCL tension and the valgus laxity of the knee. METHODS: Seven fresh-frozen, human cadaveric knees were used. Medial and lateral mean contact pressure (CP), peak contact pressure (peakCP), and contact area (CA) were measured using a pressure-sensitive film (I-Scan; Tekscan, Boston, MA)...
March 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28168428/longer-than-average-length-of-stay-in-acute-heart-failure-determinants-and-outcomes
#16
H R Omar, M Guglin
BACKGROUND: Increased length of stay (LOS) during acute heart failure (HF) hospitalization is associated with readmission and mortality. METHODS: The ESCAPE trial data were utilized to identify determinants and post-discharge outcomes of patients with acute systolic HF requiring longer-than-average LOS (≥7 days). The study endpoints were 6‑month all-cause mortality, all-cause rehospitalization, and the composite endpoint of death, cardiac rehospitalization, and cardiac transplant...
February 6, 2017: Herz
https://www.readbyqxmd.com/read/28167249/how-are-adjacent-spinal-levels-affected-by-vertebral-fracture-and-by-vertebroplasty-a-biomechanical-study-on-cadaveric-spines
#17
Jin Luo, Deborah J Annesley-Williams, Michael A Adams, Patricia Dolan
BACKGROUND CONTEXT: Spinal injuries and surgery may have important effects at neighbouring spinal levels, but previous investigations of adjacent-level biomechanics have produced conflicting results. We use 'stress profilometry' and non-contact strain measurements to investigate thoroughly this long-standing problem. PURPOSE: To determine how vertebral fracture and vertebroplasty affect compressive load-sharing and vertebral deformations at adjacent spinal levels...
February 3, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28166772/challenges-uncertainties-and-perceived-benefits-of-providing-weekend-allied-health-services-a-managers-perspective
#18
Deb Mitchell, Lisa O'Brien, Anne Bardoel, Terry Haines
BACKGROUND: Health services that operate 7 days per week are under pressure to show the increased cost of providing weekend services can be measured in improved patient outcomes. The evidence for weekend allied health services in acute medical and surgical wards is weak and there is wide variation between the services offered at different hospitals. METHODS: This qualitative study was undertaken during a multi-site stepped wedge randomised controlled trial involving twelve acute medical and surgical wards from two Australian hospitals, in which weekend allied health services were removed before being reinstated with a stakeholder driven model...
February 6, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28166120/pulmonary-artery-wedge-pressure-relative-to-exercise-workrate-in-older-men-and-women
#19
Sam Esfandiari, Stephen P Wright, Jack M Goodman, Zion Sasson, Susanna Mak
PURPOSE: An augmented pulmonary artery wedge pressure (PAWP) response may explain exercise intolerance in some humans. However, routine use of exercise hemodynamic testing is limited by a lack of data from normal older men and women. Our objective was to evaluate the exercise PAWP response and the potential for sexual dimorphism in healthy, non-dyspneic older adults. METHODS: Thirty-six healthy volunteers [18 men (54±7 years)/18 women (58±6 years)] were studied at rest (Control) and during two stages of semi-upright cycle-ergometry, at heart rates of 100 bpm (Light Exercise) and 120 bpm (Moderate Exercise)...
February 4, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28158981/hypertension-management-in-rural-primary-care-facilities-in-zambia-a-mixed-methods-study
#20
Lily D Yan, Cindy Chirwa, Benjamin H Chi, Samuel Bosomprah, Ntazana Sindano, Moses Mwanza, Dennis Musatwe, Mary Mulenga, Roma Chilengi
BACKGROUND: Improved primary health care is needed in developing countries to effectively manage the growing burden of hypertension. Our objective was to evaluate hypertension management in Zambian rural primary care clinics using process and outcome indicators to assess the screening, monitoring, treatment and control of high blood pressure. METHODS: Better Health Outcomes through Mentoring and Assessment (BHOMA) is a 5-year, randomized stepped-wedge trial of improved clinical service delivery underway in 46 rural Zambian clinics...
February 3, 2017: BMC Health Services Research
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