254 research outputs found
sj-pdf-1-jao-10.1177_03913988211056018 – Supplemental material for Effects of the atrium on intraventricular flow patterns during mechanical circulatory support
No full textSupplemental material, sj-pdf-1-jao-10.1177_03913988211056018 for Effects of the atrium on intraventricular flow patterns during mechanical circulatory support by Mojgan Ghodrati, Thomas Schlöglhofer, Alexander Maurer, Thananya Khienwad, Daniel Zimpfer, Dietrich Beitzke, Francesco Zonta, Francesco Moscato, Heinrich Schima and Philipp Aigner in The International Journal of Artificial Organs</p
Continuous-Flow Pumps in Pediatric Population
Get PDFTo overcome death on the heart transplantation waiting list, specially designed VADs for children have been introduced and successfully implanted in adolescents [1] and babies [2]. These systems work with a pulse and the pump chambers are extracorporeal. While extracorporeal VADs are vastly superior to ECMO in terms of surviving transplantation, the devices are far from perfect due to the high risk of thromboembolic events, and the design limits mobilization and precludes discharge from hospital [3, 4]. Also, a shift has occurred from not only to save a child’s life but to quality of life (QoL) on VAD support as well. Implantation of cf-VADs may be a promising option to reduce morbidity, to overcome the need for hospitalization, and to improve QoL in young patients. These devices work with a “nonphysiological” continuous flow; are small, fast, and easy to implant; and have a better reliability compared to pulsatile-flow devices. With miniaturization of pump design and increasing applications of cf-VADs in adults, implantation in smaller patients became feasible [3, 5, 6]. Experience in older children with these cf-VADs has been promising [7– 12], and the quest goes to children even below BSA 1m2. This chapter summarizes the experiences gained so far with the most commonly used cf-VADs
Aortic Dissection Dataset and Segmentations
No full textThis dataset consists of a type B Aortic Dissection (AD) CTA collection with true and false lumen expert annotations. It can be used for the development of AI-based algorithms for an automatic segmentation of ADs.For a review about the detection, segmentation, simulation and visualization of Aortic Dissections, please see:Pepe A, Li J, Rolf-Pissarczyk M, Gsaxner C, Chen X, Holzapfel GA, Egger J. Detection, segmentation, simulation and visualization of aortic dissections: A review. Medical image analysis. 2020 Oct 1;65:101773.Cite as:[1] Christian Mayer, Antonio Pepe, Sophie Hossain, Barbara Karner, Melanie Arnreiter, Jens Kleesiek, Johannes Schmid, Michael Janisch, Hannes Deutschmann, Michael Fuchsjäger, Daniel Zimpfer, Jan Egger, Heinrich Mächler. Aortic Dissection Dataset and Segmentations. figshare, 2024. DOI: 10.6084/m9.figshare.22269091[2] Christian Mayer, Antonio Pepe, Sophie Hossain, Barbara Karner, Melanie Arnreiter, Jens Kleesiek, Johannes Schmid, Michael Janisch, Hannes Deutschmann, Michael Fuchsjäger, Daniel Zimpfer, Jan Egger, Heinrich Mächler. Type B Aortic Dissection CTA Collection with True and False Lumen Expert Annotations for the Development of AI-based Algorithms. Scientific Data, Nature Portfolio 2024.</p
Sex differences among patients receiving ticagrelor monotherapy or aspirin after coronary bypass surgery: A prespecified subgroup analysis of the TiCAB trial
No full textBackground
There is limited evidence on the association of sex with outcomes among patients undergoing coronary bypass surgery (CABG) and treated with ticagrelor monotherapy or aspirin.
Methods
This was a pre-specified sub-analysis of TiCAB, an investigator-initiated placebo-controlled randomized trial. Primary efficacy endpoint was the composite of cardiovascular death, myocardial infarction, stroke, or repeat revascularization 1 year after CABG. Safety endpoint was BARC type 2, 3 or 5 bleeding.
Results
A total of 280 (15.0%) women and 1579 (85.0%) men were included. Compared with men, women were older (66.1 ± 10.2 vs. 70.1 ± 9.3 years) with more acute presentation (17.0% vs 21.1%). The incidence of the primary endpoint was similar between women and men (9.2% vs. 8.9%, HR 1.08, 95%CI 0.71–1.66, P = 0.71). Cardiovascular death occurred more often in women (2.9% vs 1.0%, adjusted HR 2.87, 95%CI 1.23–6.70, P = 0.02). The incidence of bleeding was similar between the sexes (2.2% vs. 2.5%, HR 0.91, 95% CI 0.51–1.65, P = 0.77). Ticagrelor vs aspirin was associated with a similar risk of the primary endpoint in women (10.6% vs. 7.9%, HR 1.39, 95%CI 0.63–3.05, P = 0.42) and men (9.5% vs. 8.2%, HR 1.15, 95%CI 0.82–1.62, P = 0.41;pinteraction = 0.69), and a similar risk of bleeding in women (2.9% vs. 1.4%, HR 2.09, 95%CI 0.38–11.41, P = 0.40) and men (2.2% vs. 2.8%, HR 0.80, 95%CI 0.42–1.52, P = 0.49;pinteraction = 0.35).
Conclusions
Among women and men undergoing CABG, ticagrelor monotherapy was associated with a similar risk of the primary efficacy endpoint and bleeding compared with aspirin. The risk of cardiovascular death was increased in women irrespective of antiplatelet therapy
Functional capillary impairment in patients with ventricular assist devices
No full textThe implantation of continuous – flow ventricular assist devices (VAD) is suggested to evoke angiodysplasia contributing to adverse events such as gastrointestinal bleeding. We evaluated in vivo capillary density and glycocalyx dimensions to investigate possible systemic microvascular changes in patients with chronic heart failure and VAD support vs. standard medical treatment. Forty-two patients with VAD support were compared to forty-one patients with ischemic and non-ischemic chronic heart failure (CHF) on standard pharmacotherapy and to a group of forty-two healthy subjects in a prospective cross-sectional study. Sublingual microcirculation was visualized using Sidestream Darkfield videomicroscopy and functional and perfused total capillary densities were quantified. Patients with VAD implantation were followed for one year and bleeding events were recorded. Median time after VAD implantation was 18 months. Patients were treated with centrifugal-flow devices (n = 31) or axial-flow devices (n = 11). Median functional capillary density was significantly lower in patients with VAD therapy as compared to CHF patients (196 vs. 255/mm², p = 0.042, adjusted p-value). Functional and total capillary densities were 44% and 53% lower (both p < 0.001) in patients with VAD therapy when compared to healthy subjects. Cox regression analysis revealed loss of capillary density as a significant predictor of bleeding events during one -year follow-up of VAD patients (HR: 0.987, CI (95%): 0.977–0.998, p = 0.021 for functional and 0.992, CI (95%): 0.985–0.999, p = 0.03 for total capillary density). In conclusion, patients with VAD support exhibit capillary density rarefaction, which was associated with bleeding events. If confirmed independently, capillary impairment may be evaluated as novel marker of bleeding risk
Percutaneous Transcatheter Implantable Gadgets for De Novo Aortic Valve Regurgitation After Left Ventricular Assist Device Implant: Pushing the Limits or a Feasible Bailout?
No full textOf Broomsticks, the Moderns;\u27 and Self-Expression
No full textBroomsticks have a history of making their way into Jonathan Swift\u27s works. One might recall that such is the object of Peter\u27s theologico-interpretive rantings in A Tale of a Tub, in which after some pause the Brother so often mentioned for his Erudition, who was very skill\u27d in Criticisms, had found in a certain Author, which he said should be nameless, that the same Word which in the Will is called Fringe, does also signify Broom-stick. More conspicuously, said object is also at the heart of A Meditation upon a Broomstick, an amusing opuscule whose full title, A Meditation upon a Broomstick, According to the Style and Manner of the Honourable Robert Boyle\u27s Meditations (1710), immediately points to its relation to its pretext, Robert Boyle\u27s Occasional Reflections upon Several Subjects(1665). While we must leave it to psychoanalysts to tell us what this particular choice of object reveals
about the intricacies of Swift\u27s psyche, it has been suggested that in the case of A Meditation, Swift took his cue from Boyle\u27s reference to his Occasional Reflections as loose sticks bundled up into faggots and from one of his meditations on an Instructive Tree alluding to the vine and branches ofJohn 15:1-6. Another interpretation has to do with the date of composition: though some confusion, not to say obfuscation, long prevailed as to the exact date of the composition of Swift\u27s Meditation, there is reason to believe that he wrote the work in May 1704, which would link the impetus and the imagery to A Tale
Suzerains of the Anthropocene: a Posthumanist Reading of Cormac Mccarthy's Blood Meridian and the Road
Get PDFScholars of Cormac McCarthy’s fiction often cite the violence typically present within it as abundant in its volume and nihilistic in its meaning. However, the violence in McCarthy’s work atypically does not exist for show or snuff or to progress the plot. Instead, the author repeatedly meditates upon violence and proffers dark assertions as to the nature of violence. In Blood Meridian, the bloodlust of the antagonist, Judge Holden, emerges from a being and a philosophy of the land. From the Darwinian struggle for supremacy articulated by Holden and reified by the content of the narrative, a posthuman condition built upon inter- and intraspecies violence that decentralizes the human emerges. McCarthy does this in Blood Meridian (1985) and The Road (2006) to articulate the violence inherent in the contemporary status quo of the primary human/biological condition, via respective examinations of bloodthirst in the American Southwest in 1849-50 and a post-apocalyptic near-future.However, this thesis will primarily argue that McCarthy tempers the violence present in these works with the emergence of a morality based in posthumanism. Drawing heavily from Elizabeth Grosz’ posthuman Darwinism as well as theory on the Anthropocene and other posthumanists, this essay will argue that central characters in Blood Meridian and The Road reject participation in the violence that unfolds around them and, in doing so, transcend the kill-or-be-killed binary posited as fundamental to life on earth in McCarthy’s two novels. Their transcendence is marked by the responsibilities of those species, namely humans, that have succeeded in a Darwinian framework, and that the steps beyond a continued cornucopianist existence valued in the Anthropocene lie in the application of posthuman theory to life and systems beyond the human
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