168 research outputs found
Levosimendan improves diastolic and systolic function in failing human myocardium
No full textCa2+-sensitizers increase myocardial contractility, but may worsen diastolic dysfunction. Levosimendan, through its unique troponin-C interaction, may preserve diastolic function. We investigated the effects of levosimendan (10(-7)-10(-5) M) on diastolic and systolic function in multicellular cardiac muscle preparations from end-stage failing human hearts (1 and 2.5 Hz, 37 degrees C, 1.25 mM [Ca2+], pH 7.4). Levosimendan improved systolic function: at 1 Hz, developed force (F-dev) increased from 13.84 +/- 3.27 to 16.40 +/- 3.57 (10(-7) M, P < 0.05), while diastolic force (F-dia) decreased from 5.32 +/- 0.67 to 4.94 +/- 0.61 mN/mm(2) (P < 0.05). Under control conditions, the increase in stimulation frequency from 1 to 2.5 Hz resulted in a decrease in F-dev of - 0.51 +/- 1.80 mN/mm(2) (negative force-frequency relationship). Levosimendan improved this relationship: at 10-7 M, this change became positive (+1.81 +/- 2.06 mN/mm(2), P < 0.05). Diastolic function was markedly improved in the presence of levosimendan; the increase in F-dia of 1.56 +/- 0.41 mN/mm(2) (control) was attenuated to 0.70 +/- 0.19 nN/mm(2) (P < 0.05). To allow for a more derailed analysis, preparations were sometimes divided into two groups, based on their force-frequency behavior. Twitch timing parameters were accelerated by levosimendan in preparations with a negative force-frequency relationship. Levosimendan improves both systolic and diastolic function in failing human myocardium. Effects are even more pronounced at higher heart rates and under prevailing diastolic dysfunction. (C) 2000 Elsevier Science B.V. All rights reserved
Spin asymmetries in elastic and inelastic scattering of spin-polarized electrons from spin-polarized cesium atoms
No full textBaum G, Pavlovic N, Roth B. Spin asymmetries in elastic and inelastic scattering of spin-polarized electrons from spin-polarized cesium atoms. In: Burgdörfer J, Cohen JS, Datz S, Vance CR, eds. Photonic, Electronic & Atomic Collisions. Princeton: Rinton Press; 2001: 460-470
Potentiation of beta-adrenergic inotropic response with pyruvate in failing human heart and in healthy rabbit myocardium
No full text
Potentiation of beta-adrenergic inotropic response with pyruvate in failing human heart and in healthy rabbit myocardium
No full text
Potentiation of beta-adrenergic inotropic response by pyruvate in failing human myocardium
No full textBackground: Pyruvate has been shown to increase contractile function in isolated myocardium and to improve hemodynamics in patients with congestive heart failure. We tested the hypothesis that pyruvate potentiates the inotropic response beta-adrenergic stimulation and to elevated extracellular calcium, since this may be of potential therapeutic value in the clinical setting of acute heart failure in order to circumvent deleterious effects on energy demand as can occur during catecholamine therapy. Methods and Results: We investigated isometrically contracting isolated multicellular muscle preparations from terminal failing human hearth at 37degreesC, pH 7.4, and a stimulation frequency of I Hz. At an extracellular calcium concentration of 1.25 mM, pyruvate ( 10 mM) alone increased developed force (F-dev) from 9.0+/-2.3 to 21.1+/-4.3 mN/mm(2) (n=9, P<0.001) and isoproterenol (1 muM) alone increased F-dev from 9.5+/-2.0 to 31.3+/-5.4 mN/mm(2) (P<0.001), whereas the combination of pyruvate and isoproterenol increased F-dev over-proportionally from 9.0+/-2.3 to 47.4+/-6.4 mN/mm(2) (P<0.01). In a separate series we assessed the combination of pyruvate and calcium. Although F-dev did not increase from 12 to 16 mM [Ca2+](o), 10 mM pyruvate further increased F-dev from 25.8+/-5.0 to 30.6+/-4.7 mN/mm(2) (P<0.01). Rapid cooling contractures revealed that altered myofilament responsiveness and/or sarcoplasmic reticulum (SR) calcium load must underlie the positive inotropic effect of pyruvate. Conclusion: A combination of pyruvate and P-adrenergic stimulation may be of therapeutic value in acute heart failure by reducing the concentrations of potential deleterious catecholamines that are currently necessary to maintain adequate tissue perfusion. (C) 2002 Elsevier Science BY All rights reserved
Influence of pyruvate on economy of contraction in isolated rabbit myocardium
No full textBackground: Treatment of acute heart failure frequently requires positive-inotropic stimulation. However, there is still no inotropic agent available, which combines a favourable haemodynamic profile with low expenditure for energy metabolism. Pyruvate exhibits positive inotropic effects in vitro and in patients with heart failure. The effect on myocardial energy metabolism however remains unclear, but is meaningful in light of a clinical application. Aims and methods: We investigated the influence of pyruvate on contractility and oxygen consumption in isolated isometric contracting rabbit myocardium compared to P-adrenergic stimulation with isoproterenol. Results: Pyruvate (30 mM) increased developed force from 18.7 +/- 4.1 to50.8 +/- 12.1 mN/mm(2) (n= 10,p < 0.01). Force-time integral (FTI) increased by 329%, oxygen consumption assessed by diffusion-microclectrode technique increased from 2.86 +/- 0.30 mlO(2)/min 100 g to 6.28 +/- 1.28 mlO(2)/ min 100g(n=7,p < 0.05). Economy of myocardial contraction calculated as the ratio of total FTI to oxygen consumption remained unchanged. In contrast, while isoproterenol (10 mu M) produced a comparable increase in developed force from 21.4 +/- 8.3 to 67.3 +/- 15 mN/mm(2) (n=7,p < 0.01),FTI increased only by 260% and MVO2 increased from 2.96 +/- 0.43 to 6.12 +/- 1.01 mlO(2)/min 100 g (n=7,p < 0.01); thus, economy decreased by 23% (n=7,p < 0.05). Conclusion: Pyruvate does not impair economy of myocardial contraction while isoproterenol decreases economy. Regarding energy expenditure, pyruvate appears superior to isoproterenol for the purpose of positive inotropic stimulation. (c) 2007 European Society of Cardiology. Published by Elsevier B.V. All rights reserved
Genealogy of the Van Winkle Family, Account of its Origin and Settlement in this Country, with Data 1630-1913: Van Winkle Record
No full text300 page genealogical listing of Van Winkle family in America, with name index, compiled by Jersey City historian David Van Winkle. Entries list only birth, death and marriage information, without locations, but narrative sections suggest bulk of entries are in Hudson and Bergen Counties, NJ, and later in Kentucky.
Introductory sections describe history of Dutch settlement in America, and homes and customs in Bergen, the Dutch village that became a part of Jersey City. Narrative of Jacob Wallingen and his life in the village of Winkel, Netherlands and his settlement in New Netherlands where he married Trintje Jacobs. Their descendants make up the subsequent list
The impact of ethnic background on ICU care and outcome in sepsis and septic shock – a retrospective multicenter analysis on 17,949 patients
No full textBackground
Previous studies have been inconclusive about racial disparities in sepsis. This study evaluated the impact of ethnic background on management and outcome in sepsis and septic shock.
Methods
This analysis included 17,146 patients suffering from sepsis and septic shock from the multicenter eICU Collaborative Research Database. Generalized estimated equation (GEE) population-averaged models were used to fit three sequential regression models for the binary primary outcome of hospital mortality.
Results
Non-Hispanic whites were the predominant group (n = 14,124), followed by African Americans (n = 1,852), Hispanics (n = 717), Asian Americans (n = 280), Native Americans (n = 146) and others (n = 830). Overall, the intensive care treatment and hospital mortality were similar between all ethnic groups. This finding was concordant in patients with septic shock and persisted after adjusting for patient-level variables (age, sex, mechanical ventilation, vasopressor use and comorbidities) and hospital variables (teaching hospital status, number of beds in the hospital).
Conclusion
We could not detect ethnic disparities in the management and outcomes of critically ill septic patients and patients suffering from septic shock. Disparate outcomes among critically ill septic patients of different ethnicities are a public health, rather than a critical care challenge
- …
