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Emergency Conversion from Off Pump to Cardiopulmonary Bypass in Patients with Coronary Artery Bypass Graft Surgery  

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Full Text Available Introduction: As off pump Coronary artery bypass grafting surgery (CABG is a developing method in coronary cardiac surgery, most surgeons are anxious about the danger of emergency crash conversion. In this observational study we tried to show the rate and outcome of conversion . Material and methods: In this descriptive study about 477 coronary off-pump CABG patients were operated in Ghaem hospital in Mashhad, Iran, from Jan 2012 to Jan 2013.In this group 20 patients needed to convert to Cardiopulmonary Bypass (CPB immediately .We analyzed these 20 patients and produced the results. Results: There was no cerebrovascular accident (CVA and no neurologic problems.There was one death among these 20 patients.  There was one case of renal failure who was the same patient that expired. 75% of these 20 patients had hypertension and 45%  had  diabetes .  Conclusion: 20 patients (4.19% had an emergency switch to On-pump CABG and only one death  occurred among 20 patients.

2013-08-01

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Clinical and economic outcomes associated with blood transfusions among elderly Americans following coronary artery bypass graft surgery requiring cardiopulmonary bypass  

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BACKGROUND: Blood transfusion occurring during hospitalisation for heart surgery has been shown to be associated with increased morbidity and mortality and with increased time spent in hospital, use of healthcare services, and costs. The objective of this study was to assess how perioperative blood transfusion among adults 65 years and older who underwent coronary artery bypass graft surgery requiring cardiopulmonary bypass in the United States is associated with immediate and longer term clinical and economic outcomes. MATERIALS AND METHODS: Using data from a 5% random sample of Medicare patients who underwent their first (within 2 years) coronary artery bypass graft requiring cardiopulmonary bypass procedure in 2005 or 2006, this study estimated associations (hazard ratios and regression coefficients) between transfusion status (received or not) and complications after surgery, serious adverse events, death, and costs using Cox proportional hazard and generalised linear models adjusting for patients' demographic and clinical characteristics. RESULTS: Adjusted hazard ratios were statistically significant (P<0.05) for risks of complications (1.20), serious adverse events (1.58), and death (1.49). There was also a statistically significantly (P?0.01) and strong relationship between receiving transfused blood and Medicare payments over the subsequent 45 months following discharge ($5,778 per calendar quarter for those receiving transfusion vs $5,197; all costs are measured in 2011 USD). CONCLUSION: Blood transfusion during hospitalisation for coronary artery bypass graft requiring cardiopulmonary bypass was significantly associated with increased long-term post-operative morbidity, mortality, and overall healthcare costs. This study contributes to the evidence demonstrating an association between transfusion and adverse clinical and economic outcomes by using a nationally representative longitudinal cost and utilisation database.

Ganz, Michael Lee; Wu, Ning

2014-01-01

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Predictors of inotrope use in patients undergoing concomitant coronary artery bypass graft (CABG and aortic valve replacement (AVR surgeries at separation from cardiopulmonary bypass (CPB  

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Full Text Available Abstract Background Left ventricular dysfunction is common after coronary artery bypass graft and valve replacement surgeries and is often treated with inotropic drugs to maintain adequate hemodynamic status. In this study, we aimed to identify the demographic, clinical, laboratory, echocardiographic and hemodynamic factors that are associated with use of inotropic drugs in patients undergoing concomitant coronary artery bypass graft and aortic valve replacement surgery. Methods The study included 97 patients who had undergone concomitant coronary artery bypass graft and aortic valve replacement at Regions Hospital, University of Minnesota Medical School from January 2006 to December 2008. All data were collected retrospectively after reviewing electronic medical records. Inotropic support was defined as the use of dopamine [greater than or equal to] 5 ug/kg/min; any dose of epinephrine, norepinephrine, dobutamine, and milrinone at the separation from cardiopulmonary bypass. Results Inotropic support was used in a total of 50 patients (52% at the separation from cardiopulmonary bypass. Average age of the patients requiring inotropic support was 72.2 +/- 8.8 years. The study identified four significant, independent predictors of inotrope use: (1 Cardiac index [less than or equal to]2.5 L/min/m2, (2 LVEDP [greater than or equal to] 20 mm Hg, (3 LVEF [less than or equal to]40%, and (4 CKD stage 3 to 5. Conclusion We identified four independent risk factors for postoperative use of inotropic support in patients undergoing concomitant coronary artery bypass graft and arotic valve replacement surgery at the separation from cardiopulmonary bypass. The study results will be helpful to prospectively identify patients who will likely to require inotropic support at the separation from cardiopulmonary bypass.

Nelson William B

2009-06-01

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The Effects of Etomidate and Propofol Induction on Hemodynamic and Endocrine Response in Patients Undergoing Coronary Artery Bypass Graft Surgery on Cardiopulmonary Bypass  

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Full Text Available Aim: To compare the effects of propofol and etomidate induction on hemodynamic parameters and serum cortisol levels in patients with normal left ventricular function undergoing elective coronary artery bypass graft surgery on cardiopulmonary bypass. Material and Method: After approval from the Institute Ethics committee hundred American Society of Anesthesiologists (ASA grade II or III patients undergoing scheduled coronary artery bypass surgery on cardiopulmonary bypass were enrolled in the study. Patients were allocated randomly to receive either propofol or etomidate for anesthesia induction. Anesthesia was maintained in both groups with sevoflurane, vecuronium bromide for muscle relaxation (0.1 mg/kg, boluses and fentanyl up to a total dose of 20 mcg/kg. Result: The baseline serum cortisol values were within normal limits in both the groups. The serum cortisol levels in the propofol group increased more than two fold, whereas the values in the etomidate group decreased by close to fifty percent on weaning from cardiopulmonary bypass (CPB. There was no significant difference in serum cortisol levels in the two groups at twenty-four hours after induction, although the values were close to double the baseline levels. Hemodynamically, etomidate group was more stable than propofol group following induction of anesthesia (P < 0.05. Conclusion: The surge in serum cortisol levels on the initiation of CPB seen after the use of propofol is prevented by the use of etomidate. Serum cortisol levels in both groups are well above the baseline at twenty-four hours without any untoward effects. Etomidate provides more stable hemodynamic parameters when used for induction of anesthesia as compared to propofol.

Anil K Pandey

2012-09-01

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A patent ductus arteriosus complicating cardiopulmonary bypass for combined coronary artery bypass grafting and aortic valve replacement only discovered by computed tomography 3D reconstruction.  

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We describe the case of a 59-year old male patient undergoing combined coronary artery bypass grafting and aortic valve replacement. Manipulation of the heart during cardiopulmonary bypass significantly decreased venous return. Several measures were necessary to improve venous return to a level at which continuation of the procedure was safe. Based on the initial troubles with venous return, we decided to selectively cross-clamp the aorta. This resulted in a large amount of backflow of oxygenated blood from the left ventricle, necessitating additional vents in the pulmonary artery and directly in the left ventricle. The procedure was continued uneventfully, and postoperative recovery was without significant complications. Postoperative 2D computed tomography did not show any signs of a shunt, but 3D reconstruction showed a small patent ductus arteriosus. PMID:25164136

van Middendorp, Lars B; Maessen, Jos G; Sardari Nia, Peyman

2014-12-01

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Cardiopulmonary bypass assisted resection of mediastinal masses.  

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We report a recurrent solitary fibrous tumor of the mediastinum that was encircling the right pulmonary artery. The resection of the tumor with the involved right pulmonary artery segment and sequential graft reconstruction of the vessel was facilitated by the use of cardiopulmonary bypass. We review the indications, management, and outcomes of cardiopulmonary bypass for the resection of mediastinal masses. PMID:22500568

Agathos, E Andreas; Lachanas, Elias; Karagkiouzis, Grigorios; Spartalis, Eleftherios; Tomos, Periklis

2012-05-01

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Acute Effect of Intravenous Administration of Magnesium Sulfate on Serum Levels of Interleukin-6 and Tumor Necrosis Factor-? in Patients Undergoing Elective Coronary Bypass Graft With Cardiopulmonary Bypass  

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Background: Cardiovascular problems are among the most common health issues. A considerable number of cardiac patients undergo cardiac surgery, and coronary artery disease patients constitute about two-thirds of all these surgeries. The application of cardiopulmonary bypass (CBP) usually results in some untoward effects. Objectives: Studies have suggested magnesium sulfate (MgSO4) as an anti-inflammatory agent in a coronary artery bypass graft (CABG). This study aimed to assess the effect of an IV MgSO4 infusion during elective CABG (with CBP) on the blood levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-?). Materials and Methods: During a 12 month period, after review board approval and based on inclusion and exclusion criteria, 90 patients were selected and entered randomly into one of the two study groups (MgSO4 or placebo). Anesthesia, surgery and CBP were performed in exactly the same way, except for the use of MgSO4 or a placebo. Both preoperative and postoperative plasma levels of IL-6 and TNF-? were checked and compared between the two groups using an ELISA. Results: There was no difference found between the two groups with regard to; gender, basic variables, Ejection Fraction (EF), CBP time and aortic cross-clamp time. The preoperative levels of IL-6 and TNF-? were not different; however, their postoperative levels were significantly higher in the placebo group (P value = 0.01 for IL-6 and 0.005 for TNF-?). Conclusions: This study showed that MgSO4 infusion could suppress part of the inflammatory response after CABG with CBP. This was demonstrated by decreased levels of interleukin-6 and TNF-? in postoperative serum levels in elective CABG with CBP. PMID:25237633

Aryana, Parastou; Rajaei, Samira; Bagheri, Abdolhamid; Karimi, Forouzan; Dabbagh, Ali

2014-01-01

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Metabolic derangement and cardiac injury early after reperfusion following intermittent cross-clamp fibrillation in patients undergoing coronary artery bypass graft surgery using conventional or miniaturized cardiopulmonary bypass.  

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Myocardial ischemic stress and early reperfusion injury in patients undergoing coronary artery bypass grafting (CABG) operated on using intermittent cross-clamp fibrillation (ICCF) are not presently known. The role of mini-cardiopulmonary bypass (mCPB) versus conventional CPB (cCPB) during ICCF has not been investigated. These issues have been addressed as secondary objective of randomised controlled trial (ISRCTN30610605) comparing cCPB and mCPB. Twenty-six patients undergoing primary elective CABG using ICCF were randomised to either cCPB or mCPB. Paired left ventricular biopsies collected from 21 patients at the beginning and at the end of CPB were used to measure intracellular substrates (ATP and related compounds). Cardiac troponin T (cTnT) and CK-MB levels were measured in plasma collected from all patients preoperatively and after 1, 30, 60, 120, and 300 min after institution of CPB. ICCF was associated with significant ischemic stress as seen by fall in energy-rich phosphates early after reperfusion. There was also a fall in nicotinamide adenine dinucleotide (NAD(+)) indicating cardiomyocyte death which was confirmed by early release of cTnT and CK-MB during CPB. Ischemic stress and early myocardial injury were similar for cCPB and mCPB. However, the overall cardiac injury was significantly lower in the mCPB group as measured by cTnT (mean ± SEM: 96 ± 14 vs. 59 ± 8 µg/l, p = 0.02), but not with CK-MB. ICCF is associated with significant metabolic derangement and early myocardial injury. This early outcome was not affected by the CPB technique. However, the overall cardiac injury was lower for mCPB only when measured using cTnT. PMID:24934242

Nguyen, Bao A V; Suleiman, M-Saadeh; Anderson, Jonathan R; Evans, Paul C; Fiorentino, Francesca; Reeves, Barnaby C; Angelini, Gianni D

2014-10-01

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[Heparin resistance during cardiopulmonary bypass].  

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A 74-year-old man was scheduled for coronary artery bypass graft surgery with cardiopulmonary bypass. After intravenous heparin (200 U.kg-1), the activated clotting time (ACT) increased from 124 to 436 sec. However, it decreased to 128 sec immediately after cardiopulmonary bypass. The bypass was discontinued because the addition of heparin (200 U.kg-1) proved heparin resistance. The coronary artery bypass procedure was completed uneventfully without cardiopulmonary bypass. Several recent articles have reported that heparin resistance was corrected with antithrombin III concentrates, fresh frozen plasma, or argatroban. In this case, these drugs could not be used because the mechanism of heparin resistance remains uncertain. Thus, the off-pump technique is useful for unknown heparin resistance. PMID:14531265

Maeda, Ryoko; Fukuda, Hirokazu; Nakaigawa, Yasushi; Hiruta, Masahiro; Hirabayashi, Yoshihiro; Seo, Norimasa

2003-09-01

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The Effects of Propofol Cardioplegia on Blood and Myocardial Biomarkers of Stress and Injury in Patients With Isolated Coronary Artery Bypass Grafting or Aortic Valve Replacement Using Cardiopulmonary Bypass: Protocol for a Single-Center Randomized Controlled Trial  

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Background Despite improved myocardial protection strategies, cardioplegic arrest and ischemia still result in reperfusion injury. We have previously published a study describing the effects of propofol (an anesthetic agent commonly used in cardiac surgery) on metabolic stress, cardiac function, and injury in a clinically relevant animal model. We concluded that cardioplegia supplementation with propofol at a concentration relevant to the human clinical setting resulted in improved hemodynamic function, reduced oxidative stress, and reduced reperfusion injury when compared to standard cardioplegia. Objective The Propofol cardioplegia for Myocardial Protection Trial (ProMPT) aims to translate the successful animal intervention to the human clinical setting. We aim to test the hypothesis that supplementation of the cardioplegic solution with propofol will be cardioprotective for patients undergoing isolated coronary artery bypass graft or aortic valve replacement surgery with cardiopulmonary bypass. Methods The trial is a single-center, placebo-controlled, randomized trial with blinding of participants, health care staff, and the research team. Patients aged between 18 and 80 years undergoing nonemergency isolated coronary artery bypass graft or aortic valve replacement surgery with cardiopulmonary bypass at the Bristol Heart Institute are being invited to participate. Participants are randomly assigned in a 1:1 ratio to either cardioplegia supplementation with propofol (intervention) or cardioplegia supplementation with intralipid (placebo) using a secure, concealed, Internet-based randomization system. Randomization is stratified by operation type and minimized by diabetes mellitus status. Biomarkers of cardiac injury and metabolism are being assessed to investigate any cardioprotection conferred. The primary outcome is myocardial injury, studied by measuring myocardial troponin T. The trial is designed to test hypotheses about the superiority of the intervention within each surgical stratum. The sample size of 96 participants has been chosen to achieve 80% power to detect standardized differences of 0.5 at a significance level of 5% (2-tailed) assuming equal numbers in each surgical stratum. Results A total of 96 patients have been successfully recruited over a 2-year period. Results are to be published in late 2014. Conclusions Designing a practicable method for delivering a potentially protective dose of propofol to the heart during cardiac surgery was challenging. If our approach confirms the potential of propofol to reduce damage during cardiac surgery, we plan to design a larger multicenter trial to detect differences in clinical outcomes. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 84968882; http://www.controlled-trials.com/ISRCTN84968882/ProMPT (Archived by WebCite at http://www.webcitation.org/6Qi8A51BS). PMID:25004932

Plummer, Zoe E; Baos, Sarah; Rogers, Chris A; Suleiman, M-Saadeh; Bryan, Alan J; Angelini, Gianni D; Hillier, James; Downes, Richard; Nicholson, Eamonn

2014-01-01

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The effects of stent interaction on porcine urinary bladder matrix employed as stent-graft materials.  

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Deployment of stent-grafts, derived from synthetic biomaterials, is an established minimally invasive approach for effectively treating abdominal aortic aneurysms (AAAs). However, a notable disadvantage associated with this surgical technique is migration of the deployed stent-graft due to poor biocompatibility and inadequate integration in vivo. Recently, tissue-engineered extracellular matrices (ECMs) have shown early promise as integrating stabilisation collars in this setting due to their ability to induce a constructive tissue remodelling response after in vivo implantation. In the present study the effects of stent loading on an ECM?s mechanical properties were investigated by characterising the compression and loading effects of endovascular stents on porcine urinary bladder matrix (UBM) scaffolds. Results demonstrated that the maximum stress was induced when the stent force was 8-times higher than a standard commercially available stent-graft and this represented about 20% of the failure strength of the UBM material. In addition, the influence of stent shape was also investigated. Findings demonstrated that the stress induced was higher for circular stents at low forces and a higher stress was induced on square stents when increased force was applied. Our findings demonstrate that porcine UBM possesses sufficient mechanical strength to withstand the compression and loading effects of commercially available stent-grafts in the setting of endovascular aneurysm repair. PMID:24709565

Callanan, A; Davis, N F; McGloughlin, T M; Walsh, M T

2014-06-01

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A case report and brief review of the literature on bilateral retinal infarction following cardiopulmonary bypass for coronary artery bypass grafting  

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Full Text Available Abstract Postoperative visual loss is a devastating perioperative complication. The commonest aetiologies are anterior ischaemic optic neuropathy (AION, posterior ischaemic optic neuropathy (PION, and central retinal artery occlusion (CRAO. These appear to be related to certain types of operation, most commonly spinal and cardiac bypass procedures; with the rest divided between: major trauma causing excessive blood loss; head/neck and nasal or sinus surgery; major vascular procedures (aortic aneurysm repair, aorto-bifemoral bypass; general surgery; urology; gynaecology; liposuction; liver transplantation and duration of surgery. The non-surgical risk factors are multifactorial: advanced age, prolonged postoperative anaemia, positioning (supine v prone, alteration of venous drainage of the retina, hypertension, smoking, atherosclerosis, hyperlipidaemia, diabetes, hypercoagulability, hypotension, blood loss and large volume resuscitation. Other important cardiac causes are septic emboli from bacterial endocarditis and emboli caused by atrial myxomata. The majority of AION cases occur during CPB followed by head/neck surgery and prone spine surgery. CPB is used to allow coronary artery bypass grafting on a motionless heart. It has many side-effects and complications associated with its use and we report here a case of bilateral retinal infarction during routine coronary artery bypass grafting in a young male patient with multiple risk factors for developing this complication despite steps to minimise its occurrence.

Trethowan Brian A

2011-11-01

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Cardiopulmonary exercise testing  

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Full Text Available Cardiopulmonary exercise testing (CPET is a noninvasive procedure that provides diagnostic and prognostic information and evaluates an individual’s capacity for dynamic exercise. CPET is an investigation of the respiratory, cardiovascular and cellular response to the exercise that can be done under controlled metabolic conditions. It provides assessment of the integrative exercise responses involving not only the pulmonary and cardiovascular systems but also skeletal muscle system, which are not adequately reflected through the measurement of individual organ system function. Furthermore, it is being performed increasingly in a wide spectrum of clinical applications for evaluation of undiagnosed exercise intolerance or for objective determination of functional capacity. CPET with extensive hardware and educated staffs can be used for the diagnosis of different types of clinical problems. Additionally, the increasing number of applications for which CPET is currently employed, attests to the growing recognition of its importance in medicine. J Clin Exp Invest 2014; 5 (3: 503-509

Erkan Ceylan

2014-09-01

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Prevalence and intensity of hyperglycemia in non-diabetic patients undergoing coronary artery bypass graft surgery with and without cardiopulmonary bypass  

International Nuclear Information System (INIS)

Objective was to study the prevalence and severity of hyperglycemia in nondiabetic patients undergoing cardiac operation. In an observational prospective study, 282 non-diabetic patients underwent elective off-pump (n=101) or non on-pump (n=181) coronary artery bypass grafting (CABG) surgery from March 2006 to July 2007 in Madani Heart Hospital, Tabriz, Iran. Blood glucose (BG) levels were measured during and 24 hours after operation. Frequencies of hyperglycemia (BG>-126 mg/dl) and severe hyperglycemia (BG>-180 mg/dl) and postoperative complications were compared in the 2 study groups. Prevalence of at least one episode of severe hyperglycemia was 54.6% (154/282) in our patients during and 24 hours after operation. Intra-operative hyperglycemia was slightly higher in on-pumping group. Frequency of post-operative hyperglycemia was higher, although not significantly different between the two groups. The 2 study groups were not significantly different in frequency of severe hyperglycemia during operation, although were different within 24 hours postoperative period. Prevalence of hyperglycemia especially severe hyperglycemia was high during, and after operation in both off-pump and on-pump CABG in non-diabetic patients. There was a borderline difference in blood glucose level between on-pump and off-pump CABG patients. It may be prudent to consider glycemic control protocols in these patients especially in early post-operative period. (author)eriod. (author)

15

Employment.  

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A series of articles discusses employment issues in various countries: youth employment, reduced working hours and wage cuts, dislocated workers, government employment policies, and job creation. (SK)

Social and Labour Bulletin, 1983

1983-01-01

16

The Sunflower Cardiopulmonary Research Project of Children.  

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A three year project designed to determine the value of a health program incorporating a cardiopulmonary fitness program is described. The instructional programs were in heart health, pulmonary health, nutrition, and physical fitness. A noncompetitive exercise and fitness period was employed in addition to the normal physical education time.…

Greene, Leon

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Cardiopulmonary Collapse during Labour  

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Cardiopulmonary collapse during labour is a catastrophic event caused by various medical, surgical and obstetrical conditions. It is an emergency that threatens the life of the mother and her unborn child. We present a case of a pregnant woman who suffered from preeclampsia and underwent induction of labour. Severe lung edema occurred early in labour that caused cardiopulmonary collapse. Advanced heart-lung resuscitation was established immediately and continued until an emergency cesarean se...

Kristina Larsby; Claus Klingenberg; Lasse Raatiniemi; Vasilis Sitras

2010-01-01

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A Modified Branched Graft Inversion Technique Employing a Syringe Inserter in Ascending Aortic Replacement for Type A Aortic Dissection  

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Full Text Available Purpose: To achieve good outcomes during aortic surgery with circulatory arrest, a secure and non-bleeding anastomosis must be achieved rapidly to ensure brain protection. We report our initial experiences with a modified Branched Graft Inverting (BGI technique using an inserter under mild hypothermia. We aimed to reduce the surgical duration and to prevent unnecessary damage to the fragile aorta. Methods: We retrospectively reviewed patients with type A acute aortic dissection (AAD who underwent distal anastomosis via the modified BGI technique using an inserter between January 2012 and March 2013. Open distal anastomosis was performed under mild hypothermia with right hemisphere perfusion from the right axillary artery. Results: Eight patients were enrolled. There was no mortality. Circulatory arrest time was reproducibly 20.3 ± 1.9 min, which was sufficient to complete non-bleeding distal anastomoses. The average rectal temperature during circulatory arrest was 26.5? ± 1.9?. All patients were extubated the day after the operation without any neurological deficit. Conclusion: The modified BGI technique employing an inserter and mild hypothermia offered easy, secure, and reproducible distal anastomosis for ascending aortic replacement for type A acute aortic dissection. Our outcomes were favorable and support further development of this technique.

Masashi Kawabori

2014-07-01

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Reconstruction of irradiated mandible after segmental resection of osteoradionecrosis-a technique employing a microvascular latissimus dorsi flap and subsequent particulate iliac bone grafting.  

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The fibula osteocutaneous flap has revolutionized the options of mandibular segmental defect bridging in osteoradionecrosis (ORN). In selected cases, however, the fibula flap is not an option because of atherosclerosis or other features that compromise the vascularity of the lower leg and foot. The aim of this study is to present an alternative method of mandibular segmental reconstruction employing a latissimus dorsi (LD) flap and subsequent particulate iliac free bone graft reconstruction. In 15 patients with ORN, a mandibular segmental defect was bridged with a reconstruction plate, and the defect site was primed with a LD musculocutaneous flap wrapped around the reconstruction plate to bring in vascularized tissue and optimize healing conditions for a subsequent particulate iliac free bone graft reconstruction. The management of defect closure was successful in all 15 patients. Twelve patients had a subsequent bone grafting from the posterior ileum for repair of defects up to 14 cm length. Three patients had no bone graft for various reasons. In three patients dental rehabilitation was achieved with implant supported prosthodontic appliances. Ten patients met the success criteria of uneventful graft healing with restitution of osseous continuity, mandibular height, symmetry and function, and avoidance of reconstruction plate fracture. PMID:25136407

Hillerup, Soren; Elberg, Jens Jorgen; Thorn, Jens Jorgen; Andersen, Mikael

2014-09-01

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Fluid distribution kinetics during cardiopulmonary bypass  

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Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: The purpose of this study was to examine the isovolumetric distribution kinetics of crystalloid fluid during cardiopulmonary bypass. METHODS: Ten patients undergoing coronary artery bypass grafting participated in this prospective observational study. The blood hemoglobin and the serum [...] albumin and sodium concentrations were measured repeatedly during the distribution of priming solution (Ringer's acetate 1470 ml and mannitol 15% 200 ml) and initial cardioplegia. The rate of crystalloid fluid distribution was calculated based on 3-min Hb changes. The preoperative blood volume was extrapolated from the marked hemodilution occurring during the onset of cardiopulmonary bypass. Clinicaltrials.gov: NCT01115166. RESULTS: The distribution half-time of Ringer's acetate averaged 8 minutes, corresponding to a transcapillary escape rate of 0.38 ml/kg/min. The intravascular albumin mass increased by 5.4% according to mass balance calculations. The preoperative blood volume, as extrapolated from the drop in hemoglobin concentration by 32% (mean) at the beginning of cardiopulmonary bypass, was 0.6-1.2 L less than that estimated by anthropometric methods (p

Mattias, Törnudd; Robert G., Hahn; Joachim H., Zdolsek.

2014-08-01

 
 
 
 
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Fluid distribution kinetics during cardiopulmonary bypass  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: The purpose of this study was to examine the isovolumetric distribution kinetics of crystalloid fluid during cardiopulmonary bypass. METHODS: Ten patients undergoing coronary artery bypass grafting participated in this prospective observational study. The blood hemoglobin and the serum [...] albumin and sodium concentrations were measured repeatedly during the distribution of priming solution (Ringer's acetate 1470 ml and mannitol 15% 200 ml) and initial cardioplegia. The rate of crystalloid fluid distribution was calculated based on 3-min Hb changes. The preoperative blood volume was extrapolated from the marked hemodilution occurring during the onset of cardiopulmonary bypass. Clinicaltrials.gov: NCT01115166. RESULTS: The distribution half-time of Ringer's acetate averaged 8 minutes, corresponding to a transcapillary escape rate of 0.38 ml/kg/min. The intravascular albumin mass increased by 5.4% according to mass balance calculations. The preoperative blood volume, as extrapolated from the drop in hemoglobin concentration by 32% (mean) at the beginning of cardiopulmonary bypass, was 0.6-1.2 L less than that estimated by anthropometric methods (p

Mattias, Törnudd; Robert G., Hahn; Joachim H., Zdolsek.

22

Effect of cardiopulmonary bypass on the pharmacokinetics of propranolol and atenolol  

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Full Text Available SciELO Brazil | Language: English Abstract in english The pharmacokinetics of some ?-blockers are altered by cardiopulmonary bypass (CPB). The objective of this study was to compare the effect of coronary artery bypass graft (CABG) surgery employing CPB on the pharmacokinetics of propranolol and atenolol. We studied patients receiving oral propranolol [...] with doses ranging from 80 to 240 mg (N = 11) or atenolol with doses ranging from 25 to 100 mg (N = 8) in the pre- and postoperative period of CABG with moderately hypothermic CPB (32°C). On the day before and on the first day after surgery, blood samples were collected before ?-blocker administration and every 2 h thereafter. Plasma levels were determined using high-performance liquid chromatography and data were treated by pharmacokinetics-modelling. Statistical analysis was performed using ANOVA or the Friedman test, as appropriate, and P

M.J.C., Carmona; V.A., Pereira; L.M.S., Malbouisson; J.O.C., Auler Jr.; S.R.C.J., Santos.

2009-06-01

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Effect of cardiopulmonary bypass on the pharmacokinetics of propranolol and atenolol  

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Full Text Available SciELO Brazil | Language: English Abstract in english The pharmacokinetics of some ?-blockers are altered by cardiopulmonary bypass (CPB). The objective of this study was to compare the effect of coronary artery bypass graft (CABG) surgery employing CPB on the pharmacokinetics of propranolol and atenolol. We studied patients receiving oral propranolol [...] with doses ranging from 80 to 240 mg (N = 11) or atenolol with doses ranging from 25 to 100 mg (N = 8) in the pre- and postoperative period of CABG with moderately hypothermic CPB (32°C). On the day before and on the first day after surgery, blood samples were collected before ?-blocker administration and every 2 h thereafter. Plasma levels were determined using high-performance liquid chromatography and data were treated by pharmacokinetics-modelling. Statistical analysis was performed using ANOVA or the Friedman test, as appropriate, and P

M.J.C., Carmona; V.A., Pereira; L.M.S., Malbouisson; J.O.C., Auler Jr.; S.R.C.J., Santos.

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Bone grafting: An overview  

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Full Text Available Bone grafting is the process by which bone is transferred from a source (donor to site (recipient. Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of the surgeon. A search for ideal bone graft is on and may continue till time to time. [Vet World 2010; 3(4.000: 198-200

D. O. Joshi

2010-08-01

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Surgical results of coronary artery bypass grafting without cardiopulmonary bypass: analysis of 3,410 patients / Resultados cirúrgicos na revascularização do miocárdio sem circulação extracorpórea: análise de 3.410 pacientes  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: Nos últimos anos, tem-se observado um grande avanço na cirurgia de revascularização miocárdica sem circulação extracorpórea (RMSCEC). Esse desenvolvimento deveu-se à combinação dos avanços da técnica cirúrgica e ao desenvolvimento de instrumentos que possibilitam a realização deste procedi [...] mento nas mais variadas situações. Este é um estudo retrospectivo, que visa avaliar nossa experiência com este procedimento nos últimos 11,5 anos. Os autores enfatizam o rápido progresso do método nos últimos anos, suas indicações, contra-indicações e resultados. MÉTODO: No período de agosto de 1991 e dezembro de 2002, 3.410 pacientes consecutivos, portadores de angina do peito, foram submetidos a cirurgia de revascularização miocárdica sem circulação extracorpórea. A idade variou de 13 a 93 anos (63 12,0 anos), sendo 58% dos pacientes do sexo masculino. A angina foi classificada segundo a Canadian Cardiovascular Society, sendo 6,1% na classe I, 6,8% na classe II, 46,3% na classe III e 40,8% na classe IV. RESULTADOS: A mortalidade intra-operatória foi baixa (0,4%). A mortalidade hospitalar (trinta dias de pós-operatório) foi de 2,58%. A mortalidade e morbidade, no grupo dos pacientes octogenários, foram extremamente baixas em relação aos pacientes operados com circulação extracorpórea (2,2% x 12,6%) (p Abstract in english OBJECTIVES: Over the past few years, great strides have been made in off-pump coronary surgery. This progress is due to a combination of the advances in surgical techniques and the development of instruments that make it possible to perform this procedure in the most varied situations. This is a ret [...] rospective study, the purpose of which is to assess our experience with this procedure over the last eleven and a half years. The authors underscore the rapid progress of the method in recent years and report on its indications, contraindications and results. METHODS: In the period from August 1991 to December 2003, 3,410 consecutively patients suffering from angina pectoris were submitted to off-pump coronary surgery. Ages ranged from 13 to 93 years, with a mean of 63 ± 12.0 years. Males accounted for 58% of the cases. The angina was rated according to the criteria of the Canadian Cardiovascular Society, 6.1% of the patients being in Class I, 6.8% in Class II, 46.3% in Class III and 40.8% in Class IV. RESULTS: Intraoperative mortality was low (0.4%). Hospital mortality (30 postoperative days) was 2.5%. Mortality and morbidity among the octogenarian patients were extremely low compared with patients operated on with cardiopulmonary bypass (CPB) (2.2% versus 12.6%) (p

Ricardo de Carvalho, Lima; Mozart Augusto Soares, Escobar; José Glauco, Lobo Filho; Roberto, Diniz; Antonio, Saraiva; Antonio, Césio; Mário, Gesteira; Frederico, Vasconcelos.

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Cardiopulmonary Resuscitation and real life  

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The Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Beloveds are, probably, the most well known and widely-read guidelines in Medicine. Although for decades these guidelines are regularly revisited every 5 years, the survival to cardiac arrest on the territory remain unsatisfactory, attesting itself on 6,4% or less. These discouraging outcomes caused some reflections on the validity of the guidelines concrete application. Some reviews, supported by the results ...

Fabio D’Este; Giuseppe Ragusa; Carolina Prevaldi

2006-01-01

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21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.  

Science.gov (United States)

...Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420...Cardiopulmonary bypass cardiotomy return sucker. (a) Identification. A cardiopulmonary bypass cardiotomy return sucker is a device that consists of...

2010-04-01

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21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.  

Science.gov (United States)

...2010-04-01 false Cardiopulmonary bypass pump tubing. 870.4390 Section 870.4390... § 870.4390 Cardiopulmonary bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is...

2010-04-01

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21 CFR 870.4280 - Cardiopulmonary prebypass filter.  

Science.gov (United States)

...2010-04-01 false Cardiopulmonary prebypass filter. 870.4280 Section 870.4280 ...870.4280 Cardiopulmonary prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming...

2010-04-01

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21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.  

Science.gov (United States)

...Cardiopulmonary bypass coronary pressure gauge. 870.4310 Section 870.4310...Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in...

2010-04-01

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A Reappraisal of Saphenous Vein Grafting  

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Autologous saphenous vein grafting has been broadly used as a bypass conduit, interposition graft, and patch graft in a variety of operations in cardiac, thoracic, neurovascular, general vascular, vascular access, and urology surgeries, since they are superior to prosthetic veins. Modified saphenous vein grafts (SVG), including spiral and cylindrical grafts, and vein cuffs or patches, are employed in vascular revascularization to satisfy the large size of the receipt vessels or to obtain a be...

Yuan Shi-Min; Jing Hua

2011-01-01

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Effects of cardiopulmonary bypass on propofol pharmacokinetics and bispectral index during coronary surgery  

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Full Text Available PURPOSE: Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacokinetics increase hypnotic effects after cardiopulmonary bypass. METHODS: Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10 or off-pump coronary artery bypass graft (group, n=10 coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 µg/mL. Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p<0.05 as significant. RESULTS: After cardiopulmonary bypass, despite similar plasma propofol concentrations in both groups, bispectral index values were lower in the on-pump coronary artery bypass graft group. Time to extubation after the end of propofol infusion was greater in the on-pump coronary artery bypass graft group (334 ± 117 vs. 216 ± 85 min, p = 0.04. Patients undergoing cardiopulmonary bypass had shorter biological (1.82 ± 0.5 vs. 3.67 ± 1.15h, p < 0.01 and terminal elimination (6.27 ± 1.29 vs. 10.5h ± 2.18, p < 0.01 half-life values, as well as higher total plasma clearance (28.36 ± 11.40 vs.18.29 ± 7.67 mL/kg/min, p = 0.03, compared to patients in the off-pump coronary artery bypass graft group. CONCLUSION: Aside from the increased sensitivity of the brain to anesthetics after cardiopulmonary bypass, changes in propofol pharmacokinetics may contribute to its central nervous system effects.

Ricardo Antonio G. Barbosa

2009-03-01

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Embolic activity during in vivo cardiopulmonary bypass.  

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Neurologic injury after cardiac surgery is principally associated with emboli. Although much work has focused on surgical sources of emboli, less attention has been focused on emboli associated with the heart-lung machine. We tested whether emboli are associated with discrete processes during cardiopulmonary bypass (CPB). One hundred patients undergoing cardiothoracic surgery were enrolled between April 2008 and May 2011 at a single medical center. During each surgical procedure, emboli were counted in three CPB locations: the venous side (Channel 1), before the arterial line filter (Channel 2), and after the arterial line filter (Channel 3). We used prespecified event markers to identify perfusionist interventions. Identical circuits were used on all patients. Of the 100 patients enrolled, 62 underwent isolated coronary artery bypass grafting (CABG), 17 underwent isolated valve operations, and 21 underwent CABG plus valve. Median counts across Channels 1, 2, and 3 were 69,853, 3,017, and 1,251, respectively. The greatest contributor to emboli in Channels 1, 2, and 3, respectively, were achieving the calculated CPB flow, opening of the electronic arterial line clamp, and introducing a hemofilter. The circuit technology was efficient in reducing total emboli counts from Channels 1-2 irrespective of the size of the emboli. Nearly 71% of all emboli 30-100 microm in size were removed from the circuit between Channels 2 and 3. No significant association was found between emboli counts and S100B release. Emboli occur frequently during CPB and are predominantly associated with the initiation of bypass, operation of the electronic arterial line clamp, and the initiation of a hemofilter. Continued work to reduce the occurrence of emboli is warranted. PMID:25208432

DeFoe, Gordon R; Dame, Norman A; Farrell, Mark S; Ross, Cathy S; Langner, Craig W; Likosky, Donald S

2014-06-01

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Brain microvascular function during cardiopulmonary bypass  

International Nuclear Information System (INIS)

ucose during normothermic cardiopulmonary bypass is caused by interruption of blood flow through a part of the capillary bed, possibly by microemboli, and that cerebral blood flow is an inadequate indicator of capillary blood flow. Further studies must clarify why normal microvascular function appears to be preserved during hypothermic cardiopulmonary bypass

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[Anticoagulant therapy and cardiopulmonary bypass].  

Science.gov (United States)

Cardiac surgery is an area in which coagulation monitoring has vital applications. Cardiopulmonary bypass (CPB) procedures could not be performed without an effective method of preventing blood from clotting in the extracorporeal circuit. In the early part of the twentieth century, heparin was discovered to have anticoagulant properties; it remains the anticoagulant most commonly used during CPB. Reversal of heparin effect is most frequently performed using protamine; however a number of different pharmacologic agents and reversal techniques can be utilized. CPB itself induces a "whole body inflammatory response" due to contact of blood and cellular elements whit the extracorporeal circuit. This complex interplay of systems induces a coagulopathy characterized by microvascular coagulation, platelet dysfunction, and enhanced fibrinolysis. The need to monitor anticoagulation during and after surgery is the reason that the cardiac surgical arena has evolved into a major site for the evaluation and utilization of hemostasis monitor. Heparin-induced thrombocytopenia (HIT) is a serious, immune system-mediated complication of heparin therapy often resulting in devastating thromboembolic outcomes. Alternative anticoagulation must be initiated immediately (argatroban, lepirudin and danaparoid). Lepirudin and bivalirudin has been used for on-pump cardiopulmonary bypass surgery. PMID:18938724

Lespron Robles, Ma del Carmen; Molina Méndez, Javier

2007-01-01

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Massive Rhabdomyolysis Following Cardiopulmonary Bypass  

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Here, we report a case of massive rhabdomyolysis following an uncomplicated repair of a ventricular septal defect in a five-month-old baby. Postoperatively, the patient was hemodynamically stable but metabolic acidosis continued, accompanied by fever and delayed mental recovery. The next day, he became comatose and never regained consciousness thereafter. The computed tomography of the brain revealed a diffuse brain injury. The patient followed a downhill course and eventually died on postoperative day 33. An unusually high level of creatine phosphokinase was noticed, peaking (21,880 IU/L) on postoperative day 2, suggesting severe rhabdomyolysis. The relevant literature was reviewed, and the possibility of malignant hyperthermia obscured by cardiopulmonary bypass and hypothermia was addressed. PMID:24782976

Kim, Young Sam; Yoon, Yong Han; Kim, Joung Taek

2014-01-01

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Cardiopulmonary Resuscitation and real life  

Directory of Open Access Journals (Sweden)

Full Text Available The Guidelines for Cardiopulmonary Resuscitation (CPR and Emergency Cardiovascular Beloveds are, probably, the most well known and widely-read guidelines in Medicine. Although for decades these guidelines are regularly revisited every 5 years, the survival to cardiac arrest on the territory remain unsatisfactory, attesting itself on 6,4% or less. These discouraging outcomes caused some reflections on the validity of the guidelines concrete application. Some reviews, supported by the results of some good studies recently published, and the introduction of new technologies have produced remarkable changes not only in the guidelines, but also in the methodology subtended to the review process, and the consequent creation of new recommendations. The recent publication on Circulation of the 2005 guidelines is the standing point for an analysis of the great changes carried out.

Fabio D’Este

2006-02-01

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Perioperative considerations in a sickle cell patient undergoing cardiopulmonary bypass  

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An 11-year-old child, a known case of sickle cell anaemia with a history suggestive of sickling crisis in the past was scheduled for surgical pulmonary valvotomy. Pre-operative blood transfusion and hydroxyurea were administered. Pre-operative blood transfusion is indicated in sickle cell disease patients to raise the haematocrit level and lower sickle haemoglobin (HbS) levels. Before the start of cardiopulmonary bypass (CPB), exchange transfusion was performed to reduce HbS level and raise adult haemoglobin level. Hypothermia was prevented by employing normothermic CPB. PMID:25024478

Raut, Monish S; Khanuja, Jasbir Singh; Srivastava, Sushant

2014-01-01

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Perioperative considerations in a sickle cell patient undergoing cardiopulmonary bypass.  

Science.gov (United States)

An 11-year-old child, a known case of sickle cell anaemia with a history suggestive of sickling crisis in the past was scheduled for surgical pulmonary valvotomy. Pre-operative blood transfusion and hydroxyurea were administered. Pre-operative blood transfusion is indicated in sickle cell disease patients to raise the haematocrit level and lower sickle haemoglobin (HbS) levels. Before the start of cardiopulmonary bypass (CPB), exchange transfusion was performed to reduce HbS level and raise adult haemoglobin level. Hypothermia was prevented by employing normothermic CPB. PMID:25024478

Raut, Monish S; Khanuja, Jasbir Singh; Srivastava, Sushant

2014-05-01

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Amitriptyline Intoxication Responded to Cardiopulmonary Resuscitation  

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The most severe effects in amitriptiline intoxications are related with central nervous system and cardiovascular system. Amitriptiline intoxication especially with high doses has severe cardiac effects and can result in cardiac arrest. Most favorable responses can be achieved with efficient and prolonged cardiopulmonary resuscitation. We wanted to present a case ingested high dose of amitriptiline for attempt to suicide and responded to prolonged cardiopulmonary resuscitation.

Güldem Turan; Özcan Pi?kin; Gül?en Bulut

2012-01-01

 
 
 
 
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Effect of cardiopulmonary bypass on the pharmacokinetics of propranolol and atenolol  

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Full Text Available The pharmacokinetics of some ?-blockers are altered by cardiopulmonary bypass (CPB. The objective of this study was to compare the effect of coronary artery bypass graft (CABG surgery employing CPB on the pharmacokinetics of propranolol and atenolol. We studied patients receiving oral propranolol with doses ranging from 80 to 240 mg (N = 11 or atenolol with doses ranging from 25 to 100 mg (N = 8 in the pre- and postoperative period of CABG with moderately hypothermic CPB (32°C. On the day before and on the first day after surgery, blood samples were collected before ?-blocker administration and every 2 h thereafter. Plasma levels were determined using high-performance liquid chromatography and data were treated by pharmacokinetics-modelling. Statistical analysis was performed using ANOVA or the Friedman test, as appropriate, and P < 0.05 was considered to be significant. A prolongation of propranolol biological half-life from 5.41 ± 0.75 to 11.46 ± 1.66 h (P = 0.0028 and an increase in propranolol volume of distribution from 8.70 ± 2.83 to 19.33 ± 6.52 L/kg (P = 0.0032 were observed after CABG with CPB. No significant changes were observed in either atenolol biological half-life (from 11.20 ± 1.60 to 11.44 ± 2.89 h or atenolol volume of distribution (from 2.90 ± 0.36 to 3.83 ± 0.72 L/kg. Total clearance was not changed by surgery. These CPB-induced alterations in propranolol pharmacokinetics may promote unexpected long-lasting effects in the postoperative period while the effects of atenolol were not modified by CPB surgery.

M.J.C. Carmona

2009-06-01

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Effects of cardiopulmonary bypass on propofol pharmacokinetics and bispectral index during coronary surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english PURPOSE: Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacok [...] inetics increase hypnotic effects after cardiopulmonary bypass. METHODS: Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10) or off-pump coronary artery bypass graft (group, n=10) coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 µg/mL). Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p

Ricardo Antonio G., Barbosa; Silvia Regina C. Jorge, Santos; Paul F., White; Valéria A., Pereira; Carlos R., Silva Filho; Luiz M. S., Malbouisson; Maria José C., Carmona.

2009-03-01

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Effects of cardiopulmonary bypass on propofol pharmacokinetics and bispectral index during coronary surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english PURPOSE: Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacok [...] inetics increase hypnotic effects after cardiopulmonary bypass. METHODS: Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10) or off-pump coronary artery bypass graft (group, n=10) coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 µg/mL). Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p

Ricardo Antonio G., Barbosa; Silvia Regina C. Jorge, Santos; Paul F., White; Valéria A., Pereira; Carlos R., Silva Filho; Luiz M. S., Malbouisson; Maria José C., Carmona.

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Are We Successful in Cardiopulmonary Resuscitation?  

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Full Text Available Purpose: In this study, we aimed to determine the success rate of cardiopulmonary resuscitation performed in the patients with diagnosis of cardiac arrest, and demographic characteristics of these patients. Material and Methods: The patients admitted to Adana Numune Education and Research Hospital, Department of Emergency Medicine between 01.01.2011 and 31.12.2012, and who underwent cardiopulmonary resuscitation were included to this study planned as retrospectively. The age, gender, status of judicial cases, causes and time of cardiac arrest, first observed arrest rhythm, the diseases prior to the arrest, means of arrival to emergency department, duration of cardiopulmonary resuscitation, results of cardiopulmonary resuscitation, the name of the hospitalised clinic, the existence of the operation, and outcome of the patients who underwent cardiopulmonary resuscitation in accordance with current advanced life support protocols were recorded in standard data entry form. Results: A total of 290 patients with completely accessible data were included to the study. Most of these patients were men (65.2%. The mean ages were 61 ± 19 years for men, 67 ± 14 years for women (p = 0.018. The most common diagnosis were ischemic heart disease and heart failure according to the analysis of the patient's medical history. 92 patients (31.7% were brought to the emergency department after death, and all of these patients were unsuccessful following to cardiopulmonary resuscitation. 198 patients (68.3% had cardiac arrest in the emergency department, and we determined that cardiopulmonary resuscitation application of 102 patients were successful. The most common causes of cardiac arrest were myocardial infarction and heart failure. Mostly first observed rhythm in the monitor was asystole. The response rate of cardiopulmonary resuscitation in patients with ventricular fibrillation and ventricular tachycardia was higher. Most patients were hospitalised to the coronary intensive care unit, and 11 of the 21 patients who underwent percutaneous coronary intervention were discharged from hospital in good health. Total 15 (5% of all patients included to the study were discharged in good health. Conclusion: The lower rate of success in cardiopulmonary resuscitation showed the presence of defects in all stages of the chain of life, and suggests that some actions should be performed to correct them. [Cukurova Med J 2013; 38(4.000: 601-609

Nalan Kozaci

2013-08-01

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Cardiopulmonary exercise testing. An underutilized diagnostic tool in Saudi Arabia.  

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Cardiopulmonary exercise testing as a diagnostic tool for cardiopulmonary diseases was extremely underutilized in Saudi hospitals and medical centers. Much greater efforts are needed to raise the awareness among physicians on the usefulness of CPET.

Hazzaa M. Al-Hazzaa

2004-10-01

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Pancreas grafts  

International Nuclear Information System (INIS)

Perfusion studies with sup(99m)Tc-DTPA, which has hitherto been used routinely to investigate renal grafts, have also proved useful for monitoring the perfusion of pancreas grafts. A total perfusion failure is equally reliably demonstrable as in renal grafts. Quantitatively smaller perfusion alterations can be demonstrated by monitoring the course. It seems possible to differentiate the salivary edema of a rejection reaction, well known from animal experiments, with the help of other paramters (e.g. creatinine). Further clinical studies are however necessary to confirm these results. (orig.)

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Effect of Colloid versus Crystalloid Administration of Cardiopulmonary Bypass Prime Solution on Tissue and Organ Perfusion  

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Full Text Available Background: We evaluated the effects of tissue and organ perfusionduring and after coronary artery bypass graft surgery with either colloid(Voluven or crystalloid (Lactated ringer’s as prime solution.Methods: In this prospective randomized-controlled trial study, 70patients undergoing on-pump coronary artery bypass graft surgery were randomlyassigned to receive either colloid (Voluven or crystalloid (Lactated ringer’sas prime solution, for initiation of cardiopulmonary bypass machine procedure.Tissue and organ perfusion markers including lactate, troponin I, liver andrenal function tests and electrolytes were measured sequentially, beforeinduction (T1 to second days after surgery (T5.Results: With exception of chloride and potassium levels no significantdifferences detected in other measurements, and the laboratory results wereentirely identical in both procedures.Conclusion: There was no significant difference between Voluven® (hydroxyethyl starch, HES 130/0.4 and crystalloid (Lactated ringer’s as primingsolution on the basis of organ and tissue perfusion tests assessment.

Sh Shahbazi

2011-03-01

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Cardiopulmonary resuscitation: update, controversies and new advances  

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Full Text Available Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardiopulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of life chain, cardio-pulmonary resuscitation courses for professionals who work in emergency medical services, the automated external defibrillator, the implantable cardioverter-defibrillator, and mobile intensive care units, among others. New concepts, strategies and structures motivated by new advances have also modified the treatment and improved the results of cardiopulmonary resuscitation in the hospital setting. Among them, we can cite the concept of cerebral resuscitation, the application of the life chain, the creation of the universal life support algorithm, the adjustment of drug doses, new techniques - measure of the end-tidal carbon dioxide levels and of the coronary perfusion pressure - and new drugs under research.

Alexandre C. Zago

1999-03-01

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[Redo Off-pump Coronary Artery Grafting through Left Thoracotomy].  

Science.gov (United States)

An 80-year-old man successfully underwent reoperative coronary artery bypass grafting( CABG) via left thoracotomy without cardiopulmonary bypass. The proximal end of the saphenous vein graft( SVG)was connected to the thoracic aorta using an automated proximal anastomosis system. Then the SVG routed beneath the pulmonary hilum was anastomosed to the high lateral branch and the anterior descending artery in a sequential mode. He recovered uneventfully and is free of chest pain after redo CABG. In selected patients, redo CABG for the left coronary artery can be safely performed through left thoracotomy. PMID:24917403

Oguma, Fumiaki; Sugawara, Masaaki; Hirahara, Hiroyuki

2014-06-01

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History of the evolution of cardiopulmonary resuscitation  

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Full Text Available Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references on CPR go back to the era of Ancient Egypt (3100 B.C.. Although the technique for mouth to mouth ventilation was known in ancient times, its efficacy was demonstrated just in 1958. The ease and efficacy of chest compressions were demonstrated in 1960. Electrical defibrillation may have begun in 1775, but it was applied to a victim of cardiac arrest in the 1950s. Conclusion: CPR is currently a rapidly evolving field of medical science. According to latest data, there is evidence that high quality chest compressions, prompt defibrillation if applicable and treatment of reversible causes improve Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references on CPR go back to the era of Ancient Egypt (3100 B.C.. Although the technique for mouth to mouth ventilation was known in ancient times, its efficacy was demonstrated just in 1958. The ease and efficacy of chest compressions were demonstrated in 1960. Electrical defibrillation may have begun in 1775, but it was applied to a victim of cardiac arrest in the 1950s. Conclusion: CPR is currently a rapidly evolving field of medical science. According to latest data, there is evidence that high quality chest compressions, prompt defibrillation if applicable and treatment of reversible causes improve neurologically intact long term survival of cardiac arrest victims.

George Karlis

2013-04-01

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Effects of massage therapy on sleep quality after coronary artery bypass graft surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english INTRODUCTION: Having poor sleep quality is common among patients following cardiopulmonary artery bypass graft surgery. Pain, stress, anxiety and poor sleep quality may be improved by massage therapy. OBJECTIVE: This study evaluated whether massage therapy is an effective technique for improving sle [...] ep quality in patients following cardiopulmonary artery bypass graft surgery. METHOD: Participants included cardiopulmonary artery bypass graft surgery patients who were randomized into a control group and a massage therapy group following discharge from the intensive care unit (Day 0), during the postoperative period. The control group and the massage therapy group comprised participants who were subjected to three nights without massage and three nights with massage therapy, respectively. The patients were evaluated on the following mornings (i.e., Day 1 to Day 3) using a visual analogue scale for pain in the chest, back and shoulders, in addition to fatigue and sleep. Participants kept a sleep diary during the study period. RESULTS: Fifty-seven cardiopulmonary artery bypass graft surgery patients were enrolled in the study during the preoperative period, 17 of whom were excluded due to postoperative complications. The remaining 40 participants (male: 67.5%, age: 61.9 years ± 8.9 years, body mass index: 27.2 kg/m² ± 3.7 kg/m²) were randomized into control (n = 20) and massage therapy (n = 20) groups. Pain in the chest, shoulders, and back decreased significantly in both groups from Day 1 to Day 3. The participants in the massage therapy group had fewer complaints of fatigue on Day 1 (p=0.006) and Day 2 (p=0.028) in addition, they reported a more effective sleep during all three days (p=0.019) when compared with the participants in the control group. CONCLUSION: Massage therapy is an effective technique for improving patient recovery from cardiopulmonary artery bypass graft surgery because it reduces fatigue and improves sleep.

Flavia Baggio, Nerbass; Maria Ignez Zanetti, Feltrim; Silvia Alves de, Souza; Daisy Satomi, Ykeda; Geraldo, Lorenzi-Filho.

52

Effects of massage therapy on sleep quality after coronary artery bypass graft surgery  

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Full Text Available INTRODUCTION: Having poor sleep quality is common among patients following cardiopulmonary artery bypass graft surgery. Pain, stress, anxiety and poor sleep quality may be improved by massage therapy. OBJECTIVE: This study evaluated whether massage therapy is an effective technique for improving sleep quality in patients following cardiopulmonary artery bypass graft surgery. METHOD: Participants included cardiopulmonary artery bypass graft surgery patients who were randomized into a control group and a massage therapy group following discharge from the intensive care unit (Day 0, during the postoperative period. The control group and the massage therapy group comprised participants who were subjected to three nights without massage and three nights with massage therapy, respectively. The patients were evaluated on the following mornings (i.e., Day 1 to Day 3 using a visual analogue scale for pain in the chest, back and shoulders, in addition to fatigue and sleep. Participants kept a sleep diary during the study period. RESULTS: Fifty-seven cardiopulmonary artery bypass graft surgery patients were enrolled in the study during the preoperative period, 17 of whom were excluded due to postoperative complications. The remaining 40 participants (male: 67.5%, age: 61.9 years ± 8.9 years, body mass index: 27.2 kg/m² ± 3.7 kg/m² were randomized into control (n = 20 and massage therapy (n = 20 groups. Pain in the chest, shoulders, and back decreased significantly in both groups from Day 1 to Day 3. The participants in the massage therapy group had fewer complaints of fatigue on Day 1 (p=0.006 and Day 2 (p=0.028 in addition, they reported a more effective sleep during all three days (p=0.019 when compared with the participants in the control group. CONCLUSION: Massage therapy is an effective technique for improving patient recovery from cardiopulmonary artery bypass graft surgery because it reduces fatigue and improves sleep.

Flavia Baggio Nerbass

2010-01-01

53

Effects of massage therapy on sleep quality after coronary artery bypass graft surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english INTRODUCTION: Having poor sleep quality is common among patients following cardiopulmonary artery bypass graft surgery. Pain, stress, anxiety and poor sleep quality may be improved by massage therapy. OBJECTIVE: This study evaluated whether massage therapy is an effective technique for improving sle [...] ep quality in patients following cardiopulmonary artery bypass graft surgery. METHOD: Participants included cardiopulmonary artery bypass graft surgery patients who were randomized into a control group and a massage therapy group following discharge from the intensive care unit (Day 0), during the postoperative period. The control group and the massage therapy group comprised participants who were subjected to three nights without massage and three nights with massage therapy, respectively. The patients were evaluated on the following mornings (i.e., Day 1 to Day 3) using a visual analogue scale for pain in the chest, back and shoulders, in addition to fatigue and sleep. Participants kept a sleep diary during the study period. RESULTS: Fifty-seven cardiopulmonary artery bypass graft surgery patients were enrolled in the study during the preoperative period, 17 of whom were excluded due to postoperative complications. The remaining 40 participants (male: 67.5%, age: 61.9 years ± 8.9 years, body mass index: 27.2 kg/m² ± 3.7 kg/m²) were randomized into control (n = 20) and massage therapy (n = 20) groups. Pain in the chest, shoulders, and back decreased significantly in both groups from Day 1 to Day 3. The participants in the massage therapy group had fewer complaints of fatigue on Day 1 (p=0.006) and Day 2 (p=0.028) in addition, they reported a more effective sleep during all three days (p=0.019) when compared with the participants in the control group. CONCLUSION: Massage therapy is an effective technique for improving patient recovery from cardiopulmonary artery bypass graft surgery because it reduces fatigue and improves sleep.

Flavia Baggio, Nerbass; Maria Ignez Zanetti, Feltrim; Silvia Alves de, Souza; Daisy Satomi, Ykeda; Geraldo, Lorenzi-Filho.

1105-11-01

54

Artificial neural network cardiopulmonary modeling and diagnosis  

Science.gov (United States)

The present invention is a method of diagnosing a cardiopulmonary condition in an individual by comparing data from a progressive multi-stage test for the individual to a non-linear multi-variate model, preferably a recurrent artificial neural network having sensor fusion. The present invention relies on a cardiovascular model developed from physiological measurements of an individual. Any differences between the modeled parameters and the parameters of an individual at a given time are used for diagnosis.

Kangas, Lars J. (Richland, WA); Keller, Paul E. (Richland, WA)

1997-01-01

55

Thromboxane Mediation of Cardiopulmonary Effects of Embolism  

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Humoral factors released from platelets during pulmonary embolism may be the cause of several attendant cardiopulmonary abnormalities. This study examines the role of thromboxanes (Tx) after experimental embolism induced with 0.5 g/kg autologous clot in four groups of five dogs: (a) untreated embolized controls; (b) pretreatment with the Tx synthetase inhibitor, imidazole 25 mg/kg · h i.v., starting 30 min before embolization; (c) pretreatment with the cyclooxygenase inhibitor indomethacin, ...

Utsunomiya, Takayoshi; Krausz, Michael M.; Levine, Lawrence; Shepro, David; Hechtman, Herbert B.

1982-01-01

56

Cardiopulmonary resuscitation: update, controversies and new advances  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardio [...] pulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of life chain, cardio-pulmonary resuscitation courses for professionals who work in emergency medical services, the automated external defibrillator, the implantable cardioverter-defibrillator, and mobile intensive care units, among others. New concepts, strategies and structures motivated by new advances have also modified the treatment and improved the results of cardiopulmonary resuscitation in the hospital setting. Among them, we can cite the concept of cerebral resuscitation, the application of the life chain, the creation of the universal life support algorithm, the adjustment of drug doses, new techniques - measure of the end-tidal carbon dioxide levels and of the coronary perfusion pressure - and new drugs under research.

Alexandre C., Zago; Cristine E., Nunes; Viviane R. da, Cunha; Euler, Manenti; Luís Carlos, Bodanese.

57

21 CFR 870.4340 - Cardiopulmonary bypass level sensing monitor and/or control.  

Science.gov (United States)

...Cardiopulmonary bypass level sensing monitor and/or control. 870.4340 Section...Cardiopulmonary bypass level sensing monitor and/or control. (a) Identification...cardiopulmonary bypass level sensing monitor and/or control is a device used...

2010-04-01

58

21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.  

Science.gov (United States)

...Roller-type cardiopulmonary bypass blood pump. 870.4370 Section 870.4370...Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass blood pump is a device that uses a revolving...

2010-04-01

59

21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.  

Science.gov (United States)

...Nonroller-type cardiopulmonary bypass blood pump. 870.4360 Section 870.4360 Food...Nonroller-type cardiopulmonary bypass blood pump. (a) Identification. A nonroller-type cardiopulmonary bypass blood pump is a device that uses a method other...

2010-04-01

60

21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.  

Science.gov (United States)

...Cardiopulmonary bypass heart-lung machine console. 870.4220 Section 870...Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine console is a device that...

2010-04-01

 
 
 
 
61

21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.  

Science.gov (United States)

...Cardiopulmonary bypass cardiotomy suction line blood filter. 870.4270 Section 870.4270 ...Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas...

2010-04-01

62

21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.  

Science.gov (United States)

...Cardiopulmonary bypass arterial line blood filter. 870.4260 Section 870.4260...Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part of a...

2010-04-01

63

21 CFR 870.4340 - Cardiopulmonary bypass level sensing monitor and/or control.  

Science.gov (United States)

... Cardiopulmonary bypass level sensing monitor and/or control. 870.4340 Section... Cardiopulmonary bypass level sensing monitor and/or control. (a) Identification. A cardiopulmonary bypass level sensing monitor and/or control is a device used...

2010-04-01

64

A multimodal transducer for cardiopulmonary activity monitoring in emergency.  

Science.gov (United States)

This paper is concerned with a new wearable system, which is able to monitor several vital signals and physiological variables in order to determine the cardiopulmonary activity status during emergencies. The innovative system consists of a multimodal broadband piezoelectric transducer based on polyvinylidene fluoride polymer integrated into a textile belt wrapped around the chest. An advanced electronic control unit, floating power supply, and wireless communication support make it suitable for portable monitoring during critical cardiopulmonary failures. The multimodal transducer is innovative in that only one sensitive element is employed to work as either an ultrasound (US) transceiver or piezoelectric sensor. The US transceiver is enabled to work at high frequency, i.e., it is excited by suitable pulses to emit an ultrasonic wave, which penetrates the body and receives the echo signals bouncing off the biological interfaces having different acoustic impedances. The piezoelectric sensor works at low frequency and acquires both signals generated by heart apex movements and the mechanical movement of the chest induced by respiration. This multimodality is allowed by a broadband of sensitivity jointly at a low value of the figure of merit (Q). Moreover, the transducer thickness is thin enough to assure a good adaptability to the biological site, and it is equipped with an advanced control unit enabling to switch from a high to a low working frequency. If jointly used along with an ECG wearable Holter, this transducer can be used to provide an exhaustive picture of the health status of the subject in the diagnostic and prognostic domains. PMID:19527961

Lanatà, Antonio; Scilingo, Enzo Pasquale; De Rossi, Danilo

2010-05-01

65

Earlier Application of Percutaneous Cardiopulmonary Support Rescues Patients from Severe Cardiopulmonary Failure Using the APACHE III Scoring System  

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Percutaneous cardiopulmonary support (PCPS) is a widely accepted treatment for severe cardiopulmonary failure. This system, which uses a percutaneous approach and autopriming devices, can be rapidly applied in emergency situations. We sought to identify the risk factors that could help predict in-hospital mortality, and to assess its outcomes in survivors. During a 2-yr period, 50 patients underwent PCPS for the treatment of severe cardiopulmonary failure, and of those, 22 (44%) were classifi...

Song, Suk-won; Yang, Hong-suk; Lee, Sak; Youn, Young-nam; Yoo, Kyung-jong

2009-01-01

66

Polystyrene modified by grafting  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Diversos tipos de poliestireno modificados foram obtidos através da polimerização por enxertia (graft polymerization) de estireno na presença dos seguintes modificadores: copolímero de etileno-acetato de vinila (EVA); polietileno de baixa densidade (PE) e polibutadieno (PB). Os modificadores foram u [...] tilizados em separado e combinados. Em todos os casos, manteve-se a concentração de modificador fixa em 8% em peso e foram avaliadas as propriedades dos produtos obtidos em função da sua composição. A técnica de polimerização empregada foi a de massa/suspensão. Os melhores resultados foram obtidos para os sistemas PS/modificadores mistos. Os resultados obtidos para estes sistemas comprovam que a copolimerização por enxertia gera produtos com melhores propriedades de impacto do que as obtidas, a partir de misturas mecânicas dos componentes individuais, em sistemas semelhantes. Abstract in english Several grades of modified polystyrene were obtained through the graft polymerization of styrene in the presence of modifiers such as ethylene-vinyl acetate (EVA), low density polyethylene (PE), and polybutadiene (PB). These modifiers were used by themselves and in combination. In all cases, the mod [...] ifier concentration was kept constant at 8% w/w, and the product properties were determined as a function of composition. The polymerization technique employed was that of mass/suspension. The best results were obtained for the PS/mixed modifiers systems. The results confirm that graft copolymers present better impact properties than those of mechanical blends of similar composition.

Avani Maria C, Rocha; Laura Hecker de, Carvalho; Antonio Gouveia de, Souza.

67

Bone Graft Alternatives  

Science.gov (United States)

... deformity or during a surgical procedure such as spinal fusion. What Types of Bone Grafts are There? Bone ... of bone grafts in spine surgery is during spinal fusion. The use of autogenous bone grafts for spinal ...

68

Software for interpreting cardiopulmonary exercise tests  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Cardiopulmonary exercise testing (CPET has become an important modality for the evaluation and management of patients with a diverse array of medical problems. However, interpreting these tests is often difficult and time consuming, requiring significant expertise. Methods We created a computer software program (XINT that assists in CPET interpretation. The program uses an integrative approach as recommended in the Official Statement of the American Thoracic Society/American College of Chest Physicians (ATS/ACCP on Cardiopulmonary Exercise Testing. In this paper we discuss the principles behind the software. We also provide the detailed logic in an accompanying file (Additional File 1. The actual program and the open source code are also available free over the Internet at http://www.xint.org. For convenience, the required download files can also be accessed from this article. Additional file 1 XINTlogic. This file provides the detailed logic used by the XINT program. The variable names are described in Table 1. The actual source code may also be read directly simply by opening the source code with a text editor. Click here for file Results To test the clinical usefulness of XINT, we present the computer generated interpretations of the case studies discussed in the ATS/ACCP document in another accompanying file (Additional File 2. We believe the interpretations are consistent with the document's criteria and the interpretations given by the expert panel. Additional file 2 XINTinterpretations. These are the XINT generated reports based on the five examples provided in the ATS/ACCP statement on cardiopulmonary exercise testing 1. Click here for file Conclusion Computers have become an integral part of modern life. Peer-reviewed scientific journals are now able to present not just medical concepts and experimental studies, but actual functioning medical interpretive software. This has enormous potential to improve medical diagnoses and patient care. We believe XINT is such a program that will give clinically useful interpretations when used by the medical community at large.

Corry David B

2007-10-01

69

Refractory Vascular Spasm Associated with Coronary Bypass Grafting  

Science.gov (United States)

Diffuse refractory vascular spasms associated with coronary bypass artery grafting (CABG) are rare but devastating. A 42-year-old male patient with a past history of stent insertion was referred for the surgical treatment of a recurrent left main coronary artery disease. A hemodynamic derangement developed during graft harvesting, necessitating a hurried initiation of cardiopulmonary bypass (CPB). Although CABG was carried out as planned, the patient could not be weaned from the bypass. An emergency coronary angiography demonstrated a diffuse spasm of both native coronary arteries and grafts. CPB was switched to the femorofemoral extracorporeal membrane oxygenator (ECMO). Although he managed to recover from heart failure, his discharge was delayed due to the ischemic injury of the lower limb secondary to cannulation for ECMO. We reviewed the case and literature, placing emphasis on the predisposing factors and appropriate management. PMID:25346903

Kim, Young Sam; Yoon, Yong Han; Kim, Jeoung Taek; Shinn, Helen Ki; Woo, Seong Ill; Baek, Wan Ki

2014-01-01

70

Hydroxyethyl starch versus Ringer solution in cardiopulmonary bypass prime solutions (a randomized controlled trial  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background In our study we compared the Ringer solution, which is the standard prime solution of our department, with the HES (Hydroxyethyl starch 130-0.4 solution, which can be a potential alternative prime solution with an indispensable material for the cardio-pulmonary bypass applications. Methods 140 patients undergoing to CABG (Coronary Artery Bypass Graft surgery were electively enrolled to the study. 1500 ml Ringer solution + 200 ml mannitol + 60 ml sodium bicarbonate + 150 U/kg heparin was used as a prime solution to start cardiopulmonary by-pass in 70 patients which was defined as group 1. On the other hand, 1500 ml HES 130 - 0.4 + 200 ml mannitol + 60 ml sodium bicarbonate + 150 U/kg heparin was used as a prime solution in 70 patients in group 2. Results INR (International Normalized Ratio, urea levels and blood platelet counts were significantly different between the groups. INR level was higher in group 1, while blood urea and creatinine levels and platelet count were higher in group 2 at the end of the 12th and 24nd hours postoperatively (p = 0.001. In this study, it was shown that the usage of HES 130-0.4 as a prime solution did not have negative effect on postoperative INR level, platelet count, the need for transfusion and the amount of drainage, despite the negative opinions that similar solutions caused coagulation disorders. Another interesting result of the study was that blood platelet count at 24th hour was statistically significantly higher in group 2 (p = 0.001. Conclusion HES 130-0.4 solution is an alternative colloidal solution which can be used as the prime solution or as a mixture with the crystalloids in cardio-pulmonary bypass applications.

Ozyaz?c?oglu Ahmet

2008-07-01

71

Extended resection of lung cancer invading the left subclavian artery by using cardiopulmonary bypass.  

Science.gov (United States)

We treated a 54-year-old man with large cell carcinoma of the left upper lobe invading the esophagus and the left subclavian artery (SCA) from its origin. The tumor was completely resected by lobectomy under cardiopulmonary bypass. The left SCA was dissected at the aortic arch and reconstructed with a graft. The muscle layer of the esophagus was resected, followed by patching with an intercostal muscle flap. The pathological tumor stage was T4N0M0. The tumor recurred at two months after surgery in the neck lymph nodes and brain. Both sites were treated with radiation therapy and the patient is now alive without recurrence at 26 months after surgery. Lung cancer invading the great vessels and other mediastinal structures can be cured or long survival can be obtained by extended resection and postoperative adjuvant therapy. PMID:16030485

Nomori, Hiroaki; Hirotani, Takashi; Watanabe, Kenichi; Ohtsuka, Takashi; Naruke, Tsuguo; Suemasu, Keiichi

2005-06-01

72

Graft irradiation abrogates graft-versus-host disease in combined pancreas-spleen transplantation  

International Nuclear Information System (INIS)

A model of combined pancreas-spleen transplantation (PST) was studied in LBN F1 recipients of Lewis grafts in order to evaluate the efficacy of pretransplant graft irradiation in preventing lethal graft-versus-host disease (GVHD). Recipients of unmodified PST uniformly developed severe GVHD and died (MST = 16.7 +/- 3.8 days). Whole body donor irradiation with either 500 or 250 rad prevented lethal GVHD. Similarly, ex vivo graft irradiation with either 1000 or 500 rad also resulted in normal weight gain, graft function, and host survival for the 6-week study period. Conversely, delay of graft irradiation until 3 days after transplantation failed to prevent this complication (MST = 15.8 +/- 3.7 days). Recipients of irradiated grafts displayed glucose tolerance tests that were identical to those in the control group indicating that the doses of radiation employed in these experiments were not deleterious to islet function. Irradiated spleen grafts appeared histologically normal at 6 weeks after transplantation. Cells derived from these grafts failed to stimulate lymph node enlargement in a popliteal lymph node assay for GVHD, suggesting that these spleens may have become repopulated with host cells. These experiments confirm that PST has the potential to cause lethal GVHD and suggest that pretransplant graft irradiation may be used to prevent its occurrence

73

Radiation initiated grafting  

International Nuclear Information System (INIS)

Various methods of grafting of vinyl monomers on to synthetic polymers have been presented with an emphasis for suppressing the parasitic homopolymerisation both in in-source grafting as well as post-irradiation grafting. The parameters like glass transition temperature of the polymer, preswelling, swelling along with grafting etc., have been considered in detail for obtaining the maximum graft yield with least homopolymerisation. Recent work carried out on grafting of vinyl monomers on to the synthetic fibres and films have been presented and discussed. Practical applications of radiation grafted materials are indicated. (author)

74

Grafting onto polyformaldehyde fibers  

International Nuclear Information System (INIS)

e chemical method was used during the grafting reaction. The AA- and AN-grafted PF fibers could be dyed in intense deep shades with cationic dyes. Similarly, AM-grafted substrates gave bright deep shades with acid dyes. Infrared studies, used to analyze the grafted PF fibers, indicated the presence of --COOH, --CN, and --NH2 groups introduced in the fiber structure as a result of grafting with AA, AN, and AM. 2 tables, 14 figures

75

Prueba de ejercicio con análisis de gases espirados / Cardiopulmonary exercise testing  

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish La prueba de ejercicio con análisis de gases espirados (PEAGE) es una herramienta útil tanto en el proceso diagnóstico como pronóstico de pacientes con enfermedades cardiovasculares, pulmonares, neuromusculares e incluso metabólicas. El análisis de la composición del gas espirado y las característic [...] as de la dinámica ventilatoria, nos dejan ver la manera en que la energía es transformada incluso a nivel celular (crestas mitocondriales), a través de diferentes procesos metabólicos. Mediante la PEAGE, el médico podrá discernir entre las diversas causas de disnea con origen indeterminado. Por otro lado, esta prueba representa un importante apoyo para indicar la realización de un trasplante (cardiaco, pulmonar o ambos) en pacientes con cardiopatía o neumopatía graves. La utilidad de una prueba cardiopulmonar, ha sido también comprobada en deportistas de alto rendimiento y en pacientes con cardiopatías congénitas. En el pasado, el acceso que tenían tanto el médico como el paciente a la realización de una PEAGE era restringido, debido principalmente a la complejidad y altos costos de los equipos. Sin embargo, hoy en día la tecnología se ha simplificado y los costos han disminuido, lo que ha hecho de la PEAGE una alternativa real en el trabajo cotidiano. Abstract in english Cardiopulmonary exercise test is a useful tool in the diagnosis and prognosis of patients with cardiovascular, pulmonary, neuromuscular and even metabolic disorders. The composition and the analysis of expired gas, and the characteristics of ventilatory dynamics, let us see how energy is transformed [...] , within the cells (mitochondrial cristae), through several metabolic processes. Using the cardiopulmonary exercise testing, physicians can distinguish among several causes of dyspnea with undetermined origin. On the other hand, this test represents an important support to indicate the indication of a graft-transplant (heart, lung or both) in patients with severe heart disease, lung disease or both. Cardiopulmonary test has also been used to evaluate high performance athletes and patients with congenital heart disease. In the past, physicians and patients had a restricted access to the performance of a cardiopulmonary exercise testing, mainly due to the complexity and high costs of this technology. Nowadays, this kind of equipment has been simplified and the costs lowered, in consequence this test became a real alternative in daily work.

Hermes, Ilarraza-Lomelí.

2012-06-01

76

Prueba de ejercicio con análisis de gases espirados / Cardiopulmonary exercise testing  

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish La prueba de ejercicio con análisis de gases espirados (PEAGE) es una herramienta útil tanto en el proceso diagnóstico como pronóstico de pacientes con enfermedades cardiovasculares, pulmonares, neuromusculares e incluso metabólicas. El análisis de la composición del gas espirado y las característic [...] as de la dinámica ventilatoria, nos dejan ver la manera en que la energía es transformada incluso a nivel celular (crestas mitocondriales), a través de diferentes procesos metabólicos. Mediante la PEAGE, el médico podrá discernir entre las diversas causas de disnea con origen indeterminado. Por otro lado, esta prueba representa un importante apoyo para indicar la realización de un trasplante (cardiaco, pulmonar o ambos) en pacientes con cardiopatía o neumopatía graves. La utilidad de una prueba cardiopulmonar, ha sido también comprobada en deportistas de alto rendimiento y en pacientes con cardiopatías congénitas. En el pasado, el acceso que tenían tanto el médico como el paciente a la realización de una PEAGE era restringido, debido principalmente a la complejidad y altos costos de los equipos. Sin embargo, hoy en día la tecnología se ha simplificado y los costos han disminuido, lo que ha hecho de la PEAGE una alternativa real en el trabajo cotidiano. Abstract in english Cardiopulmonary exercise test is a useful tool in the diagnosis and prognosis of patients with cardiovascular, pulmonary, neuromuscular and even metabolic disorders. The composition and the analysis of expired gas, and the characteristics of ventilatory dynamics, let us see how energy is transformed [...] , within the cells (mitochondrial cristae), through several metabolic processes. Using the cardiopulmonary exercise testing, physicians can distinguish among several causes of dyspnea with undetermined origin. On the other hand, this test represents an important support to indicate the indication of a graft-transplant (heart, lung or both) in patients with severe heart disease, lung disease or both. Cardiopulmonary test has also been used to evaluate high performance athletes and patients with congenital heart disease. In the past, physicians and patients had a restricted access to the performance of a cardiopulmonary exercise testing, mainly due to the complexity and high costs of this technology. Nowadays, this kind of equipment has been simplified and the costs lowered, in consequence this test became a real alternative in daily work.

Hermes, Ilarraza-Lomelí.

77

Strategies for cardiopulmonary exercise testing of pectus excavatum patients  

Directory of Open Access Journals (Sweden)

Full Text Available The purpose of this paper is to provide strategies for cardiopulmonary exercise testing of pectus excavatum patients. Currently, there are no standardized methods for assessing cardiovascular and pulmonary responses in this population; therefore, making comparisons across studies is difficult if not impossible. These strategies are intended for physicians, pulmonary technicians, exercise physiologists, and other healthcare professionals who conduct cardiopulmonary exercise testing on pectus excavatum patients. By using the strategies outlined in this report, comparisons across studies can be made, and the effects of pectus excavatum on cardiopulmonary function can be assessed with greater detail.

Moh H. Malek

2008-01-01

78

Strategies for cardiopulmonary exercise testing of pectus excavatum patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english The purpose of this paper is to provide strategies for cardiopulmonary exercise testing of pectus excavatum patients. Currently, there are no standardized methods for assessing cardiovascular and pulmonary responses in this population; therefore, making comparisons across studies is difficult if not [...] impossible. These strategies are intended for physicians, pulmonary technicians, exercise physiologists, and other healthcare professionals who conduct cardiopulmonary exercise testing on pectus excavatum patients. By using the strategies outlined in this report, comparisons across studies can be made, and the effects of pectus excavatum on cardiopulmonary function can be assessed with greater detail.

Moh H., Malek; Jared W., Coburn.

79

Preeclampsia induced cardiopulmonary arrest in pregnant: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available There are several medical, and obstetrical conditions that can lead to cardiopulmonary arrest during pregnancy. Preeclampsia is an important cause of cardiopulmonary arrest in pregnant woman. In case of pregnant with cardiopulmonary arrest, intensive effort is necessary to rescue the mother and baby. We report a case of a 35-years-old pregnant woman who had a severe pulmonary edema and cardiac arrest due to preeclampsia. According to recent guidelines of resuscitation, modified advanced cardiac life support was performed in the emergency department and then at 32-week gestation healthy baby was delivered by cesarean section at the 10th minutes of the resuscitation

Mehmet Tahir Gökdemir

2013-03-01

80

Trilinolein improves erythrocyte deformability during cardiopulmonary bypass.  

Science.gov (United States)

The in vitro effect of trilinolein, a triglyceride with linoleic acid as the major fatty acid residue in the esterified positions of glycerol, on erythrocyte deformability was studied in blood samples collected from 12 patients before and after cardiopulmonary bypass (CPB). Erythrocyte deformability was measured with a filtration method and expressed as red cell filtration rate (RFR). RFR was reduced after CPB and the reduction was time dependent. Trilinolein at a concentration of 10(-7) M significantly reversed the CPB-induced reduction of RFR when it was mixed with blood samples collected 30, 60 and 90 min from the start of CPB. This study confirmed the effect of CPB on erythrocyte deformability and showed that this damage could be significantly improved by mixing blood with trilinolein. PMID:8054252

Tsai, S K; Chan, P; Lee, T Y; Yung, J M; Hong, C Y

1994-01-01

 
 
 
 
81

The role of Levosimendan in cardiopulmonary resuscitation.  

Science.gov (United States)

Although initial resuscitation from cardiac arrest (CA) has increased over the past years, long term survival rates remain dismal. Epinephrine is the vasopressor of choice in the treatment of CA. However, its efficacy has been questioned, as it has no apparent bene?ts for long-term survival or favorable neurologic outcome. Levosimendan is an inodilator with cardioprotective and neuroprotective effects. Several studies suggest that it is associated with increased rates of return of spontaneous circulation as well as improved post-resuscitation myocardial function and neurological outcome. The purpose of this article is to review the properties of Levosimendan during cardiopulmonary resuscitation (CPR) and also to summarize existing evidence regarding the use of Levosimendan in the treatment of CA. PMID:24972240

Varvarousi, Giolanda; Stefaniotou, Antonia; Varvaroussis, Dimitrios; Aroni, Filippia; Xanthos, Theodoros

2014-10-01

82

Relationship of Cardiopulmonary Fitness to Flight Performance in Tactical Aviation.  

Science.gov (United States)

This report describes current endeavors to identify whether cardiopulmonary fitness can positively influence flight performance in a tactical fighter community. Population analyses of 111 subjects consisting of experienced aviators and student naval aviat...

G. R. Banta, J. D. Grissett

1987-01-01

83

A Correlation Study of Cardiopulmonary Arrests, Cholesterol and Pressures  

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This study consisted of cardiopulmonary arrests occurring between January 1990 and December 1991 in a Midwestern City in Kansas, U.S.A., with a population of 300,000. Admission cholesterol levels and hourly barometric pressures were obtained to show if there exists a relationship between cardiopulmonary arrests, cholesterol levels and barometric pressures. Statistical analysis was performed using Pearson-Moment Correlation Coefficient. Scattergrams amongst the dependent variables such as time...

Rider, S. E.; Taher, S. M.

2003-01-01

84

Endovascular stent-graft management of thoracic aortic diseases  

International Nuclear Information System (INIS)

The traditional standard therapy for descending thoracic aortic aneurysm (TAA) is open operative repair with graft replacement of the diseased aortic segment. Despite important advances in surgical techniques, anesthetic management, and post-operative care over the last 30 years, the mortality and morbidity of surgery remains considerable, especially in patients at high risk for thoracotomy because of coexisting severe cardiopulmonary abnormalities or other medical diseases. The advent of endovascular stent-graft technology provides an alternative to open surgery for selected patients with TAA. The initial experience suggests that stent-graft therapy potentially may reduce the operative risk, hospital stay and procedural expenses of TAA repair. These potential benefits are especially attractive for patients at high risk for open TAA repair. Current results of endovascular TAA therapy document operative mortalities of between 0 and 4%, aneurysm thrombosis in 90 and 100% of cases, and paraplegia as a complication in 0 and 1.6% of patients. The early success of stent-graft repair of TAA has fostered the application of these devices for the management of a wide variety of thoracic aortic pathologies, including acute and chronic dissection, intramural hematoma, penetrating ulcer, traumatic injuries, and other diseases. The results of prospective controlled trials that compare the outcomes of stent-graft therapy with those of surgical treatment in patients with specific types of aortic disease are anxiously awaited before recommendations regarding the general use of these new devices can be made with confidence

85

Outcome of cardiopulmonary resuscitation - predictors of survival  

International Nuclear Information System (INIS)

To assess the outcomes of patients undergoing cardiopulmonary resuscitation (CPR). Data were collected retrospectively of all adult patients who underwent CPR. Clinical outcomes of interest were survival at the end of CPR and survival at discharge from hospital. Factors associated with survival were evaluated using logistic regression analysis. Of the 159 patients included, 55 (35%) were alive at the end of CPR and 17 (11%) were discharged alive from the hospital. At the end of CPR, univariate logistic regression analysis found the following factors associated with survival: cardiac arrest within hospital as compared to outside the hospital (odds ratio = 2.8, 95% CI = 1.27-6.20, p-value = 0.01), both cardiac and pulmonary arrest as compared to either cardiac or pulmonary arrest (odds ratio = 0.37, 95% CI = 0.19- 0.73, p-value = 0.004), asystole as cardiac rhythm at presentation (odds ratio = 0.47, 95% CI = 0.24-0.93, p-value = 0.03), and total atropine dose given during CPR (odds ratio = 0.78, 95% CI = 0.62-0.97, p-value = 0.02). In multivariate logistic regression, cardiac arrest within hospital (odds ratio = 2.52, 95% CI = 1.06-5.99, p-value = 0.04) and both cardiac and pulmonary arrest as compared to cardiac or pulmonary arrest (odds ratio = 0.44, 95% CI = 0.21-0.91, p-value = 0.03) were associated with survival at the end of CPR. At the time of discharge from hospital, univariate logistic regression analysis found following factors that were associated with survival: cardiac arrest within hospital (odds ratio = 8.4, 95% CI = 1.09-65.64, p-value = 0.04), duration of CPR (odds ratio = 0.91, 95% CI = 0.85-0.96, p-value = 0.001), and total atropine dose given during CPR (odds ratio = 0.68, 95% CI = 0.47-0.99, p-value = 0.05). In multivariate logistic regression analysis cardiac arrest within hospital (odds ratio 8.69, 95% CI = 1.01-74.6, p-value = 0.05) and duration of CPR (odds ratio 0.92, 95% CI = 0.87-0.98, p-value = 0.01) were associated with survival at discharge from hospital. In-hospital cardiopulmonary arrest was associated with better clinical outcomes as compared to outside hospital arrest. Public education is needed to improve clinical outcomes in patients who need CPR outside hospital. (author)

86

Grafting and curing  

International Nuclear Information System (INIS)

Progress in radiation grafting and curing is briefly reviewed. The two processes are shown to be mechanistically related. The parameters influencing yields are examined particularly for grafting. For ionising radiation grafting systems (EB and gamma ray) these include solvents, substrate and monomer structure, dose and dose-rate, temperature and more recently role of additives. In addition, for UV grafting, the significance of photoinitiators is discussed. Current applications of radiation grafting and curing are outlined. The recent development of photoinitiator free grafting and curing is examined as well as the potential for the new excimer laser sources. The future application of both grafting and curing is considered, especially the significance of the occurrence of concurrent grafting during cure and its relevance in environmental considerations

87

Composite graft tympanoplasty  

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Seventy six ears with chronic suppurative otitis media and fit for tympanoplasty were subjected to grafting with combination of perichondrium and cartilage (composite graft) for restoration of sound conducting apparatus and reconstruction of canal wall. A comparison with temporal fascia grafting has been done. Composite graft procedure gave better functional improvement, helped in reconstruction of canal wall and was also useful in elimination of retraction pockets.

Mukherjee, S.; Chamyal, P. C.

1997-01-01

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Transfusion associated graft versus host disease in an immunocompetent individual following coronary artery bypass grafting  

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Full Text Available Transfusion associated graft versus host disease (TA-GVHD is a rare but commonly fatal complication of transfusion of cellular blood products, which usually occurs in immunosuppressed individuals following transfusion and subsequent engraftment of viable T lymphocytes. Very rarely it may arise in apparently immunocompetent individuals. The clinical syndrome consists of fever, skin rash, diarrhoea, hepatic dysfunction, and bone marrow aplasia. The outcome is nearly always fatal. We present here a case report of fatal TA-GVHD in a "presumed" immunocompetent patient, post coronary artery bypass grafting surgery after transfusion of blood products. The patient died 24 days after transfusion. There is a perceived increased risk of TA-GVHD following bypass grafting and other surgical procedures where cardiopulmonary bypass is required. TA-GVHD is probably underreported and the incidence is felt to be too low to warrant routine irradiation of cellular products for this group of patients. Clinicians, pathologists, and transfusion centers should be aware of this rare but devastating complication of blood transfusion after cardiac surgery.

Nagendra Girish

2008-01-01

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Radiation-induced grafting of acrylic acid onto polyethylene filaments  

Science.gov (United States)

Radiation-induced grafting of acrylic acid onto high density polyethylene (PE) filaments was carried out in order to raise softening temperature and impart flame retardance and hydrophilic properties. Mutual ?-irradiation method was employed for the grafting in a mixture of acrylic acid (AA), ethylene dichloride and water containing a small amount of ferrous ammonium sulfate. The rate of grafting was very low at room temperature. On the other hand, large percent grafts were obtained when the grafting was performed at an elevated temperature. Activation energy for the initial rate of grafting was found to be 17 {kcal}/{mol} between 20 and 60°C and 10 {kcal}/{mol} between 60 and 80°C. Original PE filament begins to shrink at 70°C, show maximum shrinkage of 50% at 130°C and then breaks off at 136°C. When a 34% AA graft is converted to metallic salt such as sodium and calcium, the graft filament retains its filament form even above 300°C and gives maximum shrinkage of 15%. Burning tests by a wire-netting basket method indicate that graft filaments and its metallic salts do not form melting drops upon burning and are self-extinguishing. Original PE filament shows no moisture absorption, however, that of AA-grafted PE increases with increasing graft percent. The sodium salt of 15% graft shows the same level of moisture regain as cotton. The AA-grafted PE filament and its metallic salts can be dyed with cationic dyes even at 1% graft. Tensile properties of PE filament is impaired neither by grafting nor by conversion to metallic salts.

Kaji, K.; Okada, T.; Sakurada, I.

90

Conflicting perspectives compromising discussions on cardiopulmonary resuscitation.  

LENUS (Irish Health Repository)

Healthcare professionals, patients and their relatives are expected to discuss resuscitation together. This study aims to identify the differences in the knowledge base and understanding of these parties. Questionnaires examining knowledge and opinion on resuscitation matters were completed during interviews of randomly selected doctors, nurses and the general public. 70% doctors, 24% nurses and 0% of a public group correctly estimated survival to discharge following in-hospital resuscitation attempts. Deficiencies were identified in doctor and nurse knowledge of ethics governing resuscitation decisions. Public opinion often conflicts with ethical guidelines. Public understanding of the nature of cardiopulmonary arrests and resuscitation attempts; and of the implications of a \\'Do Not Attempt Resuscitation (DNAR)\\' order is poor. Television medical dramas are the primary source of resuscitation knowledge. Deficiencies in healthcare professionals\\' knowledge of resuscitation ethics and outcomes may compromise resuscitation decisions. Educational initiatives to address deficiencies are necessary. Parties involved in discussion on resuscitation do not share the same knowledge base reducing the likelihood of meaningful discussion. Public misapprehensions surrounding resuscitation must be identified and corrected during discussion.

Groarke, J

2010-09-01

91

Postoperative abdominal complications after cardiopulmonary bypass  

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Full Text Available Abstract Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB. Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed. Results Of all the patients, 33(1.4% developed abdominal complications postoperatively, including 11(33.3% cases of paralytic ileus, 9(27.3% of gastrointestinal haemorrhage, 2(6.1% of gastroduodenal ulcer perforation, 2(6.1% of acute calculus cholecystitis, 3(9.1% of acute acalculus cholecystitis, 4(12.1% of hepatic dysfunction and 2(6.1% of ischemia bowel diseases. Of the 33 patients, 26 (78.8% accepted medical treatment and 7 (21.2% underwent subsequent surgical intervention. There were 5(15.2% deaths in this series, which was significantly higher than the overall mortality (2.7%. Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications. Conclusions Abdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients.

Dong Guohua

2012-10-01

92

Hantaviruses and cardiopulmonary syndrome in South America.  

Science.gov (United States)

Hantavirus (Bunyaviridae) cardiopulmonary syndrome (HCPS) is an emerging health problem in South America due to urban growth and to the expansion of agriculture and cattle-raising areas into ecosystems containing most of the species of Sigmodontinae rodents that act as hantavirus reservoirs. About 4000 HCPS cases have been reported in South America up to 2013, associated with the following hantaviruses: Andes, Anajatuba, Araraquara (ARQV), Paranoá, Bermejo, Castelo dos Sonhos, Juquitiba, Araucária, Laguna Negra, Lechiguanas, Maripa, Oran, Rio Mamore and Tunari. The transmission of hantavirus to man occurs by contact with or through aerosols of excreta and secretions of infected rodents. Person-to-person transmission of hantavirus has also been reported in Argentina and Chile. HCPS courses with a capillary leaking syndrome produced by the hantavirus infecting lung endothelial cells and mostly with a severe inflammatory process associated with a cytokine storm. HCPS starts as a dengue-like acute febrile illness but after about 3 days progresses to respiratory failure and cardiogenic shock, leading to a high fatality rate that reaches 50% for patients infected with ARQV. PMID:24508343

Figueiredo, Luiz Tadeu Moraes; Souza, William Marciel de; Ferrés, Marcela; Enria, Delia Alcira

2014-07-17

93

Radiation-induced grafting of acrylic acid onto polyethylene filaments  

International Nuclear Information System (INIS)

Radiation-induced grafting of acrylic acid onto high density polyethylene (PE) filaments was carried out in order to raise softening temperature and impart flame retardance and hydrophilic properties. Mutual ?-irradiation method was employed for the grafting in a mixture of acrylic acid (AA), ethylene dichloride and water containing a small amount of ferrous ammonium sulfate. The rate of grafting was very low at room temperature. On the other hand, large percent grafts were obtained when the grafting was performed at an elevated temperature. Activation energy for the initial rate of grafting was found to be 17 kcal/mol between 20 and 600C and 10 kcal/ mol between 60 and 800C. Original PE filament begins to shrink at 700C, shows maximum shrinkage of 50% at 1300C and then breaks off at 1360C. When a 34% AA graft is converted to metallic salt the graft filament retains its filament form even above 3000C and gives maximum shrinkage of 15%. Burning tests by a wire-netting basket method indicate that graft filaments and their metallic salts do not form melting drops upon burning and are self-extinguishing. Original PE filament shows no moisture absorption; however, that of AA-grafted PE increases with increasing graft percent. (author)

94

Septal graft in laryngeal reconstruction  

International Nuclear Information System (INIS)

A 62-year-old woman presented with symptoms of dyspnea. Ultrasonography and computed tomography examinations revealed mass extending from the cricoid cartilage to the left lobe of thyroid gland and thyroid cartilage. Cytology revealed possibility of cartilaginous origin, which was proven to be chondrosarcoma (Grade 1) from the biopsy specimen obtained during panendosopy. She underwent one stage radical resection and immediate reconstruction of laryngeal skeleton defect by mucocartilaginous graft from the nasal septum. Her postoperative course was optimal with preservation of the laryngeal functions. Twenty-eight months postoperatively, she had to undergo total laryngectomy as a salvage procedure for the advanced local recurrence. We report on the relatively easy technique for functional reconstruction of the large laryngeal defect with the employment cartilage graft from the nasal septum. (author)

95

Historical development of the cardiopulmonary ressuscitation: review study  

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Full Text Available Objective: this review aimed to describe the historical development of cardiopulmonary resuscitation, following the history of this therapeutic modality. Methods: the methodology consists of a review of the databases Medline and Lilacs looking for articles published in the last 20 years about the history and establishment of cardiopulmonary resuscitation as a therapeutic option for reversal of cardiorespiratory arrest. Results: there are historical antecedents of cardiopulmonary resuscitation from the Biblical era until the establishment of the committee of the American Heart Association. As this committee, currently, a reference in teaching and research in cardiopulmonary resuscitation in the world, its investment allowed from 2000, the development of a global consensus of resuscitation guidelines that generated international attention only on the cardiopulmonary resuscitation. Conclusion: it was noted that over the years the techniques of PCR produced an impact on modern society to the point of generating new expectations facing life and death, revealing is essential that the healthcare professional who understands your technical and scientific competence for a parade heart can make a difference between life and death of a patient.

Érika de Azevedo Leitão Mássimo, Daclé Vilma Carvalho, Talline Arêdes Hang Costa, Danilo Ulisses Oliveira

2009-07-01

96

A reappraisal of saphenous vein grafting  

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Full Text Available Autologous saphenous vein grafting has been broadly used as a bypass conduit, interposition graft, and patch graft in a variety of operations in cardiac, thoracic, neurovascular, general vascular, vascular access, and urology surgeries, since they are superior to prosthetic veins. Modified saphenous vein grafts (SVG, including spiral and cylindrical grafts, and vein cuffs or patches, are employed in vascular revascularization to satisfy the large size of the receipt vessels or to obtain a better patency. A loop SVG helps flap survival in a muscle flap transfer in plastic and reconstructive surgery. For dialysis or transfusion purposes, a straight or loop arteriovenous fistula created in the forearm or the thigh with an SVG has acceptable patency. The saphenous vein has even been used as a stent cover to minimize the potential complications of standard angioplasty technique. However, the use of saphenous vein grafting is now largely diminished in treating cerebrovascular disorders, superior vena cava syndrome, and visceral revascularization due to the introduction of angioplasty and stenting techniques. The SVG remains the preferable biomaterial in coronary artery bypass, coronary ostioplasty, free flap transfer, and surgical treatment of Peyronie disease. Implications associated with saphenous vein grafting in vascular access surgery for the purpose of dialysis and chemotherapy are considerable. Vascular cuffs and patches have been developed as an important and effective means of enhancing the patency rates of the grafts by linking the synthetic material to the receipt vessel. In addition, saphenous veins can be a cell source for tissue engineering. We review the versatile roles that saphenous vein grafting has played as well as its current status in therapy.

Yuan Shi-Min

2011-01-01

97

Grafting on polyester fibers  

International Nuclear Information System (INIS)

Acrylic acid (AA) and acrylonitrile (AN) were used to carry out grafting on polyester (PE) fibers using the techniques of initiation by ?-radiation as well as benzoyl peroxide. Extent of grafting depended upon the time, concentration of the initiator, and the monomer as well as on the irradiation dose. AA grafted fibers were rendered more hydrophilic than AN grafted fibers for equivalent amount of grafts. Considerable improvement in dyeability of the PE fibers was possible through grafting. About 50 percent to 100 percent improvement with disperse dyes was observed in case of PE fibers containing 22.4 percent and 9.0 percent graft of AA and AN, respectively. Intense fast dyeing with direct and basic (cationic) dyes was also possible, and the dye content was proportional to the extent of graft introduced in the fiber. The CN groups were reduced to NH2 groups in the AN graft on the fiber. With the increased amount of AA graft, the maxima in the zeta potential curve shifted toward higher acidic pH as greater amounts of alkali were utilized by the --COOH groups in the graft. In this respect, CN groups were less sensitive due to their lesser polarity as compared to the carboxylic groups. Surface charge density (S.C.D.) studies showed that the effective surface area of the fiber decreased with the increase in the amount of graft. Surface conductivity (S.C.) studies revealed that with increase in the number of polar groups (--COOH) on the surface of the fiber, th (--COOH) on the surface of the fiber, the S.C. increased with the increase in the amount of AA graft. In case of AN grafts, the reduction in effective surface area of the fiber played a more important role than the contribution by the CN groups to surface conductivity. (U.S.)

98

Gravity and Development of Cardiopulmonary Reflex  

Science.gov (United States)

Cardio-pulmonary reflex, which our cardiac activity is synchronized to the respiration by autonomic nervous system regulation, is called as "respiratory sinus arrhythmia" and commonly found in adult. The physiological function of the espiratory sinus arrhythmia is considered to maximize the gas exchange during respiration cycle. This respiration induced heart rate variability (RHRV) is only found in mammals and avian showing a remarkable postnatal development, whereas no RHRV in aquatic species such as fish or amphibian. To elucidate our hypothesis that gravity exposure may plays a key role in the postnatal development of RHRV as well as its evolutional origin in these ground animals, we have studied effects of hypergravity (2G) on the postnatal development of RHRV using rat. Pregnant Wister rats were kept in centrifugal cages system for 38 days from 6th days of pregnant mother to have neonates until 23 days old. Electrocardiograph was recorded from the neonates in 2 to 23 days old in 2G group with simultaneous control (1G) group. The RHRV analysis was performed by calculating a component of Fourier power spectral coincide with the respiration frequency. In both groups, averaged resting heart rate gradually increase from 2 to 23 days old. When comparing the heart rate between the two groups, the 2G group indicated significantly lower (240± 8 bpm) than 1G control (326±21 bpm, p¡0.001) in 2 days old, where as no significance in 23 days old. The RHRV of 2 days old neonates in both groups indicated very small magnitude but significantly lower in 2G group than 1G control (p¡0.01). The RHRV gradually increase during the first 2 weeks and then rapid increased to reached 45 fold of magnitude in 1G control, whereas 69 fold in 2G group. The results strongly suggested that the postnatal innervation from respiration to cardiovascular centers was gravity dependent.

Nagaoka, Shunji; Eno, Yuko; Ohira, Yoshinobu

99

A Correlation Study of Cardiopulmonary Arrests, Cholesterol and Pressures  

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Full Text Available This study consisted of cardiopulmonary arrests occurring between January 1990 and December 1991 in a Midwestern City in Kansas, U.S.A., with a population of 300,000. Admission cholesterol levels and hourly barometric pressures were obtained to show if there exists a relationship between cardiopulmonary arrests, cholesterol levels and barometric pressures. Statistical analysis was performed using Pearson-Moment Correlation Coefficient. Scattergrams amongst the dependent variables such as time, age, cholesterol, temperature and each of these dependent variables vs the independent variable, barometric pressure are depicted. Small value of the correlation coefficient in each case indicates no significant linear correlation between sudden changes in barometric pressure, cholesterol level and cardiopulmonary arrests.

S.E. Rider

2003-01-01

100

Thoracic stent-graft  

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Full Text Available The stent-graft is a device constructed from a stent and vascular graft and is inserted by means of an interventional procedure under imaging guidance. In 1986, Balko et al.1 reported the first stentgraft experiment, in which a Z stent covered with polyurethane was inserted into an animal aorta. In the early 1990s, Parodi et al.2 reported clinical introduction of the stent-graft for abdominal aortic aneurysm. In comparison to the abdominal aortic stent-graft, the thoracic stent-graft has several disadvantages, including difficulties associated with the aortic arch curvature and the relatively large caliber of the stent-graft, and the risk of central nervous system or spinal complication. However, the thoracic stentgraft is advantageous because of minimal procedural invasiveness in comparison to surgical graft replacement. In 1994, Dake et al.3 reported transluminal placement of an endovascular stent-graft for thoracic aortic aneurysm, and Kato et al.4 reported use of a stent-graft for aortic dissection and suggested that the stent-graft could be considered an alternative to surgical treatment.

Hyodoh H.

2007-01-01

 
 
 
 
101

Venous air embolism after cardiopulmonary resuscitation: the first case with histological confirmation.  

Science.gov (United States)

We report a case of intracerebral air embolism after cardiopulmonary resuscitation in a patient with a fatal myocardial infarct. Cases of cerebral air embolism rarely occur as a result of cardiopulmonary resuscitation in cases of cardiopulmonary arrest on arrival. This is the first case with postmortem histological confirmation. PMID:19144542

Arena, Vincenzo; Capelli, Arnaldo

2010-01-01

102

Normoxic and Hyperoxic Cardiopulmonary Bypass in Congenital Heart Disease  

Science.gov (United States)

Cyanotic congenital heart disease comprises a diverse spectrum of anatomical pathologies. Common to all, however, is chronic hypoxia before these lesions are operated upon when cardiopulmonary bypass is initiated. A range of functional and structural adaptations take place in the chronically hypoxic heart, which, whilst protective in the hypoxic state, are deleterious when the availability of oxygen to the myocardium is suddenly improved. Conventional cardiopulmonary bypass delivers hyperoxic perfusion to the myocardium and is associated with cardiac injury and systemic stress, whilst a normoxic perfusate protects against these insults. PMID:25328889

Mokhtari, Amir

2014-01-01

103

Axillobifemoral bypass grafting  

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INTRODUCTION Axillo-femoral bypass (AxF) means connecting the axillar and femoral artery with the graft that is placed subcutaneously [1]. Usually, this graft is connected with contralateral femoral artery via one accessory subcutaneous graft, and this connection is known as axillobifemoral bypass (AxFF). This extra-anatomic procedure is an alternative method to the standard reconstruction of aortoiliac region when there are contraindications for general or local reasons. OBJECTIVE The object...

Davidovi? Lazar B.; Mitri? Milan S.; Kosti? Dušan M.; Maksimovi? Živan V.; Cvetkovi? Slobodan D.; ?inara Ilijas S.; Dimi? Andreja D.; Ili? Nikola S.

2004-01-01

104

Grafting Polymer Loops onto Functionalized Nanotubes: Monitoring Grafting and Loop Formation  

Energy Technology Data Exchange (ETDEWEB)

Polystyrene functionalized at both ends (telechelic polymer) with epoxide groups (epoxy PS epoxy) was reacted with carboxylated multiwall carbon nanotubes (COOH MWNT) in solution in order to graft polymer chains at both ends onto the MWNT surface, forming loops. FT-IR spectroscopy was employed to monitor the formation of aromatic esters and to quantify the amount of telechelic grafted to the nanotube surface as a function of reaction time. When the samples were further annealed in the melt, an increase in the aromatic ester peak was observed, indicating that the unreacted chain ends further grafted to MWNT surfaces to form loops. By reacting the grafted nanotube samples further with monocarboxy terminated poly(4-methylstyrene) (COOH P4MS), the amount of epoxy PS epoxy that had only reacted at one end was determined. Reaction rate analysis indicates that that the grafting of epoxy PS epoxy to the nanotube surface is reaction controlled, as the FT-IR spectroscopy signal grows as a function of approximately t0.3. These studies exemplify how FT-IR spectroscopy can be used as a novel technique to quantify the amount of grafted polymer, grafting rate, and percent of difunctional polymers that form loops, and provide a method to create loop covered nanoparticles.

Ashcraft, Earl C [ORNL; Ji, Haining [ORNL; Mays, Jimmy [ORNL; Dadmun, Mark D [ORNL

2011-01-01

105

Diagnosing and managing cardiopulmonary diseases in small animals  

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Full Text Available How to cite this book review: Schoeman, J.P., 2013, ‘Diagnosing and managing cardiopulmonary diseases in small animals’, Journal of the South African Veterinary Association 84(1, Art. #954, 1 page. http://dx.doi. org/10.4102/jsava.v84i1.954

Johan P. Schoeman

2013-03-01

106

Family presence during cardiopulmonary resuscitation and invasive procedures in children  

Science.gov (United States)

Objective: To identify literature evidences related to actions to promote family's presence during cardiopulmonary resuscitation and invasive procedures in children hospitalized in pediatric and neonatal critical care units. Data sources : Integrative literature review in PubMed, SciELO and Lilacs databases, from 2002 to 2012, with the following inclusion criteria: research article in Medicine, or Nursing, published in Portuguese, English or Spanish, using the keywords "family", "invasive procedures", "cardiopulmonary resuscitation", "health staff", and "Pediatrics". Articles that did not refer to the presence of the family in cardiopulmonary resuscitation and invasive procedures were excluded. Therefore, 15 articles were analyzed. Data synthesis : Most articles were published in the United States (80%), in Medicine and Nursing (46%), and were surveys (72%) with healthcare team members (67%) as participants. From the critical analysis, four themes related to the actions to promote family's presence in invasive procedures and cardiopulmonary resuscitation were obtained: a) to develop a sensitizing program for healthcare team; b) to educate the healthcare team to include the family in these circumstances; c) to develop a written institutional policy; d) to ensure the attendance of family's needs. Conclusions: Researches on these issues must be encouraged in order to help healthcare team to modify their practice, implementing the principles of the Patient and Family Centered Care model, especially during critical episodes. PMID:24676198

Ferreira, Cristiana Araujo G.; Balbino, Flavia Simphronio; Balieiro, Maria Magda F. G.; Mandetta, Myriam Aparecida

2014-01-01

107

Predicting postoperative cardiopulmonary complications by a test of stair climbing  

International Nuclear Information System (INIS)

Objective: To assess whether a test of stair climbing ability could be used to predict the risk of developing postoperative cardiopulmonary complications in patients undergoing general anesthesia. Design: Cohort study Place and Duration of Study: The Aga Khan University Hospital, Karachi. The duration of the study was from December 2003 to December 2004. Patients and Methods: This study was carried out on consecutive, adult patients presenting for elective thoracic or abdominal surgery under general anesthesia. Pre-operatively, patients were asked to climb a standard staircase. Number of steps climbed was recorded. Those unable to climb stairs due to debilitation cardiac, pulmonary or rheumatologic disease were categorized as 0 stairs climbed. Outcome variables were postoperative cardiopulmonary complications for mortality. Period of follow-up was until hospital discharge. Results: Seventy-eight patients were enrolled; 59 (75.6%) climbed > 1 flight of stairs, 19 (24.3%) climbed 1 flight and 40% in those patients who climbed < 1 flight. The group that climbed < 1 flight tended to have complications associated with poor reserves of the cardiopulmonary systems; i.e. pulmonary edema, exacerbation of underlying lung disease. The relative risk of developing compease. The relative risk of developing complications, if unable to climb at least 1 flight of stairs, was calculated to be 1.8 (95% CI 0.7 - 4.6). Conclusion: Stair climbing can be a useful pre-operative tool to predict the risk of postoperative cardiopulmonary complications. (author)

108

Management of eclampsia: cardiopulmonary arrest resulting from magnesium sulfate overdose.  

Science.gov (United States)

An eclamptic seizure occurring at 32+2 weeks of gestation was treated with magnesium sulfate. Accidentally an overdose was given. As a consequence, the patient had a cardiopulmonary arrest. Immediate resuscitation and calcium gluconate administration did restore vital functions. Pregnancy continued for 4 weeks after the accident. Both mother and child left the hospital in good condition. PMID:1426514

Swartjes, J M; Schutte, M F; Bleker, O P

1992-10-23

109

Simultaneous use of argatroban and heparin during cardiopulmonary bypass.  

Science.gov (United States)

Heparin is the routine anticoagulant for cardiopulmonary bypass, but complications due to heparin are often reported. This study assessed argatroban as an alternative to heparin. Normothermic cardiopulmonary bypass with hemodilution was performed for 2 h in 15 dogs (mean weight, 9.8 kg) randomly assigned to 3 groups of 5 each. The controls were given heparin 200 IU x kg(-1) before cardiopulmonary bypass; group A had argatroban infused continuously at a rate of 20 microg x kg(-1) x min(-1); group H/A had half doses of both heparin (100 IU x kg(-1)) and argatroban (10 microg x kg(-1) x min(-1)). Blood samples were collected at 5 time points during the experiment. Activated clotting time, hemoglobin level, platelet counts, and serum concentrations of fibrinogen, antithrombin III, and thrombin-antithrombin III complex were measured. The platelet count was reduced significantly, and the production of thrombin-antithrombin III complex was inhibited in group H/A. Activated clotting time remained bypass. The simultaneous use of heparin and argatroban infusion might be useful for cardiopulmonary bypass with hemodilution. PMID:20124292

Okamura, Toru; Shin'oka, Toshiharu; Ishibashi, Nobuyuki; Ishii, Hikaru; Kurosawa, Hiromi

2010-02-01

110

Cardiopulmonary resuscitation policies and practices. A statewide nursing home study.  

Science.gov (United States)

We determined the prevalence of written cardiopulmonary resuscitation policies in North Carolina nursing homes and evaluated their content according to predetermined criteria. Questionnaires were mailed to 236 state-registered facilities. Two hundred nine nursing homes (88.5%) responded to the questionnaire; 83% reported having a written policy, and half (86 nursing homes) provided copies. Nine of ten nursing homes reported that cardiopulmonary resuscitation was performed at their institution, and a similar number (92%) permitted physician orders restricting cardiopulmonary resuscitation. Written policies were systematically compared with 10 model criteria. Policy content varied substantially. More than half of the policies contained provisions for authorization, informed consent, documentation, competency, review, and applicability of do not resuscitate orders. Less than half contained criteria for autonomy, treatment alternatives, dignity and quality of care, and patient identification. Nursing homes that had written policies were newer, larger, and for-profit; had a greater proportion of skilled nursing care beds; and were more likely to have both Medicare and Medicaid certification. The variations in these policies place nursing home residents at risk for having important personal rights limited or ignored. Inclusion of these 10 policy criteria in a comprehensive cardiopulmonary resuscitation policy would represent an important step toward enhancing the quality of decision making by nursing home residents. PMID:2297282

Brunetti, L L; Weiss, M J; Studenski, S A; Clipp, E C

1990-01-01

111

N- acetyl-beta-d-glucosaminidase and inflammatory response after cardiopulmonary bypass  

International Nuclear Information System (INIS)

To determine the changes in activity of plasma N-acetyl-beta-D-glucosaminidase, a marker for inflammation as well as renal, pulmonary and cardiac damage and proinflammatory cytokines in patients undergoing coronary artery bypass grafting and find out the relationship between their plasma levels with clinical outcome of patients. N-Acetyl-beta-D-glucosaminidase (NAG) activity and concentrations of tumor necrosis factor-alpha of (TNF alpha), interleukin 6 (IL-6), interleukin 8 (IL8) and granulocyte-macrophage colony stimulating factor (GM-CSF) were monitored in plasma samples of 12 angina patients undergoing coronary artery bypass grafting (CABG), before, immediately after and 5 days post-surgical procedure. Serum glucose concentrations were also monitored in those patients. Patient's clinical condition was monitored during this time period. No significant increase was observed in plasma NAG activity (a marker of inflammation) or in plasma levels of TNF alpha IL-6, IL-8 and GM-CSF immediately after surgery, indicating that cardiopulmonary bypass itself does not produce any significant amount of inflammation immediately after CABG. However, 5 days post surgery, there was a significant increase in plasma NAG activity (p=0.001), TNF alpha (p=0.047) and GM-CSF (p=0.045). There was no relationship between plasma NAG activity and clinical outcome because various parameters of renal, cardiac and pulmonary functions, though slightly affected, remained within the normal limits. ected, remained within the normal limits. Increased levels of NAG and TNF alpha did not affect clinical outcome. However, data suggest that NAG can be a potential marker for inflammation and end organ damage following CABG. An increase in GM-CSF on day 5 following CABG indicates enhanced body's defense mechanism against infection. (author)

112

Computed tomography assessment of lung structure in patients undergoing cardiac surgery with cardiopulmonary bypass  

International Nuclear Information System (INIS)

Hypoxemia is a frequent complication after coronary artery bypass graft (CABG) with cardiopulmonary bypass (CPB), usually attributed to atelectasis. Using computed tomography (CT), we investigated postoperative pulmonary alterations and their impact on blood oxygenation. Eighteen non-hypoxemic patients (15 men and 3 women) with normal cardiac function scheduled for CABG under CPB were studied. Hemodynamic measurements and blood samples were obtained before surgery, after intubation, after CPB, at admission to the intensive care unit, and 12, 24, and 48 h after surgery. Pre- and postoperative volumetric thoracic CT scans were acquired under apnea conditions after a spontaneous expiration. Data were analyzed by the paired Student t-test and one-way repeated measures analysis of variance. Mean age was 63 ± 9 years. The PaO2/FiO2 ratio was significantly reduced after anesthesia induction, reaching its nadir after CPB and partially improving 12 h after surgery. Compared to preoperative CT, there was a 31% postoperative reduction in pulmonary gas volume (P 2/FiO2 ratio or shunt fraction at ub>2 ratio or shunt fraction at 24 h postoperatively and postoperative lung alterations. The data show that lung structure is profoundly modified after CABG with CPB. Taken together, multiple changes occurring in the lungs contribute to postoperative hypoxemia rather than atelectasis alone. (author)

113

Cerebral vasoreactivity to carbon dioxide during cardiopulmonary perfusion at normothermia and hypothermia  

International Nuclear Information System (INIS)

With the pH-stat acid-base regulation strategy during hypothermic cardiopulmonary bypass (CPB), carbon dioxide (CO2) is generally administered to maintain the partial pressure of arterial CO2 at a higher level than with the alpha-stat method. With preserved CO2 vasoreactivity during CPB, this induction of respiratory acidosis can lead to a much higher cerebral blood flow level than is motivated metabolically. To evaluate CO2 vasoreactivity, cerebral blood flow was measured using a xenon 133 washout technique before, during, and after CPB at different CO2 levels in patients who were undergoing coronary artery bypass grafting with perfusion at either hypothermia or normothermia. The overall CO2 reactivity was 1.2 mL/100 g/min/mm Hg. There was no difference between the groups. The CO2 reactivity was not affected by temperature or CPB. The induced hemodilution resulted in higher cerebral blood flow levels during CPB, although this was counteracted by the temperature-dependent decrease in the hypothermia group. After CPB, a transient increase in cerebral blood flow was noted in the hypothermia group, the reason for which remains unclear. The study shows that manipulation of the CO2 level at different temperatures results in similar changes in cerebral blood flow irrespective of the estimated metabolic demand. This finding further elucidates the question of whether alpha-stat or pH-stat is the most physiological way to regulate the acid-base balance during hypothermic CPB

114

Computed tomography assessment of lung structure in patients undergoing cardiac surgery with cardiopulmonary bypass  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Hypoxemia is a frequent complication after coronary artery bypass graft (CABG) with cardiopulmonary bypass (CPB), usually attributed to atelectasis. Using computed tomography (CT), we investigated postoperative pulmonary alterations and their impact on blood oxygenation. Eighteen non-hypoxemic patie [...] nts (15 men and 3 women) with normal cardiac function scheduled for CABG under CPB were studied. Hemodynamic measurements and blood samples were obtained before surgery, after intubation, after CPB, at admission to the intensive care unit, and 12, 24, and 48 h after surgery. Pre- and postoperative volumetric thoracic CT scans were acquired under apnea conditions after a spontaneous expiration. Data were analyzed by the paired Student t-test and one-way repeated measures analysis of variance. Mean age was 63 ± 9 years. The PaO2/FiO2 ratio was significantly reduced after anesthesia induction, reaching its nadir after CPB and partially improving 12 h after surgery. Compared to preoperative CT, there was a 31% postoperative reduction in pulmonary gas volume (P

R.R., Rodrigues; A.Y., Sawada; J.-J., Rouby; M.J., Fukuda; F.H., Neves; M.J., Carmona; P., Pelosi; J.O., Auler; L.M.S., Malbouisson.

115

Cardiopulmonary bypass alters the pharmacokinetics of propranolol in patients undergoing cardiac surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english The pharmacokinetics of propranolol may be altered by hypothermic cardiopulmonary bypass (CPB), resulting in unpredictable postoperative hemodynamic responses to usual doses. The objective of the present study was to investigate the pharmacokinetics of propranolol in patients undergoing coronary art [...] ery bypass grafting (CABG) by CPB under moderate hypothermia. We evaluated 11 patients, 4 women and 7 men (mean age 57 ± 8 years, mean weight 75.4 ± 11.9 kg and mean body surface area 1.83 ± 0.19 m²), receiving propranolol before surgery (80-240 mg a day) and postoperatively (10 mg a day). Plasma propranolol levels were measured before and after CPB by high-performance liquid chromatography. Pharmacokinetic Solutions 2.0 software was used to estimate the pharmacokinetic parameters after administration of the drug pre- and postoperatively. There was an increase of biological half-life from 4.5 (95% CI = 3.9-6.9) to 10.6 h (95% CI = 8.2-14.7; P

M.J.C., Carmona; L.M.S., Malbouisson; V.A., Pereira; M.A., Bertoline; C.E.K., Omosako; K.B., Le Bihan; J.O.C., Auler Jr.; S.R.C.J., Santos.

116

[Management of cardiopulmonary bypass during cardiac surgery for patients with heparin-induced thrombocytopenia].  

Science.gov (United States)

We experienced 4 cases of open heart surgeries under preoperative diagnosis of heparin-induced thrombocytopenia(HIT). We performed operation with argatroban instead of heparin. The argatroban was administered intravenously with a bolus of 100 ?g/kg. After activated clotting time(ACT)reached over 200 seconds, continuous infusion of argatroban was started, 1~2 ?g/kg/min until the level of ACT over 250 in the case of off-pump coronary artery bypass grafting(OPCAB), with 6~10 ?g/kg/min, or the level of ACT over 400 with the use of cardiopulmonary bypass (CPB). All cases required more than 60 minutes to achieve the target ACT level after starting the argatroban. In 1 case it was impossible to achieve target level of ACT by argatroban alone, and heparin was used concomitantly. In 1 case there was a complication of membrane occlusion of CPB. Open cardiac surgery with the use of argatroban required specific care for coagulation to complete operation. PMID:23674032

Kondo, Taichi; Hirota, Masanori; Hoshino, Joji; Fukada, Yasuhisa; Isomura, Tadashi

2013-05-01

117

[Open heart surgery using cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia(HIT)].  

Science.gov (United States)

Heparin-induced thrombocytopenia (HIT) is a life-threatening side effect of heparin therapy. We report an open heart surgery with cardiopulmonary bypass( CPB) using argatroban as an anticoagulant for a patient with HIT. A 72-year-old male with a history of percutaneous coronary intervention 5 years ago, was admitted to our hospital due to congestive heart failure and heparin 10,000 units/day was administered. At 10th hospital day, his platelet count was significantly decreased and antibodies positive for type II HIT was found, so he was diagnosed HIT. Echocardiogram and coronary angiography revealed severe functional mitral regurgitation and coronary stenosis. At 24th hospital day we performed coronary artery bypass grafting( CABG) and mitral valve replacement (MVR) with CPB using argatroban as an anticoagulant. During CPB, we monitored the activated clotting time (ACT) to adjust the dose of argatroban. Though the surgical procedure itself was uneventful. We required about 4 hours to achieve adequate hemostasis after CPB. Postoperative course was uneventful. PMID:23674036

Furukawa, Hiroshi; Konishi, Toshio; Fukata, Mutsumu; Okada, Hiroshi; Sakagami, Naoko; Kurosaki, Kenji

2013-05-01

118

Computed tomography assessment of lung structure in patients undergoing cardiac surgery with cardiopulmonary bypass  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Hypoxemia is a frequent complication after coronary artery bypass graft (CABG) with cardiopulmonary bypass (CPB), usually attributed to atelectasis. Using computed tomography (CT), we investigated postoperative pulmonary alterations and their impact on blood oxygenation. Eighteen non-hypoxemic patie [...] nts (15 men and 3 women) with normal cardiac function scheduled for CABG under CPB were studied. Hemodynamic measurements and blood samples were obtained before surgery, after intubation, after CPB, at admission to the intensive care unit, and 12, 24, and 48 h after surgery. Pre- and postoperative volumetric thoracic CT scans were acquired under apnea conditions after a spontaneous expiration. Data were analyzed by the paired Student t-test and one-way repeated measures analysis of variance. Mean age was 63 ± 9 years. The PaO2/FiO2 ratio was significantly reduced after anesthesia induction, reaching its nadir after CPB and partially improving 12 h after surgery. Compared to preoperative CT, there was a 31% postoperative reduction in pulmonary gas volume (P

R.R., Rodrigues; A.Y., Sawada; J.-J., Rouby; M.J., Fukuda; F.H., Neves; M.J., Carmona; P., Pelosi; J.O., Auler; L.M.S., Malbouisson.

2011-06-01

119

Cardiopulmonary bypass alters the pharmacokinetics of propranolol in patients undergoing cardiac surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english The pharmacokinetics of propranolol may be altered by hypothermic cardiopulmonary bypass (CPB), resulting in unpredictable postoperative hemodynamic responses to usual doses. The objective of the present study was to investigate the pharmacokinetics of propranolol in patients undergoing coronary art [...] ery bypass grafting (CABG) by CPB under moderate hypothermia. We evaluated 11 patients, 4 women and 7 men (mean age 57 ± 8 years, mean weight 75.4 ± 11.9 kg and mean body surface area 1.83 ± 0.19 m²), receiving propranolol before surgery (80-240 mg a day) and postoperatively (10 mg a day). Plasma propranolol levels were measured before and after CPB by high-performance liquid chromatography. Pharmacokinetic Solutions 2.0 software was used to estimate the pharmacokinetic parameters after administration of the drug pre- and postoperatively. There was an increase of biological half-life from 4.5 (95% CI = 3.9-6.9) to 10.6 h (95% CI = 8.2-14.7; P

M.J.C., Carmona; L.M.S., Malbouisson; V.A., Pereira; M.A., Bertoline; C.E.K., Omosako; K.B., Le Bihan; J.O.C., Auler Jr.; S.R.C.J., Santos.

2005-05-01

120

Wearable system-on-a-chip UWB radar for contact-less cardiopulmonary monitoring: present status.  

Science.gov (United States)

The present status of the project aimed at the realization of an innovative wearable system-on-chip UWB radar for the cardiopulmonary monitoring is presented. The overall system consists of a wearable wireless interface including a fully integrated UWB radar for the detection of the heart beat and breath rates, and a IEEE 802.15.4 ZigBee low-power radio interface. The principle of operation of the UWB radar for the monitoring of the heart wall is summarized. With respect to the prior art, this paper reports the results of the experimental characterization of the intra-body channel loss, which has been carried out successfully in order to validate the theoretical model employed for the radar system analysis. Moreover, the main building blocks of the radar have been manufactured in 90 nm CMOS technology by ST-Microelectronics and the relevant performance are resulted in excellent agreement with those expected by post-layout simulations. PMID:19163907

Zito, D; Pepe, D; Mincica, M; Zito, F; De Rossi, D; Lanata, A; Scilingo, E P; Tognetti, A

2008-01-01

 
 
 
 
121

Radiation grafting studies of acrylic acid onto cellulose triacetate membranes  

International Nuclear Information System (INIS)

Polymer surface modifications were obtained by the application of radiation treatments, etching and grafting of acrylic acid monomers on different membranes of cellulose triacetate materials. Cellulose triacetate foils from pellet dissolution and commercial cellulose triacetate solid state nuclear track detector membranes were assayed. Irradiation with fission fragments from Cf-252 source to obtain a porous structure, 25 MeV proton beam and Co-60 ?-source to produce peroxides were employed in the experiments. The present work gives the grafting yield of AAc monomer onto CTA membranes as a function of diverse variables including irradiation parameters (?-dose, Cf-252 ff irradiation time, proton fluency and electronic energy loss (dE/dx)e), structural parameters (pore diameter and pore density, etching time and etching temperature) and grafting parameters (monomer and Mohr salt concentration, grafting time and grafting temperature)

122

Polytrimethylsylylpropyne gas separation membranes modified by radiochemical grafting of divinylbenzene  

International Nuclear Information System (INIS)

A radiochemical method was employed to obtain poly(1-trimethylsilyl-1-propyne)(PTMSP)-divinylbenzene (DVB) grafted films. DVB monomer vapors were absorbed by the PTMSP, and the grafting reaction was thereafter accomplished by 60Co ?-irradiation in a nitrogen atmosphere. The films so obtained were tested for nitrogen-oxygen separation. The performances of the membranes were studied as functions of time and percent of grafting. The DVB-grafted membranes show an increased selectivity factor and stability with time. The experimental data and some SEM observations confirm the presence of large voids in the PTMSP matrix. These voids are responsible for permeability changes during operation and disappear after the grafting procedure. 8 refs., 5 figs

123

End-Grafted Polymer Chains onto Inorganic Nano-Objects  

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Full Text Available Organic/inorganic nanohybrid materials have attracted particular scientific and technological interest because they combine the properties of the organic and the inorganic component. Inorganic nanoparticles exhibit interesting electrical, optical, magnetic and/or catalytic properties, which are related with their nano-scale dimensions. However, their high surface-to-volume ratio often induces agglomeration and leads to the loss of their attractive properties. Surface modification of the inorganic nano-objects with physically or chemically end-tethered polymer chains has been employed to overcome this problem. Covalent tethered polymer chains are realized by three different approaches: the “grafting to”, the “grafting from” and the “grafting through” method. This article reviews the synthesis of end-grafted polymer chains onto inorganic nanoparticles using “controlled/living” polymerization techniques, which allow control over the polymer characteristics and the grafting density of the end-tethered polymer chains.

Demetra S. Achilleos

2010-03-01

124

Role of cardiopulmonary mechanoreceptors in the postural regulation of renin  

International Nuclear Information System (INIS)

To change the stretch on cardiopulmonary mechanoreceptors, large shifts of blood in the capacity space were elicited by tilting and by exerting positive lower body pressure in the tilted position. Twelve volunteers underwent invasive hemodynamic studies and in 10 other subjects cardiac size was determined by radionuclide cardiography. In all 22 subjects tilting caused the expected increase of renin, which was abolished by lower body compression. Decompression caused renin to increase again. Right atrial pressure in invasive studies and end-systolic and end-diastolic counts in noninvasive studies showed a significant and strong negative correlation with renin and norepinephrine levels. Thus, the degree of stretch of the cardiopulmonary mechanoreceptors is a major determinant of reflex regulation of renin release in humans

125

Lethal systemic Degos disease with prominent cardio-pulmonary involvement  

International Nuclear Information System (INIS)

Degos disease (DD) is a rare obstructive vasculopathy characterized by distinctive skin lesions. Involvement of the soles, palms and genitalia is rare. In most cases disease has an unfavorable course and involves gastrointestinal tract, central nervous system and occasionally other organs. Pleural and pericardial involvements are usually minor manifestations with prolonged course. Death occurs in approximately 50% of the patients usually due to intestinal perforation or central nervous system bleeding. We describe a 48-year-old man of lethal systemic DD. Widespread skin lesions with involvement of palm plantar surfaces, genitalia and scalp were ignored for 3 years, whereas the disease revealed its own malignant nature. The disorder progressed to nervous, gastrointestinal and cardiopulmonary system that led to death after 5 months from onset of systemic involvement as severe restrictive cardio-pulmonary insufficiency. Autopsy showed diffuse fibrotic changes in serial membranes and internal organs. (author)

126

Role of cardiopulmonary mechanoreceptors in the postural regulation of renin  

Energy Technology Data Exchange (ETDEWEB)

To change the stretch on cardiopulmonary mechanoreceptors, large shifts of blood in the capacity space were elicited by tilting and by exerting positive lower body pressure in the tilted position. Twelve volunteers underwent invasive hemodynamic studies and in 10 other subjects cardiac size was determined by radionuclide cardiography. In all 22 subjects tilting caused the expected increase of renin, which was abolished by lower body compression. Decompression caused renin to increase again. Right atrial pressure in invasive studies and end-systolic and end-diastolic counts in noninvasive studies showed a significant and strong negative correlation with renin and norepinephrine levels. Thus, the degree of stretch of the cardiopulmonary mechanoreceptors is a major determinant of reflex regulation of renin release in humans.

Sanchez, R.A.; Marco, E.J.; Oliveri, C.; Otero, F.J.; Degrossi, O.; Moledo, L.I.; Julius, S.

1987-04-01

127

Lethal systemic Degos disease with prominent cardio-pulmonary involvement.  

Directory of Open Access Journals (Sweden)

Degos disease DD is a rare obstructive vasculopathy characterized by distinctive skin lesions. Involvement of the soles, palms and genitalia is rare. In most cases, disease has an unfavorable course and involves gastrointestinal tract, central nervous system and occasionally other organs. Pleural and pericardial involvements are usually minor manifestations with prolonged course. Death occurs in approximately 50% of the patients usually due to intestinal perforation or central nervous system bleeding. We describe a 48-year-old man of lethal systemic DD. Widespread skin lesions with involvement of palmoplantar surfaces, genitalia and scalp were ignored for 3 years, whereas the disease revealed own malignant nature. The disorder progressed to nervous, gastrointestinal and cardiopulmonary system that led to death after 5 months from onset of systemic involvement as severe restrictive cardio-pulmonary insufficiency. Autopsy showed diffuse fibrotic changes in serosal membranes and internal organs.

Ali Y. Notash

2008-01-01

128

Alcuronium kinetics in patients undergoing cardiopulmonary bypass surgery.  

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1 The disposition of alcuronium was investigated in 10 patients undergoing surgery involving cardiopulmonary bypass (CPB) and compared with results from a group of non-cardiac patients studied previously. 2 After intravenous administration of a combined bolus and infusion dosage regimen, plasma concentrations fell in a bi-exponential fashion to a mean value of 0.55 micrograms/ml immediately before the start of extracorporeal circulation. 3 During CPB an apparent steady-state of alcuronium was...

Walker, J. S.; Brown, K. F.; Shanks, C. A.

1983-01-01

129

Cardiopulmonary stress during exercise training in patients with COPD.  

Science.gov (United States)

Exercise training is an essential component of pulmonary rehabilitation. However, the cardiopulmonary stress imposed during different modalities of exercise training is not yet known. In the present study, the cardiopulmonary stress of a 12-week exercise training programme in 11 chronic obstructive pulmonary disease (COPD) patients (forced expiratory volume in one second 42+/-12%pred, age 69+/-6 yrs) was measured. Pulmonary gas exchange and cardiac frequency (f(C)) of three training sessions were measured with a portable metabolic system at the beginning, mid-term and end of the programme. Symptoms were assessed with Borg scores. The exercise intensity was compared with the recommendations for exercise training by the American College of Sports Medicine (ACSM). Training effects were significant (maximum change in work: 14+/-11 Watts, 6-min walk test: 44+/-36 m). Whole body exercises (cycling, walking and stair climbing) consistently resulted in higher cardiopulmonary stress (oxygen uptake (V'(O(2))), minute ventilation and f(C)) than arm cranking and resistance training. Dyspnoea was higher during cycling than resistance training. Patients exercised for >70% (>20 min) of the total exercise time at >40% of the V'(O(2)) reserve and f(C) reserve ("moderate" intensity according to the ACSM) throughout the programme. The cardiopulmonary stress resistance training is lower than during whole-body exercise and results in fewer symptoms. In addition, exercise testing based on guidelines using a fixed percentage of baseline peak performance and symptom scores achieves and sustains training intensities recommended according to the American College of Sports Medicine. PMID:16540501

Probst, V S; Troosters, T; Pitta, F; Decramer, M; Gosselink, R

2006-06-01

130

Argatroban for anticoagulation during cardiopulmonary bypass in an infant.  

Science.gov (United States)

Heparin induced thrombocytopenia (HIT) is a rare, but potentially life-threatening complication of heparin therapy. In patients with HIT, alternative means of anticoagulation are necessary. The authors present an infant with HIT who required anticoagulation during cardiopulmonary bypass for tricuspid valve excision in the treatment of bacterial endocarditis. The direct thrombin inhibitor, argatroban, was successfully used. Previous reports regarding the use of argatroban and other nonheparin anticoagulants for anticoagulation are reviewed and suggestions regarding argatroban dosing in infants are presented. PMID:15787926

Dyke, Peter C; Russo, Pierantonio; Mureebe, Leila; Russo, Joanne; Tobias, Joseph D

2005-04-01

131

Challenges encountered with argatroban anticoagulation during cardiopulmonary bypass  

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Use of argatroban as an alternative to heparin during cardiopulmonary bypass (CPB) in patients with heparin-induced thrombocytopenia has gained some attention in the past two decades. Dosing of argatroban during CPB is complex due to lack of complete understanding of its pharmacokinetic profile and the various elements during CPB that may alter its plasma levels. We report a case where the challenges in dosing argatroban led to failure to provide adequate anticoagulation during CPB, as eviden...

Agarwal, Shvetank; Ullom, Beth; Al-baghdadi, Yasser; Okumura, Michael

2012-01-01

132

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available ... the chest wall or arteries from the arm (radial artery) are then used to bypass the clogged ... final location using the same chest incision. The radial artery may also be used as a graft. ...

133

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available ... lower your blood cholesterol can help slow the process that clogs arteries. Exercise and losing weight, under ... the clogged arteries. Coronary Artery Bypass Graft This process of taking blood vessels from one part of ...

134

Sedative and cardiopulmonary effects of buprenorphine and xylazine in horses.  

Science.gov (United States)

This study investigated the sedative, cardiopulmonary, and gastrointestinal effects produced by buprenorphine and xylazine given in combination to horses. Six healthy adult horses underwent 4 randomized treatments, with an interval of 1 wk between treatments. A control group was given a saline solution intravenously (IV) and the experimental groups received buprenorphine [10 ?g/kg bodyweight (BW)] in combination with 1 of 3 different doses of xylazine: 0.25 mg/kg BW (BX25), 0.50 mg/kg BW (BX50), or 0.75 mg/kg BW (BX75), all of them by IV. Cardiopulmonary parameters were evaluated for 120 min after the drugs were administered and intestinal motility was observed for 12 h after treatment. Sedation was found to be dose-dependent in all groups receiving buprenorphine and xylazine and it was observed that the heart rate decreased in the first 5 min and increased at the end of the sedation period. Arterial blood gas tension analyses showed minimal alterations during the experiment. Gastrointestinal hypomotility was observed for up to 8 h. The combination of buprenorphine and 0.50 mg/kg BW of xylazine (BX50) provided a 30-minute period of sedation without intense ataxia and maintained cardiopulmonary parameters within acceptable limits for the species. PMID:21461193

Cruz, Fernando S F; Carregaro, Adriano B; Machado, Melissa; Antonow, Rômulo R

2011-01-01

135

Cardiopulmonary Exercise Capacity and Preoperative Markers of Inflammation  

Science.gov (United States)

Explanatory mechanisms for the association between poor exercise capacity and infections following surgery are underexplored. We hypothesized that aerobic fitness—assessed by cardiopulmonary exercise testing (CPET)—would be associated with circulating inflammatory markers, as quantified by the neutrophil-lymphocyte ratio (NLR) and monocyte subsets. The association between cardiopulmonary reserve and inflammation was tested by multivariable regression analysis with covariates including anaerobic threshold (AT) and malignancy. In a first cohort of 240 colorectal patients, AT was identified as the sole factor associated with higher NLR (P = 0.03) and absolute and relative lymphopenia (P = 0.01). Preoperative leukocyte subsets and monocyte CD14+ expression (downregulated by endotoxin and indicative of chronic inflammation) were also assessed in two further cohorts of age-matched elective gastrointestinal and orthopaedic surgical patients. Monocyte CD14+ expression was lower in gastrointestinal patients (n = 43) compared to age-matched orthopaedic patients (n = 31). The circulating CD14+CD16? monocyte subset was reduced in patients with low cardiopulmonary reserve. Poor exercise capacity in patients without a diagnosis of heart failure is independently associated with markers of inflammation. These observations suggest that preoperative inflammation associated with impaired cardiorespiratory performance may contribute to the pathophysiology of postoperative outcome. PMID:25061264

Sultan, Pervez; Edwards, Mark R.; Gutierrez del Arroyo, Ana; Cain, David; Sneyd, J. Robert; Struthers, Richard; Minto, Gary; Ackland, Gareth L.

2014-01-01

136

Cardiopulmonary Resuscitation Training in Sport Universities: An Italian Survey  

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Full Text Available Background: Physical activity is associated to an increased risk of sudden cardiac death (SCD. Together with primary prevention, prompt recognition and early management of SCD are crucial in order to improve survival rate. During their duty, sport trainers and teachers can play a key role in secondary prevention of cardiac arrest provided they have received an appropriate training in Cardiopulmonary Resuscitation (CPR during their curricular study. This is usually achieved through a Basic life Support and Defibrillation (BLS-D Course which in Italy formally enables to Automated External Defibrillator (AED use. Objective: To investigate the presence, the type and the diffusion of cardiopulmonary resuscitation training in Sport and Exercise Sciences Universities in Italy. Design: Descriptive survey research design was adopted for the study. Setting: The study sample consisted of 32 Italian Universities with Bachelor and Master-Level Degrees in Sport and Exercise Sciences. Methods: Teaching secretary or directly deans/ course presidents were contacted by email or telephone in order to collect information on the availability of BLS-D courses for Sport and Exercise Sciences students during the academic year 2010-2011. Results: The compliance to the survey has been >93%. Only a reduced number of the contacted Universities offered dedicated courses of Cardiopulmonary Resuscitation with license to Defibrillation according to current local regulation. Conclusion: The described situation shows a limit in the generation of a sport trainers’ category highly specialized in cardiac and respiratory emergencies: only 6 Universities organize BLS-D training with official certification.

Andrea Scapigliati

2013-08-01

137

Continuous measurement of oxygen consumption during cardiopulmonary bypass: description of the method and in vivo observations.  

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BACKGROUND: Systemic oxygen consumption is not routinely measured during cardiopulmonary bypass, despite its potential benefits. We aimed to develop a noninvasive method to continuously measure oxygen consumption using respiratory mass spectrometry during hypothermic cardiopulmonary bypass in pigs. METHODS: Nine pigs weighing 18.5 (1.6) kg underwent hypothermic (32 degrees C) cardiopulmonary bypass for 180 minutes with 120 minutes of aortic cross clamping. An AMIS 2000 mass spectrometer (Inno...

Li, J.; Stokoe, J.; Konstantinov, Ie; Edgell, D.; Cheung, Mm; Kharbanda, Rk; Redington, An

2004-01-01

138

Experimental use of a compact centrifugal pump and membrane oxygenator as a cardiopulmonary support system.  

Science.gov (United States)

Compactness and high performance are the most important requirements for a cardiopulmonary support system. The Nikkiso (HPM-15) centrifugal pump is the smallest (priming volume; 25 ml, impeller diameter; 50 mm) in clinically available centrifugal pumps. The Kuraray Menox (AL-2000) membrane oxygenator, made of double-layer polyolefin hollow fiber, has a minimum priming volume (80 ml) and a low pressure loss (65 mm Hg at 2.0 L/min of blood flow) compared with other oxygenators. The aim of this study was to evaluate the performance of the most compact cardiopulmonary support system (total priming volume: 125 ml) in animal experiments. The cardiopulmonary bypass was constructed in a canine model with the Nikkiso pump and Menox oxygenator in comparison with a conventional cardiopulmonary support system. The partial cardiopulmonary bypass was performed for 4 h to evaluate the gas exchange ability, blood trauma, serum leakage, hemodynamics, and blood coagulative parameters. The postoperative plasma free hemoglobin level of the compact cardiopulmonary system was 29.5 +/- 10.21 mg/dl (mean +/- SD), which was lower than that of the conventional cardiopulmonary system, 48.75 +/- 27.39 mg/dl (mean +/- SD). This compact cardiopulmonary system provided the advantage in terms of reduction of the priming volume and less blood damage. These results suggested the possibility of miniaturization for the cardiopulmonary bypass support system in open-heart surgery in the near future. PMID:11119082

Suenaga, E; Naito, K; Cao, Z L; Suda, H; Ueno, T; Natsuaki, M; Itoh, T

2000-11-01

139

On Pump Coronary Artery Bypass Graft Surgery Versus Off Pump Coronary Artery Bypass Graft Surgery: A Review  

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Full Text Available There are two basic ways of performing coronary artery bypass graft surgery (CABG: on pump CABG and off pump CABG. Off pump CABG is relatively a newer procedure to on-pump CABG and does not require the use of the cardiopulmonary bypass machine. On pump CABG is the more traditional method of performing bypass surgery. However its resultant inflammatory effects cause renal dysfunction, gastrointestinal distress and cardiac abnormalities which have forced the surgeons to look for alternatives to the procedure. An extensive literature search revealed that on pump CABG causes better revascularization as compared to off pump CABG while off pump CABG has a much lower post operative morbidity and mortality especially in high risk patients. We suggest that the technique used should depend on the ease of the surgeon doing the operation as both the methods seem almost equally efficient according to the review.

Muhammad Shahzeb Khan

2014-01-01

140

Maternal Employment  

Science.gov (United States)

The overwhelming evidence from years of research is that maternal employment, by itself, has little influence on the behaviors of children. More relevant issues are: mother's reasons for working, family's acceptance of mother's employment, quality of substitute child care, family's social and emotional health, and economic conditions. (Author/AJ)

Clark, Sam

1975-01-01

 
 
 
 
141

Axillobifemoral bypass grafting  

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Full Text Available INTRODUCTION Axillo-femoral bypass (AxF means connecting the axillar and femoral artery with the graft that is placed subcutaneously [1]. Usually, this graft is connected with contralateral femoral artery via one accessory subcutaneous graft, and this connection is known as axillobifemoral bypass (AxFF. This extra-anatomic procedure is an alternative method to the standard reconstruction of aortoiliac region when there are contraindications for general or local reasons. OBJECTIVE The objective of this paper is to show early and late results of AxFF bypass grafting as well as to show the indications for AxFF bypass. METHODS The sample consisted of 37 patients. The procedure was performed in 28 patients who suffered from aortoiliac occlusive disease and who were at high risk due to the comorbidity- in one patient with the rupture of juxtarenal aneurysm of abdominal aorta; in five patients with aortoenteric fistula, in two patients with iatrogenic lesion of abdominal aorta and in one female patient with anus preternaturalis definitivus who was treated for rectovaginal fistula. Donor's right axillary artery was used in 26 cases (70.3%, and donor's left axillary artery was used in 9 cases (29.7%. Dacron graft was used in 34 patients and Polytetrafluo-roethlylene graft was used in three patients. Simultaneously, profundo-plastic was done in four patients and femoro-popliteal bypass was performed in three patients. In five patients who suffered from aortoenteric fistula, simultaneous intervention of gastrointerstinal system has been done, x2 test was used for statistical evaluation and life table method was used for verification of late graft patency. RESULTS The rate of early postoperative mortality was 13.5%. The causes of death were: sepsis -1, MOFS - 3, and infarct myocardium -1. The mean follow up period was 40.1 months, ranging from six months to 17 years. During the follow up period, an early graft thrombosis was identified in two and late graft occlusion was reported in four patients. As the cause of occlusion, the progression of occlusive disease of receptive artery was identified in three patients, while anastomotic neointimae hyperplasia of recipient artery was identified in one patient. Three patients died during the follow up period. As the cause of death, CVI was reported in two patients and malignancy of the urinary tract was fpund in one patient. The other complications were - artery angulation on the level of proximal anastomosis in one patient (Figure 1, false aneurysm in one patient, perigraft seroma in one patient and graft infection in three patients. Life table method has shown that cumulative rate of late graft patency is 80.39% after five years (Graph 1. DISCUSSION Our results were analyzed and compared with the results of the study on 283 patients who had undergone aortobifemoral bypass (AFF operation due to the aortoiliac occlusive disease. This study was completed in 1995 (18. The results showed that there was no statistically significant differences between AxFF and AFF group (p>0.05, considering early mortality rate and late graft patency (Graph 2. The review of mortality and late patency rate after AxFF bypass grafting in a world well known studies has shown the similar results (Table 1. CONCLUSION The authors suggest that axilobifemoral bypass is indicated when there are contraindications or difficulties to perform anatomic reconstruction due to the abdomen condition (infection, adhesion, comorbidity as well as in high risk patients with low life expectancy.

Davidovi? Lazar B.

2004-01-01

142

Radiation grafted adhesive primers  

International Nuclear Information System (INIS)

Electron-beam and UV radiation can induce covalent attachment of unsaturated monomers onto a variety of polymer surfaces. The surface characteristics of a polymeric material can therefore be precisely manipulated by grafting the proper combination of monomers onto the surface. Radiation-grafted, sterically nonhindered tertiary acrylamides behave surprisingly well as primers for acidic pressure-sensitive adhesives. Physical and spectroscopic analyses of grafted acrylamides indicate that this unusual behavior is due to hydrogen bonding between the amide functionality in the primer and the acid functionality in the adhesive. Primary and secondary acrylamides are postulated to be less effective because they have the tendency to form hydrogen bonded dimers within the primer rather than interacting with the adhesive. (author)

143

Skin grafting in severely contracted socket with the use of ?Compo?  

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Full Text Available The results of split thickness autologous skin grafting along with the use of a dental impression material (Compo, a thermoplastic substance are presented in a series of 11 patients of acquired, severely contracted, anophthalmic sockets. Only the fornix fixation sutures and the central tarsorrhaphy were employed for the proper placement of graft without the use of retention devices. Artificial eyes were successfully fitted and retained subsequently after 6 weeks of grafting.

Betharia S

1990-01-01

144

Radial artery jump graft from anterior to posterior descending coronary artery.  

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A novel technique to achieve total arterial grafting, using a radial artery jump graft from the anterior descending coronary artery to the posterior descending artery, was employed in a preliminary series of 10 patients. All radial artery grafts were patent. This was confirmed using the SPY intraoperative fluorescence imaging system. There were no postoperative complications in any patient, and all were discharged uneventfully. PMID:19592543

Taggart, David P; Balacumaraswami, Lognathen; Venkatapathy, Ajit

2009-04-01

145

Kinetics and sites of sequestration of indium 111-labeled human platelets during cardiopulmonary bypass  

International Nuclear Information System (INIS)

A new approach for the study of the kinetics and quantification of the in vivo and ex vivo sites of sequestration of platelets during cardiopulmonary bypass (CPB) is described. Autologous platelets of four patients were labeled with 111In-oxine and reinfused on the day prior to CPB for coronary artery bypass grafting. Changes in blood 111In-labeled platelet radioactivity and blood platelet counts were monitored during the operation. In vivo 111In-labeled platelet redistribution was quantified with a scintillation camera and a computer-assisted imaging system before and after CPB. Sequestration of 111In-labeled platelets in the bubble oxygenator was measured. 111In-labeled platelet activity in the blood decreased by 46% +/- 5% within 5 minutes of CPB, but this decrease was mostly due to hemodilution; the true loss of platelets from the circulation was 13% +/- 4%. Intraoperatively, whole body 111In activity decreased by oxygenator 10.8% +/- 1.3% of administered platelets were sequestered, especially in the innermost active layers of the defoaming mesh of the bubble oxygenator. Mean survival time of circulating platelets was 58 +/- 8 hours and fitted an exponential function best. The bleeding time increased to 40 minutes during operation and returned to normal within 24 hours. During operation 111In-labeled platelets accumulated somewhat in the liver (10.7%) but not in the spleen, thorax, or hea.7%) but not in the spleen, thorax, or head. In the 48 hours after operation, platelets were sequestered mainly in the liver. The scintillation camera with computer-assisted imaging allows in vivo quantitative studies of platelet kinetics of a type which has not been possible with previous techniques

146

Cardiopulmonary bypass techniques and clinical outcomes in Beijing Fuwai Hospital: a brief clinical review.  

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The purpose of this study is to briefly summarize cardiopulmonary bypass (CPB) techniques and clinical outcomes in Beijing Fuwai Hospital. This article introduces routine CPB techniques in Fuwai Hospital, including CPB instruments, circuit setup, priming, conventional CPB management, myocardial protection, deep hypothermic circulatory arrest, ultrafiltration, autologous cell saver blood transfusion, and extracorporeal membrane oxygenation (ECMO). Clinical outcomes and further improvements of CPB management are also discussed. In 2008, 7,607 cases of cardiac surgery were performed in Fuwai Hospital, including congenital heart disease (48.33%), coronary artery disease (23.30%), rheumatic heart disease (19.45%), blood vessel disease (5.90%), reoperative surgery (1.70%), and other diseases (1.33%). The use of off-pump coronary artery bypass grafting (CABG) in isolated CABG was >50%. Thirty-eight cases of heart transplantation were also included. Total operative mortality in 2008 was 1.2%. Average postoperative stay was 9.5 days. CPB time was 70% of the patients, and aortic cross-clamping time was 50% of the cases. The self-recovery rate in the blood cardioplegia group (69.50%) was lower than the crystalloid cardioplegia group (97.40%). Thirty-five patients underwent cardiac surgery, and one patient from the cardiac internal medicine wards required ECMO support. Twenty-seven patients (75%, mean support time: 123.6 ± 54.1 hours) were weaned off ECMO successfully and discharged without severe complications. In conclusion, clinical CPB protocol used in Beijing Fuwai Hospital is a safe, simple, and conventional CPB management system that is suitable for practical clinical application in China. Further optimization is still needed to improve perfusion quality. PMID:21734556

Wang, Shigang; Lv, Shuyi; Guan, Yulong; Gao, Guodong; Li, Jingwen; Hei, Feilong; Long, Cun

2011-01-01

147

Improved red blood cell survival after cardiac operations with administration of urea during cardiopulmonary bypass  

International Nuclear Information System (INIS)

The plasma hemoglobin and red blood cell survival (half-life of 51Cr) was studied in 48 patients undergoing single valve replacement or coronary artery bypass graft. Urea or placebo was administered during cardiopulmonary bypass in a prospective, randomized, double-blind manner to test the potential effect on mechanical hemolysis. The mean plasma hemoglobin level at the end of extracorporeal circulation was significantly lower in the urea-treated groups (coronary artery bypass 342 mg/L; valve replacement 364 mg/L) than in the control groups (coronary artery bypass 635 mg/L, valve replacement 518 mg/L. The half-life of 51Cr was significantly longer in the urea-treated patients (coronary artery bypass 18 days; valve replacement 16 days) than in the control groups (coronary artery bypass 12.4 days; valve replacement 12.7 days) but still below the normal reference value (29 +/- 4 days). The plasma hemoglobin returned to near normal values (50 mg/L) the day after operation (day 1) and remained low with no differences between control and urea-treated groups. The total blood hemoglobin was followed for 2 weeks after operation and showed significantly less anemia in the urea-treated group. The lowest mean blood hemoglobin level was noted between days 5 and 9-114 (coronary artery bypass) and 107 (valve replacement) gm/L in the urea-treated patients compared to 92.3 gm/L in the control subjects. The reduction in the severity of the anemia led to less transe severity of the anemia led to less transfusion in the urea-treated patients (approximately 0.5 unit/patient) than in the control subjects (approximately 1 unit/patient) between days 3 and 14

148

Calcified myocardial necrosis in pediatric patients after cardiopulmonary resuscitation.  

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We report three autopsy cases of wide-spread myocardial necrosis with calcification in pediatric patients after temporary generalized hypoxia and initially successful cardiopulmonary resuscitation, but subsequent in-hospital death. Autopsy and histological workup in all three cases showed multiple circumscribed calcified and necrotic areas in progressive stages of organization within the myocardium. We conclude that these macro- and microscopic autopsy features appear to be related to reperfusion injuries in children as a consequence of hypoxic-ischemic changes occurring in the peri- and postresuscitation period. PMID:23264200

Buschmann, Claas T; Stenzel, Werner; Martin, Hubert; Heppner, Frank L; Guddat, Saskia S; Tsokos, Michael

2013-12-01

149

Cardiopulmonary exercise testing: arm crank vs cycle ergometry.  

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This pilot study compared oxygen consumption during arm crank and cycle ergometer tests in 15 women. The mean (SD) peak oxygen consumption was less with arm cranking (25 (5) ml.kg(-1) .min(-1)) than with cycling (40 (7) ml.kg(-1) .min(-1)), p arm cranking (13 (2) ml.kg(-1) .min(-1)) than with cycling (20 (4) ml.kg(-1) .min(-1)), p arm and leg exercise, p = 0.0007. This study suggests that arm crank cardiopulmonary exercise testing could be used for pre-operative assessment in those unable to cycle. PMID:23573845

Orr, J L; Williamson, P; Anderson, W; Ross, R; McCafferty, S; Fettes, P

2013-05-01

150

Nurses’ attitude in out-of-hospital cardiopulmonary resuscitation  

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Sudden cardiac arrest is one of the leading causes of death in Europe. Bystanders’ early Cardio-Pulmonary Resuscitation (CPR) may double or triple survival rates of out-of-hospital cardiac arrest victims.Aim: To investigate nurses’ attitude, in starting or not CPR and also the most frequent reasons that deter them from engaging in.Materials and Methods: The study had a sample of 177 nurses and assistant nurses that were working in nine hospitals of Athens. Nurses filled out the same, pred...

Maria Meidani; Maria Polikandrioti; Virginia Karamali; Theodore Kapadohos

2008-01-01

151

Challenges encountered with argatroban anticoagulation during cardiopulmonary bypass.  

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Use of argatroban as an alternative to heparin during cardiopulmonary bypass (CPB) in patients with heparin-induced thrombocytopenia has gained some attention in the past two decades. Dosing of argatroban during CPB is complex due to lack of complete understanding of its pharmacokinetic profile and the various elements during CPB that may alter its plasma levels. We report a case where the challenges in dosing argatroban led to failure to provide adequate anticoagulation during CPB, as evidenced by clot formation in the oxygenator, and extensive bleeding in the postoperative period. PMID:22345956

Agarwal, Shvetank; Ullom, Beth; Al-Baghdadi, Yasser; Okumura, Michael

2012-01-01

152

Heparin-induced thrombocytopenia and cardiopulmonary bypass: perioperative argatroban use.  

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Heparin-induced thrombocytopenia (HIT), a serious complication of heparin therapy, mandates heparin cessation and alternative anticoagulation. We report a patient with a history of HIT who successfully underwent cardiopulmonary bypass (CPB) using short-term reexposure to heparin and perioperative therapy with argatroban. No bleeding complications or HIT-related problems occurred. The pharmacokinetics of argatroban, especially its hepatic rather than renal elimination, makes it the drug of choice for some HIT patients in whom other alternative anticoagulants (eg, danaparoid and hirudin) are less well suited. Because of interference with the international normalized ratio (INR), switching from argatroban to oral anticoagulants is not straightforward. PMID:12607680

Lubenow, Norbert; Selleng, Sixten; Wollert, Hans-Georg; Eichler, Petra; Müllejans, Bernd; Greinacher, Andreas

2003-02-01

153

Determination of coronary bypass graft patency with ultrafast CT  

International Nuclear Information System (INIS)

Coronary artery bypass graft (CABG) surgery is a well-established technique for the treatment of patients with ischemic heart disease. While most patients are greatly benefited, much depends on the status of the bypass grafts. Sudden death, myocardial infarction, progressive angina, arrhythmias, ventricular function, and a variety of quality of life indices including employment all correlate with their patency. Research studies using invasive graft angiography have shown that about 20% of saphenous vein grafts are occluded by 1 year after surgery and as many as 50% by 10 years. Hence, CABG must be regarded as palliative only, and there is great need for a minimally invasive and accurate means to establish bypass graft patency. Over the past 12 months, the authors estimates are that some 2,000 patients in the United States will have had approximately 6,000 grafts studied with ultrafast computed tomography (CT). This chapter will review this experience and the accumulating data to suggest that minimally invasive, safe, and highly accurate graft evaluation may finally be possible

154

Chronic and acute effects of coal tar pitch exposure and cardiopulmonary mortality among aluminum smelter workers.  

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Air pollution causes several adverse cardiovascular and respiratory effects. In occupational studies, where levels of particulate matter and polycyclic aromatic hydrocarbons (PAHs) are higher, the evidence is inconsistent. The effects of acute and chronic PAH exposure on cardiopulmonary mortality were examined within a Kitimat, Canada, aluminum smelter cohort (n = 7,026) linked to a national mortality database (1957-1999). No standardized mortality ratio was significantly elevated compared with the province's population. Smoking-adjusted internal comparisons were conducted using Cox regression for male subjects (n = 6,423). Ischemic heart disease (IHD) mortality (n = 281) was associated with cumulative benzo[a]pyrene (B(a)P) exposure (hazard ratio = 1.62, 95% confidence interval: 1.06, 2.46) in the highest category. A monotonic but nonsignificant trend was observed with chronic B(a)P exposure and acute myocardial infarction (n = 184). When follow-up was restricted to active employment, the hazard ratio for IHD was 2.39 (95% confidence interval: 0.95, 6.05) in the highest cumulative B(a)P category. The stronger associations observed during employment suggest that risk may not persist after exposure cessation. No associations with recent or current exposure were observed. IHD was associated with chronic (but not current) PAH exposure in a high-exposure occupational setting. Given the widespread workplace exposure to PAHs and heart disease's high prevalence, even modest associations produce a high burden. PMID:20702507

Friesen, Melissa C; Demers, Paul A; Spinelli, John J; Eisen, Ellen A; Lorenzi, Maria F; Le, Nhu D

2010-10-01

155

[Heparin-induced thrombocytopenia after on-pump coronary artery bypass grafting].  

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We report herein a case of a patient who suffered heparin-induced thrombocytopenia (HIT) after on-pump coronary bypass grafting (CABG). A 62-year-old woman had received coronary angiography with heparin 4 months before CABG. She had been given heparin for 7 days before CABG, and underwent the operation under cardiopulmonary bypass uneventfully. She experienced thrombosis of multiple vein grafts without deep venous thrombosis or pulmonary embolism postoperatively. During percutaneous coronary intervention for residual coronary stenoses, acute multiple thromboses in coronary stents developed. We suspected HIT and administered argatroban instead of heparin. She recovered from shock after intra-aortic balloon pump insertion and balloon angioplasty for in-stent thromboses. HIT should be suspected whenever a thrombosis suddenly occurs in perioperative cardiac patients. Early diagnosis and treatment for HIT is essential to prevent subsequent thromboembolic events. PMID:20533732

Kigawa, Ikutaro; Okamura, Yusuke; Fukuda, Sachito; Miyairi, Takeshi

2010-06-01

156

Leukocyte-Aprotinin Atrial Fibrillation Study (LAFFS: Impact of Aprotinin and Leukofiltration on Atrial Fibrillation, Renal Insufficiency and Encephalopathy Post-Cardiopulmonary Bypass  

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Full Text Available Abstract Purpose:  Atrial fibrillation remains the leading postoperative complication following cardiopulmonary bypass.  A randomized trial was undertaken to evaluate the effectiveness of leukocyte filtration and aprotinin, applied separately and in combination, on the incidence of post-operative atrial fibrillation.   A secondary component of the study was the impact of these adjunct interventions on post-surgical renal and neurological dysfunction. Methods:  A total of 1,220 patients undergoing primary isolated coronary artery bypass grafting were randomly assigned to one of four treatment groups.  The control group (305 patients received standard cardiopulmonary bypass with moderately hypothermic (34ºC cardioplegic arrest.  In the filtration group (310 patients leukocyte reducing filters were incorporated into the bypass circuit.  The aprotinin group (285 patients received full Hammersmith dose aprotinin.  The combination therapy group (320 patients received both aprotinin and leukocyte filtration. Results:  The incidences of atrial fibrillation were 25% in the control group, 16% in the filtration group, 19% in the aprotinin group and 10% in the combination therapy group (P < 0.001.  Renal dysfunction was detected in 3% of the control group, 2% of the filtration group, 8% of the aprotinin group, and 5% of the combination group (P < 0.005.  Neurological dysfunction occurred in 2% of the control group, 2% of the filtration group, 1% of the aprotinin group, and 2% of the combination group (P = n.s.. Conclusions: Combination therapy with aprotinin and leukocyte filtration markedly reduced atrial fibrillation post-cardiopulmonary bypass, and was more effective than the individual treatments.  Aprotinin treatment increased the incidence of renal dysfunction, and the addition of leukocyte filtration partially mitigated this detrimental effect of aprotinin.

Robert T. Mallet

2008-12-01

157

Coronary Artery Bypass Graft  

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Full Text Available ... needed to prevent a heart attack or other heart problems. A CABG surgery includes taking blood vessels from other parts of ... inform your doctor in case you feel your heart is beating quickly, slowly, or skipping ... artery bypass graft surgery is relatively safe. Risks and complications are rare ...

158

Water-soluble graft copolymers of starch-acrylamide and uses therefor  

Science.gov (United States)

Graft copolymers having starch as the central chain with grafted side chains of acrylamide or acrylamide-acrylic acid, and a process for preparation of such copolymers in the presence of Ce.sup.+4 or other redox initiators. These copolymers are employed in preparing highly viscous aqueous solutions that are particularly useful in oil recovery from subterranean wells.

Butler, George B. (Gainesville, FL); Hogen-Esch, Thieo E. (Gainesville, FL); Meister, John J. (Dallas, TX); Pledger, Jr., Huey (Gainesville, FL)

1983-08-23

159

Postgraduate Education for Physical Therapists at Cardiopulmonary Area in Colombia  

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Full Text Available This paper presents the supply of postdegreeprograms in the cardiopulmonary area in Colombiain orden to show its state and sufficiency.Plans of formation, objectives, curricular approach,methodology and profile of performanceare analyzed in terms of costs, duration,supply, location and research capabilities.Our results show problems in regard to supplyas well as unanimous criteria and strategic alliances.There are no Gremial associations thatfavor both discussion and analysis about epidemiologistaspects of respiratory and cardiovasculardiseases in Colombia there is necessityof professionals in this area with experience.Knowledge and appropiated skills in management,administration, laws, agreements andpublic policies that cover the affected population.Also, it is exposed that the Universities whitthis programs require support and pursuit forprofessionals positioning both in national andinternational context.MethodologyA descriptive study was carried out with a datacollection made in a period between April-Decemberof 2006. Cards were done and they allowedto review different aspects such as costs,occupational profile, duration, modality, methodology,practical component and evaluation inthe offering universities of programs of postdegreein the cardiopulmonary area for physiotherapists.Later an analysis was made oncurriculum, profiles, objectives, contents, professionalcompetitions the areas of research.

Diana Durán Palomino

2007-09-01

160

Coronary artery bypass surgery: beating heart or cardiopulmonary bypass?  

Science.gov (United States)

In this study, we examined the early results for patients who underwent beating heart coronary bypass surgery and compared these results with those of conventional coronary bypass surgery.A total of 1094 patients who underwent isolated coronary artery bypass surgery between January 2009 and December 2011 in our clinic were included in this study. Seventy-three patients in whom cardiopulmonary bypass was not used (group 1) were compared to 1021 patients in whom cardiopulmonary bypass was used (group 2).The mean age was 60.7 ± 9.3 in group 1 and 58.9 ± 9.7 in group 2 (P > 0.05). There was no significant difference between the two groups in terms of gender, or the coexistence of diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), and hypertension (P > 0.05). There was no significant difference between group 1 and group 2 in terms of development of postoperative atrial fibrillation (AF), use of an intra-aortic balloon pump, need for re-operation for bleeding, or duration of hospital stay and intensive care unit stay (P > 0.05). The need for inotropic support and the amount of mediastinal drainage were less in group 1 than in group 2 (P = 0.002, P 0.05). There was no mortality in group 1, whereas it was calculated as 1.8% in group 2 (P = 0.63).Beating heart coronary artery bypass surgery decreases the need for inotropic support and transfusion. PMID:24463921

Cakir, Habib; Uncu, Hasan; Gur, Ozcan; Yurekli, Ismail; Acipayam, Mehmet; Ozsoyler, Ibrahim

2014-01-01

 
 
 
 
161

Do Radiologists Want/Need Training in Cardiopulmonary Resuscitation?  

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Purpose: Prompt and effective cardiopulmonary resuscitation (CPR) decreases morbidity and mortality following cardiopulmonary arrest. Radiologists are frequently confronted with severely ill patients, who may deteriorate at any time. Furthermore, they have to be aware of life-threatening reactions towards contrast media. This study was designed to assess experience and self-estimation of German-speaking radiologists in CPR and cardiac defibrillation (CD). Material and Methods: 650 German-speaking radiologists were audited by a specially designed questionnaire, which was sent via e-mail. The answers were expected to be re-mailed within a 2-month period. Results: The response rate was 12.6%. 72.8% of the responders had performed at least 1 CPR (range 9.5 {+-} 13.1) and 37% at least 1 CD. 67.9% had had opportunities to attend training courses, which had been utilized by 41.8% of them. The last training of the responders was more than 2 years ago in 69.2% and more than 5 years ago in 37%. Of all responders 75.6% expressed the need for further education. Conclusion: The small response rate indicates the small importance of CPR in the subpopulation surveyed. The vast majority of the responders, however, showed interest in basic and advanced life support and advocated regular updates. It seems reasonable that radiological Dept. themselves should organize courses in order to cope with their specific situations.

Schellhammer, F. [St. Katharinen Hospital, Frechen (Germany). Dept. of Radiology

2003-03-01

162

Dacron graft aneurysm treated by endovascular stent-graft  

International Nuclear Information System (INIS)

A 72-year old man who underwent aorto-bifemoral bypass with insertion of a Dacron graft 18 years previously presented with an aneurysm in the left limb of his graft. Angiography also demonstrated a bilateral occlusion of the popliteal arteries. Computed tomography (CT) angiography was performed and showed a localized dilation of 3 cm in the left limb of the graft, which had a diameter of 14 mm throughout. In view of the technical difficulties of a surgical procedure, an endovascular stent was considered. Through a left femoral arteriotomy. a stent graft was inserted and deployed in the left limb of the graft. This resulted in total exclusion of the Dacron graft aneurysm. To the best of our knowledge, this is the first report of such a procedure.

163

Dacron Graft Aneurysm Treated by Endovascular Stent-Graft  

International Nuclear Information System (INIS)

A 72-year old man who underwent aorto-bifemoral bypass with insertion of a Dacron graft 18 years previously presented with an aneurysm in the left limb of his graft. Angiography also demonstrated a bilateral occlusion of the popliteal arteries. Computed tomography (CT) angiography was performed and showed a localized dilation of 3 cm in the left limb of the graft, which had a diameter of 14 mm throughout. In view of the technical difficulties of a surgical procedure, an endovascular stent was considered. Through a left femoral arteriotomy, a stent graft was inserted and deployed in the left limb of the graft. This resulted in total exclusion of the Dacron graft aneurysm. To the best of our knowledge, this is the first report of such a procedure

164

Siloxane-grafted membranes  

Science.gov (United States)

Composite cellulosic semipermeable membranes are disclosed which are the covalently bonded reaction product of an asymmetric cellulosic semipermeable membrane and a polysiloxane containing reactive functional group. The two reactants chemically bond by ether, ester, amide or acrylate linkages to form a siloxane-grafted cellulosic membrane having superior selectivity and flux stability. Selectivity may be enhanced by wetting the surface with a swelling agent such as water.

Friesen, D.T.; Obligin, A.S.

1989-10-31

165

Using skeletonised grafts for coronary artery bypass grafting.  

Science.gov (United States)

Coronary artery bypass graft surgery relieves angina symptoms and reduces mortality among ischaemic heart disease patients. It remains the gold standard for the treatment of multi-vessel and left main coronary artery disease. It is a well-known fact that internal mammary artery conduits have excellent and long-lasting patency when used for coronary artery bypass grafting. Its supremacy is largely because it prevents atherosclerosis. The old-style internal mammary artery bypass grafting, classically known as pedicle grafting, includes a circular rim of tissue around the graft. Bilateral pedicled internal mammary arteries, especially among diabetic patients, have been reported to cause complications in the sternum like sternal osteomyelitis. In many studies it has been reported that dissection of pedicled internal mammary artery can lead to sternal devascularisation which can lead to higher incidence of infections. Considering the higher incidence of deep sternal infections in patients with double pedicled arterial grafts, dissection of internal mammary artery in skeletonised manner was proposed. In this review, we outline the advantages of skeletonised grafting with respect to incidence of sternal infection, patency rates, blood flow, post-coronary artery bypass graft pain and the length of the graft. PMID:25272561

Bawany, Faizan Imran; Khan, Muhammad Shahzeb; Khan, Asadullah; Kazi, Abdul Nafey; Naeem, Muhammed

2014-05-01

166

Stenting an aortopulmonary conduit with peripheral cardiopulmonary bypass support.  

Science.gov (United States)

Although surgically created aortopulmonary (AP) shunts are uncommon in the adult congenital heart disease population, they are often used in patients with pulmonary atresia. For these patients, the shunt is a vital supply of pulmonary blood flow and thus obstruction of the shunt may lead to pulmonary hypoperfusion and hypoxia thereby increasing morbidity and mortality. This report describes a safe and effective method of stenting the conduit with the hemodynamic support of peripheral cardiopulmonary bypass (PCB). Prior to the procedure, a multimodality assessment of a stenosis in a kinked AP conduit using computed tomography, angiography, intravascular ultrasound (IVUS), and pressure wire assessment (PWA) was utilized. While PCB, IVUS, and PWA have all been used to great effect in various clinical scenarios, the combined use of these techniques has not been previously been described in the setting of intervention in adult congenital heart disease. PMID:23592486

Incani, Alexander; Lee, Joseph C; Nicolae, Mugur J; Walters, Darren L

2014-01-01

167

Assessment of Knowledge of Medical Staff about Cardiopulmonary Ressucitation (CPR  

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Full Text Available This survey, evaluated the level of awareness and knowledge among the medical staff about conditions and methods of performing cardiopulmonary ressucitation. The study sampling comprised 497 subjects including 208 residents and 262 interns of ten university hospitals in Tehran. In regard to the basic principles, this has been 43.54% (SD = 13.36%, in drug and fluid therapy 31.22% (GD = 13.22%, in electroshock 43.6% (SD=21.12%, in appropriate approach to the problem 34.73% (SD=13.42% and in complications of CPR 17.7% (SD = 15.25%. Considering the results of the project, the medical staff have insufficient knowledge of CPR "md it does not improve significantly during internship and residency period. Therefore, there is a great necessity for the medical students to attend basic and advanced CPR courses during their study

M. PGoranaraki

1998-04-01

168

Induced hypothermia after cardiopulmonary resuscitation: possible adverse effects  

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Full Text Available The last several years have seen an increased interest in the use of induced hypothermia after witnessed cardiopulmonary resuscitation (CPR. The main reason for its use is protection of the brain and hence, better neurological outcome in these patients. Therefore, induced hypothermia after CPR has become a part of standard recommendations in the 2005 Resuscitation Guidelines. At the same time, hypothermia can have many adverse effects. In the event of pre-hospital and/or in-hospital induction of hypothermia, without adequate monitoring and controlled cooling, hypothermia can cause serious complications, without beneficial effects on the brain. This article explains the most frequent adverse effects of hypothermia and possible hazardous outcomes for patients.

Milanovic, Rudlof

2007-04-01

169

Blood damage related to cardiopulmonary bypass: in vivo and in vitro comparison of two different centrifugal pumps.  

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Cardiopulmonary bypass (CPB) induces hemolysis and the activation of the inflammatory and coagulation systems. Several components of the CPB equipment may contribute to such phenomenon. We tested the effects of two differently designed centrifugal pumps (Bio-Pump, Medtronic and Revolution, Cobe) on several markers of hemolysis, coagulation, and inflammation: plasma free hemoglobin,prothrombin fragment 1.2, platelet factor 4, and P-selectin. Twenty patients requiring coronary artery bypass grafting were randomized to undergo CPB with one of the study centrifugal pumps, and 10 experiments (5 for each pump) were performed with a closed loop circuit to assess pumps' performances over 6 circulation hours using human blood. CPB induced a significant elevation of all the tested markers. Neither in the in vivo nor in the in vitro study were significant differences observed between the groups. Because the Revolution centrifugal pump, which was recently designed and distributed, produced results comparable with those obtained with the BioPump, it should be considered as safe as the Bio-Pump to perform clinical CPB. PMID:15497388

Paparella, Domenico; Galeone, Antonella; Venneri, Maria Teresa; Coviello, Maria; Visicchio, Giuseppe; Cappabianca, Giangiuseppe; Maselli, Giorgia; Marraudino, Nicola; Quaranta, Michele; De Luca Tupputi Schinosa, Luigi

2004-01-01

170

Patient experiences living with split thickness skin grafts.  

Science.gov (United States)

The standard of care for deep burns is autologous split thickness skin grafting. Although adequate to resurface a deep wound, the resulting skin is chronically abnormal. The purpose of this study was to describe the experience of patients with split thickness skin grafts to help guide future investigations related to skin regeneration. In this study, an interpretive description qualitative methodology was employed. Subjects participated in a two-part single patient interview that was recorded and transcribed. A nurse with experience in clinical burn care coded and interpreted the data. Participants were recruited through presentation to a university based outpatient burn clinic for follow up from autologous split thickness skin grafting. Eight male patients and four female patients 20-62 years old ranging 2-29 months post-skin grafting were enrolled in the study. The most significant concerns voiced by patients were identified and organized into five themes: (1) a new normal, (2) split thickness skin graft symptoms, (3) appearance of new skin, (4) coping, and (5) participation in future clinical trials. Participants reported that the abnormalities related to their split thickness skin grafts were significant enough that they would be willing to participate in a future clinical trial investigating new cell-based therapies. PMID:24794227

Burnett, L N; Carr, E; Tapp, D; Raffin Bouchal, S; Horch, J D; Biernaskie, J; Gabriel, V

2014-09-01

171

Rationale, design and methodology for a Prospective Randomized Study of graft patency in Off-pump and On-pump MultI-Vessel coronary artery bypasS Surgery (PROMISS using multidetector computed tomography  

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Full Text Available Abstract Background Off-pump coronary artery bypass grafting has been accused of possibly compromising graft patency. Sixteen slice computed tomography has shown good diagnostic accuracy in the assessment of coronary bypass graft patency when compared with conventional coronary artery angiography and is less invasive. The study hypothesis is that coronary artery bypass grafting (CABG performed without cardiopulmonary bypass (Off-Pump has equivalent early graft patency as if performed with cardiopulmonary bypass (On-Pump and may have reduced complication rate. Methods/Design The Prospective Randomized Comparison of Off-Pump and On-Pump MultI-vessel Coronary Artery BypasS Surgery (PROMISS is a controlled, single blinded, single centre clinical trial, comparing early graft patency using 16-slice computed tomography in patients with multi-vessel coronary artery disease operated either without or with extracorporeal circulation. Inclusion criteria are multivessel disease with an indication for first time, isolated, non emergent coronary artery bypass grafting with a minimum of three distal anastomoses. Secondary end points are peri-operative mortality, combined morbidity, length of stay, neuro-cognitive testing at 6 weeks and adverse events, stress test and quality of life at 6 months and one year. The sample size of one hundred and fifty patients was calculated in order to enable the detection of a 5% difference in graft patency, with 80% power, considering a minimum of 3 distal anastomoses per patient. Enrolment started in April 2005 and ended July 2007 with study closure in July 2008. Conclusion The PROMISS trial aims to shed new light on the effect of Off-Pump as compared to On-Pump coronary artery bypass surgery on graft patency, assessed by multidetector computed tomography, in unselected patients with multivessel coronary artery disease. Trial Registration Current Controlled Trials ISRCTN58800729

Magalhães Manuel

2008-07-01

172

Awareness of cardiopulmonary resuscitation in medical-students and doctors in Rawalpindi-Islamabad, Pakistan  

International Nuclear Information System (INIS)

Objective: To assess the level of awareness regarding basic and practical knowledge of cardiopulmonary resuscitation and its importance in the eyes of medical/dental students and doctors. Methods: The cross-sectional study was conducted in medical and dental colleges as well as hospitals of Rawalpindi and Islamabad, Pakistan, from June to September 2011. Non-probability convenience sampling was used and structured questionnaires on basic and practical knowledge of the procedure were distributed. The questionnaire had 26 items related to basic and advanced knowledge of the required skills. Doctors were divided into two groups based on their years of service and practice. Those with less than 5 years' experience were grouped as junior doctors, while rest as senior doctors. Descriptive statistics were employed to analyse the data using SPPS version 17 and Microsoft Excel. Percentages were worked out and the results were interpreted. Result: Of the 1000 questionnaires distributed, 646 (64.6%) were received duly filled and represented the study sample. Of the 646 participants, 34 (5.26%) were dentists, 424 (65.63%) were medical students, 92 (14.24%) were doctors and 96 (14.86%) were dental students. Basic knowledge of doctors was found to be better than that of dentists (n=96; 50% vs. n=8; 23%). Similarly, the advance knowledge of doctors was better than the dentists (n=53; 58% vs. n=11; 31%). The basic knowledge of junior doctors was found to be almost equal to the seniorwas found to be almost equal to the senior doctors (n=26; 44.75% vs. n=15; 45.5%). The advance knowledge of junior doctors was found to be better than the senior doctors (n=27; 45.37% vs. n=10; 29.48%). Among the students, 157 (37%) of the medical students had basic knowledge of CPR, while 36 (38%) dental students had basic knowledge of the topic. Medical students had more advanced knowledge (n=157; 37%) than dental students (n=34; 35%). Conclusion: The awareness of basic and advance knowledge of cardiopulmonary resuscitation skills in medical/dental students and doctors in Rawalpindi and Islamabad was inadequate. (author)

173

Axonal regeneration through arterial grafts.  

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The left common peroneal nerves of adult inbred mice were severed and allowed to regenerate through the lumina of Y-shaped tubes comprising grafts of abdominal aorta and its bifurcation. Very little regeneration took place within the grafts unless the distal nerve stump was inserted into one limb of the Y-tube. Using syngeneic grafts virtually all the axons regenerating through the lumen grew down the limb of the Y-tube containing the distal nerve. Using non-syngeneic grafts, however, a subst...

Anderson, P. N.; Turmaine, M.

1986-01-01

174

Utilising cardiopulmonary bypass for cancer surgery. Malignancy-induced protein C deficiency and thrombophilia.  

LENUS (Irish Health Repository)

Cardiopulmonary bypass has evolved over the last 30 years. It is an important tool for the cardiac surgeon today and also has applications in non-cardiac operations such as surgery to extract tumours. Such patients undergoing surgery for cancer may be at an increased risk of a thromboembolic event post surgery, due to disturbances in the normal clotting pathway leading to hypercoagulability. One such disturbance is malignancy-induced Protein C deficiency. A deficiency of Protein C can cause hypercoagulabitity. Recent studies have examined cardiopulmonary bypass and inherited Protein C deficiency. However, surgery for cancer patients with a malignancy-induced Protein C deficiency involving cardiopulmonary bypass has not been reported. Surgery using CPB in these patients may result in increased morbidity and mortality. The objective of this article is to review the literature in order to discuss the occurrence, the aetiology and possible management of cancer patients with malignancy-induced Protein C deficiencies that require cardiopulmonary bypass for their surgery.

Marshall, C

2012-02-03

175

The Effectiveness of Ultrasound in Patients with Non-Traumatic Cardiopulmonary Arrest  

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Objective: The purpose of this study was to evaluate the effectiveness of using cardiac ultrasound in emergency departments to direct resuscitation after cardiopulmonary arrest. Material and Methods: The study was performed prospectively on 73 patients who underwent cardiopulmonary resuscitation in the emergency department at Gaziantep University Faculty of Medicine between January and December 2010. Two senior doctors, who had received emergency cardiac ultrasonography training, performed th...

Suat Zengin; Cuma Y?ld?r?m; Behçet Al; Sinan Genç; Hasan K?l?ç; Mehmet Do?an

2012-01-01

176

72 hours standby time of wet-primed cardiopulmonary bypass circuits: a microbiological quality assurance study.  

Science.gov (United States)

In a microbiological sample study of 15 wet-primed cardiopulmonary bypass circuits in standby mode for 72 hours under regular clinical conditions, no contamination of the priming fluid or the connectors could be detected. Hand contact surfaces of the machines demonstrated environmental microorganisms. These findings indicate the safe use of primed cardiopulmonary bypass circuits in standby mode for 72 hours. A surface disinfection of hand contact surfaces immediately before use is recommended. PMID:24788708

Schulz-Stübner, Sebastian; Schorer, Cornelia; Ennker, Jürgen; Bauer, Stefan; Schaumann, Reiner

2014-10-01

177

Acid base changes in arterial and central venous blood during cardiopulmonary resuscitation.  

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Twenty-seven patients in cardiopulmonary arrest had simultaneous measurements of arterial and central venous blood gases during cardiopulmonary resuscitation (CPR) with a pneumatic chest comparison and ventilation device. Mean central venous and arterial hydrogen ion concentrations, PCO2 and calculated bicarbonate concentrations were significantly different (P less than 0.01) at all sampling times (0, 10 and 20 min). Central venous blood samples predominantly showed a respiratory acidosis in ...

Steedman, D. J.; Robertson, C. E.

1992-01-01

178

Use of Argatroban for anticoagulation during cardiopulmonary bypass in a patient with heparin allergy.  

Science.gov (United States)

The use of Argatroban for treatment of heparin-induced thrombocytopenia (HIT) and for percutaneous coronary intervention in patients with HIT is well described and FDA approved. The use of Argatroban for cardiopulmonary bypass remains off label and the subject of a few case reports. We report the case of a patient with a heparin allergy requiring cardiopulmonary bypass (CPB) for mitral valve replacement. Argatroban was successfully used as anticoagulation for CPB. PMID:18760617

Smith, Alan I; Stroud, Robert; Damiani, Peter; Vaynblat, Mikhail

2008-11-01

179

Correlation of femoral artery vs radial artery pressures with central pressure after cardiopulmonary bypass in children  

International Nuclear Information System (INIS)

To assess the effectiveness of femoral and radial arterial lines on the correlation of peripheral and central mean arterial blood pressure in children after discontinuation of cardiopulmonary bypass. Fifty children scheduled for cardiac surgery with cardiopulmonary bypass were included in the study. After approval from the hospital ethics committee and informed consent. 50 children undergoing cardiac surgical procedures with cardiopulmonary bypass were randomly assigned to two different groups. In Group- A (RAP, n-2) a radial arterial line and in Group-B (FAP, n-25) a femoral arterial line was used to monitor the blood pressure. Simultaneous mean peripheral arterial pressure and mean central aortic pressure were recorded before cardiopulmonary bypass and 5 mins after separation from the cardiopulmonary bypass. The correlation of mean peripheral arterial pressure (radial and femoral) versus mean aortic pressure were compared. The data was recorded as Mean +- SD and P-value. The ages of children ranged from 4-12 years and their weight from 14.1-28.5 kg. In all of them following cardiopulmonary bypass, aortic pressure correlates better with femoral arterial pressure (p<0.001). The radial arterial line readings under estimated central aortic pressure when compared to femoral arterial line readings. Aortic pressure readings correlate better with femoral arterial pressure than radial arterial pressure in children. (author)

180

Polyether/Polyester Graft Copolymers  

Science.gov (United States)

Higher solvent resistance achieved along with lower melting temperature. New technique provides method of preparing copolymers with polypivalolactone segments grafted onto poly (2,6-dimethyl-phenylene oxide) backbone. Process makes strong materials with improved solvent resistance and crystalline, thermally-reversible crosslinks. Resulting graft copolymers easier to fabricate into useful articles, including thin films, sheets, fibers, foams, laminates, and moldings.

Bell, Vernon L., Jr.; Wakelyn, N.; Stoakley, D. M.; Proctor, K. M.

1986-01-01

 
 
 
 
181

Radiation-induced graft polymerization of polyacrylamide onto polyethylene nonwoven fabric (PE NWF) for phenol adsorption  

International Nuclear Information System (INIS)

Polyethylene nonwoven fabric was functionalized using radiation-induced graft polymerization of acrylonitrile by ?-rays from 60Co source. The simultaneous grafting technique was employed wherein the polyethylene fibers were irradiated in nitrogen atmosphere in the presence of acrylonitrile dissolved in 1:1 water/methanol solvent. The effects of different grafting parameters to the grafting yield were evaluated. The optimum values of dose rate, absorbed dose and concentration of monomer were found to be 6kGy h-1, 25kGy and 10% w/w acrylonitrile, respectively. Using the optimum conditions, the degree of grafting of approximately 14% is achieved. The grafted polyethylene fibers were reacted with hydroxylamine to introduce amidoxime functional groups on the nonwoven fabric. The unmodified, grafted and functionalized fibers were characterized using Attenuated Total Reflectance - Fourier Transformed Infrared Spectroscopy (FTIR - ATR) and Scanning Electron Microscopy (SEM). The results of these tests confirmed the successful grafting of acrylonitrile and functionalization to amidoxime functional groups. The ability of the amidoximated grafted polyethylene to remove phenol from aqueous solutions was investigated. The results from Gas Chromatography - Flame Ionization Detection (GC - FID) indicated that approximately 58% of the phenol was removed. (author)

182

Electron beam-induced graft copolymerization of vinyl monomers on to polyester fibre  

International Nuclear Information System (INIS)

Electron beam-induced graft copolymerization of acrylic acid on to multifilament PET fibre was carried out by simultaneous method. The fibre was impregnated with acrylic acid at room temperature and the impregnated fibre was irradiated with electron beams in air. The effects of impregnation time, swelling agent, monomer composition, dose, dose rate and grafting temperature have been investigated. Four hour impregnation time was found to be sufficient to obtain the maximum weight percentage of grafting for this system. Among the swelling agents employed, formic acid was found to be the most effective. Some properties of several percentage of grafting have been studied by means of Optical Microscope, X-rays Microanalyzer and Differential Scanning Calorimeter. Optical microscopic observations show that the diameter of graft fibres increases with the increasing percentage of grafting. X-rays microscope analysis shows that the distribution of grafts across the PET cross-sections is more intense at the surface in comparison to the core of the fibres. It is learned from DSC measurements that the melting point of graft fibres decreases slightly as the weight percentage of grafting increases. (author)

183

A Comparison of Interposition and Femoropopliteal Bypass Grafts in the Management of Popliteal Artery Trauma  

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Full Text Available Background: Peripheral vascular injury associated with lower limb trauma is a well-known emergency. The experience for the management of popliteal artery trauma have mainly come from managing the traumas of military personnels during Iran-Iraq war. The present study compared the effects of two currently-used surgical techniques in the management of popliteal trauma, namley femoropopliteal bypass graft and interposition vein graft on limb salvage. Methods: A retrospective review of 40 patients with popliteal artery trauma admitted to the trauma unit of a university teaching hospital during 2003 to 2008. The patients had undergone femoropopliteal bypass graft (n=26 or interposition vein graft (n=14 for the management of popliteal trauma. Results: The amputation rate among patients managed by femoropopliteal bypass or interposition vein graft was 35.7% and 61.5%, respectively. Knee stability among patients managed by interposition graft group was 57.7% and in those managed by femoropopliteal bypass graft was 85.7%. Conclusion: The rates of knee stability achieved by the employed techniques indicate that femoropopliteal bypass vein graft is superior, and therefore, preferable to the interposition vein graft in the management of popliteal artery trauma

Mohammad Ali Mohammadzade

2011-03-01

184

The effects of venous cannulation technique and cardioplegia type on plasma potassium concentration and arterial blood pressure during cardiopulmonary bypass.  

LENUS (Irish Health Repository)

The cannulation method and cardioplegia solution used during cardiopulmonary bypass (CPB) may both influence plasma potassium concentrations ([K+]) and mean arterial blood pressure (MAP). Bi-caval or right atrial cannulation methods are routinely used in conjunction with crystalloid or blood cardioplegia. We investigated the influence of cannulation method and cardioplegia solutions on plasma [K+] and MAP during cardiopulmonary bypass. Sixty consecutive patients undergoing elective coronary artery bypass grafting (CABG) using CPB were studied. They were randomly divided into three groups of 20 patients. Patients in Group A underwent bi-caval venous cannulation and received crystalloid cardioplegia. Group B patients underwent right atrial cannulation and received crystalloid cardioplegia. Group C patients underwent right atrial cannulation and received blood cardioplegia. In each case. cardioplegia was administered antegrade via the aortic root. Plasma [K+], MAP. and hemoglobin concentration (Hb) were measured over an 8-min period following cardioplegia administration (pilot studies indicated pressure changes occuring post cardioplegia administration up to this time). The combination of bi-caval cannulation and crystalloid cardioplegia (Group A) was associated with the least increase in plasma [K+] and no decrease in MAP. The maximum [K+] for this Group was 4.2 mmol\\/L (4.6% increase). The minimum mean pressure was 57 mmHg (13.6% increase). Both right atrial cannulation groups (B and C) showed a large rise in plasma [K+] and a decrease in MAP. Group B maximum [K+] was 5.2 mmol\\/L (27.5% increase). Group C was also 5.2 mmol\\/L (26.0% increase). Group C showed the largest pressure decrease, the minimum mean pressure was 45 mmHg (21.3% decrease). The Group B minimum mean pressure was 45 mmHg (8.7% decrease). Our results show that patients undergoing CPB operations who are deemed to be at increased risk of suffering adverse effects from hypotensive episodes may benefit from bicaval cannulation and caval snaring, in preference to right atrial cannulation. Crystalloid cardioplegia may be preferable to blood cardioplegia in these cases to maintain the MAP.

Coleman, E T

2012-02-03

185

The cardiopulmonary reflexes of spontaneously hypertensive rats are normalized after regression of left ventricular hypertrophy and hypertension  

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Cardiopulmonary reflexes are activated via changes in cardiac filling pressure (volume-sensitive reflex) and chemical stimulation (chemosensitive reflex). The sensitivity of the cardiopulmonary reflexes to these stimuli is impaired in the spontaneously hypertensive rat (SHR) and other models of hypertension and is thought to be associated with cardiac hypertrophy. The present study investigated whether the sensitivity of the cardiopulmonary reflexes in SHR is restored when cardiac hypertrophy...

Uggere, T. A.; Abreu, G. R.; Cabral, A. M.; Bissoli, N. S.

2000-01-01

186

Viability of cartilage grafts in various forms.  

Science.gov (United States)

The viability of cartilage grafts, in many forms, has been researched since the using of cartilage grafts in surgical procedures. Cryopreservation period and viability of cartilage grafts have remained unclear. This study was performed to investigate the durability, viability, and behavior of fresh or cryopreserved cartilage grafts when used as autografts or allografts in various forms.Six cartilage grafts (1 of each preparation type; 3 blocks and 3 diced) were prepared by wrapping with Surgicel or autogenous fascia, or they were left bare. After the graft preparation stage, the cartilage grafts were inserted into pockets prepared on the dorsum of each rabbit. Groups 1, 2, 3, and 4 (6 rabbits in each group) received autogenous fresh grafts, allogenous fresh grafts, autogenous cryopreserved grafts, and allogenous cryopreserved grafts, respectively. All cartilage grafts were implanted for 2 months.At the end of the second month, specimens were harvested and analyzed. The bare grafts provided the most viable specimens. There was no significant difference between the frozen or fresh and allograft or autograft groups with respect to viability and resorption ratios. The bare block graft, in all groups, survived significantly more than the other graft types.Allografts (homografts), similar autografts, did not create major problems, and they had excellent host tolerance and low antigenicity, especially when the perichondrium was removed. Viability and durability of the bare grafts (diced and block) were better than fascia or Surgicel-wrapped cartilage graft forms. PMID:21959409

Firat, Cemal; Gurlek, Ali; Aydin, Nasuhi Engin; Aydn, Nasuhi Engin

2011-09-01

187

A Reliable Method for Rhythm Analysis during Cardiopulmonary Resuscitation  

Science.gov (United States)

Interruptions in cardiopulmonary resuscitation (CPR) compromise defibrillation success. However, CPR must be interrupted to analyze the rhythm because although current methods for rhythm analysis during CPR have high sensitivity for shockable rhythms, the specificity for nonshockable rhythms is still too low. This paper introduces a new approach to rhythm analysis during CPR that combines two strategies: a state-of-the-art CPR artifact suppression filter and a shock advice algorithm (SAA) designed to optimally classify the filtered signal. Emphasis is on designing an algorithm with high specificity. The SAA includes a detector for low electrical activity rhythms to increase the specificity, and a shock/no-shock decision algorithm based on a support vector machine classifier using slope and frequency features. For this study, 1185 shockable and 6482 nonshockable 9-s segments corrupted by CPR artifacts were obtained from 247 patients suffering out-of-hospital cardiac arrest. The segments were split into a training and a test set. For the test set, the sensitivity and specificity for rhythm analysis during CPR were 91.0% and 96.6%, respectively. This new approach shows an important increase in specificity without compromising the sensitivity when compared to previous studies. PMID:24895621

Ayala, U.; Irusta, U.; Ruiz, J.; Eftestøl, T.; Kramer-Johansen, J.; Alonso-Atienza, F.; Alonso, E.; González-Otero, D.

2014-01-01

188

Measuring behavioral outcomes in cardiopulmonary rehabilitation: AN AACVPR STATEMENT.  

Science.gov (United States)

Outcome measurement in cardiopulmonary rehabilitation is required for optimal assessment of program quality, effectiveness of treatments, and evaluation of patient progress. Recent position statements from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), American College of Cardiology, American Heart Association, American Thoracic Society, and American College of Chest Physicians have provided state-of-the-art information on the importance of assessing performance and outcome measures for optimal program effectiveness. Such measures are also required for AACVPR program certification. To meet current standards of practice, the AACVPR developed an Outcomes Matrix that includes 4 domains: Health, Clinical, Behavioral, and Service. Although the Clinical and Health domains have been most commonly used in outcome reporting (eg, 6-minute walk test, quality-of-life survey scores), behavioral measures have received less attention, primarily because they have been perceived as being more difficult to measure and quantify over time. This statement describes 5 common behavioral outcome measures: smoking cessation, medication use, supplemental oxygen use, exercise habits, and nutritional behaviors. Sample questions and calculations for each of these behavioral measures are also provided. By using these measures at program entry and completion, cardiac and pulmonary rehabilitation practitioners can effectively track and document behavioral changes over time for physicians, third-party insurance providers, or hospital administrators and thus demonstrate the effectiveness of exercise and educational interventions on patient overall health and well-being. PMID:19471140

Verrill, David; Graham, Helen; Vitcenda, Mark; Peno-Green, Laura; Kramer, Valerie; Corbisiero, Teresa

2009-01-01

189

Retention of cardiopulmonary resuscitation skills after initial overtraining.  

Science.gov (United States)

The authors have examined cardiopulmonary resuscitation (CPR) skills retention in a police force initially trained to instructor level performance skills as defined by the 1977 American Heart Association Instructor Manual. In 1977, the entire Winnipeg Police Force received a basic 8-h course of CPR training with recording manikins. Each training session was followed by a written test and a performance test on the recording manikin using instructor level tape criteria as the standard. Between 12 and 18 months later, 116 personnel were randomly selected for retesting. The first min of one-man CPR on the two tapes was compared. Retention was expressed as a percentage, i.e., retest score/training score x 100. Retention scores were as follows: knowledge, 76%; assessment skills, 83%; call for help, 85%; numbers of adequate ventilations, 100%; numbers of adequate compressions, 97%. Total assessment time and incidence of potentially injurious performance were the same. Deliverate overtraining of highly motivated and mature nonmedical basic rescuers results in satisfactory skills retention for at least 1 year. PMID:7428390

Tweed, W A; Wilson, E; Isfeld, B

1980-11-01

190

Acute mesenteric ischemia after cardio-pulmonary bypass surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Acute mesenteric ischemia (AMI is a highly-lethal surgical emergency. Several pathophysiologic events (arterial obstruction, venous thrombosis and diffuse vasospasm lead to a sudden decrease in mesenteric blood flow. Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities, leading to multi-organ failure and death. Early diagnosis is difficult because the clinical presentation is subtle, and the biological and radiological diagnostic tools lack sensitivity and specificity. Therapeutic options vary from conservative resuscitation, medical treatment, endovascular techniques and surgical resection and revascularization. A high index of suspicion is required for diagnosis, and prompt treatment is the only hope of reducing the mortality rate. Studies are in progress to provide more accurate diagnostic tools for early diagnosis. AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB. Several factors contribute to the systemic hypo-perfusion state, which is the most frequent pathophysiologic event. In this particular setting, the clinical presentation of AMI can be misleading, while the laboratory and radiological diagnostic tests often produce inconclusive results. The management strategies are controversial, but early treatment is critical for saving lives. Based on the experience of our team, we consider prompt exploratory laparotomy, irrespective of the results of the diagnostic tests, is the only way to provide objective assessment and adequate treatment, leading to dramatic reduction in the mortality rate.

Bassam Abboud, Ronald Daher, Joe Boujaoude

2008-09-01

191

New insights onto cardiopulmonary nematodes of dogs in Sardinia, Italy.  

Science.gov (United States)

Dog heartworms Angiostrongylus vasorum and Dirofilaria immitis cause severe parasitological diseases; the importance of these parasitosis is growing due to their health impact on animals, the possible zoonotic implications and the recent spreading across several European countries and previously non-endemic areas. The aim of this study is to update the epidemiological scenario of cardiopulmonary nematodes A. vasorum and D. immitis in dogs of Sardinia island and to perform a morphological identification of larvae by the use of the Baermann and Knott techniques respectively and the molecular characterization of the mitochondrial cytochrome c oxidase subunit I (cox1) and the second ribosomal transcribed spacer region (ITS-2) of larvae L1 of A. vasorum. In the present study, 3.4% (5/146) of dogs resulted positive at Baermann technique for A. vasorum while 8.9% (61/684) to D. immitis. If on one side A. vasorum can be considered an emerging parasite in Sardinia, the parasitic pressure and the risk of infection for D. immitis in the island seems to be increased compared with the recent past. PMID:24525757

Pipia, A P; Varcasia, A; Tosciri, G; Seu, S; Manunta, M L; Mura, M C; Sanna, G; Tamponi, C; Brianti, E; Scala, A

2014-04-01

192

Evaluation of a cardiopulmonary-resuscitation training manual for pharmacists.  

Science.gov (United States)

The development and evaluation of a training manual for pharmacists participating in cardiopulmonary resuscitation (CPR) efforts at an institution encompassing ambulatory-care, acute-care, and emergency-trauma facilities are described. The manual was developed to familiarize pharmacists who had little or no experience in CPR procedures with the equipment and medications used and the pharmacist's role on the CPR team. To evaluate the effectiveness of the manual, a 29-question multiple-choice test was administered to 35 staff pharmacists who were randomly assigned to study and control groups. Training manuals were issued to members of the study group, who were asked to document time spent studying them. Three weeks after the pretest, the same test was administered to all subjects. There was no control on the number of CPR events attended during the three-week period. The study group spent less than two hours (mean +/- S.D. = 97.5 +/- 34.22 min) using the manual. For the study group, posttest scores were significantly higher than pretest scores. The difference in pretest scores for the study and control groups was not significant, but for the posttest the study group scores were significantly higher. Because use of the manual appeared to improve knowledge of drug therapy and procedures used in CPR, the pharmacy department incorporated it into its orientation procedure. PMID:6846346

Smolarek, R T; Solomon, D K; Powell, M F; Roffe, B D

1983-03-01

193

Brain computed tomographic findings in post-cardiopulmonary resuscitation patients  

International Nuclear Information System (INIS)

We retrospectively assessed the brain computed tomographic (CT) findings in 22 post-cardiopulmonary resuscitation (CPR) patients excluding neonatal cases. On the basis of the CT findings, the patients were divided into two groups. Eight patients (36.4 %) had bilateral abnormal lowdensity areas in the basal ganglia (Group I). The remaining 14 patients (63.6 %) had no abnormalities in that area (Group II). In Group I, the incidence of primary cardiac arrest and duration of advanced life support (ALS) was significantly different (p < 0.05) from Group II. Sex, age, duration of basic life support (BLS), time elapsed from initiation of BLS to initial CT and from initiation of ALS to initial CT was not significantly different between the two groups. Outcome was very poor in both groups and no significant difference was noted between them. We conclude that primary cardiac arrest and long duration of ALS were predictors of abnormal bilateral low-density areas in the basal ganglia in post-CPR patients. However, their appearance was not related to outcome. (author)

194

Family presence during cardiopulmonary resuscitation: who should decide?  

Science.gov (United States)

Whether to allow the presence of family members during cardiopulmonary resuscitation (CPR) has been a highly contentious topic in recent years. Even though a great deal of evidence and professional guidelines support the option of family presence during resuscitation (FPDR), many healthcare professionals still oppose it. One of the main arguments espoused by the latter is that family members should not be allowed for the sake of the patient's best interests, whether it is to increase his chances of survival, respect his privacy or leave his family with a last positive impression of him. In this paper, we examine the issue of FPDR from the patient's point of view. Since the patient requires CPR, he is invariably unconscious and therefore incompetent. We discuss the Autonomy Principle and the Three-Tiered process for surrogate decision making, as well as the Beneficence Principle and show that these are limited in providing us with an adequate tool for decision making in this particular case. Rather, we rely on a novel principle (or, rather, a novel specification of an existing principle) and a novel integrated model for surrogate decision making. We show that this model is more satisfactory in taking the patient's true wishes under consideration and encourages a joint decision making process by all parties involved. PMID:23557910

Lederman, Zohar; Garasic, Mirko; Piperberg, Michelle

2014-05-01

195

Inhibition of neutrophil activity improves cardiac function after cardiopulmonary bypass  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The arterial in line application of the leukocyte inhibition module (LIM in the cardiopulmonary bypass (CPB limits overshooting leukocyte activity during cardiac surgery. We studied in a porcine model whether LIM may have beneficial effects on cardiac function after CPB. Methods German landrace pigs underwent CPB (60 min myocardial ischemia; 30 min reperfusion without (group I; n = 6 or with LIM (group II; n = 6. The cardiac indices (CI and cardiac function were analyzed pre and post CPB with a Swan-Ganz catheter and the cardiac function analyzer. Neutrophil labeling with technetium, scintigraphy, and histological analyses were done to track activated neutrophils within the organs. Results LIM prevented CPB-associated increase of neutrophil counts in peripheral blood. In group I, the CI significantly declined post CPB (post: 3.26 ± 0.31; pre: 4.05 ± 0.45 l/min/m2; p 2; p = 0.23. Post CPB, the intergroup difference showed significantly higher CI values in the LIM group (p Conclusion Our data provides strong evidence that LIM improves perioperative hemodynamics and cardiac function after CPB by limiting neutrophil activity and inducing accelerated sequestration of neutrophils in the spleen.

Grünwald Frank

2007-10-01

196

Tendencias en resucitación cardiopulmonar / Trends in cardiopulmonary resuscitation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Menos del 10% de las personas que sufren una parada cardíaca son resucitados con éxito y regresan a sus hogares para vivir vidas productivas. Nuevos enfoques de la resucitación podrían modificar de forma sustancial este resultado tan triste. Cuatro tendencias en resucitación cardiopulmonar (RCP) par [...] ecen tener el mayor potencial para mejorar el pronóstico: los sistemas para la prevención de la parada cardíaca mediante reconocimiento precoz de los signos de alarma e intervención oportuna; el cambio hacia una resucitación orientada hacia el flujo sanguíneo, enfatizando la realización ininterrumpida de una RCP de alta calidad con un papel limitado de la ventilación; la importancia creciente de la tecnología guiando las intervenciones en resucitación, mejorando el proceso humano de toma de decisiones, y el empleo de la hipotermia. Abstract in english Less than 10% of those individuals who suffer an episode of sudden cardiac arrest are successfully resuscitated and return home to live productive lives. New approaches to cardiac resuscitation could substantially improve such dismal outcome. Four current trends in cardiopulmonary resuscitation (CPR [...] ) have the greatest potential for improving outcome: the development of systems that can prevent cardiac arrests through recognition of early warning signs and timely intervention; a shift towards a flow-based resuscitation emphasizing the delivery of high-quality uninterrupted CPR limiting the role of ventilation; the growing role of technology in driving resuscitation interventions, incrementally enhancing the human decision-making process, and the use of hypothermia.

Raúl-Jaime, Gazmuri; Jesús-Andrés, Álvarez-Fernández.

2009-02-01

197

Modification of synthetic fibers by radiation-induced grafting  

International Nuclear Information System (INIS)

The present report describes studies to modify properties of synthetic fibers by radiation-induced grafting technique. This technique was employed since it is considered to be generally applicable to the grafting of a radically polymerizable monomer onto fiber. Three synthetic fibers were used mainly in the present studies; (1) polyester fiber which is ranked as the first in the amount of production in the synthetic fibers at present and is expected to increase in its importance in the future, (2) poly (vinyl chloride) fiber which is inexpensive and fire-retardant, and (3) polyethylene fiber which is not yet used in apparel at present. In order to perform the grafting, the following two methods were studied; one is to graft monomer uniformly in the fiber preventing homopolymerization of the monomer outside of the fiber, and the other to graft monomer only on the fiber surface. Using these methods, the following experiments were carried out and fairly good results as expected were obtained. (1) In the case of polyester fiber it was intended to make this more hydrophilic and fire-retardant. (2) Concerning to poly(vinyl chloride) fiber experiments were carried out to make the fiber more hydrophilic and simultaneously more heat-resistant. (3) In the case of polyethylene fiber, target was fire-retardance and heat-resistance. (author)

198

Radiation grafting of hydroxyethyl methacrylate on low density polyethylene and electric capacity of grafting copolymer  

International Nuclear Information System (INIS)

Grafting polymerization of hydroxyethyl methacrylate on low density polyethylene film has been studied by direct method. An effect of radiation dose, dose rate, concentration of cupric ion and polar monomer on grafting rate of polyethylene has been discussed. The grafted product was characterized by infrared spectrum. It was found that the electric capacity of grafting copolymer increase with the increasing of grafting rate

199

Evaluation of graft patency by intravenous digital subtraction angiography after vascular reconstruction  

International Nuclear Information System (INIS)

Intravenous digital subtraction angiography (IVDSA) was employed to evaluate graft patency after reconstructive vascular surgery in 45 cases with various vascular diseases. IVDSA offered equally valuable information about the patency of the graft, compared with conventional arteriography. In the peripheral vascular disease, IVDSA readily demonstrated patency or occlusion of the graft, even in the complex one, and the result of evaluation by IVDSA correlated well with that inferred by postoperative change in ankle pressure index measured by Doppler ultrasound technique. In the aortic disease, IVDSA was effective to rule out stenosis or leakage at the anastomotic site of the graft, and was also useful in the detection of the patency of the reconstructed inferior mesenteric artery after surgery for abdominal aortic aneurysm. The procedure in IVDSA is simple and safe, and it can be performed on an outpatient basis. IVDSA is a reliable and valuable approach in the evaluation of the graft patency after reconstructive vascular surgery. (author)

200

Saphenous vein graft vs. radial artery graft searching for the best second coronary artery bypass graft.  

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Coronary artery bypass grafting (CABG) was first used in the late 1960s. This revolutionary procedure created hope among ischemic heart disease patients. Multiple conduits are used and the golden standard is the left internal mammary artery to the left anterior descending artery. Although all approaches were advocated by doctors, the use of saphenous vein grafts became the leading approach used by the majority of cardiac surgeons in the 1970s. The radial artery graft was introduced at the same time but was not as prevalent due to complications. It was reintroduced into clinical practice in 1989. The procedure was not well received initially but it has since shown superiority in patency as well as long-term survival after CABG. This review provides a summary of characteristics, technical features and patency rates of the radial artery graft in comparison with venous conduits. Current studies and research into radial artery grafts and saphenous vein grafts for CABG are explored. However, more studies are required to verify the various findings of the positive effects of coronary artery bypass grafting with the help of radial arteries on mortality and long-lasting patency. PMID:24198449

Al-Sabti, Hilal Ali; Al Kindi, Adil; Al-Rasadi, Khalid; Banerjee, Yajnavalka; Al-Hashmi, Khamis; Al-Hinai, Ali

2013-10-01

 
 
 
 
201

Pulmonary hemodynamics and perioperative cardiopulmonary-related mortality in patients with portopulmonary hypertension undergoing liver transplantation.  

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In the setting of moderate to severe pulmonary artery hypertension, orthotopic liver transplantation (OLT) may be complicated by pulmonary hemodynamic instability and cardiopulmonary mortality. We retrospectively studied the relationship between cardiopulmonary-related mortality and initial (untreated) pre-OLT pulmonary hemodynamics in 43 patients with portopulmonary hypertension who underwent attempted OLT. Thirty-six patients were reported in 18 peer-reviewed studies, and 7 patients underwent OLT at our institution since 1996. Transplantation procedure outcome, mean pulmonary artery pressure (MPAP), pulmonary vascular resistance (PVR), cardiac output, pulmonary capillary wedge pressure, and transpulmonary gradient (TPG) are summarized. Overall mortality was reported in 15 of 43 patients (35%). Fourteen of the 15 deaths (93%) were primarily related to cardiopulmonary dysfunction. Two deaths were intraoperative, 8 deaths occurred during the transplantation hospitalization, and 4 patients died of cardiopulmonary deterioration posthospitalization. In 4 patients, the transplantation procedure could not be successfully completed. Cardiopulmonary mortality was associated with greater pre-OLT MPAP (49 +/- 14 v 36 +/- 7 mm Hg; P define optimal pretransplantation treatments and pulmonary hemodynamic criteria that minimize OLT mortality associated with portopulmonary hypertension. PMID:10915166

Krowka, M J; Plevak, D J; Findlay, J Y; Rosen, C B; Wiesner, R H; Krom, R A

2000-07-01

202

Functional capacity in children and young adults with sickle cell disease undergoing evaluation for cardiopulmonary disease.  

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Although cardiopulmonary disease is associated with decreased functional capacity among adults with sickle cell disease (SCD), its impact on functional capacity in children with SCD is unknown. We evaluated 6-min walk (6MW) distance in 77 children and young adults with SCD undergoing screening for cardiopulmonary disease. Of 30 subjects who also underwent cardiopulmonary exercise testing, we found evidence for decreased exercise capacity in a significant proportion. Exercise capacity was related to baseline degree of anemia and was significantly lower in subjects with a history of recurrent acute chest syndrome. We found that 6MW distance adjusted for weight and body surface area was shorter in subjects with restrictive lung disease but that only 6MW adjusted for weight remained significantly shorter when we controlled for baseline hemoglobin. Exercise capacity was not significantly different in subjects with and without cardiopulmonary disease. We conclude that restrictive lung disease is associated with shorter 6MW distances in children and young adults with SCD, but that variables associated with decreased exercise capacity, other than anemia, remain unclear. Our study underscores the importance of further delineating the direct pathophysiologic processes that contribute to decreased exercise capacity observed among individuals with SCD and cardiopulmonary disease. PMID:19705433

Liem, Robert I; Nevin, Mary A; Prestridge, Adrienne; Young, Luciana T; Thompson, Alexis A

2009-10-01

203

Evidence of systemic cytokine release in patients undergoing cardiopulmonary bypass.  

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Cardiopulmonary bypass (CPB) causes a systemic inflammatory response syndrome (SIRS), which can progress to an acute lung inflammation known as postperfusion syndrome. We developed a two-phase hypothesis: first, that SIRS, as indicated by elevated cytokines post-CPB, would be correlated with postoperative pulmonary dysfunction (Phase I), and second, that the cytokine interleukin-6 (IL-6) is predominantly released from the heart in CPB patients (Phase II). Blood samples were collected from patients undergoing CPB for elective cardiac surgery. In seven patients (Phase I), arterial samples were drawn before, during (5 minutes and 60 minutes), and after CPB. In 14 patients (Phase II), samples were collected from the coronary sinus, superior vena cava, and a systemic artery at the times indicated previously. Samples were analyzed with enzyme-linked immunosorbent assay: IL-1, IL-6, IL-8, IL-10, and tumor necrosis factor-alpha were assessed in Phase I and IL-6 assessed in Phase II. In Phase I, IL-6, IL-8, and IL-10 were elevated after CPB, but only IL-6 concentrations correlated with lung function. In summary, Phase I data demonstrate that increased IL-6 levels at the end of CPB correlate with reduced lung function postoperatively. In Phase II, IL-6 elevation was similar at all sample sites suggesting that the heart is not the major source of IL-6 production. We suggest that IL-6 be implemented as a prognostic measure in patient care, and that patients with elevated IL-6 after CPB be targeted for more aggressive anti-inflammatory therapy to protect lung function. PMID:16350379

Halter, Jeffrey; Steinberg, Jay; Fink, Gregory; Lutz, Charles; Picone, Anthony; Maybury, Rubie; Fedors, Nathan; DiRocco, Joseph; Lee, Hsi-Ming; Nieman, Gary

2005-09-01

204

Hitos sobre el test cardiopulmonar de ejercicio Cardiopulmonary exercise test  

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Full Text Available El test cardiopulmonar de ejercicio TCPE (CPET en la literatura anglosajona evalúa aspectos dinámicos de la la fisiología cardiorespiratoria, en contraste, las pruebas funcionales estáticas no reproducen la condición activa de un individuo. No obstante su complejo montaje e interpretación, en el último decenio ha habido un creciente interés en aplicarlo en la detección de mecanismos de disnea. Al respecto, la curva flujo/volumen dinámica permite demostrar limitación de flujos e hiperinflación dinámica, también esta prueba permite profundizar en el análisis del intercambio gaseoso en ejercicio. La utilidad de estas pruebas en la evaluación funcional pre-operatoria compleja es destacada. Dada su alta reproducibilidad, el TCPE continúa siendo un alto referente en pruebas cardíacas de esfuerzo. Publicaciones cardiológicas enfatizan su valor pronóstico como indicador de sobrevida, seguimiento de terapias y enlistado para trasplante en insuficiencia cardíaca congestiva, utilizando parámetros máximos y submáximos. Entre los primeros el consumo cumbre o punta de oxígeno, y en los submáximos el equivalente ventilatorio de anhídrido carbónico y el consumo de oxígeno en el umbral lácticoCardiopulmonary exercise test (CPET evaluates cardiorespiratory function in dynamic conditions, in contrast to static pulmonary function tests which can not reproduce the dynamic situation of an individual. Despite its complex implementation there has been growing interest in CPET in evaluating the mechanisms of dyspnoea With this respect dynamic flow/volume curve is useful in identifying expiratory airflow limitation and dynamic hyperinflation. Besides gas exchange analysis during exercise deepens the quality of information in that subject. Its utility for decision making in complex perioperative evaluation can not be overemphasized. Considering its high reproducibility, this method is a highly valuable tool in cardiac stress testing. Several publications in Cardiology emphasize its value in diagnosis, follow up, prognosis and enlisting for transplant in congestive heart failure. Remarkably useful are maximal and submaximal indices obtained during exercise, such as peak oxygen consumption among the maximals, and carbon dioxide equivalent and oxygen consumption at lactic threshold, among the submaximal indicators

RODRIGO SOTO F

2008-01-01

205

Factors influencing outcomes after cardiopulmonary resuscitation in emergency department  

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BACKGROUND: The outcome of cardiopulmonary resuscitation (CPR) may depend on a variety of factors related to patient status or resuscitation management. To evaluate the factors influencing the outcome of CPR after cardiac arrest (CA) will be conducive to improve the effectiveness of resuscitation. Therefore, a study was designed to assess these factors in the emergency department (ED) of a city hospital. METHODS: A CPR registry conforming to the Utstein-style template was conducted in the ED of the First Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2011. The outcomes of CPR were compared in various factors groups. The primary outcomes were rated to return of spontaneous circulation (ROSC), 24-hour survival, survival to discharge and discharge with favorable neurological outcomes. Univariate analysis and multivariable logistic regression analysis were performed to evaluate factors associated with survival. RESULTS: A total of 725 patients were analyzed in the study. Of these patients, 187 (25.8%) had ROSC, 100 (13.8%) survived for 24 hours, 48 (6.6%) survived to discharge, and 23 (3.2%) survived to discharge with favorable neurologic outcomes. A logistic regression analysis demonstrated that the independent predictors of ROSC included traumatic etiology, first monitored rhythms, CPR duration, and total adrenaline dose. The independent predictors of 24-hour survival included traumatic etiology, cardiac etiology, first monitored rhythm and CPR duration. Previous status, cardiac etiology, first monitored rhythms and CPR duration were included in independent predictors of survival to discharge and neurologically favorable survival to discharge. CONCLUSIONS: Shockable rhythms, CPR duration ?15 minutes and total adrenaline dose ?5 mg were favorable predictors of ROSC, whereas traumatic etiology was unfavorable. Cardiac etiology, shockable rhythms and CPR duration ?15 minutes were favorable predictors of 24-hour survival, whereas traumatic etiology was unfavorable. Cardiac etiology, shockable rhythms, CPR duration ?15 minutes were favorable predictors of survival to discharge and neurologically favorable survival to discharge, but previous terminal illness or multiple organ failure (MOF) was unfavorable.

Xue, Ji-ke; Leng, Qiao-yun; Gao, Yu-zhi; Chen, Shou-quan; Li, Zhang-ping; Li, Hui-ping; Huang, Wei-jia; Cheng, Jun-yan; Zhang, Jie; He, Ai-wen

2013-01-01

206

Pulse transit time and blood pressure during cardiopulmonary exercise tests.  

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Pulse transit time (PTT), the interval between ventricular electrical activity and peripheral pulse wave, is assumed to be a surrogate marker for blood pressure (BP) changes. The objective of this study was to analyze PTT and its relation to BP during cardiopulmonary exercise tests (CPET). In 20 patients (mean age 51+/-18.4 years), ECG and finger-photoplethysmography were continuously recorded during routine CPETs. PTT was calculated for each R-wave in the ECG and the steepest slope of the corresponding upstroke in the plethysmogram. For each subject, linear and non-linear regression models were used to assess the relation between PTT and upper-arm oscillometric BP in 9 predefined measuring points including measurements at rest, during exercise and during recovery. Mean systolic BP (sBP) and PTT at rest were 128 mm Hg and 366 ms respectively, 197 mm Hg and 289 ms under maximum exercise, and 128 mm Hg and 371 ms during recovery. Linear regression showed a significant, strong negative correlation between PTT and sBP. The correlation between PTT and diastolic BP was rather weak. Bland-Altman plots of sBP values estimated by the regression functions revealed slightly better limits of agreements for the non-linear model (-10.9 to 10.9 mm Hg) than for the linear model (-13.2 to 13.1 mm Hg). These results indicate that PTT is a good potential surrogate measure for sBP during exercise and could easily be implemented in CPET as an additional parameter of cardiovascular reactivity. A non-linear approach might be more effective in estimating BP than linear regression. PMID:24564606

Wibmer, T; Doering, K; Kropf-Sanchen, C; Rüdiger, S; Blanta, I; Stoiber, K M; Rottbauer, W; Schumann, C

2014-01-01

207

Alternatives to unfractionated heparin for anticoagulation in cardiopulmonary bypass.  

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Despite the progress made in the development of cardiopulmonary bypass (CPB) equipment, systemic anticoagulation with unfractionated heparin and post-bypass neutralization with protamine are still used in most perfusion procedures. However, there are a number of situations where unfractionated heparin, protamine or both cannot be used for various reasons. Intolerance of protamine can be addressed with extracorporeal heparin removal devices, perfusion with (no) low systemic heparinization and, to some degree, by perfusion with alternative anticoagulants. Various alternative anticoagulation regimens have been used in cases of intolerance to unfractionated heparin, including extreme hemodilution, low molecular weight heparins, danaparoid, ancrod, r-hirudin, abciximab, tirofiban, argatroban and others. In the presence of heparin-induced thrombocytopenia (HIT) and thrombosis, the use of r-hirudin appears to be an acceptable solution which has been well studied. The main issue with r-hirudin is the difficulty in monitoring its activity during CPB, despite the fact that ecarin coagulation time assessment is now available. A more recent approach is based on selective blockage of platelet aggregation by means of monoclonal antibodies directed to GPIIb/IIIa receptors (abciximab) or the use of a GPIIb/IIIa inhibitor (tirofiban). An 80% blockage of the GPIIb/IIIa receptors and suppression of platelet aggregation to less than 20% allows the giving of unfractionated heparin and running CPB in a standard fashion despite HIT and thrombosis. Likewise, at the end of the procedure, unfractionated heparin is neutralized with protamine as usual and donor platelets are transfused if necessary. GPIIb/IIIa inhibitors are frequently used in interventional cardiology and, therefore, are available in most hospitals. PMID:11565896

von Segesser, L K; Mueller, X; Marty, B; Horisberger, J; Corno, A

2001-09-01

208

Attitudes of patients toward cardiopulmonary resuscitation in the dialysis unit.  

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Some dialysis units have a policy of performing cardiopulmonary resuscitation (CPR) on all patients who experience cardiac arrest while undergoing dialysis. However, to perform CPR on patients who do not want it is contrary to ethics and the law. We interviewed hemodialysis patients in 12 units in Missouri, New York, and West Virginia to learn their attitudes about CPR. Four hundred sixty-nine of 830 patients (57%) agreed to be interviewed. Eighty-seven percent of patients wanted to undergo CPR if cardiac arrest were to occur while undergoing dialysis. Patients who had seen CPR on television were more likely to report that they knew what CPR was (94% versus 68%; P nursing home (9% versus 3%; P = 0.017). Blacks were significantly more likely to want CPR than whites (adjusted odds ratio, 6.56; 95% confidence interval, 2.57 to 22.27). Only 20 of 58 patients (35%) who did not want CPR were certain they had a do-not-resuscitate order in their dialysis chart. Ninety-two percent of patients who wanted CPR agreed that patients who did not want CPR should have their wishes respected by the dialysis unit. We conclude that most dialysis patients want to undergo CPR, but also want other patients' preferences not to be resuscitated to be respected. Dialysis units need to do a better job of identifying patients who prefer not to be resuscitated and respecting their wishes in the event of cardiac arrest while undergoing dialysis. Most importantly, nephrologists and dialysis unit staff need to educate dialysis patients about the poor outcomes with CPR so that dialysis patients' decisions about CPR are informed. PMID:11576889

Moss, A H; Hozayen, O; King, K; Holley, J L; Schmidt, R J

2001-10-01

209

Interventions in infrainguinal bypass grafts.  

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The interventional radiologist plays an important role in the detection and prevention of infrainguinal bypass failure. Early detection and evaluation of flow-limiting lesions effectively preserve graft (venous bypass and polyester or expanded polytetrafluoroethylene bypass) patency by identifying stenoses before occlusion occurs. Delay in treatment of the at-risk graft may result in graft failure and a reduced chance of successful revascularization. For this reason, surveillance protocols form an important part of follow-up after infrainguinal bypass surgery. As well as having an understanding of the application of imaging techniques including ultrasound, MR angiography, CT angiography and digital subtraction angiography, the interventional radiologist should have detailed knowledge of the minimally invasive therapeutic options. Percutaneous transluminal angioplasty (PTA), or alternatively cutting balloon angioplasty, is the interventional treatment of choice in prevention of graft failure and occlusion. Further alternatives include metallic stent placement, fibrinolysis, and mechanical thrombectomy. Primary assisted patency rates following PTA can be up to 65% at 5 years. When the endovascular approach is unsuccessful, these therapeutic options are complemented by surgical procedures including vein patch revision, jump grafting, or placement of a new graft. PMID:16284703

Müller-Hülsbeck, S; Order, B-M; Jahnke, T

2006-01-01

210

FAS grafted superhydrophobic ceramic membrane  

International Nuclear Information System (INIS)

The hydrophobic properties of ?-Al2O3 membrane have been obtained by grafting fluoroalkylsilane (FAS) on the surface of the membrane. The following grafting parameters were studied: the eroding time of the original membrane, the grafting time, the concentration of FAS solution and the multiplicity of grafting. Hydrophobicity of the membranes was characterized by contact angle (CA) measurement. The thermogravimetric analysis (TGA) was used to investigate the weight loss process (25-800 deg. C) of the fluoroalkylsilane grafted on Al2O3 powders under different grafting conditions. The morphologies of the membranes modified under different parameters were examined by field emission scanning electron microscopy (FE-SEM) and the surface roughness (Ra) was measured using white light interferometers. A needle-like structure was observed on the membrane surface after modification, which causes the change of Ra. On the results above, we speculated a model to describe the reaction between FAS and ?-Al2O3 membrane surface as well as the formed surface morphology.

211

Coronary artery bypass grafting in a patient with protein S deficiency: perioperative implications.  

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Protein S (PS) along with activated protein C plays an important role in the down-regulation of in vivo thrombin generation. Its deficiency can cause abnormal and inappropriate clot formation within the circulation necessitating chronic anticoagulation therapy. The risk of developing thrombotic complications is heightened in the perioperative period in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Heparin resistance is very rare in these patients, especially when antithrombin levels are near normal. Management of CPB in this scenario is quite challenging. We report the perioperative management, particularly the CPB management, of a patient with type I PS deficiency and incidentally detected heparin resistance, who underwent coronary artery bypass grafting with CPB. PMID:24994735

Balan, Baskaran; Chengode, Suresh; Al Sabti, Hilal; Rao, Ram Narayan

2014-01-01

212

Pressure and time dependence of the cardiopulmonary reflex response in patients with hypertensive cardiomyopathy  

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Full Text Available The first minutes of the time course of cardiopulmonary reflex control evoked by lower body negative pressure (LBNP in patients with hypertensive cardiomyopathy have not been investigated in detail. We studied 15 hypertensive patients with left ventricular dysfunction (LVD and 15 matched normal controls to observe the time course response of the forearm vascular resistance (FVR during 3 min of LBNP at -10, -15, and -40 mmHg in unloading the cardiopulmonary receptors. Analysis of the average of 3-min intervals of FVR showed a blunted response of the LVD patients at -10 mmHg (P = 0.03, but a similar response in both groups at -15 and -40 mmHg. However, using a minute-to-minute analysis of the FVR at -15 and -40 mmHg, we observed a similar response in both groups at the 1st min, but a marked decrease of FVR in the LVD group at the 3rd min of LBNP at -15 mmHg (P = 0.017, and -40 mmHg (P = 0.004. Plasma norepinephrine levels were analyzed as another neurohumoral measurement of cardiopulmonary receptor response to LBNP, and showed a blunted response in the LVD group at -10 (P = 0.013, -15 (P = 0.032 and -40 mmHg (P = 0.004. We concluded that the cardiopulmonary reflex response in patients with hypertensive cardiomyopathy is blunted at lower levels of LBNP. However, at higher levels, the cardiopulmonary reflex has a normal initial response that decreases progressively with time. As a consequence of the time-dependent response, the cardiopulmonary reflex response should be measured over small intervals of time in clinical studies.

Otto M.E.B.

2004-01-01

213

Radiation grafting on natural films  

International Nuclear Information System (INIS)

Different methods of polymer grafting using gamma irradiation are reported in the present study for the preparation of newly functionalized biodegradable films, and some important properties related to their mechanical and barrier properties are described. Biodegradable films composed of zein and poly(vinyl alcohol) (PVA) were gamma-irradiated in presence of different ratios of acrylic acid (AAc) monomer for compatibilization purpose. Resulting grafted films (zein/PVA-g-AAc) had their puncture strength (PS=37–40 N mm?1) and puncture deformation (PD=6.5–9.8 mm) improved for 30% and 50% PVA in blend, with 5% AAc under 20 kGy. Methylcellulose (MC)-based films were irradiated in the presence of 2-hydroxyethyl methacrylate (HEMA) or silane, in order to determine the effect of monomer grafting on the mechanical properties of films. It was found that grafted films (MC-g-HEMA and MC-g-silane) using 35% monomer performed higher mechanical properties with PS values of 282–296 N mm?1 and PD of 5.0–5.5 mm under 10 kGy. Compatibilized polycaprolactone (PCL)/chitosan composites were developed via grafting silane in chitosan films. Resulting trilayer grafted composite film (PCL/chitosan-g-silane/PCL) presented superior tensile strength (TS=22 MPa) via possible improvement of interfacial adhesion (PCL/chitosan) when using 25% silane under 10 kGy. Finally, MC-based films containing crystalline nanocellulose (CNC) as a filling agent were prepared and irradiated in presence of trimethylolpropane trimethacrylate (TMPTMA) as a grafted plasticizer. Grafted films (MC-g-TMPTMA) presented superior mechanical properties with a TS of 47.9 MPa and a tensile modulus (TM) of 1792 MPa, possibly due to high yield formation of radicals to promote TMPTMA grafting during irradiation. The addition of CNC led to an additional improvement of the barrier properties, with a significant 25% reduction of water vapor permeability (WVP) of grafted films. - Highlights: • Irradiation of zein/PVA/acrylic acid improved the mechanical properties of films. • Irradiation of Methylcellulose/NCC/TMPTMA improved the barrier properties of films. • Irradiation of chitosane/Methylcellulose/HEMA/silane improved the strength of films

214

A Nanotechnology-Based Elastomeric Vascular Graft  

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The biocompatible of a vascular graft can be controlled by the surface composition and texture of the surface. In particular, the surface of a synthetic elastomer can be modified to mimic the functionality of the inner vascular lumen. We will investigate the effect of the texture and surface composition of cross-linked polydimethylsiloxane (PDMS) films on endothelial cell attachment, spreading, and function. The smooth surface, nanometer scale roughness, of thin PDMS films and self-supporting PDMS substrates has been created by spin coating and casting while optical gratings have been employed as stamps for printing texture, micrometer scale stripes of ridges and grooves, onto PDMS substrates. The smooth surface of self-supporting PDMS has been activated and modified with 3-(triethoxysilyl)propylsuccinic anhydride (TESPSA) via self-assemble technique. The attachment of TESPSA is characterized by contact angle and x-ray photoelectron spectroscopy. The RGD peptide is selectively grafted to the TESPSA and then characterized. Endothelial cell behavior is then investigated as a function of surface texture and composition.

Uttayarat, Pimporn; Composto, Russell

2003-03-01

215

Combined Psoas Compartment-Sciatic Block in a Pediatric Patient with High-Risk Cardiopulmonary  

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Full Text Available There is high potential for complications in cardiopulmonary high-risk patients with valvular heart disease at perioperative period. The operation was planned due to pathological fracture of the femoral shaft of a nine year old male patient weighing 26 kilograms. He had 3o tricuspid insufficiency, 3o mitral insufficiency and pulmonary hypertension in preoperative evaluation. Sciatic nerve block and psoas compartment block was performed to patient for anesthesia and analgesia. In conclusion we think that combined psoas compartment-sciatic nerve block may be a good alternative to other methods of anesthesia in high-risk pediatric patients with cardiopulmonary perspective in lower-extremity surgery.

Levent Þahin

2013-03-01

216

Global and regional changes of cardiopulmonary blood volume under continuous work load  

International Nuclear Information System (INIS)

The present study describes a method for the continuous determination of global and regional stress-induced alterations of cardiopulmonary blood volumes in normals, trained athletes and patients with latent cardiac insufficiency. In contrast to normals and athletes there is an increase of the total cardiac blood volume in the cardiac patients. There are also significant differences in blood volume changes of the left lung between normals and athletes on the one hand and the cardiac patients on the other. The method is simple and non-hazardous; it permits the observation of the obviously different adaptation of the cardiopulmonary system during exercise in normals, athletes and cardiac patients. (orig.)

217

Spontaneous grafting of diazonium salts: chemical mechanism on metallic surfaces.  

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The spontaneous reaction of diazonium salts on various substrates has been widely employed since it consists of a simple immersion of the substrate in the diazonium salt solution. As electrochemical processes involving the same diazonium salts, the spontaneous grafting is assumed to give covalently poly(phenylene)-like bonded films. Resistance to solvents and to ultrasonication is commonly accepted as indirect proof of the existence of a covalent bond. However, the most relevant attempts to demonstrate a metal-C interface bond have been obtained by an XPS investigation of spontaneously grafted films on copper. Similarly, our experiments give evidence of such a bond in spontaneously grafted films on nickel substrates in acetonitrile. In the case of gold substrates, the formation of a spontaneous film was unexpected but reported in the literature in parallel to our observations. Even if no interfacial bond was observed, formation of the films was explained by grafting of aryl cations or radicals on the surface arising from dediazoniation, the film growing later by azo coupling, radical addition, or cationic addition on the grafted phenyl layer. Nevertheless, none of these mechanisms fits our experimental results showing the presence of an Au-N bond. In this work, we present a fine spectroscopic analysis of the coatings obtained on gold and nickel substrates that allow us to propose a chemical structure of such films, in particular, their interface with the substrates. After testing the most probable mechanisms, we have concluded in favor of the involvement of two complementary mechanisms which are the direct reaction of diazonium salts with the gold surface that accounts for the observed Au-N interfacial bonds as well as the formation of aryl cations able to graft on the substrate through Au-C linkages. PMID:22793962

Mesnage, Alice; Lefèvre, Xavier; Jégou, Pascale; Deniau, Guy; Palacin, Serge

2012-08-14

218

Surface-grafted polymers from electrodeposited macroprecursors  

Science.gov (United States)

The use of electrochemically deposited macroprecursors for tethering polymers onto conducting surfaces is presented. Specifically, anodic electropolymerization was used as a tool to electrodeposit the precursors on electrodes that mediated the grafting of polymers onto surfaces. With this approach, patterning of surface-grafted polymers was also made possible through selective electrodeposition of the conjugated polymer network of the macroprecursors. This approach was used to fabricate protein and cell-resistant poly(poly(ethylene glycol) methyl ether methacrylate) (PPEGMEMA) brushes on Au surfaces. A chain transfer agent (CTA) was electrodeposited on the Au surface that served as the macroprecursor for the subsequent surface-initiated reversible addition-fragmentation chain transfer (SI-RAFT) polymerization of poly(ethylene glycol) methyl ether methacrylate (PEGMEMA). X-ray photoelectron spectroscopy (XPS) results showed the stability of the electrogenerated CTA under anodic conditions while successful brush growth was confirmed by surface techniques including XPS, ellipsometry, atomic force microscopy (AFM), and contact angle measurements. The PPEGMEMA-coated substrate exhibited protein and cell-repellant properties comparable to other reported PEG-functionalized surfaces. The proposed approach also yielded polymer-patterned surfaces as discussed in Chapters 3 and 4. An electroactive photocrosslinker was employed to facilitate the dual mode patterning of polystyrene (PS) on the surface by either electropatterning or photopatteming route. An electrodeposited CTA was also utilized to selectively grow surface-grafted PS on conducting regions of the substrate. Subsequent backfilling of nonconducting areas with a silane atom transfer radical polymerization (ATRP) initiator directed the growth of poly-N-isopropylacrylamide (PNIPAM) that produced a patterned binary polymer system. The patterns were successfully characterized by AFM and IR-imaging. Surface-grafted poly(N-vinyl carbazole) (PVK) film on indium tin oxide (ITO) was fabricated using this technique. This surface was used as a hole transporting layer (HTL) for a photovoltaic device as a possible replacement for existing poly(3,4-ethylene dioxythiophene) : poly(styrene sulfonate) (PEDOT:PSS). Device testing showed a comparable performance between the tethered PVK HTL and PEDOT:PSS as HTLs.

Rellamas Tria, Maria Celeste

219

Guías de Reanimación Cardiopulmonar / Guides for Cardiopulmonary Resuscitation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish El presente artículo busca como objetivo primordial, una aproximación a las Guías 2010 y principales cambios; estamos convencidos que el entrenamiento y aprendizaje de ella se basa en los conceptos de metodología activa y simulación clínica, no podemos tener un conocimiento de la ciencia y protocolo [...] s de reanimación cardiopulmonar sin antes no haber experimentado la discusión de temas y desarrollo de casos escenarios vivenciales, para cada uno de los tópicos descritos a continuación. Una de las estrategias más importantes es la diseminación de los conceptos contenidos en las Guías ILCOR de Reanimación Cardiopulmonar que se han consensuado en la ERC y AHA. Ello ha permitido que el personal de salud trate a los pacientes victimas de paro cardiaco o emergencias cardiacas con mayor eficiencia. Las guías actuales fundamentan todos sus aspectos en investigación y recomendaciones, los cambios se iniciaron con una variación sustantiva de la cadena de supervivencia incorporando conceptos de integración de cuidados postparo1,2. Las Guías de Reanimación Cardiopulmonar fueron publicadas y puestas on-line (Resuscitation y American Heart Association) en Octubre 18, 20109,10. Abstract in english The objective of the present article is the approach of 2010 ECC & CPR Guidelines and their principal modifications. Guidelines are the result of scientific evidence and clinical research that support statements and new recommendations. Some important changes in 2010 present in the Chain of Survival [...] which includes aspects of Postresuscitation Care1,2. CPR Guidelines were published and uploaded on-line (Resuscitation and Circulation publication) in October 18th, 20109,10. One of the most important training and learning strategies is the dissemination of concepts from ILCOR CPR and ECC Guidelines which had extended into ERC and AHA. This has allowed the medical personnel to treat patients victims of cardiac arrest or cardiac emergency efficiently. We are convinced that interactive methodology and clinical simulation are essential for training and learning. We cannot know cardiopulmonary resuscitation without discussion of science and performance of lively clinical scenery cases for each of the main topics in CPR and ECC.

Raffo, Escalante-Kanashiro.

220

Guías de Reanimación Cardiopulmonar / Guides for Cardiopulmonary Resuscitation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish El presente artículo busca como objetivo primordial, una aproximación a las Guías 2010 y principales cambios; estamos convencidos que el entrenamiento y aprendizaje de ella se basa en los conceptos de metodología activa y simulación clínica, no podemos tener un conocimiento de la ciencia y protocolo [...] s de reanimación cardiopulmonar sin antes no haber experimentado la discusión de temas y desarrollo de casos escenarios vivenciales, para cada uno de los tópicos descritos a continuación. Una de las estrategias más importantes es la diseminación de los conceptos contenidos en las Guías ILCOR de Reanimación Cardiopulmonar que se han consensuado en la ERC y AHA. Ello ha permitido que el personal de salud trate a los pacientes victimas de paro cardiaco o emergencias cardiacas con mayor eficiencia. Las guías actuales fundamentan todos sus aspectos en investigación y recomendaciones, los cambios se iniciaron con una variación sustantiva de la cadena de supervivencia incorporando conceptos de integración de cuidados postparo1,2. Las Guías de Reanimación Cardiopulmonar fueron publicadas y puestas on-line (Resuscitation y American Heart Association) en Octubre 18, 20109,10. Abstract in english The objective of the present article is the approach of 2010 ECC & CPR Guidelines and their principal modifications. Guidelines are the result of scientific evidence and clinical research that support statements and new recommendations. Some important changes in 2010 present in the Chain of Survival [...] which includes aspects of Postresuscitation Care1,2. CPR Guidelines were published and uploaded on-line (Resuscitation and Circulation publication) in October 18th, 20109,10. One of the most important training and learning strategies is the dissemination of concepts from ILCOR CPR and ECC Guidelines which had extended into ERC and AHA. This has allowed the medical personnel to treat patients victims of cardiac arrest or cardiac emergency efficiently. We are convinced that interactive methodology and clinical simulation are essential for training and learning. We cannot know cardiopulmonary resuscitation without discussion of science and performance of lively clinical scenery cases for each of the main topics in CPR and ECC.

Raffo, Escalante-Kanashiro.

2010-10-01

 
 
 
 
221

Albumin in the cardiopulmonary bypass prime: how little is enough?  

Science.gov (United States)

Previous studies have demonstrated high transoxygenator pressures with noncoated hollow-fiber membrane oxygenators. These reports have been associated with dramatic platelet count drops during cardiopulmonary bypass (CPB). It has also been shown that adding human albumin to the prime of the bypass circuit reduces, if not eliminates, these problems. This study was conducted to determine what is the smallest amount of albumin added to the prime that will still display its protective effects. Eighty patients undergoing nonemergency open-heart surgery were randomly divided into four groups. Groups I and II received the Sarns Turbo 440 oxygenator with 0.0375 g of albumin/100 ml of prime and 0.125 g of albumin/100 ml of prime, respectively, added to the pump prime. Groups III and IV received the Medtronic Maxima-PRF oxygenator with 0.0375 g of albumin/100 ml of prime and 0.125 g of albumin/100 ml of prime, respectively, added to the pump prime. Pre-CPB, on CPB (15-20 min after the initiation of bypass) and warming hemoglobin, hematocrit and platelet counts were drawn on all patients. Net platelet count drop, which accounted for hemodilutional effects, was calculated for all specimens and compared to previous results obtained from the test oxygenators without albumin in the prime. The net platelet count drops for the study groups were as follows: Sarns oxygenator with no albumin in the prime = 11.8+/-12.5%; Sarns oxygenator with 0.0375 g of albumin/100 ml prime = -3.7+/-10.8%; Sarns oxygenator with 0.125 g of albumin/100 ml prime = -2.0+/-12.6%; Medtronic oxygenator with no albumin in the prime = 20.1+/-14.5%; Medtronic oxygenator with 0.0375 g albumin/100 ml prime = -6.9+/-8.7%; and Medtronic oxygenator with 0.125 g albumin/100 ml prime = -14.0+/-12.4%. Our results illustrate that adding as little as 0.0375 g albumin/100 ml prime (3 ml of 25% solution/2000 ml of prime) to the pump prime illicits the beneficial effects of surface coating on platelet loss during CPB. PMID:10411245

Palanzo, D A; Zarro, D L; Montesano, R M; Manley, N J

1999-05-01

222

Hitos sobre el test cardiopulmonar de ejercicio / Cardiopulmonary exercise test  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish El test cardiopulmonar de ejercicio TCPE (CPET en la literatura anglosajona) evalúa aspectos dinámicos de la la fisiología cardiorespiratoria, en contraste, las pruebas funcionales estáticas no reproducen la condición activa de un individuo. No obstante su complejo montaje e interpretación, en el úl [...] timo decenio ha habido un creciente interés en aplicarlo en la detección de mecanismos de disnea. Al respecto, la curva flujo/volumen dinámica permite demostrar limitación de flujos e hiperinflación dinámica, también esta prueba permite profundizar en el análisis del intercambio gaseoso en ejercicio. La utilidad de estas pruebas en la evaluación funcional pre-operatoria compleja es destacada. Dada su alta reproducibilidad, el TCPE continúa siendo un alto referente en pruebas cardíacas de esfuerzo. Publicaciones cardiológicas enfatizan su valor pronóstico como indicador de sobrevida, seguimiento de terapias y enlistado para trasplante en insuficiencia cardíaca congestiva, utilizando parámetros máximos y submáximos. Entre los primeros el consumo cumbre o punta de oxígeno, y en los submáximos el equivalente ventilatorio de anhídrido carbónico y el consumo de oxígeno en el umbral láctico Abstract in english Cardiopulmonary exercise test (CPET) evaluates cardiorespiratory function in dynamic conditions, in contrast to static pulmonary function tests which can not reproduce the dynamic situation of an individual. Despite its complex implementation there has been growing interest in CPET in evaluating the [...] mechanisms of dyspnoea With this respect dynamic flow/volume curve is useful in identifying expiratory airflow limitation and dynamic hyperinflation. Besides gas exchange analysis during exercise deepens the quality of information in that subject. Its utility for decision making in complex perioperative evaluation can not be overemphasized. Considering its high reproducibility, this method is a highly valuable tool in cardiac stress testing. Several publications in Cardiology emphasize its value in diagnosis, follow up, prognosis and enlisting for transplant in congestive heart failure. Remarkably useful are maximal and submaximal indices obtained during exercise, such as peak oxygen consumption among the maximals, and carbon dioxide equivalent and oxygen consumption at lactic threshold, among the submaximal indicators

RODRIGO, SOTO F; IVAN, CAVIEDES S.

223

Novel electronic refreshers for cardiopulmonary resuscitation: a randomized controlled trial  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Currently the American Red Cross requires that individuals renew their cardiopulmonary resuscitation (CPR certification annually; this often requires a 4- to 8-hour refresher course. Those trained in CPR often show a decrease in essential knowledge and skills within just a few months after training. New electronic means of communication have expanded the possibilities for delivering CPR refreshers to members of the general public who receive CPR training. The study’s purpose was to determine the efficacy of three novel CPR refreshers - online website, e-mail and text messaging – for improving three outcomes of CPR training - skill retention, confidence for using CPR and intention to use CPR. These three refreshers may be considered “novel” in that they are not typically used to refresh CPR knowledge and skills. Methods The study conducted two randomized clinical trials of the novel CPR refreshers. A mailed brochure was a traditional, passive refresher format and served as the control condition. In Trial 1, the refreshers were delivered in a single episode at 6 months after initial CPR training. In Trial 2, the refreshers were delivered twice, at 6 and 9 months after initial CPR training, to test the effect of a repeated delivery. Outcomes for the three novel refreshers vs. the mailed brochure were determined at 12 months after initial CPR training. Results Assignment to any of three novel refreshers did not improve outcomes of CPR training one year later in comparison with receiving a mailed brochure. Comparing outcomes for subjects who actually reviewed some of the novel refreshers vs. those who did not indicated a significant positive effect for one outcome, confidence for performing CPR. The website refresher was associated with increased behavioral intent to perform CPR. Stated satisfaction with the refreshers was relatively high. The number of episodes of refreshers (one vs. two did not have a significant effect on any outcomes. Conclusions There was no consistent evidence for the superiority of novel refreshers as compared with a traditional mailed brochure, but the low degree of actual exposure to the materials does not allow a definitive conclusion. An online web-based approach seems to have the most promise for future research on electronic CPR refreshers.

Magura Stephen

2012-11-01

224

Nurses’ attitude in out-of-hospital cardiopulmonary resuscitation  

Directory of Open Access Journals (Sweden)

Full Text Available Sudden cardiac arrest is one of the leading causes of death in Europe. Bystanders’ early Cardio-Pulmonary Resuscitation (CPR may double or triple survival rates of out-of-hospital cardiac arrest victims.Aim: To investigate nurses’ attitude, in starting or not CPR and also the most frequent reasons that deter them from engaging in.Materials and Methods: The study had a sample of 177 nurses and assistant nurses that were working in nine hospitals of Athens. Nurses filled out the same, predetermined questionnaire, voluntarily and anonymously. The collected answers were analyzed with the help of the statistical program SPSS v.16, using x2 and Kendall’s Tau-B methods.Results: From 177 participants, 78% (137 were women and 22% (40 men with mean age 31 years (±7. According to their education, 16% (28 were Assistant Nurses, 79% (140 Registered Nurses (ATEI, AEI and 5% (9 Nurses had an MSc diploma. Nurses that had been recently trained in certified BLS courses felt more confident and were more willing to start CPR in a known victim (p=0.004 and in an unknown victim (p=0.02 comparing to nurses that had been trained a long time ago or never. Most frequent reasons nurses reported that deter them from starting CPR are the fear of a possible lawsuit (43%, the fear of harming instead of helping (30% and the fear of infectious transmission from victim to rescuer (15%. The fear of harming correlates considerably with lower ages (the younger the nurse the more is afraid, p=0.04 and also correlates substantially with the training in a certified CPR course (the more a nurse is trained, the less is afraid, p<0.001. Accordingly, the fear of infection diminishes as long as the CPR training is repeated (p=0.03.Conclusions: According to the results, there is a necessity of continuous education and re-education of nurses, in certified Basic Life Support programs. With frequent and specialized training, nurses will show more willingness to engage in an out-of-hospital arrest situation, in a familiar or unknown victim and, moreover, fears that deter them from starting CPR are remarkably reduced.

Maria Meidani

2008-10-01

225

Dopexamine increases internal mammary artery blood flow following coronary artery bypass grafting.  

LENUS (Irish Health Repository)

OBJECTIVE: Vasoactive agents and inotropes influence conduit-coronary blood flow following coronary artery bypass grafting (CABG). It was hypothesized that dopexamine hydrochloride, a dopamine A-1 (DA-1) and beta(2) agonist would increase conduit-coronary blood flow. A prospective randomized double blind clinical trial was carried out to test this hypothesis. DA-1 receptors have previously been localized to human left ventricle. METHODS: Twenty-six American Society of Anaesthesiology class 2-3 elective coronary artery bypass graft patients who did not require inotropic support on separation from cardiopulmonary bypass (CPB) were studied. According to a randomized allocation patients received either dopexamine (1 microg\\/kg per min) or placebo (saline) by intravenous infusion for 15 min. Immediately prior to and at 5,10 and 15 min of infusion, blood flow through the internal mammary and vein grafts (Transit time flow probes, Transonic Ltd.), heart rate, cardiac index, mean arterial pressure and pulmonary haemodynamics were noted. The data were analysed using multivariate analysis of variance. RESULTS: Low-dose dopexamine (1 microg\\/kg per min) caused a significant increase in mammary graft blood flow compared to placebo at 15 min of infusion (P=0.028, dopexamine group left internal mammary artery (LIMA) flow of 43.3+\\/-14.2 ml\\/min, placebo group LIMA flow at 26.1+\\/-16.3 ml\\/min). Dopexamine recipients demonstrated a non-significant trend to increased saphenous vein graft flow (P=0.059). Increased heart rate was the only haemodynamic change induced by dopexamine (P=0.004, dopexamine group at 85.2+\\/-9.6 beats\\/min and placebo group at 71.1+\\/-7.6 beats\\/min after 15 min of infusion). CONCLUSION: This study demonstrates that administration of dopexamine (1 microg\\/kg per min) was associated with a significant increase in internal mammary artery graft blood flow with mild increase in heart rate being the only haemodynamic change. Low-dose dopexamine may improve graft flow in the early post CABG period with minimal haemodynamic changes.

Flynn, Michael J

2012-02-03

226

Experimental Study of a Novel Method of Cardiopulmonary Resuscitation Using a Combination of Percutaneous Cardiopulmonary Support and Liposome-encapsulated Hemoglobin (TRM645  

Directory of Open Access Journals (Sweden)

Full Text Available Percutaneous cardiopulmonary support (PCPS has been applied for cardiopulmonary arrest (CPA. We have developed a novel method of cardiopulmonary resuscitation using PCPS combined with liposome-encapsulated hemoglobin (TRM645 to improve oxygen delivery to vital organs. Ventricular fibrillation was electrically induced to an adult goat for 10 min. Next, PCPS (30 ml/kg/min, V/Q: 1 was performed for 20 min. Then, external defibrillation was attempted and observed for 120 min. The TRM group (n5 was filled with 300 mL of TRM645 for the PCPS circuit. The control group (n5 was filled with the same volume of saline. The delivery of oxygen (DO2 and oxygen consumption (VO2 decreased markedly by PCPS after CPA, compared to the preoperative values. DO2 was kept at a constant level during PCPS in both groups, but VO2 slowly decreased at 5, 10, and 15 min of PCPS in the control groups, demonstrating that systemic oxygen metabolism decreased with time. In contrast, the decreases in VO2 were small in the TRM group at 5, 10, and 15 min of PCPS, demonstrating that TRM645 continuously maintained systemic oxygen consumption even at a low flow rate. AST and LDH in the TRM group were lower than the control. There were significant differences at 120 min after the restoration of spontaneous circulation (p<0.05.

Ogata,Yoshitaka

2008-08-01

227

Improvement of antithrombogenicity of a fluoro polymer by radiation-induced grafting of hydrophilic monomer  

International Nuclear Information System (INIS)

Fluoro polymers have been used as biomaterials in medical field since they have good compatibility with both tissue and blood, and their biomaterial application are of variety. Blood compatibility of fluoro polymers, however, are not always enough for every applications. Especially, there is a large difficulty in the application for artificial vessel with small radius below than 4 mm. In the present study, grafting of a hydrophilic monomer onto a fluoro polymer has been carried out to improve blood compatibility of the fluoro polymer. The technique of grafting employed here was simultaneous irradiation method of gamma rays from a 60Co source. The fluoro polymer and the hydrophilic monomer used in the experiment were alternative copolymer of ethylene and tetrafluoethylene(AFLON) and N,N-dimethylacry lamide(DMAA), respectively. After grafting, it was found by in vitro tests that antithrombogenicity of AFLON was improved by grafting of DMAA. It was, however, also found that degree of the improvement is affected by grafting conditions. When ethyl acetate was used as a solvent for the graft copolymerization, the improvement was affected by dose rate. Blood compatibility of DMAA-g-AFLON obtained at a higher dose rate of 1 x 105 rad/h was not improved, while it was improved in the sample of DMAA-g-AFLON obtained at a lower dose rate of 1 x 104 rad/h. On the other hand, when acetone was used as a solvent for the grafting, the degree of grafting gave a significant effect on the improvement. Blood compatibility of all samples with grafting percent more than 20 % was improved by grafting of DMAA. (author)

228

Grafted megaporous materials as ion-exchangers for bioproduct adsorption.  

Science.gov (United States)

Megaporous chromatographic materials were manufactured by a three-step procedure, including backbone synthesis, chemical grafting, and introduction of ion-exchange functionality. The backbone of the adsorbent cylindrical bodies was prepared by polymerization of methacrylic acid and poly(ethylene glycol) diacrylate at sub-zero temperatures. Grafting was performed employing glycidyl methacrylate and a chemical initiator, cerium ammonium nitrate. The degree of grafting was adjusted by modifying the concentration of the initiator in the reaction mixture to a range of values (23, 39, 62, 89, and 105%). Further, the pendant epoxy-groups generated by the previous step were reacted to cation- and anion-exchanging moieties utilizing known chemical routes. Infrared spectroscopy studies confirmed the incorporation of epoxy and ion-exchanger groups to the backbone material. Optimized materials were tested for chromatography applications with model proteins; the dynamic binding capacity, as recorded at 10% breakthrough and 2.0 × 10(-4) m/s superficial velocity, were 350 and 58 mg/g for the cation-exchanger and the anion-exchanger material, respectively. These results may indicate that long tentacle-type polymer brushes were formed during grafting therefore increasing the ability of the megaporous body to efficiently capture macromolecules. PMID:23401432

Bibi, Noor Shad; Fernández-Lahore, Marcelo

2013-01-01

229

POST CORONARY ARTERY BYPASS GRAFT STUDY (CABG)  

Science.gov (United States)

Relative effectiveness of moderate versus more aggressive lipid lowering, and of low dose anticoagulation versus placebo, in delaying saphenous vein coronary bypass graft atherosclerosis and preventing occlusion of saphenous grafts of patients with saphenous vein coronary bypass ...

230

Transapical arterial cannulation for salvage cardiopulmonary bypass in transcatheter aortic valve replacement.  

Science.gov (United States)

Hemodynamic instability during transcatheter aortic valve replacement procedures may require transient cardiopulmonary bypass for support. In patients with severe atherosclerosis, peripheral cannulation may not be possible. This method of direct left ventricle cannulation during transapical TAVR is a facile means to provide arterial inflow. PMID:25282226

Brinster, Derek R; Patel, Jay A; McCarthy, Harry L; Aron, Ty M; Gertz, Zachary M

2014-10-01

231

Assessment of Sleep Quality and Sleep Disordered Breathing Based on Cardiopulmonary Coupling.  

Science.gov (United States)

An assessment of sleep quality and sleep disordered breathing is determined from cardiopulmonary coupling between two physiological data series. An R-R interval series is derived from an electrocardiogram (ECG) signal. The normal beats from the R-R interv...

A. L. Goldberger, C. K. Peng, J. E. Mietus, R. J. Thomas

2005-01-01

232

Anaesthetic Considerations for Noncoronary Surgery on a Perfused Beating Heart under Cardiopulmonary Bypass.  

Directory of Open Access Journals (Sweden)

Full Text Available Myocardial revascularisation on a beating heart with or without cardiopulmonary bypass has significantly reduced the incidence of cardioplegic myocardial injury. With this advantage in view, noncoronary open heart surgery was performed on a beating heart under cardiopulmonary bypass. We discuss the anaesthetic management of such cases. Thirty-three patients aged 14-56 years underwent open heart surgery on a perfused beating heart. Eleven of them underwent open mitral valvotomy, eighteen underwent mitral valve replacement, repair of atrial septal defect was performed in 3 patients and one had removal of left atrial myxoma. Cardiopulmonary bypass was instituted with aortic and bicaval cannulation. At normothermia, aorta was cross-clamped and continuous coronary perfusion was maintained through an aortic root needle at a rate of 4-6 mL/Kg/minute facilitating a beating heart. Trans-oesophageal echocardiography was routinely deployed. Anaesthetic considerations were focused towards the maintenance of the beating state of the heart, that included, strict control of electrolyte balance, maintenance of adequate perfusion pressure and ST segment monitoring. All the patients could be weaned off cardiopulmonary bypass without defibrillation or significant inotropic support. There was no operative mortality. Open heart surgery on a beating heart for non-coronary cardiac conditions appears to be a good and reproducible option to protect the myocardium from deleterious effects of cardioplegic arrest.

Tomar Akhlesh

2002-01-01

233

Comparative cardiopulmonary toxicity of soy biofuel and diesel exhaust in healthy and hypertensive rats  

Science.gov (United States)

Increased use of renewable energy sources raise concerns about health effects of emissions from such sources. We conducted a comprehensive analysis of relative cardiopulmonary health effects of exhausts from 1) 100% soy biofuel (B100), 2) 20% soy biofuel + 80% low sulfur petroleu...

234

Usefulness of the cardiopulmonary exercise testing in the asses of unexplained dyspnoea  

International Nuclear Information System (INIS)

Dyspnoea is a frequent presenting complaint. The assess of this symptom is problematic when its cause is unknown once the initial diagnosis tests are done. Cardiopulmonary exercise testing is an important clinical tool to evaluate dyspnoea as it provides an approach to the integrative exercise responses involving all the organ systems. This would not be possible to reflect by means of individual studies.

235

Simultaneous repair of pectus excavatum and congenital heart disease without cardiopulmonary bypass or sternal osteotomy.  

Science.gov (United States)

A 8-year-old girl with severe pectus excavatum and an atrial septal defect had simultaneous repair of the both defects, using thransthoracic occlusion for atrial septal defect and improved Nuss technique for the pectus excavatum. Neither cardiopulmonary bypass nor sternotomy was required in this procedure. Details of the procedure and outcome are described. PMID:25319880

Sun, Yong; Zhu, Peng; Zheng, Shao-Yi

2014-01-01

236

EMPLOYERS EXPECTATIONS AND STUDENTS EMPLOYABILITY SKILLS  

Digital Repository Infrastructure Vision for European Research (DRIVER)

As a result of the increased competition and rapid changing economy, entry and survival of graduates in industries is tougher than ever before. The employers' expectations are changing day by day and graduates have to obtain new skills for their sustainability. Mere academic skill alone will not help the graduates for better employment. Due to lack of employability skills graduates are not employable even though there are opportunities. In this study an attempt is made to find out the organiz...

Sudha, G.

2013-01-01

237

Reoperative coronary artery bypass grafting  

Directory of Open Access Journals (Sweden)

Full Text Available Reoperative coronary artery bypass grafting (redo CABGoperation is associated with a high rate of mortality up to11.4%. It has been estimated that 10-20% of patients withhistory of coronary artery bypass grafting (CABG operationneed redo CABG operation within 10 years. Due tohigh operation risk percutaneous coronary interventionshave emerged as the preferred treatment for the patientswith a history of CABG operation and presenting withacute coronary syndrome. Here, we reported percutaneouscoronary intervention in a patient needed redo CABGoperation. J Clin Exp Invest 2013; 4 (3: 380-382Key words: Acute coronary syndrome, redo CABG operation,percutaneous coronary intervention.

Hüseyin Katlandur

2013-09-01

238

[Radioindication of bone graft healing].  

Science.gov (United States)

To control the state of transplanted bone in different terms following the plastic procedure a radioisotope study by strontium-85 was performed in 29 patients. The results of scannography (in 31 cases) and radiometry (in 42 cases) were analysed. The determination of the character of strontium-85 distribution and the intensity of its accumulation in the operated extremity makes it possible to assess the graft condition and the intensity of osteogenesis a greater precision and earlier than does roentgenography. Radioisotope investigation conducted dynamically enable the prognostication of the course of the graft healing process. PMID:333749

Kuznetsova, L B; Pavlova, L P; Kondrat'ev, V G; Khmelev, O N

1977-01-01

239

Graft healing in anterior cruciate ligament reconstruction  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Successful anterior cruciate ligament reconstruction with a tendon graft necessitates solid healing of the tendon graft in the bone tunnel. Improvement of graft healing to bone is crucial for facilitating an early and aggressive rehabilitation and ensuring rapid return to pre-injury levels activity. Tendon graft healing in a bone tunnel requires bone ingrowth into the tendon. Indirect Sharpey fiber formation and direct fibrocartilage fixation confer different anchorage stre...

Chen Chih-Hwa

2009-01-01

240

New variant for whole pancreas grafting  

International Nuclear Information System (INIS)

A new variant for whole pancreas grafting is described in which a segment of the duodenum and the spleen is included in the graft. The graft is placed extraperitoneally as in kidney transplantation. The exocrine drainage is with side-to-side anastomosis between duodenum and bladder. The spleen is irradiated to prevent the occurrence of GVHD, as is reported in splenic transplantation

 
 
 
 
241

Improvement of polymer stability by radiation grafting  

International Nuclear Information System (INIS)

th respect to the consumption of monomer, the grafting yield being less than 0.5%. Surface grafting is an efficient photostabilization method since grafted stabilizer is chemically bound to a polymeric surface and in this way the problem of evaporation of blended stabilizers during the prolonged use of polymeric materials is eliminated. (author)

242

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: CLINICAL OUTCOMES OF PATELLA TENDON AND HAMSTRING TENDON GRAFTS  

Directory of Open Access Journals (Sweden)

Full Text Available An injury to the ACL can result in significant functional impairment. It has been estimated that more than 100,000 new ACL injuries occur each year. Surgeons employ numerous techniques for reconstruction of the ACL. Of critical importance is the source of the graft to replace the damaged ACL. The graft choices include autografts (the patient's own tissue, allografts (donor tendon, and synthetic/prosthetic ligaments. Tissue harvest sites for autografting include the middle third of the patella tendon, the quadriceps tendon, semitendinosus tendon, gracilis tendon, iliotibial band, tensor fascia lata, and the Achilles tendon. Selection of the type of graft material is predicated upon the tissue's ability to tolerate high levels of stress. Likewise, the clinical presentation and functional outcome is related to the graft material selected. This manuscript specifically examined the patella tendon and hamstring tendon grafts. Numerous manuscripts that studied the outcomes of these graft materials were compiled to help the clinician appreciate the advantages and disadvantages of each of the graft materials. Outcome measures such as thigh circumference, knee range of motion, isokinetic strength, knee stability, pain, and vertical jump/1-leg hop were incorporated. The purpose of this manuscript was to compare and contrast the clinical presentation of patients who underwent an ACL reconstruction using the patella tendon versus the hamstring tendons. This information can be valuable to the clinician when considering the rehabilitation protocol after ACL reconstruction

Dawn T. Gulick

2002-09-01

243

Anterior cruciate ligament reconstruction: clinical outcomes of patella tendon and hamstring tendon grafts.  

Science.gov (United States)

An injury to the ACL can result in significant functional impairment. It has been estimated that more than 100,000 new ACL injuries occur each year. Surgeons employ numerous techniques for reconstruction of the ACL. Of critical importance is the source of the graft to replace the damaged ACL. The graft choices include autografts (the patient's own tissue), allografts (donor tendon), and synthetic/prosthetic ligaments. Tissue harvest sites for autografting include the middle third of the patella tendon, the quadriceps tendon, semitendinosus tendon, gracilis tendon, iliotibial band, tensor fascia lata, and the Achilles tendon. Selection of the type of graft material is predicated upon the tissue's ability to tolerate high levels of stress. Likewise, the clinical presentation and functional outcome is related to the graft material selected. This manuscript specifically examined the patella tendon and hamstring tendon grafts. Numerous manuscripts that studied the outcomes of these graft materials were compiled to help the clinician appreciate the advantages and disadvantages of each of the graft materials. Outcome measures such as thigh circumference, knee range of motion, isokinetic strength, knee stability, pain, and vertical jump/1-leg hop were incorporated. The purpose of this manuscript was to compare and contrast the clinical presentation of patients who underwent an ACL reconstruction using the patella tendon versus the hamstring tendons. This information can be valuable to the clinician when considering the rehabilitation protocol after ACL reconstruction. PMID:24701126

Gulick, Dawn T; Yoder, Heather N

2002-09-01

244

Gamma radiation-induced grafting of glycidyl methacrylate (GMA) onto water hyacinth fibers  

Science.gov (United States)

Water hyacinth fibers (Eichhornia crassipes) were functionalized using radiation-induced graft polymerization of glycidyl methacrylate by ?-rays from 60Co source. The simultaneous grafting technique was employed wherein the water hyacinth fibers were irradiated in nitrogen atmosphere in the presence of glycidyl methacrylate dissolved in water/methanol solvent. The effects of different grafting parameters to the grafting yield were evaluated. The optimal values of solvent, absorbed dose, dose rate, and concentration of monomer were found to be 1:3 (volume/volume) water-methanol solvent, 10 kGy, 8 kGy h-1 dose rate and 5% volume/volume glycidyl methacrylate, respectively. Using the optimum conditions, degree of grafting of approximately 58% was achieved. The grafted water hyacinth fibers were characterized using Attenuated Total Reflectance-Fourier Transformed Infrared Spectroscopy (ATR-FTIR), Thermogravimetric Analysis (TGA), Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectroscopy (EDX). The results of these tests confirmed the successful grafting of glycidyl methacrylate onto water hyacinth fibers.

Madrid, Jordan F.; Nuesca, Guillermo M.; Abad, Lucille V.

2013-04-01

245

PAI-1 and t-PA/PAI-1 complex potential markers of fibrinolytic bleeding after cardiac surgery employing cardiopulmonary bypass  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Enhanced bleeding remains a serious problem after cardiac surgery, and fibrinolysis is often involved. We speculate that lower plasma concentrations of plasminogen activator inhibitor – 1 (PAI-1 preoperatively and tissue plasminogen activator/PAI-1 (t-PA/PAI-1 complex postoperatively might predispose for enhanced fibrinolysis and increased postoperative bleeding. Methods Totally 88 adult patients (mean age 66?±?10 years scheduled for cardiac surgery, were enrolled into a prospective study. Blood samples were collected pre-operatively, on admission to the recovery and at 6 and 24 hours postoperatively. Patients with a surgical bleeding that was diagnosed during reoperation were discarded from the study. The patients were allocated to two groups depending on the 24-hour postoperative chest tube drainage (CTD: Group I > 500ml, Group II ? 500ml. Associations between CTD, PAI-1, t-PA/PAI-1 complex and D-dimer were analyzed with SPSS. Results Nine patients were excluded because of surgical bleeding. Of the 79 remaining patients, 38 were allocated to Group I and 41 to Group II. The CTD volumes correlated with the preoperative plasma levels of PAI-1 (r = ? 0.3, P = 0.009. Plasma concentrations of preoperative PAI-1 and postoperative t-PA/PAI-1 complex differed significantly between the groups (P Conclusions Lower plasma concentrations of PAI-1 preoperatively and t-PA/PAI-1 complex postoperatively leads to higher plasma levels of D-dimer in association with more postoperative bleeding after cardiac surgery.

Ozolina Agnese

2012-10-01

246

Radiation Induced Graft Copolymerization of Polyvinyl Alcohol  

International Nuclear Information System (INIS)

In order to improve the properties of polyvinyl alcohol films and fibres, the graft copolymerization of various vinyl monomers to polyvinyl alcohol films by gamma ray irradiation was investigated. When thin films of polyvinyl alcohol were irradiated in a large excess of styrene no graft copolymerization was observed. With films containing more than 5% water the grafting proceeded smoothly. The highest value of styrene grafted was about 1,000% at a dose of 7X106r. The presence of water in the monomer solution was found to increase considerably the amount of grafted monomer. Methyl methacrylate behaved similarly to styrene in the grafting to polyvinyl alcohol films, the presence of a certain amount of water being essential. The efficiency of the grafting of methyl methacrylate was generally larger than that of the grafting of styrene. The highest value of the grafted methyl methacrylate was 4,000% and obtained at a dose of 5 X 105 r. Some experiments were carried out with acrylonitrile and vinyl acetate but compared with styrene and methyl methacrylate the efficiencies of the grafting of these monomers were not so high. The degree of swelling of the graft copolymers of polyvinyl-alcohol-styrene or methyl methacrylate in organic solvents was measured at 30oC. The relation between the degree of swelling and the percentage of monomer grafted was given by (degree of swelling %) = k (monomer grafted %)n. For polymers grafted with styrene n = 1, but for those grafted with methyl methacrylate n < 1. n and k have characteristic values which depend on the solvents used. (author)

247

Successful rescue from cardiac arrest in a patient with postinfarction left ventricular blow-out rupture: "extra-pericardial aortic cannulation" for establishment total cardiopulmonary bypass.  

Science.gov (United States)

We report a quick and simple technique to establish cardiopulmonary bypass (CPB) in a left ventricular (LV) blow-out rupture. A 74-year-old woman with a diagnosis of acute myocardial infarction suddenly collapsed and lost consciousness. A venous-arterial extracorporeal membrane oxygenation (ECMO) device was inserted by femoral cannulation. Emergent median sternotomy was performed. The pericardium was not opened first, and the thymus was divided to expose the ascending aorta just above the pericardial reflection. After placing two purse-string sutures on the distal ascending aorta, a 7-mm aortic cannula (Terumo, Tokyo, Japan) was inserted. The pericardium was then incised. A large volume of blood was expelled from the pericardial space, and CPB was initiated with suction drainage. A two-stage venous drainage cannula was then inserted from the right atrial appendage without hemodynamic collapse. After cardiac arrest, closure of ruptured LV wall and concomitant coronary artery bypass grafting were performed. The patient was weaned from CPB with an intra-aortic balloon pump (IABP) and the previously inserted venous-arterial ECMO. Extra-pericardial aortic cannulation is an effective and reproducible method to prepare for CPB in emergent cases of LV rupture. PMID:25179976

Ohira, Suguru; Yaku, Hitoshi; Nakajima, Shunsuke; Takahashi, Akihiko

2014-08-01

248

Markers of primary graft dysfunction  

DEFF Research Database (Denmark)

The present invention relates to methods for diagnosing transplant rejection, or a condition associated with transplant rejection, such as, primary graft dysfunction in a subject, to antigen probe arrays for performing such a diagnosis, and to antigen probe sets for generating such arrays.

Hagedorn, Peter Technical University of Denmark,

249

Endovascular stent grafting: a review  

Energy Technology Data Exchange (ETDEWEB)

Endovascular stent grafts are intravascular devices composed of surgical graft material and a metallic frame, (Fig. 1). Their main application has been to treat aneurysms, but they have been used in vascular trauma and are being investigated for use in occlusive disease. Their advantage in treating aneurysms over conventional surgical treatment is that they are loaded into relatively small delivery systems (Fig. 2) and can be introduced to the area of interest from a remote site - usually the femoral artery. This avoids the morbidity of surgical exposure in difficult sites, such as the thoracic aorta, and lessens the cardiovascular stress to patients by eliminating the need to surgically cross-clamp the vessel being treated. The first description of abdominal aortic aneurysm exclusion by an endovascular stent graft was provided by Parodi and colleagues in 1991. Much of the early clinical experience in endovascular stent grafting was obtained from centres in Australia and Europe, and they are now reporting midterm follow-up data. There are now many centres in Canada and the United States involved in endovascular research and practice. (author)

Kribs, S. [Univ. of Western Ontario, Dept. of Vascular and Interventional Radiology, London, Ontario (Canada)

2001-06-01

250

Polyether-polyester graft copolymer  

Science.gov (United States)

Described is a polyether graft polymer having improved solvent resistance and crystalline thermally reversible crosslinks. The copolymer is prepared by a novel process of anionic copolymerization. These polymers exhibit good solvent resistance and are well suited for aircraft parts. Previous aromatic polyethers, also known as polyphenylene oxides, have certain deficiencies which detract from their usefulness. These commercial polymers are often soluble in common solvents including the halocarbon and aromatic hydrocarbon types of paint thinners and removers. This limitation prevents the use of these polyethers in structural articles requiring frequent painting. In addition, the most popular commercially available polyether is a very high melting plastic. This makes it considerably more difficult to fabricate finished parts from this material. These problems are solved by providing an aromatic polyether graft copolymer with improved solvent resistance and crystalline thermally reversible crosslinks. The graft copolymer is formed by converting the carboxyl groups of a carboxylated polyphenylene oxide polymer to ionic carbonyl groups in a suitable solvent, reacting pivalolactone with the dissolved polymer, and adding acid to the solution to produce the graft copolymer.

Bell, Vernon L. (inventor)

1987-01-01

251

Histoplasma infection of aortofemoral bypass graft.  

Science.gov (United States)

Histoplasma infection of vascular grafts is extremely rare. To our knowledge, there are only 4 cases reported with Histoplasma capsulatum infection of the aortic graft. All had previous disseminated histoplasmosis and atherosclerotic peripheral vascular disease. They were treated surgically with explantation of the infected graft and reimplantation of new graft in extra-anatomic uninfected site. The authors present a new case of H capsulatum infection of aortofemoral bypass graft, but unlike the other cases, this case was managed without surgical intervention. PMID:23928546

Patel, Nishit; Bronze, Michael S

2014-05-01

252

MR angiography of peripheral arterial bypass grafts  

International Nuclear Information System (INIS)

This paper investigates the applicability of MR angiography in the evaluation of graft patency in peripheral vascular disease. MR angiography and digital subtraction angiography (DSA) were performed in 20 patients with 25 grafts, including two aortoiliac, ten aortofemoral, four femorofemoral, and nine femoropopliteal arterial bypass grafts. Retrospective blinded studies of each method were done separately. Patency was found by MR angiography in 20 of 25 grafts. Occlusion was noted in five and anastomotic aneurysm in one. These MR angiographic findings were in complete agreement with DSA findings. The above results seem to suggest a possible role of MR angiography in follow-up after peripheral vascular graft surgery

253

Vascular grafting strategies in coronary intervention  

Directory of Open Access Journals (Sweden)

Full Text Available With the growing need for coronary revascularizations globally, several strategies to restore blood flow to the heart have been explored. Bypassing the atherosclerotic coronary arteries with autologous grafts, synthetic prostheses and tissue-engineered vascular grafts continue to be evaluated in search of a readily available vascular graft with clinically acceptable outcomes. The development of such a vascular graft including tissue engineering approaches both in situ and in vitro is herein reviewed, facilitating a detailed comparison on the role of seeded cells in vascular graft patency.

KibretMequanint

2014-06-01

254

Evaluation of the graft flow reserve after coronary artery bypass grafting by stress {sup 201}Tl myocardial SPECT. Comparison between arterial grafts and venous grafts  

Energy Technology Data Exchange (ETDEWEB)

We performed stress {sup 201}Tl myocardial SPECT to evaluate ischemia and perfusion reserve after coronary artery bypass grafting (CABG). A total of 103 patients was performed stress {sup 201}Tl myocardial SPECT one month after CABG. Each patient`s myocardium was divided into 9 segments and visually evaluated using five grade scoring system (0=defect, 1=severe decrease, 2=moderate decrease, 3=mild decrease, 4=normal uptake). Eleven of 133 (8.27%) segments covered by patent venous grafts showed reversible {sup 201}Tl defect, however, 36 of 117 (30.8%) segments which covered by patent arterial grafts showed reversible {sup 201}Tl defect. This finding was observed more significantly in arterial grafts than in venous grafts (p<0.001). These finding suggests that arterial grafts have lower flow capacity than venous grafts at peak exercise. (author)

Ichikawa, Akihiro; Taki, Junichi; Nakajima, Kenichi; Kawasuji, Michio; Tonami, Norihisa [Kanazawa Univ. (Japan). School of Medicine

1997-01-01

255

Effectiveness of Grafting for the Improvement of Salinity and Drought Tolerance in Tomato (Solanum lycopersicon L.  

Directory of Open Access Journals (Sweden)

Full Text Available Grafting is considered to be an environmentally friendly technique for reducing the yield losses caused by salinity and/or drought. Therefore, the present study aims to employ grafting for improvement the tolerance of tomato (Solanum lycopersicon L. to salt and drought stresses. Two greenhouse experiments were conducted during the 2011/2012 and 2012/2013 seasons. Each experiment included 12 treatments, representing all combinations of 2 grafting treatments (Farida cv grafted onto Unifort rootstock and ungrafted Farida cv and 6 abiotic stress treatments (salt stress and/or water stress. The stress treatments consisted of two levels of salinity (non-saline water with an average Electrical Conductivity (EC of 1.2 dS m-1 and saline water with an EC of 4.5 dS m-1 applied at three irrigation rates (100, 75 and 50% of crop Evapotranspiration (ETc. The results demonstrated that the grafted plants had significantly higher values for vegetative growth, yield and Water Use Efficiency (WUE in comparison with the un-grafted plants. Conversely, grafted plants had significantly lower values for fruit quality traits vitamin C and Total Soluble Solid (TSS and leaf concentrations of Na+, Cl¯ and proline. The interaction effects indicated that under the water stress and the salt stress treatments, grafting alleviated the negative effects of these stresses on most of the studied traits. The positive effects of grafting on plant growth and productivity support the feasibility of the technique as a method for improving salt and drought tolerance in tomato grown under greenhouse conditions.

Mahmoud A. Wahb-Allah

2014-01-01

256

Retrenchment in Malaysia: Employer’s Right?  

Directory of Open Access Journals (Sweden)

Full Text Available There are several ways to put a contract of employment to an end. One of them is by way of retrenchment.  Termination of employment by way of retrenchment may be relevant when the employer restructures his business. The focus of this article is to evaluate the application of the principle Last in First Out (LIFO in the case of retrenchment in Malaysia. This article will also assess to what extent the courts defend the prerogative of the employer to retrench his employee in the case of redundancy.

Hamidah Marsono

2008-11-01

257

EMPLOYERS EXPECTATIONS AND STUDENTS EMPLOYABILITY SKILLS  

Directory of Open Access Journals (Sweden)

Full Text Available As a result of the increased competition and rapid changing economy, entry and survival of graduates in industries is tougher than ever before. The employers' expectations are changing day by day and graduates have to obtain new skills for their sustainability. Mere academic skill alone will not help the graduates for better employment. Due to lack of employability skills graduates are not employable even though there are opportunities. In this study an attempt is made to find out the organizations needs and the skills the engineering students actually possess. From the results it is very clear that students are far behind in their needed skill set.

G. SUDHA

2013-05-01

258

Hydrophilic Silicone Resins Obtained by Radiation Grafting  

International Nuclear Information System (INIS)

N-vinylpyrrolidone was grafted radiochemically on a silicone resin by pre-irradiation in the presence of oxygen. Under these conditions, peroxide groups capable of initiating radical copolymerization are formed. The trapped radicals do not seem to make any contribution. An RTV (Room Temperature Vulcanization) type silicone resin was used, i. e. a poly(dimethylsiloxane) crosslinked by vinyl-silane bonds. The unsaturated product was transparent. The silicones containing phenyl groups as well as saturated resins were also studied. Irradiation with 60Co gamma rays was performed in the 10-kCi irradiator of the Radiation Applications Group (GAR) at Saclay. Brief pre-irradiation tests with an electron accelerator were also performed. The amount of polyvinylpyrrolidone(PVP) grafted depends on the pre-irradiation dose and dose-rate as well as on the temperature and duration of the grafting proper. These different parameters were analysed. The grafting efficiency of PVP can be as much as 60%. The grafted copolymers are more or less opaque and coloured sections show that grafting remains peripheral. The transparency can be restored by immersion in water. The swelling in water is such that the ratio of absorbed water to grafted PVP varies between 0.8 and 1.5. When the grafting efficiency is higher than 50%, it is observed that the grafted PVP redissolves after swelling. The redissolving is due to the breaking of the grafted chains. For grafting rates below 30%, the grafted PVP silicones have notably high thermal stability. Examination of some properties of the grafted PVP silicones shows the additive nature of the properties of the grafted copolymers. Reference is made to the possible applications of these products, especially in biology and medicine. (author)

259

Endovascular Stent-Graft Repair as a Late Secondary Procedure After Previous Aortic Grafts  

International Nuclear Information System (INIS)

Thoracic and abdominal aortic endovascular procedures as alternatives to aortic reoperations were studied in three different cases. An anastomotic aneurysm after previous thoracic aortic graft for coarctation, a second-stage elephant trunk repair (descending thoracic aortic aneurysm), and a secondary aneurysm proximal to a previous abdominal aortic graft were successfully treated with endovascular stent-grafts. During the follow-up period no lethal events or major aortic or graft-related complications were observed, except a type II endoleak in the anastomotic aortic aneurysm case. An endovascular stent-graft can be safely deployed into a previously implanted vascular graft, avoiding repeat surgery

260

Determining the degree of grafting for poly (vinylidene fluoride) graft-copolymers using fluorine elemental analysis  

International Nuclear Information System (INIS)

Acrylic acid (AAc) and styrene (St) were grafted onto poly (vinylidene fluoride) (PVDF) powder or membrane samples by pre-irradiation graft copolymerization. The grafted chains were proved by FT-IR spectroscopy analysis. The degree of grafting (DG) of the grafted PVDF was determined by fluorine elemental analysis (FEA) method, and was compared with the DGs determined by weighing method, acid-base back titration method and quantitative FT-IR method. The results show that the FEA method is accurate, convenient and universal, especially for the grafted polymer powders. (authors)

 
 
 
 
261

New perspectives of nitric oxide donors in cardiac arrest and cardiopulmonary resuscitation treatment.  

Science.gov (United States)

Nitric oxide (NO) is often used to treat heart failure accompanied with pulmonary edema. According to present knowledge, however, NO donors are contraindicated when systolic blood pressure is less than 90 mmHg. Based on recent findings and our own clinical experience, we formulated a hypothesis about the new breakthrough complex lifesaving effects of NO donors in patients with cardiac arrest and cardiopulmonary resuscitation therapy. It includes a direct hemodynamic effect of NO donors mediated through vasodilation of coronary arteries in cooperation with improvement of cardiac function and cardiac output through reversible inhibition of mitochondrial complex I and mitochondrial NO synthase, followed by reduction in reactive oxygen species and correction of myocardial stunning. Simultaneously, an increase in vascular sensitivity to sympathetic stimulation could lead to an increase in diastolic blood pressure. Confirmation of this hypothesis in clinical practice would mean a milestone in the treatment for cardiac arrest and cardiopulmonary resuscitation. PMID:23712508

Kruzliak, Peter; Pechanova, Olga; Kara, Tomas

2014-05-01

262

Dose-responsive model of smoke inhalation injury. Severity-related alteration in cardiopulmonary function  

Energy Technology Data Exchange (ETDEWEB)

The dose responsiveness of selected physiologic indices was studied in a sheep model of smoke inhalation injury. In this model, graded severity of injury was achieved by changing the contact time with smoke (defined by unit), whereas other variables were kept constant. Blood gas and cardiopulmonary indices were measured in 70 sheep, including 12 controls, either 24 or 72 hours after exposure to 3, 6, 9, 12, 15, or 18 units of smoke. A 12-unit dose of smoke was fatal within 72 hours and an 18-unit dose was fatal within 24 hours. The best correlation between smoke dose and response was observed in arterial oxygen tension 24 hours after exposure. At 24 hours, most of the cardiopulmonary indices showed significant change only after a 12-unit exposure. Although the exact shape of the dose-response curve could not be defined, sigmoid or curved linear shape was suggested, reflecting the progressive deterioration.

Shimazu, T.; Yukioka, T.; Hubbard, G.B.; Langlinais, P.C.; Mason, A.D. Jr.; Pruitt, B.A. Jr.

1987-07-01

263

Cardiopulmonary bypass using argatroban as an anticoagulant for a 6.0-kg pediatric patient.  

Science.gov (United States)

A patient was born with transposition of the great arteries, double-outlet right ventricle, interrupted aortic arch, and a ventricular septal defect and underwent a Damus-Kaye-Stansel procedure with a modified Blalock-Taussig shunt at 14 days old. Three months later, this patient presented with hypoxia and bradycardia was found to have a thrombus present in the main pulmonary artery extending to right pulmonary artery. After initiation of thrombolytic therapy, the patient became severely hypoxic and required the institution of extracorporeal membrane oxygenation. As the result of unknown heparin resistance independent of adequate antithrombin III levels, argatroban therapy was used to achieve desired anticoagulation. The patient was taken to the operating room and converted to conventional cardiopulmonary bypass once adequate activated clotting times were achieved using argatroban. This case report summarizes the use of argatroban as an anticoagulant for a 6.0-kg pediatric patient undergoing cardiopulmonary bypass. PMID:16350385

Mejak, Brian; Giacomuzzi, Carmen; Shen, Irving; Boshkov, Lynn; Ungerleider, Ross

2005-09-01

264

Assessment of aorto-coronary bypass graft patency and graft flow by contrast enhanced computed tomography  

International Nuclear Information System (INIS)

Recent advances in computed tomography have led to clinically useful imaging of the cardiovascular structures with remarkable resolution. In 44 patients with 66 aorto-coronary bypass grafts, the efficacy of contrast enhanced computed tomography to determine graft patency and estimate graft flow was studied. After the proper scanning level was selected by scout scans, sequential scans with a 5 seconds scanning time and a 5 seconds interscan period were performed during the rapid injection of a 30 ml bolus of contrast medium into an antecubital vein. Patency of grafts was determined by a characteristic enhancement with contrast medium that coincides with appearance of contrast in the aorta. Comparing CECT with conventional graft angiography, our results gave a 91% sensitivity for CECT detection of graft patency, a 91% specificity and a 91% accuracy. Variables, such as follows, were measured by plotting the time-density curve of dynamic scans. ?CT = increasing rate of CT number, Max CT = peak CT number - ?CT = clearance rate of CT number. The mean graft flow was measured intraoperatively by using an electromagnetic flowmeter. To determine if CECT can quantitate graft flow, correlation between the mean graft flow and variables was studied. There was significant correlation between the mean graft flow and -?CT of graft/ -?CT of Ao. (p<0.001). These findings indicates that CECT has promise as a safe and relatively noninvasive technique for determining bypass graft patency and estimating graft flow. (author)

265

Post-surgical complications of symphyseal block graft with and without soft tissue grafting  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: To determine whether soft tissue augmentation prior to block grafting will minimize post-block grafting soft tissue complications. Methods: This longitudinal controlled pilot study was conducted at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia from October 2010 to January 2013. Fourteen sites requiring block grafting were divided into 2 groups: Group A - 7 sites in 6 patients were subjected to monocortical block graft (control; and Group B - 7 sites in 6 patients were subjected to soft tissue graft through new tunnel technique, followed by monocortical block graft (test. Results: In Group A, 2 patients had wound dehiscence and graft exposure. The first that had an exposure of 3x4 mm resulted in 45% resorption of the graft. The second had an exposure of 4x5 mm followed by infection, which resulted in 75% resorption of the graft. In the other 5 cases, sites healed with no complications and minimal resorption (0-15%. In Group B - there were generalized 1-2 mm increases in the thickness of soft tissue following soft tissue graft. Recipient sites healed with no complications or infection following block grafting. Block graft resorption ranged from 0-15%. Conclusion: More complications were seen in those patients who did not receive soft tissue augmentation, thus demonstrating the importance of soft tissue preparation prior to block grafting, especially in patients having thin soft tissue. 

Ali S. AlGhamdi

2013-06-01

266

Testosterone Exacerbates Neuronal Damage Following Cardiac Arrest and Cardiopulmonary Resuscitation in Mouse  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Male animals exhibit greater neuronal damage following focal cerebral ischemic injury in many experimental injury models, however the mechanism of this is unknown. This study used cardiac arrest and cardiopulmonary resuscitation (CA/CPR) in male mice exposed to physiological vs. pharmacological doses of testosterone and tested the hypothesis that testosterone increases damage following global cerebral ischemia. Analysis of histological damage 72 hrs after resuscitation revealed a complex dose...

Nakano, Takaaki; Hurn, Patricia D.; Herson, Paco S.; Traystman, Richard J.

2010-01-01

267

Cardiopulmonary effects of a ketamine hydrochloride/acepromazine combination in healthy cats.  

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The effect of a ketamine hydrochloride/acepromazine combination on the cardiopulmonary function of 11 healthy cats was studied. Test parameters included cardiac output, measured by thermodilution, heart rate, respiratory rate, arterial blood pressure (systolic, diastolic and mean) and arterial blood gas analysis. Values for systemic vascular resistance, cardiac index and stroke volume were calculated. The cardiac output, cardiac index, stroke volume, arterial blood pressure and arterial blood...

Ingwersen, W.; Allen, D. G.; Dyson, D. H.; Pascoe, P. J.; O Grady, M. R.

1988-01-01

268

Neutralizing Antibodies and Sin Nombre Virus RNA after Recovery from Hantavirus Cardiopulmonary Syndrome  

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Patients who later have a mild course of hantavirus cardiopulmonary syndrome (HCPS) are more likely to exhibit a high titer of neutralizing antibodies against Sin Nombre virus (SNV), the etiologic agent of HCPS, at the time of hospital admission. Because administering plasma from patients who have recovered from HCPS to those in the early stages of disease may be an advantageous form of passive immunotherapy, we examined the neutralizing antibody titers of 21 patients who had recovered from S...

Ye, Chunyan; Prescott, Joseph; Nofchissey, Robert; Goade, Diane; Hjelle, Brian

2004-01-01

269

Cardiopulmonary exercise testing prior to myeloablative allo-SCT: a feasibility study.  

Science.gov (United States)

The feasibility of symptom-limited cardiopulmonary exercise testing (CPET) prior to allo-SCT was assessed in addition to the prognostic value of CPET-derived measures. CPET was performed prospectively on 21 patients with hematologic malignancies, with assessments of peak (for example, peak oxygen consumption, VO2peak) and submaximal (for example, ventilatory threshold (VT)) measures of cardiopulmonary function. No serious adverse events were observed during CPET procedures, with 95% of patients achieving criteria for a peak test. Mean VO2peak was 24.7±6.4?mL?kg(-1?)min(-1) (range: 10.9-35.5), equivalent to 29%±17% below that of age-matched healthy controls. All patients proceeded with the conditioning regimen followed by allo-SCT. Median follow-up was 25 months. During this period, 11 (52.4%) patients died (n=6, relapsed disease; n=5, non-relapse mortality (NRM)); 9 patients (43%) developed pulmonary toxicity. In univariate analyses, both peak and submaximal markers of cardiopulmonary function were predictors of OS, pulmonary toxicity and NRM. For OS, the HR for VO2peak and VT were 0.89 (95% CI, 0.8-0.99, P=0.04) and 0.84 (95% CI, 0.71-0.98, P=0.03), respectively. In conclusion, CPET is safe and feasible prior to allo-SCT. Patients have marked impairments in cardiopulmonary function prior to allo-SCT. CPET-derived metrics may complement conventional measures to improve risk stratification. PMID:25068429

Kelsey, C R; Scott, J M; Lane, A; Schwitzer, E; West, M J; Thomas, S; Herndon Ii, J E; Michalski, M G; Horwitz, M E; Hennig, T; Jones, L W

2014-10-01

270

Reproducibility of cardiac power output and other cardiopulmonary exercise indices in patients with chronic heart failure.  

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Cardiac power output is a direct measure of overall cardiac function that integrates both flow- and pressure-generating capacities of the heart. The present study assessed the reproducibility of cardiac power output and other more commonly reported cardiopulmonary exercise variables in patients with chronic heart failure. Metabolic, ventilatory and non-invasive (inert gas re-breathing) central haemodynamic measurements were undertaken at rest and near-maximal exercise of the modified Bruce pr...

Jakovljevic, Dg; Seferovic, Pm; Nunan, D.; Donovan, G.; Trenell, Mi; Grocott-mason, R.; Brodie, Da

2012-01-01

271

The Effectiveness of Ultrasound in Patients with Non-Traumatic Cardiopulmonary Arrest  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: The purpose of this study was to evaluate the effectiveness of using cardiac ultrasound in emergency departments to direct resuscitation after cardiopulmonary arrest. Material and Methods: The study was performed prospectively on 73 patients who underwent cardiopulmonary resuscitation in the emergency department at Gaziantep University Faculty of Medicine between January and December 2010. Two senior doctors, who had received emergency cardiac ultrasonography training, performed the cardiac ultrasound, which was done from the apical and subxiphoid windows. SonoSite Titan was used as the sonography device. Ultrasound evaluation and pulse controls were performed spontaneously. SPSS 18.0 was used for statistical analysis. Results: The cases included 38 males and 35 females. 57.5% of the cardiopulmonary arrest incidents occurred out of the hospital. Only 8.2% of patients had a femoral pulse during the initial evaluation; 91.8% showed no femoral pulse. Although 31.5% of patients had a regular rhythm, 54.8% did not, and ventricular fibrillation was present in 13.7% of patients. Ultrasound inspection detected a heart rate in 13.7% of patients and ventricular fibrillation in 9.6%. In 76.7% of the cases, no heart rate was observed. There were 42 patients with asystole, two with a normal rate and 14 with valvular motion. Ventricular fibrillation was detected in seven cases, and following the evaluation performed simultaneously with ultrasound, pericardial tamponade was found in two and right ventricular enlargement in four cases. Global hypokinesia was detected in one patient and hypovolemia in one patient. Conclusion: Doctors trained in emergency cardiac ultrasonography can use cardiac ultrasound as a supplementary method for managing cardiopulmonary resuscitation and making appropriate decisions.

Suat Zengin

2012-06-01

272

OUTCOMES OF THE FIFTH INTERNATIONAL CONFERENCE ON PEDIATRIC MECHANICAL CIRCULATORY SUPPORT SYSTEMS AND PEDIATRIC CARDIOPULMONARY PERFUSION  

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The overall objective of the Conference was to bring together internationally know clinicians, bioengineers, and basic scientists involved in research on pediatric mechanical cardiac support systems and pediatric cardiopulmonary bypass procedures. The primary focus was to explicitly describe the problems with current pediatric mechanical circulatory support systems, methods, and techniques during acute and chronic support. The organizers were able to bring together respected international sch...

U?ndar, Akif

2009-01-01

273

Revisiting cardiopulmonary exercise testing applications in heart failure: aligning evidence with clinical practice.  

Science.gov (United States)

American Heart Association/American College of Cardiology class recommendations and associated level of evidence for cardiopulmonary exercise testing (CPX) have been put forth. A new paradigm is proposed for CPX use and interpretation in heart failure (HF). Evidence for this new paradigm will be provided, showing that clinical utilization, class recommendations, and the associated level of evidence for CPX in the HF population can be expanded significantly. PMID:25061999

Arena, Ross; Guazzi, Marco; Cahalin, Lawrence P; Myers, Jonathan

2014-10-01

274

Developing Pulmonary Vasculopathy in Systemic Sclerosis, Detected with Non-Invasive Cardiopulmonary Exercise Testing  

Science.gov (United States)

Background Patients with systemic sclerosis (SSc) may develop exercise intolerance due to musculoskeletal involvement, restrictive lung disease, left ventricular dysfunction, or pulmonary vasculopathy (PV). The latter is particularly important since it may lead to lethal pulmonary arterial hypertension (PAH). We hypothesized that abnormalities during cardiopulmonary exercise testing (CPET) in patients with SSc can identify PV leading to overt PAH. Methods Thirty SSc patients from the Harbor-UCLA Rheumatology clinic, not clinically suspected of having significant pulmonary vascular disease, were referred for this prospective study. Resting pulmonary function and exercise gas exchange were assessed, including peakVO2, anaerobic threshold (AT), heart rate- VO2 relationship (O2-pulse), exercise breathing reserve and parameters of ventilation-perfusion mismatching, as evidenced by elevated ventilatory equivalent for CO2 (VE/VCO2) and reduced end-tidal pCO2 (PETCO2) at the AT. Results Gas exchange patterns were abnormal in 16 pts with specific cardiopulmonary disease physiology: Eleven patients had findings consistent with PV, while five had findings consistent with left-ventricular dysfunction (LVD). Although both groups had low peak VO2 and AT, a higher VE/VCO2 at AT and decreasing PETCO2 during early exercise distinguished PV from LVD. Conclusions Previously undiagnosed exercise impairments due to LVD or PV were common in our SSc patients. Cardiopulmonary exercise testing may help to differentiate and detect these disorders early in patients with SSc. PMID:21179195

Dumitrescu, Daniel; Oudiz, Ronald J.; Karpouzas, George; Hovanesyan, Arsen; Jayasinghe, Amali; Hansen, James E.; Rosenkranz, Stephan; Wasserman, Karlman

2010-01-01

275

Effect of Dextrose-Crystalloid Priming Solution on Fluid Requirements and Urine Output During Cardiopulmonary Bypass  

Science.gov (United States)

We examined the influence of the addition of dextrose to crystalloid cardiopulmonary bypass priming solution. Ten patients received only lactated Ringer's solution during the perioperative period and as their cardiopulmonary bypass priming solution, while ten others, managed identically in all other respects, received only 5% dextrose in lactated Ringer's solution (D 5LR). During cardiopulmonary bypass, patients who did not receive glucose required more supplementary fluid (20.0 vs 2.2 ml Kg?1 hr?1) to maintain adequate flow rates, but made less urine (1.1 vs 2.8 ml Kg?1) than their glucose-treated cohorts. Postoperative hemoglobin was significantly lower in the group receiving lactated Ringer's solution (?14%) but not in the patients receiving D 5LR (?6%). We conclude that the addition of dextrose to a crystalloid priming solution decreases intraoperative fluid requirements and helps restore precardiopulmonary bypass hemoglobin without the need for diuretics or blood products. (Texas Heart Institute Journal 1986; 13:341-344) PMID:15226867

Metz, Samuel; Hacker, Jerriann

1986-01-01

276

Effect of carotid and aortic baroreceptors on cardiopulmonary reflex: the role of autonomic function  

Directory of Open Access Journals (Sweden)

Full Text Available We determined the sympathetic and parasympathetic control of heart rate (HR and the sensitivity of the cardiopulmonary receptors after selective carotid and aortic denervation. We also investigated the participation of the autonomic nervous system in the Bezold-Jarish reflex after selective removal of aortic and carotid baroreceptors. Male Wistar rats (220-270 g were divided into three groups: control (CG, N = 8, aortic denervation (AG, N = 5 and carotid denervation (CAG, N = 9. AG animals presented increased arterial pressure (12% and HR (11% compared with CG, while CAG animals presented a reduction in arterial pressure (16% and unchanged HR compared with CG. The sequential blockade of autonomic effects by atropine and propranolol indicated a reduction in vagal function in CAG (a 50 and 62% reduction in vagal effect and tonus, respectively while AG showed an increase of more than 100% in sympathetic control of HR. The Bezold-Jarish reflex was evaluated using serotonin, which induced increased bradycardia and hypotension in AG and CAG, suggesting that the sensitivity of the cardiopulmonary reflex is augmented after selective denervation. Atropine administration abolished the bradycardic responses induced by serotonin in all groups; however, the hypotensive response was still increased in AG. Although the responses after atropine were lower than the responses before the drug, indicating a reduction in vagal outflow after selective denervation, our data suggest that both denervation procedures are associated with an increase in sympathetic modulation of the vessels, indicating that the sensitivity of the cardiopulmonary receptors was modulated by baroreceptor fibers.

T.L. Fernandes

2010-07-01

277

Preparation of polypyrrole composite with radiation induced grafted co-polymer  

International Nuclear Information System (INIS)

To improve the mechanical strength of conducting, polypyrrole, TEFLON-FEP based composite was prepared. In order to obtain good surface conductance acrylic acid was grafted onto the fluorinated co-polymer backbone employing ?-irradiation technique. Surface resistance of the prepared composite was of the order 104 ohm/cm2 (author). 4 refs., 1 tab., 1 fig

278

Fixation of tibial plateau fractures with synthetic bone graft versus natural bone graft: a comparison study.  

LENUS (Irish Health Repository)

The goal of this study was to determine differences in fracture stability and functional outcome between synthetic bone graft and natural bone graft with internal fixation of tibia plateau metaphyseal defects.

Ong, J C Y

2012-06-01

279

On mechanism of radiation ion graft polymerization  

International Nuclear Information System (INIS)

The mechanisms of initiation of radiation ion graft poiymerization anO growth of the grafted chains in the polymer matrix, are considered. The specific ion solvation is the principal factor, determining the solvent effect on the rate of the radiation ion graft. The ion graft rate is maximum in the point of the basic relaxation transition of the swelled polymer (glass-transition temperature). The radiation graft polymerization is considered as totality of radical and ion processes. The equation, determining the dependence of the ion process quota contribution, depending on dose rate and content of inhibitor admixtures (H2O) in the system is derived and analysed. The increase of the ion process quota contribution with increase of the dose rate is established. The ion process begins to be clearly manifest at the dose rate 103 Gy/s during the radiation graft copolymerization of styrene with acrylonitrile

280

Histological evaluation of the influence of magnetic field application in autogenous bone grafts in rats  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Bone grafts are widely used in oral and maxillofacial reconstruction. The influence of electromagnetic fields and magnets on the endogenous stimulation of target tissues has been investigated. This work aimed to assess the quality of bone healing in surgical cavities filled with autogenous bone grafts, under the influence of a permanent magnetic field produced by in vivo buried devices. Methods Metal devices consisting of commercially pure martensitic stainless steel washers and titanium screws were employed. Thirty male Wistar rats were divided into 3 experimental and 3 control groups. A surgical bone cavity was produced on the right femur, and a bone graft was collected and placed in each hole. Two metallic washers, magnetized in the experimental group but not in the control group, were attached on the borders of the cavity. Results The animals were sacrificed on postoperative days 15, 45 and 60. The histological analysis of control and experimental samples showed adequate integration of the bone grafts, with intense bone neoformation. On days 45 and 60, a continued influence of the magnetic field on the surgical cavity and on the bone graft was observed in samples from the experimental group. Conclusion The results showed intense bone neoformation in the experimental group as compared to control animals. The intense extra-cortical bone neoformation observed suggests that the osteoconductor condition of the graft may be more susceptible to stimulation, when submitted to a magnetic field.

Ponzoni Deise

2009-01-01

 
 
 
 
281

Revascularização do miocárdio sem circulação extracorpórea: resultados imediatos / Miocardial revascularization without cardiopulmonary bypass; early results  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A cirurgia de revascularização do miocárdio sem uso de circulação extracorpórea (CEC) foi realizada por TRAPP & BISARYA14, na década de 70. Coube, entretanto, a BUFFOLO et alii2, 3 em nosso meio, e a BENETTI et alii¹, na Argentina, o seu uso sistemático, a sua padronização e recomendação, como uma a [...] lternativa válida e segura. Com o objetivo de avaliar a reprodutibilidade da técnica, morbidade e mortalidade, as dificuldades técnicas e as possibilidades de incorporá-las à rotina, os autores apresentam os resultados obtidos em 182 pacientes submetidos a revascularização do miocárdio com pontes de veia safena e/ou torácica interna sem a utilização do sistema de circulação extracorpórea. Foram operados por esta técnica 182 pacientes; 128/182 (70,3%) do sexo masculino e 54/128 (29,7%) do feminino, cujas idades variaram de 40 a 79 anos (m=58,8 anos), com lesões das artérias coronárias: interventricular anterior (IA), direita (CD), diagonal (DI) e marginal (MG). Foram revascularizadas 277 artérias: a IA 159/277 (57,4%), a CD 62/277 (22,4%), a DI 44/277 (15,9%) e a MG 12/277 (4,3%). A artéria torácica interna esquerda foi utilizada em 60 (21,7%) vezes e a veia safena 217/277 (78,3%). O tempo de isquemia variou de 5 a 33 minutos, com média de 14 minutos. Como complicações na série estudada foram observadas: espasmo coronário em 6/182 (3,3%), infarto agudo do miocárdio em 3/182 (1,6%), sangramento em 2/182 (1,1 %), embolia pulmonar em 2/182 (1,1%) e mediastinite em 1/182 (0,6%). Cinco/182 (2,7%) pacientes foram a óbito no período de pósoperatório imediato, sem relação com a técnica utilizada. Os autores concluem que a técnica pode ser realizada em casos selecionados, com segurança e bons resultados pela maioria dos cirurgiões. A técnica reduz os custos da operação e, em alguns subgrupos (idosos, portadores de doenças sistêmicas), pode ser a melhor alternativa. Abstract in english Myocardial revascularization surgery without the use of cardiopulmonary bypass was performed by Trapp and Ankeney in the 1970's. However it fell to Buffolo in Brazil and Benetti in Argentina to introduce its systematic use, standardization and recommendation as a valid and safe alternative modality [...] of treatment. With the aim of evaluating the technique's reproducibility, morbidity and mortality, its technical difficulties and the possibilities of incorporating it into routine practice, the authors present the results obtained in 182 patients submitted to myocardial revascularization with saphenous and/or thoracic internal bypass without the use of cardiopulmonary bypass. One hundred and eighty-two patients were operated on using this technique: 128 (70.3%) males and 54 (29.7%) females, whose ages ranged from 40 to 79 years (mean = 58.8 years), with lesions of coronary arteries: interventricular anterior (IA); right coronary (RD); diagonal artery (DI) and marginal artery (MG). Two hundred and seventy-seven arteries were revasculahsed: 159/277 IA's (57.4%), 62/277 CD's (22.4%), 44/277 DI's (15.9%) and 12/277 MG's (4.3%). The left thoracic internal artery was used on 60/277 (21.7%) occasions and the saphenous vein on 217/277 (78.3%). The duration of the ischemia ranged from 5 to 33 minutes with a mean of 14 minutes. The following conditions were noted in the study as complications: coronary spasm in 6/182 cases (3.3%), acute myocardial infarct in 3/182 (0.6%), bleeding in 2/182 (1.1%), pulmonary embolism in 1/182 (0.6%) and mediastinitis in 1/182 (0.6%). Five/182 patients (2.7%) died in the immediate postoperative period from causes unrelated to the technique employed. The authors conclude that the technique may be safely carried out by most surgeons in selected cases with good results. The technique reduces the costs of surgery and in some subgroups, such as the elderly and those suffering from systemic disease, it may be the best alternative.

Ricardo de Carvalho, Lima; Mozart, Escobar; José, Wanderley Neto; Luís Daniel, Torres; Décio O, Elias; José Teles de, Mendonça; Ricardo, Lagreca; Renato, Dellassanta; Luis Gonzaga, Granja; Mônica, Farias; Hemerson, Gama.

1993-09-01

282

Evaluation of irradiated Dallon vascular grafts  

International Nuclear Information System (INIS)

Dallon24 vascular grafts sterilized radially or by autoclaving were the subject of our investigation on piglets weighting 20-30 kgs. The grafts were implanted into the surgical defect of the descending thoracic aorta, according to previously elaborated surgical model. On the basis of gross and microscopic findings it was proved that Dallon24 vascular grafts are suitable for the clinical use and that the radial sterilization does not change their biological properties. (author)

283

Argatroban as a potential anticoagulant in cardiopulmonary bypass-studies in a dog model.  

Science.gov (United States)

Argatroban is a selective thrombin inhibitor synthesized in Japan. Argatroban, which has a high affinity for thrombin, and markedly inhibits thrombin-induced reactions, has been used in patients with artherosclerosis obliterans. The efficiency of argatroban, instead of heparin, as an anticoagulant in dog models of cardiopulmonary bypass was explored. In the first study, argatroban was administered as a bolus plus infusion for 1 h during cardiopulmonary bypass at doses of 1.0 mg + 10 microg/kg per min, 2.0 mg + 10 microg/kg per min and 3.0 mg + 10 microg/kg per min (n = 2 per group). Activated clotting time and arterial gas analyses were performed beforehand and 10 min thereafter. In the second study, there were four groups. In the first group (n = 5), no coated extracorporeal circuit was used and heparin (2 mg/kg) was used as an anticoagulant. In the second group (n = 5), a coated extracorporeal circuit was used and heparin was used (2 mg/kg) as an anticoagulant. In the third group (n = 3), no coated extracorporeal circuit was used and argatroban (2.0 mg + 10 microg/kg per min) was used as an anticoagulant. In the fourth group (n = 5), a coated extracorporeal circuit was used and argatroban was used (2.0 mg + 10 microg/kg per min) as an anticoagulant. All animals were perfused for 120 min at 40 ml/kg per minute. Platelet count, activated clotting time, thrombin-antithrombin III complex, antithrombin III, fibrinogen, fibrinogen degradation products and C3a were measured to evaluate platelet, coagulofibrinolytic and the complement system. Activated clotting time values and the effect of argatroban during cardiopulmonary bypass indicated a dose-dependent response. The next highest dosing group (2.0 mg + 10 microg/kg per minute) had activated clotting time values of 250-300 seconds during cardiopulmonary bypass, and fell after reaching near-normal levels within 60 minutes. No clots were noted in the extracorporeal circuit. The argatroban group showed lower levels in their coagulofibrinolytic system compared with the heparin group. The platelet count remained at a high level in the argatroban group. It is concluded that the combination of heparinized cardiopulmonary bypass circuits, and the use of argatroban as an anticoagulant, is safe and reduces the activation of coagulation and fibrinolytic systems and preserves platelet count. PMID:10353669

Sakai, M; Ohteki, H; Narita, Y; Naitoh, K; Natsuaki, M; Itoh, T

1999-03-01

284

Molecular Dynamics in grafted layers of poly(dimethylsiloxane) (PDMS)  

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Dielectric relaxation spectroscopy 10^-1 Hz to 10^6 Hz) is employed to study the molecular dynamics of poly(dimethylsiloxane) (PDMS, Mw=1.7 10^5 g/mol and Mw=9.6 10^4 g/mol as grafted films with thicknesses d below and above the radius of gyration Rg. For d smaller than Rg the molecular dynamics becomes faster by up to three orders of magnitude with respect to the bulk resulting in a pronounced decrease of the Vogel temperature T0 and hence the calorimetric glass transition ...

Hartmann, L.; Pouret, P.; Leger, L.; Kremer, F.

2002-01-01

285

Characterization of radiation-induced grafting reactions  

International Nuclear Information System (INIS)

Various methods for characterization the initiators and products of grafting reactions (ESR spectroscopy, tracer technique, voltammetry, and polarography) are described. Recent developments and analytical techniques are considered. (author)

286

Nuclear accidents and bone marrow graft  

International Nuclear Information System (INIS)

In case of serious contamination, the only efficacious treatment is the bone marrow grafts. The graft types and conditions have been explained. To restrict the nuclear accidents consequences, it is recommended to: - take osseous medulla of the personnel exposed to radiations and preserve it , that permits to carry out rapidly the auto-graft in case of accidents; - determine, beforehand, the HLA group of the personnel; - to register the voluntary donors names and addresses, and their HLA group, that permits to find easily a compatible donar in case of allo-graft. (author)

287

Graft union formation in artichoke grafting onto wild and cultivated cardoon: an anatomical study.  

Science.gov (United States)

In order to develop a non-chemical method such as grafting effective against well-known artichoke soil borne diseases, an anatomical study of union formation in artichoke grafted onto selected wild and cultivated cardoon rootstocks, both resistant to Verticillium wilt, was performed. The cardoon accessions Belgio (cultivated cardoon) and Sardo (wild cardoon) were selected as rootstocks for grafting combinations with the artichoke cv. Romolo. Grafting experiments were carried out in the autumn and spring. The anatomical investigation of grafting union formation was conducted by scanning electron microscopy (SEM) on the grafting portions at the 3rd, 6th, 10th, 12th day after grafting. For the autumn experiment only, SEM analysis was also performed at 30 d after grafting. A high affinity between artichoke scion and cardoon rootstocks was observed, with some genotype differences in healing time between the two bionts. SEM images of scion/rootstock longitudinal sections revealed the appearance of many interconnecting structures between the two grafting components just 3d after grafting, followed by a vascular rearrangement and a callus development during graft union formation. De novo formation of many plasmodesmata between scion and rootstock confirmed their high compatibility, particularly in the globe artichoke/wild cardoon combination. Moreover, the duration of the early-stage grafting process could be influenced not only by the scion/rootstock compatibility, but also by the seasonal conditions, being favored by lower temperatures and a reduced light/dark photoperiod. PMID:23932643

Trinchera, Alessandra; Pandozy, Gianmarco; Rinaldi, Simona; Crinò, Paola; Temperini, Olindo; Rea, Elvira

2013-12-15

288

Hybrid Repair of Complex Thoracic Aortic Arch Pathology: Long-Term Outcomes of Extra-anatomic Bypass Grafting of the Supra-aortic Trunk  

International Nuclear Information System (INIS)

Hybrid repair constitutes supra-aortic debranching before thoracic endovascular aortic repair (TEVAR). It offers improved short-term outcome compared with open surgery; however, longer-term studies are required to assess patient outcomes and patency of the extra-anatomic bypass grafts. A prospectively maintained database of 380 elective and urgent patients who had undergone TEVAR (1997–2011) was analyzed retrospectively. Fifty-one patients (34 males; 17 females) underwent hybrid repair. Median age was 71 (range, 18–90) years with mean follow-up of 15 (range, 0–61) months. Perioperative complications included death: 10 % (5/51), stroke: 12 % (6/51), paraplegia: 6 % (3/51), endoleak: 16 % (8/51), rupture: 4 % (2/51), upper-limb ischemia: 2 % (1/51), bypass graft occlusion: 4 % (2/51), and cardiopulmonary complications in 14 % (7/51). Three patients (6 %) required emergency intervention for retrograde dissection: (2 aortic root repairs; 2 innominate stents). Early reintervention was performed for type 1 endoleak in two patients (2 proximal cuff extensions). One patient underwent innominate stenting and revision of their bypass for symptomatic restenosis. At 48 months, survival was 73 %. Endoleak was detected in three (6 %) patients (type 1 = 2; type 2 = 1) requiring debranching with proximal stent graft (n = 2) and proximal extension cuff (n = 1). One patient had a fatal rupture of a mycotic aneurysm and two arch aneurysms expanded. No bypass graft occluded after ted. No bypass graft occluded after the perioperative period. Hybrid operations to treat aortic arch disease can be performed with results comparable to open surgery. The longer-term outcomes demonstrate low rates of reintervention and high rates of graft patency.

289

Industrial application of electron beams for grafting and vulcanization  

International Nuclear Information System (INIS)

The topics discussed are radiation graft polymerization; industrial application of radiation grafting - ion exchange membrane for a battery separator, ammonia adsorbent, non-flammable PE (polyethylene) foam; R and D on radiation grafting, radiation vulcanization of natural rubber

290

Effect of bidispersity in grafted chain length on grafted chain conformations and potential of mean force between polymer grafted nanoparticles in a homopolymer matrix.  

Science.gov (United States)

In efforts to produce polymeric materials with tailored physical properties, significant interest has grown around the ability to control the spatial organization of nanoparticles in polymer nanocomposites. One way to achieve controlled particle arrangement is by grafting the nanoparticle surface with polymers that are compatible with the matrix, thus manipulating the interfacial interactions between the nanoparticles and the polymer matrix. Previous work has shown that the molecular weight of the grafted polymer, both at high grafting density and low grafting density, plays a key role in dictating the effective inter-particle interactions in a polymer matrix. At high grafting density nanoparticles disperse (aggregate) if the graft molecular weight is higher (lower) than the matrix molecular weight. At low grafting density the longer grafts can better shield the nanoparticle surface from direct particle-particle contacts than the shorter grafts and lead to the dispersion of the grafted particles in the matrix. Despite the importance of graft molecular weight, and evidence of non-trivial effects of polydispersity of chains grafted on flat surfaces, most theoretical work on polymer grafted nanoparticles has only focused on monodisperse grafted chains. In this paper, we focus on how bidispersity in grafted chain lengths affects the grafted chain conformations and inter-particle interactions in an implicit solvent and in a dense homopolymer polymer matrix. We first present the effects of bidispersity on grafted chain conformations in a single polymer grafted particle using purely Monte Carlo (MC) simulations. This is followed by calculations of the potential of mean force (PMF) between two grafted particles in a polymer matrix using a self-consistent Polymer Reference Interaction Site Model theory-Monte Carlo simulation approach. Monte Carlo simulations of a single polymer grafted particle in an implicit solvent show that in the bidisperse polymer grafted particles with an equal number of short and long grafts at low to medium grafting density, the short grafts are in a more coiled up conformation (lower radius of gyration) than their monodisperse counterparts to provide a larger free volume to the longer grafts so they can gain conformational entropy. The longer grafts do not show much difference in conformation from their monodisperse counterparts at low grafting density, but at medium grafting density the longer grafts exhibit less stretched conformations (lower radius of gyration) as compared to their monodisperse counterparts. In the presence of an explicit homopolymer matrix, the longer grafts are more compressed by the matrix homopolymer chains than the short grafts. We observe that the potential of mean force between bidisperse grafted particles has features of the PMF of monodisperse grafted particles with short grafts and monodisperse grafted particles with long grafts. The value of the PMF at contact is governed by the short grafts and values at large inter-particle distances are governed by the longer grafts. Further comparison of the PMF for bidisperse and monodisperse polymer grafted particles in a homopolymer matrix at varying parameters shows that the effects of matrix chain length, matrix packing fraction, grafting density, and particle curvature on the PMF between bidisperse polymer grafted particles are similar to those seen between monodisperse polymer grafted particles. PMID:21599087

Nair, Nitish; Wentzel, Nathaniel; Jayaraman, Arthi

2011-05-21

291

A review of 155 extra-anatomic bypass grafts  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Extra-anatomic bypass grafting has been used as treatment for patients with aorto-iliac disease who were considered unfit for aortic surgery. Eighty five percent of the patients had ischaemic pain at rest or skin necrosis. One hundred and three femorofemoral (FF) grafts, 40 axillounifemoral and 12 axillobifemoral grafts were performed. Femoropopliteal extension grafts were performed in 39 cases. The three year cumulative graft patency rate was 69% for FF grafts and 48% for both types of axill...

Foster, M. C.; Mikulin, T.; Hopkinson, B. R.; Makin, G. S.

1986-01-01

292

Design and development of multilayer vascular graft  

Science.gov (United States)

Vascular graft is a widely-used medical device for the treatment of vascular diseases such as atherosclerosis and aneurysm as well as for the use of vascular access and pediatric shunt, which are major causes of mortality and morbidity in this world. Dysfunction of vascular grafts often occurs, particularly for grafts with diameter less than 6mm, and is associated with the design of graft materials. Mechanical strength, compliance, permeability, endothelialization and availability are issues of most concern for vascular graft materials. To address these issues, we have designed a biodegradable, compliant graft made of hybrid multilayer by combining an intimal equivalent, electrospun heparin-impregnated poly-epsilon-caprolactone nanofibers, with a medial equivalent, a crosslinked collagen-chitosan-based gel scaffold. The intimal equivalent is designed to build mechanical strength and stability suitable for in vivo grafting and to prevent thrombosis. The medial equivalent is designed to serve as a scaffold for the activity of the smooth muscle cells important for vascular healing and regeneration. Our results have shown that genipin is a biocompatible crosslinker to enhance the mechanical properties of collagen-chitosan based scaffolds, and the degradation time and the activity of smooth muscle cells in the scaffold can be modulated by the crosslinking degree. For vascular grafting and regeneration in vivo, an important design parameter of the hybrid multilayer is the interface adhesion between the intimal and medial equivalents. With diametrically opposite affinities to water, delamination of the two layers occurs. Physical or chemical modification techniques were thus used to enhance the adhesion. Microscopic examination and graft-relevant functional characterizations have been performed to evaluate these techniques. Results from characterization of microstructure and functional properties, including burst strength, compliance, water permeability and suture strength, showed that the multilayer graft possessed properties mimicking those of native vessels. Achieving these FDA-required functional properties is essential because they play critical roles in graft performances in vivo such as thrombus formation, occlusion, healing, and bleeding. In addition, cell studies and animal studies have been performed on the multilayer graft. Our results show that the multilayer graft support mimetic vascular culture of cells and the acellular graft serves as an artery equivalent in vivo to sustain the physiological conditions and promote appropriate cellular activity. In conclusion, the newly-developed hybrid multilayer graft provides a proper balance of biomechanical and biochemical properties and demonstrates the potential for the use of vascular tissue engineering and regeneration.

Madhavan, Krishna

293

Influence of tranexamic acid in postoperative bleeding of cardiac surgery with cardiopulmonary bypass Influência do ácido tranexâmico no sangramento pós-operatório de cirurgias cardíacas com circulação extracorpórea  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: To analyze the influence of tranexamic acid in postoperative bleeding of cardiac surgery with cardiopulmonary bypass. METHOD: 51 patients who underwent heart surgery with cardiopulmonary bypass were randomly divided in 2 groups: Group I - control, with 12 coronary artery disease patients and 14 valve disease patients. Group II - Tranexamic acid, with 14 coronary artery disease patients and 11 valve disease patients. The Group I after venous access, received 250 ml of 0.9% normal saline solution as a placebo, Group II received 100 milligram per kilogram of body weight of tranexamic acid diluted in 250 ml of 0.9% normal saline solution. Blood samples were taken and examined at entry to Intensive care unit and after 12, 24 and 36 hours in the postoperative period. The groups were compared concerning factors which might influence the postoperative bleeding and transfusion required: age, gender, creatinine, duration of Cardiopulmonary bypass, hematocrit, platelets and fibrinogen variations, number of saphenous vein grafts performed, mammary artery used and valve replacement or repair. The postoperative bleeding was evaluated from the 1st to 4th hours and the total. Data were analyzed by appropriate statistic methods (Student T-test, X² test and Fischer's test; a p-value of less than 0.05 was the accepted level of significance. RESULTS: Concerning the postoperative bleeding and transfusion required, there was a statistically significant reduction in its average in valve disease patients in Group II. In coronary disease patients there was only a slight tendency. There was no significant statistical difference as far as the thromboembolic or renal complications were concerned. CONCLUSION: In valve disease patients, there was a reduction in bleeding and the need of transfusions of red blood cells, both of which had statistical differences. In coronary disease patients there was only a reduced tendency. The use of tranexamic acid was not related to further thromboembolic complications or renal insufficiency in the assessed groups.OBJETIVO: Analisar a influência do ácido tranexâmico no sangramento pós-operatório de cirurgia cardíaca com circulação extracorpórea (CEC. MÉTODO: Foram randomizados, em 2 grupos, 51 pacientes submetidos a cirurgia cardíaca com auxílio de CEC. Grupos: Grupo I - controle, com 26 pacientes, sendo 12 com doença coronariana obstrutiva e 14 com lesões valvulares; Grupo II - ácido tranexâmico, com 25 pacientes, sendo 14 com doença coronariana obstrutiva e 11 com lesões valvulares. No grupo I foram infundidos 250ml de solução fisiológica (SF 0,9%, após acesso venoso; o grupo II recebeu 100mg/kg de peso corpóreo de ácido tranexâmico diluído em 250ml de SF 0,9%, após acesso venoso. Foram colhidas amostras de sangue para exames na admissão ao CTI, após 12, 24 e 36 horas de pós-operatório. Os grupos foram comparados com relação a fatores que pudessem influir no sangramento pós-operatório e na necessidade de hemotransfusão: idade, sexo, creatinina, tempo de CEC, variação no hematócrito, plaquetas, fibrinogênio, número de pontes safenas, uso da artéria torácica interna, troca ou reconstrução valvar. Foram avaliados o sangramento no pós-operatório da 1a a 4a horas e o total. O método estatístico empregado foi o teste t de Student, com correção de Welch, dependendo do caso, para os dados contínuos. Os dados categóricos (sexo, troca valvar, etc. foram analisados pelo teste não paramétrico do X². Em algumas situações foi usado teste exato de Fisher. Em todos os casos foi utilizado índice de significância p < 0,05. RESULTADOS: Com relação ao sangramento pós-operatório e a utilização de hemoderivados, houve redução da média dos mesmos nos pacientes com lesões valvulares no Grupo II, com diferença estatística. Com relação às complicações tromboembólicas ou renais, não houve diferença estatística entre os grupos. CONCLUSÃO: Nos pacientes com lesões valvulares, ocorreu redução do sangramento e da necessidade de

Flávio Donizete Gonçalves

2002-12-01

294

Education for Employment: Realizing Arab Youth Employment  

Science.gov (United States)

The Arab world is "overwhelmingly young", and the human potential throughout the area is tremendous. Recent events across the region have "amplified the social and economic disconnect between skills, jobs, and opportunity." To address this situation, a group of organizations (including the Islamic Development Bank), started the Education for Employment (e4e) initiative. The basic goal of the initiative is to position "education as a major priority to drive improved employment prospects." On their website, visitors can look over a brief summary of their work, and also look over their report from April 2011. The report is based on 200 in-depth interviews and surveys of over 1500 employers and 1500 youth throughout the region. Visitors can download the 150 page report, or view the executive summary here in Arabic or English. The report's chapters include "Perspectives of e4e Stakeholders" and "The e4e Challenge in the Arab World".

295

Biodegradability of poly(3-hydroxybutyrate) film grafted with vinyl acetate: Effect of grafting and saponification  

International Nuclear Information System (INIS)

Radiation-induced graft polymerization of vinyl acetate (VAc) onto poly(3-hydroxybutyrate) (PHB) film was carried out. At a degree of grafting higher than 5%, the grafted films (PHB-g-VAc) completely lost the enzymatic degradability that is characteristic of PHB due to the grafted VAc covering the surface of the PHB film. However, the biodegradability of the PHB-g-VAc films was recovered when the films were saponified in alkali solution under optimum conditions. Graft chains of the PHB-g-VAc film reacted selectively to become biodegradable polyvinyl alcohol (PVA). The biodegradability of the saponified PHB-g-VAc film increased rapidly with time

296

Grafted methylenediphosphonate ion exchange resins  

Science.gov (United States)

An ion exchange resin is disclosed that is comprised of an insoluble copolymer onto which are grafted pendent groups that provide 1.0 to about 10 mmol/g dry weight phosphorous. The pendent groups have the formula ##STR1## wherein R is hydrogen, a cation or mixtures thereof; and R.sup.1 is hydrogen or an C.sub.1 -C.sub.2 alkyl group. The resin also contains zero to about 5 mmol/g dry weight of pendent aromatic sulfonate groups. Processes for making and using an ion exchange-resin are also disclosed.

Trochimcznk, Andrzej W. (Knoxville, TN); Gatrone, Ralph C. (Plymouth, PA); Alexandratos, Spiro (Knoxville, TN); Horwitz, E. Philip (Naperville, IL)

1998-01-27

297

The olecranon bone graft for nasal augmentation.  

Science.gov (United States)

The olecranon bone graft offers an alternative to the cranial bone when autogenous material is preferred in the repair of moderate deficiencies of the nasal dorsum. The predictably thick cortex of the olecranon allows the crafting of a customized implant, and minimal donor site morbidity makes it a safe alternative to the cranial graft. PMID:1570775

Hodgkinson, D J

1992-01-01

298

DIAGNOSTICS OF COMPATIBILITY OF GRAFTING COMPONENTS ??????????? ????????????? ??????????? ????????  

Directory of Open Access Journals (Sweden)

Full Text Available The article deals with the main point of worked out and experimentally tested express-metodology to estimate biological compatibility between stock and scion in the process of grafting. The article also identifies the main diagnostic signs characterizing both compatibility and incompability of grafting components

Bondorina I. A.

2011-09-01

299

Conjoined double internal mammary artery grafting.  

Science.gov (United States)

Double internal mammary artery (IMA) grafting to the coronary arteries was performed on 82 patients. In ten of them one IMA was used as a free graft, and was proximally connected to the other ("conjoined" double IMA), the indications being insufficient supply of adequate veins, diseased aortic wall, availability of only a short right IMA segment for free grafting, occluded left subclavian artery, and when distal and scattered lesions of relatively important vessels had to be bypassed. Additional sequential IMA anastomoses were performed in four patients and an additional sequential vein graft in a fifth. All patients became angina-free postoperatively and have remained so during observation up to 16 months. Recatheterization studies were performed in six patients and in all of them the IMA-to-IMA (n = 6) and distal anastomoses (n = 26) were patent. Conjoined double IMA grafting is an important option available to the cardiac surgeon for management of selected patients with coronary artery disease. PMID:7792554

Gurevitch, J; Barak, J; Miller, H I; Kramer, A; Paz, Y; Yakirevich, V

1994-01-01

300

Grafting of styrene onto fluoropolymers films  

Energy Technology Data Exchange (ETDEWEB)

Grafting of styrene onto poly(vinylidenefluoride) (PVDF) and poly(tetrafluoroethylene) (PTFE) films was studied for the synthesis of ion exchange membranes. Radiation-induced grafting of styrene onto PVDF and PTFE films was investigated by simultaneous method using a Co{sup 60} source. The films of PVDF and PTFE were irradiated at total dose of 20 to 120 kGy and chemical changes were monitored after contact with styrene. Films of PTFE and PVDF were immersed in styrene/toluene 1:1 and were submitted to gamma radiation. After irradiation the samples were evaluated at periods of 0, 7, 14, 21 and 28 days, at room temperature in order to measure the grafting degree. Results of infrared spectroscopic analysis (FTIR), differential scanning calorimetry (DSC), thermogravimetry analysis (TGA) and the degree of grafting (DOG) were evaluated. The characterization techniques showed that irradiated PVDF and PTFE films exhibited a much higher grafting degree at 120 kGy. (author)

Geraldes, Adriana N.; Zen, Heloisa A.; Parra, Duclerc F.; Lugao, Ademar B.; Linardi, Marcelo [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil). Centro de Quimica e Meio Ambiente], E-mail: angeral@ipen.br

2007-07-01

 
 
 
 
301

Pathogenesis of cardiac graft failure in children  

Directory of Open Access Journals (Sweden)

Full Text Available For many critical cardiac conditions such as cardio-myopathy, congenital heart defects, or arrhythmogenic disorders, cardiac transplantation is often an accepted treatment with optimistic one- and five-year survival rates of 90% and 75% in the pediatric patient population, respectively. However, poor long-term survival is a cause for concern, with cardiac graft failure being the leading cause in late mortality transplant recipients. Cardiac graft failure occurs through several mechanisms. However, the most common causes include cardiac allograft vasculopathy, myocardial fibrosis, and fibrofatty changes. Risk factors exacerbate these mechanisms through rejection, immunosuppressive drug side effects, hypertension, diabetes mellitus, renal dysfunction, and viral infection to increase the chance of cardiac graft failure. Changes in expression levels of various genes offer diagnostic potential for the future of cardiac transplantation. Through a comprehensive review of how multiple factors can lead a cardiac graft into failure, we hope to contribute to the longevity of cardiac grafts and pediatric heart transplant recipients.

Jenny Lin

2012-12-01

302

The use of recipient superficial femoral vein as a venous graft for portal vein reconstruction in right lobe living donor liver transplantation.  

Science.gov (United States)

In living donor liver transplantation (LDLT), portal vein thrombosis (PVT) in the recipient is frequently regarded as a contraindication. To reconstruct the PV of a right-lobe liver graft (RLG) using an interposition or jump graft from the splenomesenteric junction, various vein grafts and technical modifications have been introduced. The internal jugular, external iliac, or great saphenous veins have been utilized in such reconstructive procedures. However, the superficial femoral vein (SFV) is preferable to the autologous vein grafts in terms of caliber, wall thickness, and length. We employed the recipient SFV to reconstruct PVT among 40 adult LDLT using RLG. Thirty-three were reconstructed by single end-to-end anastomosis with the right or left recipient PV. Three patients were transplanted with a RLG using 2 separated PVs reconstructed by double anastomoses with both the right and left PVs of the recipient. The remaining 4 patients required venous grafting for portal reconstruction. We used the recipient SFV as an interposition or jump graft from the splenomesenteric junction to the graft PV. There were 2 cases of anastomotic PV stenosis; 1 in portal reconstruction without a venous graft and the other with a SFV graft. Both were treated successfully by balloon angioplasty. The recipient SFV is an excellent size match for the PV reconstruction as a long interposition or jump conduit when the venous system from the deceased donor is not available. The indication for LDLT in patients with complete PVT should be carefully decided before transplantation in terms of portal reconstruction. PMID:19249512

Sato, K; Sekiguchi, S; Watanabe, T; Enomoto, Y; Akamastu, Y; Kawagishi, N; Miyagi, S; Takeda, I; Sato, A; Fujimori, K; Satomi, S

2009-01-01

303

Influence of weft-knitted tubular fabric on radial mechanical property of coaxial three-layer small-diameter vascular graft.  

Science.gov (United States)

The goal of this study was to evaluate the radial mechanical property of the small-diameter polyurethane vascular grafts reinforced by weft-knitted tubular polyester/spandex fabrics. The polyester/spandex tubular fabrics with different blend ratios were prepared on a weft-knitting machine to reinforce small-diameter polyurethane vascular grafts. Phase separation technique was employed to produce coaxial three-layer small-diameter polyurethane vascular grafts at room temperature. Morphology of the polyurethane vascular grafts was examined by scanning electron microscope (SEM), and micropores were observed on both inner and cross section surfaces. Radial tensile property and compliance of small-diameter polyurethane vascular grafts with and without reinforcement by polyester/spandex tubular fabrics were characterized. The effect of polyester/spandex tubular fabric on the mechanical property of polyurethane vascular grafts was studied. The results indicated that the radial tensile strength of the vascular graft was improved by the tubular fabric, and that the influence of tubular fabric on compliance was small compared to that of wall thickness. It was notable that the wall thickness of the vascular grafts was a major factor in controlling the compliance in the radial direction. Therefore, a coaxial three-layer small-diameter polyurethane vascular graft with excellent compliance and tensile strength could be obtained by controlling the wall thickness and using polyester/spandex fabric as reinforcement. © 2011 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 100B: 342-349, 2012. PMID:22113920

Yang, Hongjun; Zhu, Guocheng; Zhang, Zhen; Wang, Zhenzhen; Fang, Jian; Xu, Weilin

2012-02-01

304

Quantitative blood flow measurements in the small animal cardiopulmonary system using digital subtraction angiography  

International Nuclear Information System (INIS)

Purpose: The use of preclinical rodent models of disease continues to grow because these models help elucidate pathogenic mechanisms and provide robust test beds for drug development. Among the major anatomic and physiologic indicators of disease progression and genetic or drug modification of responses are measurements of blood vessel caliber and flow. Moreover, cardiopulmonary blood flow is a critical indicator of gas exchange. Current methods of measuring cardiopulmonary blood flow suffer from some or all of the following limitations--they produce relative values, are limited to global measurements, do not provide vasculature visualization, are not able to measure acute changes, are invasive, or require euthanasia. Methods: In this study, high-spatial and high-temporal resolution x-ray digital subtraction angiography (DSA) was used to obtain vasculature visualization, quantitative blood flow in absolute metrics (ml/min instead of arbitrary units or velocity), and relative blood volume dynamics from discrete regions of interest on a pixel-by-pixel basis (100x100 ?m2). Results: A series of calibrations linked the DSA flow measurements to standard physiological measurement using thermodilution and Fick's method for cardiac output (CO), which in eight anesthetized Fischer-344 rats was found to be 37.0±5.1 ml/min. Phantom experiments were conducted to calibrate the radiographic density to vessel thickness, allowing a link of DSA cardiac output measurements to cardiopulmonary blood flow measurements in discrete regions of interest. The scaling factor linking relative DSA cardiac output measurements to the Fick's absolute measurements was found to be 18.90xCODSA=COFick. Conclusions: This calibrated DSA approach allows repeated simultaneous visualization of vasculature and measurement of blood flow dynamics on a regional level in the living rat.

305

Quantitative blood flow measurements in the small animal cardiopulmonary system using digital subtraction angiography  

Energy Technology Data Exchange (ETDEWEB)

Purpose: The use of preclinical rodent models of disease continues to grow because these models help elucidate pathogenic mechanisms and provide robust test beds for drug development. Among the major anatomic and physiologic indicators of disease progression and genetic or drug modification of responses are measurements of blood vessel caliber and flow. Moreover, cardiopulmonary blood flow is a critical indicator of gas exchange. Current methods of measuring cardiopulmonary blood flow suffer from some or all of the following limitations--they produce relative values, are limited to global measurements, do not provide vasculature visualization, are not able to measure acute changes, are invasive, or require euthanasia. Methods: In this study, high-spatial and high-temporal resolution x-ray digital subtraction angiography (DSA) was used to obtain vasculature visualization, quantitative blood flow in absolute metrics (ml/min instead of arbitrary units or velocity), and relative blood volume dynamics from discrete regions of interest on a pixel-by-pixel basis (100x100 {mu}m{sup 2}). Results: A series of calibrations linked the DSA flow measurements to standard physiological measurement using thermodilution and Fick's method for cardiac output (CO), which in eight anesthetized Fischer-344 rats was found to be 37.0{+-}5.1 ml/min. Phantom experiments were conducted to calibrate the radiographic density to vessel thickness, allowing a link of DSA cardiac output measurements to cardiopulmonary blood flow measurements in discrete regions of interest. The scaling factor linking relative DSA cardiac output measurements to the Fick's absolute measurements was found to be 18.90xCO{sub DSA}=CO{sub Fick}. Conclusions: This calibrated DSA approach allows repeated simultaneous visualization of vasculature and measurement of blood flow dynamics on a regional level in the living rat.

Lin Mingde; Marshall, Craig T.; Qi, Yi; Johnston, Samuel M.; Badea, Cristian T.; Piantadosi, Claude A.; Johnson, G. Allan [Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States)

2009-11-15

306

New guidelines for cardiopulmonary resuscitation / Novas diretrizes da ressuscitação cardiopulmonar / Nuevas directrices para la resucitación cardiopulmonar  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A parada cardiorrespiratória (PCR) é intercorrência de grave ameaça à vida; a ressuscitação cardiopulmonar (RCP) representa desafio para a investigação e a avaliação por parte do enfermeiro e sua equipe. Esse estudo apresenta as mais recentes recomendações internacionais sobre atendimento da parada [...] cardiorrespiratória, baseado nas Diretrizes de 2005 da American Heart Association (AHA). Essas diretrizes sobre RCP fundamentam-se num processo de revisão extenso, organizado pelo International Liasion Committee on Resuscitation (ILCOR). As manobras básicas e avançadas de RCP com qualidade podem salvar vidas. Abstract in spanish La parada cardiorrespiratoria (PCR) es una ocurrencia que presenta una grave amenaza a la vida; la resucitación cardiopulmonar (RCP) representa un desafío para la investigación y la evaluación por parte del enfermero y su equipo. Este estudio presenta las más recientes recomendaciones internacionale [...] s sobre la atención a la parada cardiorrespiratoria, basada en las Directrices de 2005 de la American Heart Asociation (AHA). Esas directrices sobre RCP se fundamentan en un proceso de revisión extenso, organizado por el International Liasion Committee on Resuscitation (ILCOR). Las maniobras básicas y avanzadas de RCP ofrecidas con calidad pueden salvar vidas. Abstract in english Cardiopulmonary arrest (CPA) poses a severe threat to life; cardiopulmonary resuscitation (CPR) represents a challenge for research and assessment by nurses and their team. This study presents the most recent international recommendations for care in case of cardiopulmonary heart arrest, based on th [...] e 2005 Guidelines by the American Heart Association (AHA). These CPR guidelines are based on a large-scale review process, organized by the International Liaison Committee on Resuscitation (ILCOR). High-quality basic and advanced CPR maneuvers can save lives.

Maria Celia Barcellos, Dalri; Izilda Esmenia Muglia, Araújo; Renata Cristina de Campos Pereira, Silveira; Silvia Rita Marin da Silva, Canini; Regilene Molina Zacareli, Cyrillo.

1060-10-01

307

New guidelines for cardiopulmonary resuscitation Nuevas directrices para la resucitación cardiopulmonar Novas diretrizes da ressuscitação cardiopulmonar  

Directory of Open Access Journals (Sweden)

Full Text Available Cardiopulmonary arrest (CPA poses a severe threat to life; cardiopulmonary resuscitation (CPR represents a challenge for research and assessment by nurses and their team. This study presents the most recent international recommendations for care in case of cardiopulmonary heart arrest, based on the 2005 Guidelines by the American Heart Association (AHA. These CPR guidelines are based on a large-scale review process, organized by the International Liaison Committee on Resuscitation (ILCOR. High-quality basic and advanced CPR maneuvers can save lives.La parada cardiorrespiratoria (PCR es una ocurrencia que presenta una grave amenaza a la vida; la resucitación cardiopulmonar (RCP representa un desafío para la investigación y la evaluación por parte del enfermero y su equipo. Este estudio presenta las más recientes recomendaciones internacionales sobre la atención a la parada cardiorrespiratoria, basada en las Directrices de 2005 de la American Heart Asociation (AHA. Esas directrices sobre RCP se fundamentan en un proceso de revisión extenso, organizado por el International Liasion Committee on Resuscitation (ILCOR. Las maniobras básicas y avanzadas de RCP ofrecidas con calidad pueden salvar vidas.A parada cardiorrespiratória (PCR é intercorrência de grave ameaça à vida; a ressuscitação cardiopulmonar (RCP representa desafio para a investigação e a avaliação por parte do enfermeiro e sua equipe. Esse estudo apresenta as mais recentes recomendações internacionais sobre atendimento da parada cardiorrespiratória, baseado nas Diretrizes de 2005 da American Heart Association (AHA. Essas diretrizes sobre RCP fundamentam-se num processo de revisão extenso, organizado pelo International Liasion Committee on Resuscitation (ILCOR. As manobras básicas e avançadas de RCP com qualidade podem salvar vidas.

Maria Celia Barcellos Dalri

2008-12-01

308

Difference between pre-operative and cardiopulmonary bypass mean arterial pressure is independently associated with early cardiac surgery-associated acute kidney injury  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Cardiac surgery-associated acute kidney injury (CSA-AKI contributes to increased morbidity and mortality. However, its pathophysiology remains incompletely understood. We hypothesized that intra-operative mean arterial pressure (MAP relative to pre-operative MAP would be an important predisposing factor for CSA-AKI. Methods We performed a prospective observational study of 157 consecutive high-risk patients undergoing cardiac surgery with cardiopulmonary bypass (CPB. The primary exposure was delta MAP, defined as the pre-operative MAP minus average MAP during CPB. Secondary exposure was CPB flow. The primary outcome was early CSA-AKI, defined by a minimum RIFLE class - RISK. Univariate and multivariate logistic regression were performed to explore for association between delta MAP and CSA-AKI. Results Mean (± SD age was 65.9 ± 14.7 years, 70.1% were male, 47.8% had isolated coronary bypass graft (CABG surgery, 24.2% had isolated valve surgery and 16.6% had combined procedures. Mean (± SD pre-operative, intra-operative and delta MAP were 86.6 ± 13.2, 57.4 ± 5.0 and 29.4 ± 13.5 mmHg, respectively. Sixty-five patients (41% developed CSA-AKI within in the first 24 hours post surgery. By multivariate logistic regression, a delta MAP?26 mmHg (odds ratio [OR], 2.8; 95%CI, 1.3-6.1, p = 0.009 and CPB flow rate ?54 mL/kg/min (OR, 0.2, 0.1-0.5, p Conclusion A large delta MAP and lower CPB flow during cardiac surgery are independently associated with early post-operative CSA-AKI in high-risk patients. Delta MAP represents a potentially modifiable intra-operative factor for development of CSA-AKI that necessitates further inquiry.

Kanji Hussein D

2010-09-01

309

Cistatina C e taxa de filtração glomerular em cirurgia cardíaca com circulação extracorpórea / Cystatin C and glomerular filtration rate in the cardiac surgery with cardiopulmonary bypass  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Avaliar a cistatina C como marcador de função renal em pacientes submetidos à cirurgia de cardíaca com circulação extracorpórea, comparando com a dosagem sérica de creatinina. MÉTODOS: Foram analisados 50 pacientes consecutivos submetidos à cirurgia de revascularização do miocárdio. A funç [...] ão renal foi avaliada com a dosagem sérica de cistatina C e de creatinina no pré-operatório, no primeiro e no quinto dia de pós-operatório. Foram utilizadas as fórmulas de Cockcroft-Gault (CG) e Modification of Diet in Renal Disease (MDRD) para calcular a taxa de filtração glomerular estimada (TFG) através da creatinina, e a fórmula de Larsson para a TFG estimada através da cistatina C (TFG-Cis). RESULTADOS: A creatinina e o TFG através das fórmulas de CG e MDRD não mostraram diferença significativa nos momentos estudados. Após a agressão renal pela cirurgia, houve um aumento da cistatina C no 1º e 5º pós-operatório, sendo que no 5º pós-operatório com diferença estatisticamente significativa (P Abstract in english OBJECTIVE: The aim of this study was to compare cystatin C versus creatinine as a marker for acute kidney injury in patients submitted to cardiac surgery with cardiopulmonary bypass. METHODS: Fifty consecutive patients submitted to coronary artery bypass grafting were studied. Renal function was eva [...] luated by serum cystatin C and creatinine. Blood samples were obtained from each patient at three time points: before operation, and on the first and fifth postoperative days. Glomerular filtration rate (GFR) was calculated by Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Larsson (Cys-GFR) formulas. RESULTS: Creatinine and GFR by CG and MDRD formulas did not show statistical difference between study times. After renal injury from surgery, there was an increase in cystatin C on the 1st and 5th day after surgery, being significantly different on the 5th postoperative (P

Marcello Laneza, Felicio; Rubens Ramos de, Andrade; Yara Marcondes Machado, Castiglia; Marcos Augusto de Moraes, Silva; Pedro Thadeu Galvão, Vianna; Antonio Sergio, Martins.

2009-09-01

310

Imaging features of anterior cruciate ligament reconstruction graft insufficiency  

International Nuclear Information System (INIS)

Objective: To investigate the imaging features of anterior cruciate ligament (ACL) graft insufficiency. Methods: X-Ray and MR imaging examinations in 24 consecutive patients who had ACL reconstructive graft insufficiency were retrospectively evaluated for tunnel position, osteoarthrosis and its related complications. Follow-up arthroscopy showed 16 graft tears and 8 graft laxities. Fisher exact test was used to compare tunnel malpositions, the proportion of graft tear on MRI and osteoarthrosis between graft tear group and graft laxity group. Results: Two malpositions of tibial tunnel and 3 malpositions of femoral tunnel were seen in graft tear group. Three-malpositions of tibial tunnel and 4 malpositions of femoral tunnel were seen in graft laxity group. The proportion of tibial or femoral malposition showed no significant difference between the two groups (P=0.289, P=0.167). In graft tear group, 15 complete graft tears were diagnosed correctly, 1 partial tear was misdiagnosed as normal on MRI. In graft laxity group, 4 grafts were diagnosed as normal and 4 were considered as graft tear on MRI. A significant difference was seen between the two groups (P=0.028) in the proportion of graft tear diagnosed on MRI. Fourteen osteoarthrosis were seen in graft tear group and 5 in graft laxity group. No significant difference was seen between the two groups (P= 0.289) in the proportion of osteoarthrosis. Conclusion: The proportions of tunnel malposition and osteoarthrosis showed no significant difference between the graft tear group and graft Laxity group. Most graft tears can be diagnosed accurately on MRI, but some cases of graft laxity may be misdiagnosed for graft tear. (authors)

311

Electrical failure during cardiopulmonary bypass: an evaluation of incidence, causes, management and guidelines for preventative measures.  

LENUS (Irish Health Repository)

The incidence of electrical failure during cardiopulmonary bypass (CPB) has been reported to occur in approximately 1 per 1000 cases. While the resultant morbidity and mortality is low, electrical failure is a life-threatening scenario. We report three major electrical failures during CPB in a patient population of 3500 over a 15-year period. These cases involved mains failure and generator shut down, mains failure and generator power surge, and failure of the uninterruptable power supply (UPS), which caused protected sockets to shut down. Protocols for preventative maintenance, necessary equipment, battery backup and guidelines for the successful management of such accidents during CPB are discussed.

Hargrove, M

2012-02-03

312

Emergent cardiopulmonary bypass for a 180 kilogram patient: support with a single oxygenator.  

Science.gov (United States)

As obesity increases in prevalence, so will cases in which patients present at the boundaries of care. We report the support of a class III obese man, having a body mass index of 60.8 kg/m2 and in acute renal failure, with a single Trillium-coated Affinity NT Hollow Fiber oxygenator in cardiopulmonary bypass for an emergent aortic valve replacement secondary to infective endocarditis. A maximum oxygen delivery of 807.51 mL of oxygen per minute is reported for this oxygenator in this case report. PMID:24303600

Hunter, Kyler T; Lopez, Angela R; Yun, Kwok L

2013-09-01

313

Cardiopulmonary arrest following administration of Cyclomydril eyedrops for outpatient retinopathy of prematurity screening.  

Science.gov (United States)

Eyedrops used for mydriasis and cycloplegia can be systemically absorbed, causing serious side effects, including oxygen desaturation, apnea, bradycardia, transient hypertension, delayed gastric emptying, and transient paralytic ileus. These effects can be more serious in infants because of their lower body mass and immature cardiovascular and nervous systems. We report a case of a 27-week-old infant who suffered a cardiopulmonary arrest after the administration of only Cyclomydril eyedrops (Alcon Laboratories, Fort Worth, TX) during an outpatient retinopathy of prematurity examination. PMID:24698618

Lee, Jung M; Kodsi, Sylvia R; Gaffar, Majida A; Rubin, Steven E

2014-04-01

314

Effects of current inhalation exposure methods on cardiopulmonary function of immature dogs  

International Nuclear Information System (INIS)

Approximately 9% of 84 3-mo-old dogs exposed to inhalation of radioactive aerosols have experienced respiratory failure during exposure. A study was conducted to evaluate effects of exposure on cardiopulmonary function of immature dogs. Results indicate that the combination of nose breathing and breathing into the aerosol delivery cone quadrupled breathing effort of 3-mo-old dogs. Excitement exacerbated a failure to maintain adequate alveolar ventilation and resulted in CO2 retention and acidosis. General anesthesia and use of an endotracheal tube alleviated problems due to nasal airflow resistance and behaviorally-related increases in ventilatory requirement

315

Cardiopulmonary Bypass induced Fever and Systemic inflammatory response syndrome in Paediatric patients: Management Strategy  

Directory of Open Access Journals (Sweden)

Full Text Available Cardiopulmonary bypass is considered to be the common culprit for the occurrence of fever in the immediate post-operative period i.e, within 24 hours in pediatric patients. Other common causes contributing to fever are anaesthetic drugs, blood transfusions & pain. This early fever usually manifests as tachy-arrthymias in recovery room requiring interventions. This review intends to know the pathophysiology of fever and systemic inflammatory response syndrome after bypass (SIRAB onset, preventive aspects and better management of the fever in the post-operative period. 

Ravi Ghatnatti

2013-04-01

316

A pilot study of effects of cardiopulmonary resuscitation training on participants' self-concepts.  

Science.gov (United States)

The administration of cardiopulmonary resuscitation (CPR) was taught to a group of 12 adults. The Tennessee Self-concept Scale Form-C and the Fundamental Interpersonal Relations Orientation-Behavior Scale (FIRO-B) were administered before and after their training. A control group of 12 was administered both scales twice with one day between administrations. Analysis indicated both groups showed significant differences between the pre- and posttest administrations on expressed affection on the FIRO-B. However, participants in a brief CPR course did not score significantly differently from a control group on these measures, as expected. PMID:6634343

Elliott, T R; Byrd, E K

1983-10-01

317

Recognition and management of heparin-induced thrombocytopenia in pediatric cardiopulmonary bypass patients.  

Science.gov (United States)

Repeated exposure to unfractionated heparin is the rule in many congenital heart disease patients. Heparin-induced thrombocytopenia occurs in 1% to 3% of adult cardiac surgeries, and carries high thrombotic morbidity (38% to 81%) and mortality (approximately 28%). Although heparin-induced thrombocytopenia appears to be infrequent in pediatric patients, particularly neonates, our evolving experience suggests postcardiopulmonary bypass congenital heart disease patients may be at increased risk. Diagnostic and therapeutic challenges include frequency of thrombocytopenia after cardiopulmonary bypass, imperfect laboratory testing, lack of established dosing of alternative anticoagulants (such as argatroban and lepirudin), and increased anticoagulant-related bleeding in young children. PMID:16731103

Boshkov, Lynn K; Kirby, Aileen; Shen, Irving; Ungerleider, Ross M

2006-06-01

318

Binary mixed homopolymer brushes grafted on nanorod particles: A self-consistent field theory study  

Science.gov (United States)

We employ the self-consistent field theory to study phase structures of brush-rod systems composed of two chemically distinct linear homopolymers. The polymer chains are uniformly grafted on the surface of a nanorod particle of finite length and comparable radius to the polymer radius of gyration. A "masking" technique treating the cylindrical boundary is introduced to solve the modified diffusion equations with an efficient and high-order accurate pseudospectral method involving fast Fourier transform on an orthorhombic cell. A rich variety of structures for the phase separated brushes is predicted. Phase diagrams involving a series of system parameters, such as the aspect ratio of the nanorod, the grafting density, and the chain length are constructed. The results indicate that the phase structure of the mixed brush-rod system can be tailored by varying the grafted chain length and/or the aspect ratio of the rod to benefit the fabrication of polymeric nanocomposites.

Ma, Xin; Yang, Yingzi; Zhu, Lei; Zhao, Bin; Tang, Ping; Qiu, Feng

2013-12-01

319

Binary mixed homopolymer brushes grafted on nanorod particles: A self-consistent field theory study  

Energy Technology Data Exchange (ETDEWEB)

We employ the self-consistent field theory to study phase structures of brush-rod systems composed of two chemically distinct linear homopolymers. The polymer chains are uniformly grafted on the surface of a nanorod particle of finite length and comparable radius to the polymer radius of gyration. A “masking” technique treating the cylindrical boundary is introduced to solve the modified diffusion equations with an efficient and high-order accurate pseudospectral method involving fast Fourier transform on an orthorhombic cell. A rich variety of structures for the phase separated brushes is predicted. Phase diagrams involving a series of system parameters, such as the aspect ratio of the nanorod, the grafting density, and the chain length are constructed. The results indicate that the phase structure of the mixed brush-rod system can be tailored by varying the grafted chain length and/or the aspect ratio of the rod to benefit the fabrication of polymeric nanocomposites.

Ma, Xin; Yang, Yingzi; Tang, Ping, E-mail: pingtang@fudan.edu.cn, E-mail: fengqiu@fudan.edu.cn; Qiu, Feng, E-mail: pingtang@fudan.edu.cn, E-mail: fengqiu@fudan.edu.cn [Department of Macromolecular Science, The State Key Laboratory of Molecular Engineering of Polymers, Key Laboratory of Computational Physical Sciences, Fudan University, Shanghai 200433 (China); Zhu, Lei [Department of Macromolecular Science and Engineering, Case Western Reserve University, Cleveland, Ohio 44106-7202 (United States); Zhao, Bin [Department of Chemistry, University of Tennessee, Knoxville, Tennessee 37996 (United States)

2013-12-07

320

Binary mixed homopolymer brushes grafted on nanorod particles: A self-consistent field theory study  

International Nuclear Information System (INIS)

We employ the self-consistent field theory to study phase structures of brush-rod systems composed of two chemically distinct linear homopolymers. The polymer chains are uniformly grafted on the surface of a nanorod particle of finite length and comparable radius to the polymer radius of gyration. A “masking” technique treating the cylindrical boundary is introduced to solve the modified diffusion equations with an efficient and high-order accurate pseudospectral method involving fast Fourier transform on an orthorhombic cell. A rich variety of structures for the phase separated brushes is predicted. Phase diagrams involving a series of system parameters, such as the aspect ratio of the nanorod, the grafting density, and the chain length are constructed. The results indicate that the phase structure of the mixed brush-rod system can be tailored by varying the grafted chain length and/or the aspect ratio of the rod to benefit the fabrication of polymeric nanocomposites

 
 
 
 
321

Tumescent Anethesia : A Useful Technique For Harvesting Split- Thickness Skin Graft  

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Full Text Available Tumescent anesthesia is a now an established technique for regional anesthesia of the skin and the subcutaneous fatty tissue. The unsurpassed simplicity and safely of this procedure have opened up the gates for newer indications. We have employed this technique for harvesting split-thickness grafts in various conditions. We have found that this technique is extremely simple in which large areas can be anesthetized for harvesting split-thickness skin grafts safely. The good passive resistance achieved facilitates easy harvesting of split-thickness grafts along with minimal bleeding and long lasting pain relief. We found this to be an inexpensive, safe and simple technique with elimination of risks and expenses of general anesthesia.

Saraf Sanjay

2004-01-01

322

Assessing employment in Malta  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In this paper the total number of employed and the full-time equivalent employment in Malta are estimated for the last three decades. These series give a new picture of the historical development of employment and productivity in Malta. The estimated full-time equivalent time series, in spite of its limitations, is a first step on the way towards a comprehensive statistical measure of labour input in Malta

Grech, Aaron George

2003-01-01

323

Inflorescence stem grafting made easy in Arabidopsis  

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Full Text Available Abstract Background Plant grafting techniques have deepened our understanding of the signals facilitating communication between the root and shoot, as well as between shoot and reproductive organs. Transmissible signalling molecules can include hormones, peptides, proteins and metabolites: some of which travel long distances to communicate stress, nutrient status, disease and developmental events. While hypocotyl micrografting techniques have been successfully established for Arabidopsis to explore root to shoot communications, inflorescence grafting in Arabidopsis has not been exploited to the same extent. Two different strategies (horizontal and wedge-style inflorescence grafting have been developed to explore long distance signalling between the shoot and reproductive organs. We developed a robust wedge-cleft grafting method, with success rates greater than 87%, by developing better tissue contact between the stems from the inflorescence scion and rootstock. We describe how to perform a successful inflorescence stem graft that allows for reproducible translocation experiments into the physiological, developmental and molecular aspects of long distance signalling events that promote reproduction. Results Wedge grafts of the Arabidopsis inflorescence stem were supported with silicone tubing and further sealed with parafilm to maintain the vascular flow of nutrients to the shoot and reproductive tissues. Nearly all (87% grafted plants formed a strong union between the scion and rootstock. The success of grafting was scored using an inflorescence growth assay based upon the growth of primary stem. Repeated pruning produced new cauline tissues, healthy flowers and reproductive siliques, which indicates a healthy flow of nutrients from the rootstock. Removal of the silicone tubing showed a tightly fused wedge graft junction with callus proliferation. Histological staining of sections through the graft junction demonstrated the differentiation of newly formed vascular connections, parenchyma tissue and lignin accumulation, supporting the presumed success of the graft union between two sections of the primary inflorescence stem. Conclusions We describe a simple and reliable method for grafting sections of an Arabidopsis inflorescence stem. This step-by-step protocol facilitates laboratories without grafting experience to further explore the molecular and chemical signalling which coordinates communications between the shoot and reproductive tissues.

Nisar Nazia

2012-12-01

324

Plasma-grafted alkaline anion-exchange membranes based on polyvinyl chloride for potential application in direct alcohol fuel cell  

Science.gov (United States)

Plasma grafting is employed to prepare alkaline anion-exchange membranes in this study. The attenuated total reflection Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy and thermo gravimetric analysis demonstrate that the benzyltrimethylammonium cationic groups are successfully introduced into the polyvinyl chloride matrix via plasma grafting, quaternization and alkalization. The plasma-grafted alkaline anion-exchange membrane exhibits a satisfactory ionic exchange capacity (1.01 mmol g-1), thermal stability, mechanical property, ionic conductivity (0.0145 S cm-1) and methanol permeability (9.59 × 10-12 m2 s-1), suggesting a great potential for application in direct alcohol fuel cells. The open circuit voltage of air-breathing ADAFC using plasma-grafted alkaline anion-exchange membrane is 0.796 V with 1 M EtOH solution at ambient temperature.

Hu, Jue; Zhang, Chengxu; Cong, Jie; Toyoda, Hirotaka; Nagatsu, Masaaki; Meng, Yuedong

2011-05-01

325

Economic Analysis of Employment  

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Full Text Available In social policy, a distinct field is the employment policies. Their aim is to maintain and increase employment through direct or indirect actions. These actions are intended to provide jobs for young people entering the labor market, for the unemployed and others who want to hire as employees. This paper aims to achieve a perspective on labor market and employment policies with its typologies, causes, effects, generated by these policies on the individuals and society. The employment impact on the population identifies and examines various indicators of the labor market

Oana Camelia Iacob

2013-12-01

326

Extracorporeal cardiopulmonary support may be an efficient rescue of patients after massive pulmonary embolism. An experimental porcine study  

DEFF Research Database (Denmark)

INTRODUCTION: Treatment of massive pulmonary embolism leading to cardiac arrest is controversial but restitution of circulation within a shorter time is crucial. Cardiopulmonary support and therapeutic hypothermia is an option for cardiac arrest and could be used to treat massive PE. However, hypothermia may influence the effect of the ongoing intrinsic fibrinolysis. OBJECTIVES: To establish a porcine model of massive pulmonary embolism, to show that cardiopulmonary support can rescue pigs with massive pulmonary embolism and to examine the effect of hypothermia on fibrinolysis. METHODS: Pigs ~80kg were anesthetised and prepared for cardiopulmonary support. Repetitive injections of preformed blood thrombi into the right atrium were done until cardiac arrest. Cardiopulmonary support was established and eighteen pigs were randomised into 3 groups: Normothermia (38-39°C); hypothermia (33-34°C); or medication with recombinant tissue plasminogen activator. After three hours the pigs were weaned from cardiopulmonarysupport, and after 15minutes with spontaneous circulation assassinated and autopsied. Remaining thrombi in the lungs were weighed. RESULTS: The development of fatal pulmonary embolism was highly reproducible. All 18 pigs could be weaned from cardiopulmonary support and survived more than 15minutes. The amount of remaining thromboemboli was substantial in all groups and not significantly different between groups. Normothermic group 20.0±2.2g, Hypothermic group 17.0±3.7g, and rt-PA group 14.3±3.2g. CONCLUSIONS: Cardiopulmonary support could rescue pigs with massive pulmonary embolism. Hypothermia did not reduce the emboli but may for other reasons be beneficial. The optimal additional treatment is still unknown but treatment modalities can be tested in this model.

Kjærgaard, Benedict; Rasmussen, Bodil Steen

2012-01-01

327

Increased bone formation using calcium sulfate-calcium phosphate composite graft.  

Science.gov (United States)

Calcium phosphates (CaPO4) and faster-resorbing calcium sulfate (CaSO4) are successfully employed as synthetic bone grafts for treatment of contained defects. We used a canine critical-sized bone defect model to study an injectable CaSO4/CaPO4 composite graft that incorporated a matrix of CaSO4 and dicalcium phosphate dihydrate into which beta-tricalcium phosphate granules were distributed. The area fraction, ultimate compressive stress, and elastic modulus of restored bone and the relative rates of material resorption were compared between the CaSO4/CaPO4 composite graft and pure CaSO4 pellets and to normal canine bone. The area fraction of bone in stained sections and the ultimate compressive stress of the regenerated bone were greater using the CaSO4/CaPO4 composite graft compared to pure CaSO4 pellets after 13 and 26 weeks and were greater than normal bone. The elastic modulus of restored bone in defects treated with CaSO4/CaPO4 composite graft was greater than in defects treated with CaSO4 pellets after 26 weeks, but similar to specimens of normal bone. A small amount of CaSO4/CaPO4 composite graft and no CaSO4 pellets remained after 13 or 26 weeks. This novel CaSO4/CaPO4 composite holds promise for clinical applications where a strong, injectable, slower-resorbing, and biocompatible bone graft substitute would be advantageous. PMID:17415007

Urban, Robert M; Turner, Thomas M; Hall, Deborah J; Inoue, Nozomu; Gitelis, Steven

2007-06-01

328

Atrial septal defect closure on cardiopulmonary bypass in a sickle cell anemia: Role of hydroxyurea and partial exchange transfusion  

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Full Text Available Partial exchange transfusion during cardiopulmonary bypass, while conducting cardiac surgery may be a useful technique in patients with high level of sickle hemoglobin. Along with this preoperative use of hydroxyurea and alternative analgesic modalities such as transcutaneous electrical nerve stimulation in postoperative period may be beneficial, in our opinion. A 16-year-old female of Turner?s syndrome having sickle cell anemia scheduled for closure of arterial septal defect on cardiopulmonary bypass was managed with partial exchange transfusion and warm cardioplegia.

Gosavi Kundan

2010-01-01

329

Cardio-pulmonary exercise testing: An objective approach to pre-operative assessment to define level of perioperative care  

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Full Text Available Cardiopulmonary exercise testing is a non-invasive, objective method of assessing integrated response of heart, lungs and musculoskeletal system to incremental exercise. Though it has been in use for a few decades, the recent rise in its use as a preoperative test modality is reviewed. A brief account of cardiopulmonary exercise test, as it is carried out in practice and its applications, is given. The physiological basis is explained and relationship of pathophysiology of poor exercise capacity with various test variables is discussed. Its use for prediction of postoperative morbidity in various noncardiopulmonary surgical procedures is reviewed.

Bhagwat Milind

2010-01-01

330

Successful resuscitation of a patient with critical aortic stenosis and cardiac arrest by peripheral cardiopulmonary support system.  

Science.gov (United States)

Patients with critical aortic stenosis have an increased risk of complications during diagnostic cardiac catheterization, and those who arrest are particularly difficult to resuscitate. Recent advances in therapeutic techniques may change this unfavorable prognosis, as it is illustrated in the presented case. A 68 year-old women with critical aortic stenosis sustained a cardiac arrest during diagnostic cardiac catheterization. Conventional cardiopulmonary resuscitation for 45 minutes failed to restore cardiac function and rhythm, which had degenerated to ventricular fibrillation, electromechanical dissociation, and asystole. Peripheral cardiopulmonary support system restored cardiac rhythm and blood pressure, with a subsequent successful aortic valve replacement. PMID:2354511

Pavlides, G S; Cieszkowski, J; Timmis, G C; O'Neill, W

1990-06-01

331

Polytetrafluoroethylene vein composite grafts across the knee.  

Science.gov (United States)

Fifteen Gore-tex vein composite femoral-popliteal artery bypass procedures were performed during the four year period of December 1975 to December 1979. Nine were performed for salvage of the limb and six, for incapacitating claudication. Preoperatively, all patients had an arteriographic evaluation of the outflow tract. CPR by the life-table method was 63 per cent at six years. Early failures were three occlusions within two months in patients with poor outflow. One late occlusion occurred at 16 months, and the limb was salvaged with a femoral tibial bypass graft. Another late occlusion was treated by thrombectomy at 24 months with continued patency. Late revision was carried out in one patient at seven months. This consisted of repair of a stenosis of the distal popliteal artery with salvage of the graft. Only two of ten grafts available for evaluation beyond one year have become occluded. All patients operated upon for claudication or with good runoff have patent grafts. On the contrary, none of the grafts to an isolated popliteal segment remained patent. When there is not sufficient autogenous saphenous vein available for femoral-popliteal bypass, the ready availability of a synthetic graft makes it an attractive choice. Nevertheless, our 63 per cent CPR at six years strongly suggests that the composite graft is a durable option. PMID:6612572

Scribner, R G; Beare, J P; Harris, E J; Sydorak, G R; Tawes, R L; Brown, W H

1983-09-01

332

Surface grafting density analysis of high anti-clotting PU-Si-g-P(MPC) films  

International Nuclear Information System (INIS)

Well-defined zwitterionic polymer brushes with good blood compatibility were studied, grafted from polyurethane (PU) substrate (PU-Si-g-P(MPC)) by surface-initiated reverse atom transfer radical polymerization (SI-RATRP). We found that the structure of polymer brushes and hence their properties greatly depend on the grafting density. To solve the problems of the normal method for grafting density measurement, i.e., more requirements for qualified and proficient instrument operator, we established an effective and feasible way instead of the conventional method of spectroscopic ellipsometer combined with gel permeation chromatograph (ELM/GPC) to calculate the grafting density of PU-Si-g-P(MPC) films by using a software named ImageJ 1.44e in combination with scanning electronic microscope (SEM) or atomic microscope (AFM). X-ray photoelectron spectroscopy (XPS), SEM and AFM were employed to analyze the surface topography and changes of elements before and after graft modification of the synthetic PU-Si-g-P(MPC) biofilms.

333

Radiation-induced graft copolymerization to polyester, 18  

International Nuclear Information System (INIS)

Properties of polyester (polyethylene terephthalate) fibers grafted with acrylic acid (AA) and methacrylic acid were measured not only in the form of free acid but also in the form of sodium and calcium salts. Nearly the same moisture regain as that of cotton was obtained in the cases of sodium acrylate graft (AA-Na) and methacrylate graft (MAA-Na) at 14 and 18% graft respectively. Although the rate of water droplet absorption by the wicking test revealed that the rate increased with grafting, it is generally lower than that of cotton. Only AA-Na graft showed similar rate as that of cotton at 5% graft. All other grafts i.e. AA, AA-Ca, MAA and MAA-Na grafts showed lower rate than cotton even at higher percent graft. Results of frictional electricity test were similar, AA-Na graft showed satisfactory low static charge, whereas the effect of the grafting was insufficient in the cases of AA, MAA and MAA-Na grafts. Polyester fibers above 10% AA graft were dyed homogeneously to deep color with cationic and disperse dyes. AA, AA-Na and AA-Ca grafts showed almost the same dyeability. In the case of MAA grafts, only MAA-Na graft showed good dyeability. Fibers dyed with cationic dyes showed poor light fastness. Nor or very little change in tensile properties of polyester fibers were observed upon grafting of acrylic acid. However, strength and modulus of grafts decrease when AA grafts above 15% graft were converted to AA-Na by treatment in aqueous sodium bicarbonate solution. (auth.)

334

Surgical treatment of infected aortic grafts.  

Science.gov (United States)

An infection of an aortic prosthesis is a severe condition with high morbidity and mortality rates. Surgical treatment of an infected aortic graft or infected aortic stent-graft focuses on treatment of the infection and maintaining or restoring perfusion of the lower limbs. Over the years various reconstruction options have been introduced, each claiming to be the most successful in securing lower limb perfusion. Consensus about the optimum treatment strategy is lacking. The frail patient population and the relative rarity of the disease limits research on this topic which is an important reason for this lack of consensus. In order to determine which of the various treatment options is the most suitable to treat aortic graft infections, this systematic review was conducted of the available literature of the last 20 years. The search strategy and data collection were based on the guidelines of the Meta-analysis Of Observational Studies in Epidemiology (MOOSE). Appropriate inclusion and exclusion criteria were defined. A total of 862 possibly relevant papers were identified. After applying the in- and exclusion, data on mortality, morbidity and complications were extracted from a total of 93 papers. This review covers the various surgical treatment options available in the treatment of infected aortic (stent) grafts. Strategies concerning graft excision are discussed as are the advantages and disadvantages of the extra-anatomic reconstruction and its counterpart, the in situ reconstruction (using antibiotic-impregnated grafts, autologous vein grafts, fresh or cryopreserved allografts, and silver impregnated grafts). Available evidence was summarized and used to construct a clinical decision flowchart. All reconstruction options seem to have their pros and cons, and all have their use in specific situations. The treatment of infected aortic grafts must therefore be tailor-made. PMID:23207555

Berger, P; Van Herwaarden, J A; Harkisoen, S; De Vries, J P M; Ekkelenkamp, M; Moll, F L

2012-12-01

335

Maternal Employment: 1979.  

Science.gov (United States)

Maternal employment is a part of modern family life, a response to changes such as smaller families and more efficient household management. Not only does maternal employment meet parents' needs, but it is a pattern better suited for socializing the child for the adult role s/he will occupy. (Author/GC)

Hoffman, Lois Wladis

1979-01-01

336

Left Coronary Ostial Stenosis after the Modified Bentall Using a Long Interposed Coronary Graft in a Patient with Pectus Excavatum.  

Science.gov (United States)

A 26-year-old man presented chest oppression. He had pectus excavatum associated with Loeys-Dietz syndrome and a history of redo aortic root replacement with the modified Bentall technique using an 8-mm long interposed graft to the left coronary ostium. Coronary angiography revealed severe stenosis of both left coronary ostium and proximal left anterior descending artery, which was supposed to be resulted from thrombosis in the interposed graft. The left coronary system was bypassed through a left thoracotomy, which was suitable in this patient because the pectus excavatum would prevent harvest of the left internal thoracic artery through re-median sternotomy and to avoid potential sternal reentry injury of the heart. Although the left anterior descending artery was easily accessed under off-pump technique, exposure and anastomosis of the circumflex coronary artery was more difficult than expected without cardiopulmonary bypass as the pectus excavatum and adhesion of the heart prevented anterior shift and rotation of the heart. PMID:23445802

Kato, Yasuyuki; Hattori, Koji; Motoki, Manabu; Takahashi, Yosuke; Nishimura, Shinsuke; Shibata, Toshihiko

2013-02-28

337

The Effect of Low-Dose of Ketamine Infusion on Stress Responses in Coronary Artery Bypass Graft Surgery  

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Full Text Available Background: Open heart surgery is associated with acute perioperative changes in plasma levels of neurohormonal stress factors,cortisol,interleukin-6 and C-reactive protein. Human studies involving cardiopulmonary bypass have shown that very low doses of ketamine can attenuate the markers of inflammation without adverse effects. The aim of this study was to investigate whether, low dose infusion of ketamine when administered during 48 hours after induction , have anti-inflammatory effect and attenuate stress factors, in on-pump coronary artery bypass graft surgery.Methods: In this prospective randomized-controlled trial, 50 patients undergoing on-pump coronary artery bypass graft were randomly assigned to receive either 1.25mcg/kg/min of ketamine (Ketamine group, n=25 or normal saline (Control group, n=25 infusion during and for 48 hours after surgery. Inflammatory and stress response markers including C-reactive protein, cortisol, White blood cell count and differential , glucose and lactate level were measured ,before induction (T1, 4 hours after surgery (T2, and on the first and the second days after surgery (T3 and T4.Results: The level of lactate were higher in ketamine compared with control group four hours after operation (P< 0.05 without any significant differences detected in other measurements. Conclusion: Low dose ketamine did not cause any change in C-reactive protein, cortisol, White blood cell count and glucose level, however lactate level was higher compared to control group.

S Azemati

2010-03-01

338

Grafting heterogeneous catalyst with gamma radiation  

International Nuclear Information System (INIS)

A process for the production of a heterogeneous catalyst comprises the steps of: irradiating an organic macromolecular substrate or a metal substrate with ionising or ultra violet radiation in the presence of a monomer selected from the group consisting of o-, m-, or p- styryl diphenyl phosphine and o-, m- or p- phenyl acrylyl diphenyl phosphine, to graft the monomer to the substrate; and reacting the graft copolymer with a homogeneous catalyst selected from the group consisting of catalytic metal salts and catalytic organometallic complexes such that the graft copolymer conjugate becomes a ligand of the catalyst

339

Salvage of a failing dialysis graft by percutaneous creation of a jump bypass graft.  

Science.gov (United States)

Percutaneous salvage of failing arteriovenous grafts with diffuse disease or occlusion in the venous outflow remains an issue with no ideal solution. The present report describes a method of percutaneous creation of vascular bypasses in a patient with a failing graft. The patient had a long-segment stenosis in the venous outflow of a brachial-cephalic dialysis graft, and the graft was salvaged by conversion to a brachial-basilic graft. Notably, this method allowed the bypass to safely traverse a long distance (20 cm), and at 8 months, the graft remained functional and free of complications. In principle, this approach can be applied to different situations in which superficial bypass conduits are desired. PMID:17675628

Kuo, Michael D; Son, Dennis H; Miller, Franklin J

2007-08-01

340

Does individual experience affect performance during cardiopulmonary resuscitation with additional external distractors?  

Science.gov (United States)

Cardiopulmonary resuscitation is perceived as a stressful task. Additional external distractors, such as noise and bystanders, may interfere with crucial tasks and might adversely influence patient outcome. We investigated the effects of external distractors on resuscitation performance of anaesthesia residents and consultants with different levels of experience. Thirty physicians performed two simulated resuscitation scenarios in random order, one scenario without additional distractors (control) and one scenario with additional distractors (noise, scripted family member). Resuscitation performance was assessed by a score based on European Resuscitation Council guidelines, presented as median (IQR [range]). We found that performance scores were lower under experimental conditions (11.8 (9.0-19.5 [-9.0 to 28.5]) than under control conditions 19.5 (14.0-25.5 [5.0-29.5]), p = 0.0002). No interaction was observed between additional distractors and experience level (p = 0.4480). External distractors markedly reduce the quality of cardiopulmonary resuscitation. This suggests that all team members, including senior healthcare providers, require training to improve performance under stressful conditions. PMID:24888475

Krage, R; Tjon Soei Len, L; Schober, P; Kolenbrander, M; van Groeningen, D; Loer, S A; Wagner, C; Zwaan, L

2014-09-01

 
 
 
 
341

A review of cardiopulmonary research in brazilian medical journals: clinical, surgical and epidemiological data  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Research in the field of cardiopulmonary disease in Brazil has been very active in recent decades. The combination of PUBMED, SCieLO, open access and online searching has provided a significant increase in the visibility of Brazilian journals. This newly acquired international visibility has in turn [...] resulted in the appearance of more original research reports in the Brazilian scientific press. This review is intended to highlight part of this work for the benefit of the readers of "Clinics." We searched through PUBMED for noteworthy articles published in Brazilian medical journals included in the Journal of Citation Reports of the Institute of Scientific Information to better expose them to our readership. The following journals were examined: "Arquivos Brasileiros de Cardiologia," "Arquivos Brasileiros de Endocrinologia e Metabologia," "Brazilian Journal of Medical and Biological Reviews," "Jornal Brasileiro de Pneumologia," "Jornal de Pediatria," "Revista Brasileira de Cirurgia Cardiovascular," "Revista da Associação Médica Brasileira," Revista da Escola de Enfermagem U.S.P." and "São Paulo Medical Journal." These journals publish original investigations in the field of cardiopulmonary disease. The search produced 71 references, which are briefly examined.

Carlos, Serrano; Mauricio Rocha e, Silva.

342

Initiation of the "abdominal pump" research of cardiopulmonary resuscitation by increasing intraabdominal pressure  

Directory of Open Access Journals (Sweden)

Full Text Available As there are contra-indications for chest compression for cardiopulmonary resuscitation (CPR, and strong chest compression may produce fracture of ribs, and also the occurrence of imbalance between ventilation and perfusion, we explored the effect of abdominal compression for CPR after cardiac arrest. Our previous research conducted in animals, and also in several clinical cases indicated that better circulatory and respiratory support effects and a higher survival rate could be achieved with CPR based on increasing intra-abdominal pressure. To study the mechanism of "abdominal pump" to achieve cardiopulmonary and cerebral resuscitation, the author has studied the anatomical physiological features of abdominal compression, and proposed the mechanism of "abdominal pump" for CPR. It provides highly theoretical guidance and practical value to the "abdominal pump" for CPR. It's our impression that abdominal compression is as important as chest compression in CPR, and it might prevent complications of chest compression with high success rate. DOI: 10.11855/j.issn.0577-7402.2014.10.01

Li-xiang WANG

2014-10-01

343

Occupational affiliation does not influence practical skills in cardiopulmonary resuscitation for in-hospital healthcare professionals  

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Full Text Available Abstract Background D-CPR (Defibrillator Cardiopulmonary Resuscitation is a technique for optimal basic life support during cardiopulmonary resuscitation (CPR. Guidelines recommend that healthcare professionals can perform CPR with competence. How CPR training and provision is organized varies between hospitals, and it is our impression that in Sweden this has generally improved during the last 15-20 years. However, some hospitals still do not have any AED (Automated External Defibrillators. The aim was to investigate potential differences in practical skills between different healthcare professions before and after training in D-CPR. Methods Seventy-four healthcare professionals were video recorded and evaluated for adherence to a modified Cardiff Score. A Laerdal Resusci Anne manikin in connection to PC Skill reporting System was used to evaluate CPR quality. A simulated CPR situation was accomplished during a 5-10 min scenario of ventricular fibrillation. Paired and unpaired statistical methods were used to examine differences within and between occupations with respect to the intervention. Results There were no differences in skills among the different healthcare professions, except for compressions per minute. In total, the number of compression per minute and depth improved for all groups (P P Conclusion Nearly all healthcare professionals learned to use the AED. There were no differences in CPR skill performances among the different healthcare professionals.

Thoren Ann-Britt

2011-01-01

344

A dose-responsive model of smoke inhalation injury. Severity-related alteration in cardiopulmonary function.  

Science.gov (United States)

The dose responsiveness of selected physiologic indices was studied in a sheep model of smoke inhalation injury. In this model, graded severity of injury was achieved by changing the contact time with smoke (defined by "unit"), whereas other variables were kept constant. Blood gas and cardiopulmonary indices were measured in 70 sheep, including 12 controls, either 24 or 72 hours after exposure to 3, 6, 9, 12, 15, or 18 units of smoke. A 12-unit dose of smoke was fatal within 72 hours and an 18-unit dose was fatal within 24 hours. The best correlation between smoke dose and response was observed in arterial oxygen tension 24 hours after exposure. At 24 hours, most of the cardiopulmonary indices showed significant change only after a 12-unit exposure. Although the exact shape of the dose-response curve could not be defined, sigmoid or curved linear shape was suggested, reflecting the progressive deterioration. Images Fig. 3. Fig. 4A. Fig. 4B. PMID:3606236

Shimazu, T; Yukioka, T; Hubbard, G B; Langlinais, P C; Mason, A D; Pruitt, B A

1987-01-01

345

113Insup(m) radiocardiographic measurements of cardiopulmonary parameters in healthy subjects and in cardiac patients  

International Nuclear Information System (INIS)

Single detector arrangements are used to measure heart radioactivity curves in healthy subjects and in patients with various heart failures. A method is developed from a modified gamma function to determine the cardiopulmonary parameters from the radiocardiograms: systemic flow, pulmonary flow, right to left shunting flow, left to right shunting flow, regurgitant fractions, stroke volume, atrial blood volumes, ventricular end-diastolic volumes, pulmonary blood volume and ejection fractions. The method is well suited to clinical routine and requires only a desk calculator or a mini-computer for data handling. The cardiopulmonary parameters were measured from 70 healthy subjects with following results: cardiac index 3.46+-0.72 l/min/m2, stroke index 49+-9 ml/b/m2, right atrial blood volume 35+-13 ml/m2, right ventricular end-diastolic volume 76+-15 ml/m2, pulmonary blood volume 250+-51 ml/m2, left atrial blood volume 41+-15 ml/m2, left ventricular end-diastolic volume 75+-15 ml/m2, right heart ejection fraction 0.64+-0.11, left heart ejection fraction 0.66+-0.12. These values agree closely with the data accumulated from more elaborate methods. (author)

346

Cardiopulmonary assessment of medetomidine, ketamine, and butorphanol anesthesia in captive Thomson's gazelles (Gazella thomsoni).  

Science.gov (United States)

This investigation evaluated the cardiopulmonary effects of medetomidine, ketamine, and butorphanol anesthesia in captive juvenile Thomson's gazelles (Gazella thomsoni). Butorphanol was incorporated to reduce the dose of medetomidine necessary for immobilization and minimize medetomidine-induced adverse cardiovascular side effects. Medetomidine 40.1 +/- 3.6 microg/kg, ketamine 4.9 +/- 0.6 mg/kg, and butorphanol 0.40 +/- 0.04 mg/kg were administered intramuscularly by hand injection to nine gazelles. Times to initial effect and recumbency were within 8 min postinjection. Cardiopulmonary status was monitored every 5 min by measuring heart rate, respiratory rate, indirect blood pressure, end-tidal CO2, and indirect oxygen-hemoglobin saturation by pulse oximetry. Venous blood gases were collected every 15 min postinjection. Oxygen saturations less than 90% in three gazelles suggested hypoxemia. Subsequent immobilized gazelles were supplemented with intranasal oxygen throughout the anesthetic period. Sustained bradycardia (ketamine, and butorphanol can be used to safely anesthetize Thomson's gazelles for routine, noninvasive procedures. More invasive procedures, such as castration, can be readily performed with the additional use of local anesthetics. PMID:12790416

Chittick, E; Horne, W; Wolfe, B; Sladky, K; Loomis, M

2001-06-01

347

Observations on some cardiopulmonary effects of midazolam, xylazine and a midazolam / ketamine combination in the goat  

Directory of Open Access Journals (Sweden)

Full Text Available Xylazine, midazolam and a midazolam / ketamine combination were administered to 6 goats in a randomised 3-way block design. All goats received all treatments with at least a 7-day interval between treatments. Statistically significant (P < 0.05 changes were observed in some of the measured cardiopulmonary variables for xylazine and midazolam/ ketamine. Xylazine administration resulted in statistically significant decreases in minute volume, arterial partial pressure of oxygen, heart rate andmeanarterial blood pressure. The increase in arterial partial pressure of carbon dioxide was not statistically significant. For the midazolam / ketamine combination, the decrease in tidal volume was statistically significant, but not the decrease in minute volume and increase in arterial partial pressure of carbon dioxide. The decrease in the arterial partial pressure of oxygen was also statistically significant. The mean arterial blood pressure for the combination was statistically significantly higher compared to xylazine. The changes in cardiopulmonary variables after midazolam administration were not statistically significant, such as tidal and minute volume, arterial partial pressure of oxygen and carbon dioxide. However, clinically significant effects such as hypoventilation and hypoxia were observed after its administration. The change in mean arterial blood pressure was minimal.

G.F. Stegmann

2012-07-01

348

Scoring System for Predicting Saphenous Vein Graft Patency in Coronary Artery Bypass Grafting  

Science.gov (United States)

The initial and long-term benefits of coronary artery bypass grafting depend upon maintaining the coronary blood flow supplied by the graft. In order to devise a scoring system for predicting graft patency, we evaluated presumptive correlations between saphenous vein graft patency and the characteristics of saphenous veins that were used as conduits in coronary revascularization. We prospectively evaluated 1,000 saphenous vein segments that were implanted in 403 consecutive patients who underwent on-pump coronary artery bypass grafting at our hospital from January 2006 through February 2009. Branches, varicosity, diameter, and wall thickness were evaluated, and a scoring system was created in order to obtain a value for each characteristic. The patients were postoperatively monitored for 1 year, and graft patency was then evaluated with the use of 64-slice multidetector computed tomography. Lesions were found in 12.3% of the grafts. All of the evaluated characteristics of the grafts had a significant correlation with saphenous vein graft flow (P <0.0001). Using the venous characteristics in our statistical analysis, we devised a formula to obtain a score (range, 4–12) to predict the patency of each graft. A cutoff score of 7 yielded 87.8% sensitivity and 82.8% specificity. Our scoring system has good prognostic value. We believe that it can assist surgeons in choosing the most appropriate conduit and target vessel for coronary artery bypass grafting, especially in high-risk patients who are particularly dependent on blood flow through saphenous vein grafts. PMID:20978562

Sarzaeem, Mahmood Reza; Mandegar, Mohammad Hossein; Roshanali, Farideh; Vedadian, Ali; Saidi, Bahare; Alaeddini, Farshid; Tabarestani, Nardin

2010-01-01

349

Study on radiation graft copolymerization of MMA onto SBS. Pt.1: Liquid phase radiation graft copolymerization  

International Nuclear Information System (INIS)

This paper introduces mainly experimental results of graft copolymerization of styrene-butadiene-styrene (SBS) with methyl methacrylate (MMA) in solution by ?-ray irradiation. Effects of irradiation dose and monomer concentration on mass increment and graft yield onto two types of SBS have been discussed. FTIR characterization of the irradiated samples showed that the monomer had been grated to the SBS molecular chains, while thermal performance of the graft products, SBS-g-MMA, was measured by DSC. (authors)

350

Coronary Artery Bypass Grafting Combined with Total Occlusion of Internal Carotid Artery  

Directory of Open Access Journals (Sweden)

Full Text Available Background: The presence of significant carotid stenosis in coronary artery bypass grafting (CABG patients increases the risk of either transient ischemic attack or stroke. However, there is a dearth of data on the risk for patients with unilateral total occlusion of the carotid artery. We herein report our results of cardiac surgery in patients with unilateral total occlusion of the carotid artery. Methods: We examined 10,000 patients who underwent carotid artery duplex scanning before CABG or other cardiac procedures between January 2001 and September 2006 at Tehran Heart Center. The occlusions were detected via carotid Doppler screening and were confirmed through conventional or MR angiography. Among these patients, 15 (0.15% patients had unilateral total occlusion of the internal carotid artery, and all of them underwent elective cardiac surgery. During cardiopulmonary bypass, the mean arterial pressure was maintained at above 60 mmHg with vasopressure drugs and increasing flow pump.Results: There were 4 patients with left and 11 patients with right carotid occlusions. Four patients had a history of cerebrovascular accident. The mean cross-clamp time (min and perfusion time (min was 50.7±17.3 and 94.2±26.7, respectively. The mean graft number was 4.1±0.9. One of these patients expired intraoperatively because of low cardiac output. In one (6.66% patient, postoperative cerebrovascular accident occurred on the contralateral side of the totally occluded region. All the patients recovered uneventfully. Conclusion: Our results suggest that CABG can be performed in patients with unilateral total occlusion of the internal carotid artery without ipsilateral stroke using our strategies.

Seyed Hesameddin Abbasi

2008-08-01

351

Levosimendan usage in patients with left ventricle dysfunction in coronary artery bypass graft surgery  

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Full Text Available Introduction: In this study we explicated early results of patients (the patients in whom levosimendan was used who underwent coronary artery bypass graft surgery with ejection fraction 35% or less. We compared this group with the patients in whom levo-simendan was not used. Material and Methods: 97 patients who have 35% ejection fraction or less taken to isolated coronary artery bypass surgery between January 2009 and December 2011 in our clinic are chosen for this study retrospectively. We compared the patients in whom levosimendan was used with the patients in whom levosimendan was not used. Levo- simendan (Simdax, Abbott has been used according to surgeon’s decision in patients. Results: The mean age of group 1 was 62.3 ± 7.6, and the mean age of group 2 was 59.3 ± 10.5 (p > 0.05. It was detected that the average ejection fraction was less in group 1 (p < 0.05. There were no statistically significant difference between the two groups in terms of demand for inotropics, demand for intraaortic balloon pump, revision (because of bleeding, atrial fibrillation, discharging intervals, intensive care unit time, cross clamp and cardiopulmonary bypass time (p > 0.05. It was found that need for blood transfusion were less in group 1 than group 2 (p < 0.05. There were no statistically significant difference between the two groups in terms of mortality (p > 0.05. Conclusion: We consider levosimendan reduces need for blood transfusion in coronary artery bypass graft surgery. This results may change with increasing number of patients so we consider that multicenter larger study is needed.

Habib Cakir

2012-10-01

352

Processos de proteção dos garfos na enxertia da mangueira Grafting processes for mango tree protection  

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Full Text Available Diferentes processos de proteção dos garfos foram pesquisados na produção de mudas por enxertia, da mangueira ‘Tommy Atkins’. Os tratamentos utilizados foram os seguintes: saquinho de polietileno (testemunha, filme de PVC, parafilme, cera de abelha, parafina e parafina + vaselina. Verificou-se que o filme de PVC e o parafilme proporcionaram pegamentos de enxertia semelhantes à testemunha (40,60%, 56,62% e 48,33%, respectivamente, enquanto que para os demais tratamentos, os percentuais de pegamento foram muito baixos (Different processes of graft protection were evaluated in the process of grafting ‘Tommy Atkins’ mango trees. The treatments employed were the following: polyethylene bag (control, PVC film, parafilm, bee wax, paraffin and paraffin + vaseline. It was verified that both PVC film and parafilm presented successful grafting in relation to the control (40.60%, 56.62% and 48.33%, respectively, while the other treatments presented low success rate (<10%. It was concluded that the PVC film or parafilm can be employed optionally as a replacement of the plastic bag for protection of mango grafting.

Angelo Pedro Jacomino

2000-03-01

353

Spreader graft placement: A simplified technique for young surgeons.  

Science.gov (United States)

The spreader graft is a longitudinal graft placed between the dorsal septum and the upper lateral cartilage in a submucoperichondrial pocket. This graft has functional and aesthetic indications. Although placement and suturing of the spreader graft to the septum is an easy part of rhinoplasty for the experienced surgeon, it can be difficult and time-consuming for young surgeons. Here we suggest a very simple technique for easier placement and suturing of spreader grafts. PMID:25037303

Varedi, P; Bohluli, B; Bayat, M; Mohammadi, F

2014-10-01

354

Anterior Cruciate Ligament Graft Choices: A Review of Current Concepts  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The graft choice for anterior cruciate ligament (ACL) reconstruction continues to be controversial. There are several options available for the treating surgeon, including Bone Patellar Tendon Bone (BPTB) grafts, Hamstring tendon (HT) grafts, allografts and synthetic grafts. Within the last decade there have been several comparative trials and meta-analysis, which have failed to provide an answer with regards to the best graft available. The aim of this review is to understand the current con...

Dheerendra, Sujay K.; Khan, Wasim S.; Singhal, Rohit; Shivarathre, Deepak G.; Pydisetty, Ravi; Johnstone, David

2012-01-01

355

Grafting of different European beech (Fagus sylvatica L.) cultivars  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The survey was conducted in 2008 on the European beech (Fagus sylvatica L.) at the Faculty of Agriculture and Life Sciences, University of Maribor. We grafted four different cultivars: 'Pendula', 'Atropunica', 'Zlatia' and 'Tricolor'. The grafting took place in the spring using bench grafting approach combined with side wedge grafting technique. We investigated the impact of different cultivars on the success of grafting. For each cultivar we analysed the impact of rootstock thickness, lengt...

Cerar, Tina

2010-01-01

356

Graft Rejection and Graft Failure After Penetrating Keratoplasty or Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy  

DEFF Research Database (Denmark)

PURPOSE:: To compare the frequency of rejection episodes and graft failure because of surgical complications or rejection after Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK) for Fuchs endothelial dystrophy. METHODS:: A total of 201 eyes of 201 consecutive patients with Fuchs endothelial dystrophy undergoing keratoplasty were included. One hundred two patients underwent DSAEK and 99 PK in the period January 1, 2000, to December 31, 2010. Postoperative topical steroid treatment was similar in the 2 groups. Most patients in the PK group received a short course of oral prednisolone, which was not prescribed for patients undergoing DSAEK. Patient records were retrospectively reviewed; rejection episodes and causes of graft failures were recorded, and Kaplan-Meier survival curves up to 5 years after surgery were computed and compared. RESULTS:: All rejection episodes and most graft failures occurred during the first 2 years after surgery. In this period, rejection episodes were noted in 16% of PK and in 5% of DSAEK-treated eyes (P = 0.03). During the first 5 years, significantly more DSAEK grafts than PK grafts had failed (P = 0.04) but only 2 PK-treated and no DSAEK-treated grafts failed because of rejection. CONCLUSION:: The frequency of graft rejection episodes is higher after PK than DSAEK for primary endothelial disease, despite the use of oral prednisolone in the PK group. Early graft failure is more common after DSAEK than after PK, whereas graft failure because of previous rejection episodes is uncommon after DSAEK and PK.

Hjortdal, Jesper; Pedersen, Iben B

2013-01-01

357

Grafting of Methacrylonitrile and Ethyl Methacrylate onto Jute Fibre: Physico-chemical Characteristics of Grafted Jute  

Science.gov (United States)

Modification of bleached jute fibre was done by graft co-polymerization with vinyl monomers e.g. methacrylonitrile and ethyl methacrylate, in aqueous medium using H2O2-Na2S2O3 as redox initiators. To make the process efficient, the optimized polymerization condition was established. The maximum percent grafting and grafting efficiency obtained at optimum grafting condition were 11.3 and 20.4% for MAN, respectively and that of 17.6 and 27.5% for EMA. Modification of bleached jute fibre with MAN and EMA reduced the loss in breaking strength and the yellowing on exposure to sunlight in air.

Mondal, Md. Ibrahim H.; Islam Farouqui, Faisul; Abu Hanif, Md.; Shafiur Rahman, G. M.; Asadul Hoque, Md.

2005-10-01

358

29 CFR 783.7 - “Employer”, “employee”, and “employ”.  

Science.gov (United States)

...Definitions § 783.7 “Employer”, “employee”, and “employ”. The Act's major provisions...child labor. The Act provides its own definitions of “employer”, “employee...as used in the Act. An employer may have...

2010-07-01

359

29 CFR 779.19 - Employer, employee, and employ.  

Science.gov (United States)

...Definitions § 779.19 Employer, employee, and employ. The Act's major provisions...oppressive child labor. The Act provides its own definitions of “employer,” “employee”, and...terms, as used in the Act. An employer may have an...

2010-07-01

360

29 CFR 784.8 - “Employer,” “employee,” and “employ.”  

Science.gov (United States)

...Definitions § 784.8 “Employer,” “employee,” and “employ.” The Act's major provisions...child labor. The Act provides its own definitions of “employer,” “employee” and...as used in the Act. An employer may have...

2010-07-01

 
 
 
 
361

Buccal Mucosal Graft in Repeat Urethroplasty  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Introduction: Our aim was to evaluate the efficacy of a tubed buccal mucosal graft in repeat urethroplasty for patients with urethral stricture and failed previous operations.

Gholamreza Pourmand; Sepehr Salem; Alireza Sina; Hooman Djaladat; Abdorasol Mehrsai

2005-01-01

362

Mechanical Bench Grafting for Apple Propagation  

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Full Text Available Mechanically and manually prepared stock and scion for bench grafting were adopted in four phases for apple propagation i.e., mechanically made stock and manually prepared scion, second phase was vice versa while in third stage both the stock and scion were prepared mechanically. In fourth operation all the grafting process was performed by hand made scion and stock. Maximum sprouting and success percentage of 93.2 and 83.2 respectively was recorded in the mechanically prepared scion and stock. Results proved that this operation was also the most efficient which took 95.4 minutes only to graft hundred plants of apple. In conclusion mechanical technique for bench grafting in apple propagation was recorded as the best and efficient method.

Muhammad Ashraf Sumrah

2002-01-01

363

Iliac crest reconstruction after tricortical graft harvesting.  

Science.gov (United States)

Twenty-eight patients underwent anterior iliac crest reconstruction after the harvesting of autogenous tricortical graft. The anterior iliac crest was reconstructed using the resected rib from the thoracoabdominal approach. The authors evaluated graft site pain and residual deformity, radiographic evidence of rib incorporation, and the incidence of lateral femoral cutaneous nerve injury. There were no reports of graft site pain greater than "acceptable" levels, requiring nonnarcotic analgesics on an intermittent basis and not interfering with activities of daily living. Four lateral femoral cutaneous nerve neuropraxias were recorded, none of clinical significance. The authors advocate the use of autogenous tricortical anterior iliac crest bone graft when performing reconstructive spinal surgery, followed by reconstruction of the iliac crest with the resected rib from the surgical approach. PMID:7919644

Harris, M B; Davis, J; Gertzbein, S D

1994-06-01

364

Graft Union Formation in Tomato Plants: Peroxidase and Catalase Involvement  

Science.gov (United States)

• Background and Aims The use of grafted plants in vegetable crop production is now being expanded greatly. However, few data are available on the formation of graft unions in vegetables. In this work, the structural development of the graft union formation in tomato plants is studied, together with the possible relationship with activities of peroxidases and catalases. • Methods Tomato (Lycopersicon esculentum Mill.) seedlings of cultivar Fanny were grafted on the rootstock of cultivar AR?9704 using the ‘tongue approach grafting’ method, and were grown in a crop chamber. A study of the structural development of the graft union and the involvement of peroxidases and catalases in the process of graft formation was carried out during the first stages of the graft union (4, 8 and 15 d after grafting). • Key Results Observation of the structure of the graft union showed formation of xylem and phloem vessels through the graft union 8 d after grafting. In addition, root hydraulic conductance, L0, indicate that the graft union is fully functional 8 d after grafting, which coincided with an increase of peroxidase and catalase activities. • Conclusions These results suggest that increased peroxidase and catalase activities might be implicated in graft development in tomato plants. PMID:14630693

FERNÁNDEZ?GARCÍA, NIEVES; CARVAJAL, MICAELA; OLMOS, ENRIQUE

2004-01-01

365

Effect of different grafting methods for absorption, translocation and distribution of 59Fe in apple trees  

International Nuclear Information System (INIS)

The test result with 59Fe demonstrate that the iron content in leaves by belly grafting is higher than that by cleft grafting and cutting grafting, and the content of chlorophyll in leaves and height and diameter of apple seedling by belly grafting is larger than cleft grafting and cutting grafting too. It is important to replace cleft grafting and cutting grafting with belly grafting as a method of top-working to correct chlorosis and improve growth of new cultivar

366

Pre-operative atorvastatin therapy to decrease the systemic inflammatory response after coronary artery bypass grafting.  

Science.gov (United States)

The effect of pre-operative atorvastatin on systemic inflammatory response syndrome (SIRS), often seen after coronary artery bypass grafting (CABG) was evaluated in 40 patients undergoing elective CABG. Patients were divided into two groups: group I (pre-operative LDL cholesterol > or = 100 mg/dl; n = 20) received 20 mg/day atorvastatin for at least 15 days pre-operatively; group II (pre-operative LDL cholesterol < 100 mg/dl; n = 20) did not receive antihyperlipidaemic agents. All patients underwent CABG with cardiopulmonary bypass. Blood samples were taken pre-operatively and 24 h post-operatively. There were no significant differences between the two groups in terms of demographic, pre-operative or operative parameters. At 24 h post-operatively, median high-sensitivity C-reactive protein and mean interleukin-6 levels were significantly lower in group I compared with group II. There were no other significant differences in post-operative parameters between the two groups, except for duration of stay in the intensive care unit, which was shorter in group I patients. In conclusion, pre-operative atorvastatin treatment in patients undergoing elective CABG decreased inflammation parameters and could be effective in preventing SIRS. PMID:19094433

Dereli, Y; Ege, E; Kurban, S; Narin, C; Sarigül, A; Yeniterzi, M

2008-01-01

367

Influence of triflusal on platelet activation after coronary artery bypass graft.  

Science.gov (United States)

The aim of the study was to investigate the effects of the antiplatelet agent triflusal on the changes in platelet function in patients who underwent a cardiopulmonary bypass for coronary arteries (CABG). In 20 surgical patients, blood was sampled before and at the conclusion of surgery, 48 h later (in the intensive care unit), and after 10 days of treatment with 600 mg/day triflusal (triflusal was administered from the first day after surgery). Adenosine diphosphate (ADP) and collagen-induced platelet aggregation in whole blood, granular release of beta-thromboglobulin and platelet release of thromboxane B2 were measured. Basal values were compared with results in a group of ten healthy volunteers. All platelet determinations of activation were higher in coronary patients than in healthy volunteers. Immediately after CABG, the platelet reactivity to ADP and collagen were significantly lower, and release of beta-thromboglobulin and thromboxane B2 were higher, than in the pre-CABG samples. During the patient's stay in the intensive care unit, all values tend to return to pre-CABG values. Triflusal inhibits both platelet beta-thromboglobulin (63% with respect to the post-CABG value) and thromboxane B2 (91% with respect to the post-CABG value) release. Platelet aggregation after 10 days of triflusal treatment tended to return to the pre-CABG values. In conclusion, Triflusal reduces platelet activation caused by the coronary artery bypass graft surgery. PMID:10759013

Prieto, M A; De La Cruz, J P; Del Prado, M F; Sánchez de la Cuesta, F

2000-03-01

368

The outcome of thoracic epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery  

Science.gov (United States)

Background: Thoracic epidural anesthesia (TEA) improves analgesia and outcomes after a cardiac surgery. As aging is a risk factor for postoperative pulmonary complications, TEA is of particular importance in elderly patients undergoing coronary artery bypass graft (CABG). Methods: Fifty patients aged 65–75 years; ASA II and III scheduled for elective CABG were included in the study. Patients were randomized to receive either general anesthesia (GA) group alone or GA combined with TEA group. Heart rate (HR), mean arterial pressure (MAP), and central venous pressure were recorded. Total dose of fentanyl ?g/kg, aortic cross clamping, cardiopulmonary bypass (CPB) time, time to first awaking and extubation, arterial blood gases, visual analog scale (VAS) score in intensive care unit were reported. Postoperative pulmonary function tests were done. Results: TEA showed a significant HR and lower MAP compared with the GA group. The total dose of intraoperative fentanyl and nitroglycerine were significantly lower in the TEA. Patients in TEA group have statistically significantly higher PaO2, lower PaCO2, increase in Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1) Conclusions: TEA reduced severity of postoperative pulmonary function and restoration was faster in TEA group in elderly patients undergoing CABG. Also, it resulted in earlier extubation and awakening, better analgesia, lower VAS. PMID:22412771

El-Morsy, Gamal Z.; El-Deeb, Alaa

2012-01-01

369

Dermis fat grafting in contracted socket  

Directory of Open Access Journals (Sweden)

Full Text Available 5 cases of severely contracted sockets were recon-structed with the use of dermis-fat graft. This type of graft is extremely useful as it is more viable and is a suitable replacement for soft tissue deficiency as in case of contracted socket. Excellent results were obtained and this method seems to be the method of choice in the manage-ment of such cases.

Betharia S

1988-01-01

370

Grafting of a LLDPE using gamma irradiation  

International Nuclear Information System (INIS)

In this investigation, the grafting of a commercial linear low-density polyethylene (LLDPE) with different concentrations of diethyl maleate (DEM, 5 and 15 wt.%) was carried out at different absorbed doses from a cobalt-60 source of gamma rays (0, 15, 30, 50, 100, 200 kGy). This process was performed in a decalin solution at 10% w/v to obtain a homogeneous dispersion of the monomer into the polyethylene matrix. The grafting degree was estimated by means of FTIR using a calibration curve reported in literature. Thermal properties of the functional polymers were studied by thermogravimetric analysis (TGA). Melt flow index (MFI) values were also taken. The results found indicate that the grafting degree increases as the concentration of DEM in the reaction mixture and the absorbed doses are increased upto 100 kGy, as expected. However, the behavior at higher doses is attributed to secondary reactions such as long-chain branching and/or crosslinking, which are faster than radical reactions responsible for the grafting of the DEM onto the polymeric chain. This fact was ascertained by the decrease of the MFI values as the applied irradiation was increased, irrespective of the quantity of DEM used in the grafting reaction. Therefore, in order to obtain a high grafting degree, the absorbed dose should be estimated carefully. Initial degradation temperatures of the grafted PEs decreased when the gamma irradiation dose was higher than 100 kGy. This indicates that the thermal stability decreases as higher doses are applied to the material, which is associated to branching and crosslinking. The grafting degree never exceeded 0.3 mol%, which demonstrates the low efficiency of the functionalization procedure here presented

371

Fusarium incarnatum/equiseti hemodialysis graft infection  

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Full Text Available Hemodialysis graft infections typically occur as a result of contamination by skin flora at the time of insertion or become secondarily infected after high-grade bacteremia. Infection of implanted vascular devices with filamentous fungi is rare. We report a case of infection of an implanted polytetrafluoroethylene dialysis graft with Fusarium incarnatum/equiseti that did not grow in cultures of tissue but was identified by molecular means.

Jeffery D. Punch

2010-08-01

372

Mechanical Bench Grafting for Apple Propagation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Mechanically and manually prepared stock and scion for bench grafting were adopted in four phases for apple propagation i.e., mechanically made stock and manually prepared scion, second phase was vice versa while in third stage both the stock and scion were prepared mechanically. In fourth operation all the grafting process was performed by hand made scion and stock. Maximum sprouting and success percentage of 93.2 and 83.2 respectively was recorded in the mechanically prepared scion and stoc...

Muhammad Ashraf Sumrah; Allah Bakhsh; Zahid Hussain; Shafique Ahmad

2002-01-01

373

Grafting-responsive miRNAs in cucumber and pumpkin seedlings identified by high-throughput sequencing at whole genome level.  

Science.gov (United States)

Grafting is an important agricultural technique widely used for improving growth, yields and tolerance of crops to abiotic and biotic stresses. As one type of endogenous, non-coding small RNAs, microRNAs (miRNAs) regulate development and responsiveness to biotic and abiotic stresses by negatively mediating expression of target genes at the post-transcriptional level. However, there have been few detailed studies to evaluate the role of miRNAs in mediation of grafting-induced physiological processes in plants. Cucumis sativus and Cucurbita moschata are important vegetables worldwide. We constructed eight small RNA libraries from leaves and roots of seedlings that were grafted in the following four ways: (1) hetero-grafting, using cucumber as scion and pumpkin as rootstock; (2) hetero-grafting, with pumpkin as scion and cucumber as rootstock; (3) auto-grafting of cucumbers and (4) auto-grafting of pumpkins. High-throughput sequencing was employed, and more than 120 million raw reads were obtained. We annotated 112 known miRNAs belonging to 40 miRNA families and identified 48 new miRNAs in the eight libraries, and the targets of these known and novel miRNAs were predicted by bioinformatics. Grafting led to changes in expression of most miRNAs and their predicted target genes, suggesting that miRNAs may play significant roles in mediating physiological processes of grafted seedlings by regulating the expression of target genes. The potential role of the grafting-responsive miRNAs in seedling growth and long-distance transport of miRNA was discussed. These results are useful for functional characterization of miRNAs in mediation of grafting-dependent physiological processes. PMID:24279842

Li, Chaohan; Li, Yansu; Bai, Longqiang; Zhang, Tieyao; He, Chaoxing; Yan, Yan; Yu, Xianchang

2014-08-01

374

Positive end-expiratory pressure improves survival in a rodent model of cardiopulmonary resuscitation using high-dose epinephrine.  

LENUS (Irish Health Repository)

Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pulmonary vascular resistance, and potentially improve cardiac output, its use during CPR would increase survival.

McCaul, Conán

2009-10-01

375

EFFECTS OF INHALATION OF SOLUBLE METALLIC CONSTITUENTS OF PARTICULATE MATTER ON CARDIOPULMONARY, THERMOREGULATORY, AND BIOCHEMICAL PARAMETERS IN GUINEA PIGS  

Science.gov (United States)

EFFECTS OF INHALATION OF SOLUBLE METALLIC CONSTITUENTS OF PARTICULATE MATTER ON CARDIOPULMONARY, THERMOREGULATORY, AND BIOCHEMICAL PARAMETERS IN GUINEA PIGS. JP Nolan1, LB Wichers2, J Stanek3, UP Kodavanti1, MCJ Schladweiler1, PA Evansky1, ER Lappi1, DL Costa1, and WP Watkinson1...

376

Local graft irradiation in renal transplant rejection  

International Nuclear Information System (INIS)

From 1977 to 1988, of 142 renal transplantations, seven recipients (4.9%) received local graft irradiation following rejective reaction refractory to antirejection medical managements. Concurrent with the administration of pulsed high dose methylprednisolone and other antirejection medical managements, the graft was irradiated with a total dose of 6.0 Gy-150 cGy per fraction every other day at the midplane of the graft using two opposing portals of 4MX Linac. The fields were defined by palpation and echography. All patients had improvements in serum creatinine on the 10th day after beginning the irradiation. Four patients with peripheral lymphocytosis during the irradiation combined with pulsed high dose methylprednisolone improved in renal functions. On the other hand, out of 3 patients with lymphcytopenic changes, in two the transplanted graft was removed due to deteriorations, and the other patient is currently suffering from chronic rejection. Local graft irradiation can be useful in maintaining a rejective graft and reversing its functions in some patients whose rejective reaction failed to respond to the antirejection medical managements. (author)

377

Additive effects in radiation grafting and curing  

International Nuclear Information System (INIS)

Full text: Detailed studies on the accelerative effect of novel additives in radiation grafting and curing using acrylated monomer/oligomer systems have been performed in the presence of ionising radiation and UV as sources. Methyl methacrylate (MMA) is used as typical monomer for these grafting studies in the presence of the additives with model backbone polymers, cellulose and propropylene. Additives which have been found to accelerate these grafting processes are: mineral acid, occlusion compounds like urea, thermal initiators and photoinitiators as well as multifunctional monomers such as multifunctional acrylates. The results from irradiation with gamma rays have also been compared with irradiation from a 90W UV lamp. The role of the above additives in accelerating the analogous process of radiation curing has been investigated. Acrylated urethanes, epoxies and polyesters are used as oligomers together with acrylated monomers in this work with uv lamps of 300 watts/inch as radiation source. In the UV curing process bonding between film and substrate is usually due to physical forces. In the present work the presence of additives are shown to influence the occurrence of concurrent grafting during cure thus affecting the nature of the bonding of the cured film. The conditions under which concurrent grafting with UV can occur will be examined. A mechanism for accelerative effect of these additives in both grafting and curing processes has been proposed involving radiation effects and partitioning phenomena

378

Graft-copolymerization onto carbon black  

International Nuclear Information System (INIS)

Radiation-induced graft copolymerization of vinyl monomer onto carbon black was performed. During the ?-ray- and electron beam-induced polymerization (In-source), or the electron beam post-polymerization, the graft-copolymerization behavior was affected by the kinds of both carbon blacks and monomers, i.e. the smaller the size of carbon black particles, the higher the apparent grafted fraction. Homopolymer in the grafted carbon black samples was washed out by the solvent of the polymer, and the extracted polymer seemed to be dimer or trimer of the used monomer. In the case of the post-polymerization with the pre-irradiation doses of 50 Mrad, homopolymer was hardly observed. The polymer sheets of plastics or rubbers with grafted carbon black had an electrical conductivity unalterable considerably by the heating cycles. The particles of grafted carbon black in the sheet might be kept much more at the surface layer within 100 nm depth than at the inner layer. (author)

379

CUTTINGS AND GRAFTING IN ROOTSTOCKS OF TOMATO  

Directory of Open Access Journals (Sweden)

Full Text Available When performing in plants by grafting methods slit at the time of grafting is discarded cup rootstock. In this context, the aim of this work is to evaluate the technique of cutting in tomato plants that exhibit characteristics for use as rootstocks for tomato grafting and attachment provided by clones Cup compared to rootstocks propagated by seeds . For execution of the work, two experiments were conducted in the agricultural year 2013, for the first experiment was rooting three rootstocks: 1 wild species Solanum pennellii 'LA716', 2 access mini-tomato 6889; and 3 Witness (tomato Santa Cruz Kada® for the second experiment we evaluated the handle grafting rootstocks propagated by cuttings, compared to the same propagated by seeds. For the first experiment, treatments rootstocks access mini-tomato 6889 and witness, provided the greatest percentage of cuttings. For the second experiment, to evaluate the variable takes grafting, it was found that tomato rootstocks propagated by cuttings provide a good grip grafting the same or similar propagated by seeds.

A. R. Zeist

2014-09-01

380

Deficiency of employability capacity  

Directory of Open Access Journals (Sweden)

Full Text Available Young unemployed people have comprised one of the significantly largest groups of the unemployed people in Latvia in recent years. One of the reasons why young people have difficulty integrating into the labour market is the “expectation gap” that exists in the relations between employers and the new generation of workers. Employers focus on capacity-building for employability such individual factors as strength, patience, self-discipline, self-reliance, self-motivation, etc., which having a nature of habit and are developed in a long-term work socialization process, which begins even before the formal education and will continue throughout the life cycle. However, when the socialization is lost, these habits are depreciated faster than they can be restored. Currently a new generation is entering the labour market, which is missing the succession of work socialization. Factors, such as rising unemployment and poverty in the background over the past twenty years in Latvia have created a very unfavourable employability background of “personal circumstances” and “external factors”, which seriously have impaired formation of the skills and attitudes in a real work environment. The study reveals another paradox – the paradox of poverty. Common sense would want to argue that poverty can be overcome by the job. However, the real state of affairs shows that unfavourable coincidence of the individual, personal circumstances and external factors leads to deficit of employability capacity and possibility of marked social and employment deprivation.

Pelse I.

2012-10-01

 
 
 
 
381

Coronary artery bypass grafting and sensorineural hearing loss, a cohort study  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Sudden sensorineural hearing loss is routinely encountered by the otologist. The etiology is varied and often identifiable. One of the relatively less frequent causes is surgery. Apart from being an established entity with otological surgeries, sensorineural hearing loss has also been known to occur after non-otological procedures under general anesthesia. Commonest amongst these procedures is cardiopulmonary bypass, an association that has long been recognized. However, despite the proposition of diverse hypotheses in the past, the pathophysiology remains unclear. Methods The study is a prospective matched cohort study that will be carried out in Aga Khan University Hospital, Karachi, Pakistan. Participants among exposed would include all those patients who would be undergoing coronary artery bypass surgery in the hospital who fall under the criteria for inclusion. Unexposed group would comprise of patients undergoing a non-bypass procedure of similar duration under the same type of anesthesia who meet the selection criteria. Both these groups will undergo audiometric testing at our hospital on three different occasions during the course of this study. Initially before the procedure to test the baseline hearing capacity; then one week after the procedure to assess any changes in hearing ability following the surgery; and finally a third audiogram at six weeks follow-up to assess further changes in any hearing deficits noted during the second phase of testing. Certain variables including the subjects' demographics and those concerning the procedure itself will be noted and used later for risk factors analysis. A detailed past medical and surgical history will also be obtained. Data analysis would include calculation of relative risk and significance of the results, by running the chi-square test. Other statistical tests like Fisher exact test may then be employed to facilitate data interpretation. Continuous scale may then be employed and multivariate linear regression used. Discussion This study is planned to obtain a better understanding of the correlation between sudden sensorineural hearing loss and cardiopulmonary bypass. Being the first major cohort trial in this line of investigation, the project is designed to identify the existence of any significant relationship between cardiopulmonary bypass and sensorineural hearing deficit.

Ashraf Omer

2005-12-01

382

Choice of vein-harvest technique for coronary artery bypass grafting: rationale and design of the REGROUP trial.  

Science.gov (United States)

The Randomized Endo-vein Graft Prospective (REGROUP) trial (ClinicalTrials.gov NCT01850082) is a randomized, intent-to-treat, 2-arm, parallel-design, multicenter study funded by the Cooperative Studies Program (CSP No. 588) of the US Department of Veterans Affairs. Cardiac surgeons at 16 Veterans Affairs (VA) medical centers with technical expertise in performing both endoscopic vein harvesting (EVH) and open vein harvesting (OVH) were recruited as the REGROUP surgeon participants. Subjects requiring elective or urgent coronary artery bypass grafting using cardiopulmonary bypass with use of ?1 saphenous vein graft will be screened for enrollment using pre-established inclusion/exclusion criteria. Enrolled subjects (planned N = 1150) will be randomized to 1 of the 2 arms (EVH or OVH) after an experienced vein harvester has been assigned. The primary outcomes measure is the rate of major adverse cardiac events (MACE), including death, myocardial infarction, or revascularization. Subject assessments will be performed at multiple times, including at baseline, intraoperatively, postoperatively, and at discharge (or 30 days after surgery, if still hospitalized). Assessment of leg-wound complications will be completed at 6 weeks after surgery. Telephone follow-ups will occur at 3-month intervals after surgery until the participating sites are decommissioned after the trial's completion (approximately 4.5 years after the full study startup). To assess long-term outcomes, centralized follow-up of MACE for 2 additional years will be centrally performed using VA and non-VA clinical and administrative databases. The primary MACE outcome will be compared between the 2 arms, EVH and OVH, at the end of the trial duration. PMID:24633760

Zenati, Marco A; Gaziano, J Michael; Collins, Joseph F; Biswas, Kousick; Gabany, Jennifer M; Quin, Jacquelyn A; Bitondo, Jerene M; Bakaeen, Faisal G; Kelly, Rosemary F; Shroyer, A Laurie; Bhatt, Deepak L

2014-06-01

383

Enxerto composto de artéria torácica interna esquerda e veia safena magna: estudo angiográfico após oito anos / Left internal thoracic artery and saphenous vein as a composite graft: 8-year angiographic follow-up study  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O uso de enxerto composto de artéria torácica interna esquerda (ATIE) com segmentos arteriais ou segmentos de veia safena magna (VSM) pode permitir a revascularização completa do sistema coronariano esquerdo (SCE) sem circulação extracorpórea (CEC) e sem manuseio da aorta ascendente (MAA), como form [...] a de tentar reduzir alguns riscos e complicações no pós-operatório imediato. Neste trabalho, relatamos os resultados angiográficos, após oito anos, de dois pacientes submetidos à cirurgia de revascularização do SCE com enxerto composto de ATIE e VSM, sem CEC e sem MAA. Abstract in english The use of a composite graft with left internal thoracic artery (LITA) and arterial or saphenous vein (SV) grafts can allow the complete revascularization of the left coronary system (LCS) without cardiopulmonary bypass (CPB) and without ascending aorta manipulation (AAM), in order to reduce some co [...] mplications in the immediate postoperative. This study shows 8-year angiographic follow-up results of two patients underwent no-touch aorta off-pump coronary artery bypass grafting (CABG) using LITA and SV as a composite graft to supply LCS.

José Glauco, Lobo Filho; Heraldo Guedis, Lobo Filho; Francisco José Cabral, Mesquita; Jaime Paula Pessoa, Linhares Filho.

2010-03-01

384

Enxerto composto de artéria torácica interna esquerda e veia safena magna: estudo angiográfico após oito anos / Left internal thoracic artery and saphenous vein as a composite graft: 8-year angiographic follow-up study  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O uso de enxerto composto de artéria torácica interna esquerda (ATIE) com segmentos arteriais ou segmentos de veia safena magna (VSM) pode permitir a revascularização completa do sistema coronariano esquerdo (SCE) sem circulação extracorpórea (CEC) e sem manuseio da aorta ascendente (MAA), como form [...] a de tentar reduzir alguns riscos e complicações no pós-operatório imediato. Neste trabalho, relatamos os resultados angiográficos, após oito anos, de dois pacientes submetidos à cirurgia de revascularização do SCE com enxerto composto de ATIE e VSM, sem CEC e sem MAA. Abstract in english The use of a composite graft with left internal thoracic artery (LITA) and arterial or saphenous vein (SV) grafts can allow the complete revascularization of the left coronary system (LCS) without cardiopulmonary bypass (CPB) and without ascending aorta manipulation (AAM), in order to reduce some co [...] mplications in the immediate postoperative. This study shows 8-year angiographic follow-up results of two patients underwent no-touch aorta off-pump coronary artery bypass grafting (CABG) using LITA and SV as a composite graft to supply LCS.

José Glauco, Lobo Filho; Heraldo Guedis, Lobo Filho; Francisco José Cabral, Mesquita; Jaime Paula Pessoa, Linhares Filho.

385

Employers' Gas Association (ZPZ)  

International Nuclear Information System (INIS)

Employers' Gas Association (ZPZ) is the institution which main task is to maintain the optimum conditions for dynamic development of its members' activities, their business activities and to maintain the common or individual interests o fits members. To meet this objective, the association: - maintains the interests of association members during discussions with representative authorities, central state administration bodies and the trade unions regarding the economic and social policy and the questions which are to be the subject matter of collective bargaining, conclusion of contracts and the collective agreements of higher force; - is the member of enterprising, negotiating and advisory authorities; - coordinates the procedure and promotes the common interests of its members in relation to the representative