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Safety And Efficacy Of Routine Bridging Anticoagulation For Subtherapeutic Anticoagulation In Outpatients With A Left Ventricular Assist Device, David C. Shisler, Gaurang N. Vaidya, Lori Muncy, Rajakrishnan Vijayakrishnan, Mark S. Slaughter, Emma J. Birks, Dmitry Abramov 2018 University of Louisville

Safety And Efficacy Of Routine Bridging Anticoagulation For Subtherapeutic Anticoagulation In Outpatients With A Left Ventricular Assist Device, David C. Shisler, Gaurang N. Vaidya, Lori Muncy, Rajakrishnan Vijayakrishnan, Mark S. Slaughter, Emma J. Birks, Dmitry Abramov

The VAD Journal

Background

Anticoagulation with vitamin K antagonists is vital to prevent pump thrombosis in patients with left ventricular assist devices (LVADs). However, the safety and efficacy of bridging anticoagulation for the routine management of subtherapeutic international normalized ratio (INR) in stable outpatients remains poorly characterized.

Methods

In this retrospective study, a total of 60 LVAD outpatients had 110 episodes of subtherapeutic INR noted on routine testing. 34 of these episodes were managed with parenteral bridging anticoagulation and 76 were managed with only an adjusted dose of warfarin. The rates of bleeding and thromboembolic adverse events following these episodes of subtherapeutic INR ...


Gastritis Induced St Segment Elevation On Electrocardiogram, Obadah Aqtash, Ahmed Amro, Ala Gabi, Amal Sobeih, Dr. Mehiar El-Hamdani, Ellen A. Thompson 2018 Marshall University

Gastritis Induced St Segment Elevation On Electrocardiogram, Obadah Aqtash, Ahmed Amro, Ala Gabi, Amal Sobeih, Dr. Mehiar El-Hamdani, Ellen A. Thompson

Ellen A. Thompson

ST segment elevation on an electrocardiogram (EKG) is an alarming finding that warrants an urgent coronary angiogram. Early diagnosis and intervention is extremely important in the setting of Acute Coronary Syndrome (ACS) to prevent irreversible myocardium damage and reduce the mortality rate. However, it is very important to know that not all ST- Elevations (STE) on EKG are due to myocardial infraction. Etiologies can be divided into cardiac and non-cardiac causes. Cardiac causes can include coronary aneurysm and acute pericarditis while non-cardiac causes can include acute cholecystitis and pulmonary embolism. In this paper, we are presenting a unique case of ...


Gastritis Induced St Segment Elevation On Electrocardiogram, Obadah Aqtash, Ahmed Amro, Ala Gabi, Amal Sobeih, Dr. Mehiar El-Hamdani, Ellen A. Thompson 2018 Marshall University

Gastritis Induced St Segment Elevation On Electrocardiogram, Obadah Aqtash, Ahmed Amro, Ala Gabi, Amal Sobeih, Dr. Mehiar El-Hamdani, Ellen A. Thompson

Marshall Journal of Medicine

ST segment elevation on an electrocardiogram (EKG) is an alarming finding that warrants an urgent coronary angiogram. Early diagnosis and intervention is extremely important in the setting of Acute Coronary Syndrome (ACS) to prevent irreversible myocardium damage and reduce the mortality rate. However, it is very important to know that not all ST- Elevations (STE) on EKG are due to myocardial infraction. Etiologies can be divided into cardiac and non-cardiac causes. Cardiac causes can include coronary aneurysm and acute pericarditis while non-cardiac causes can include acute cholecystitis and pulmonary embolism. In this paper, we are presenting a unique case of ...


Pathophysiology Of Infective Endocarditis (Ie) Associated With Intravenous Drug Use, Kaleigh Cline 2018 Otterbein University

Pathophysiology Of Infective Endocarditis (Ie) Associated With Intravenous Drug Use, Kaleigh Cline

Master of Science in Nursing (MSN) Student Scholarship

Intravenous drug use (IVDU) is an activity that has the potential of devastating outcomes and affects individuals all over the world. One potential outcome a patient using IV drugs may experience is infective endocarditis (IE). This poster details the significance of IE, its underlying pathophysiology, significance of pathophysiology, signs and symptoms, and nursing implications.


Role Of Echocardiography In The Intensive Care Unit: Overview Of The Most Common Clinical Scenarios, Luca Longobardo, Concetta Zito, Scipione Carerj, Giuseppe Caracciolo, Bijoy K. Khandheria 2018 University of Messina

Role Of Echocardiography In The Intensive Care Unit: Overview Of The Most Common Clinical Scenarios, Luca Longobardo, Concetta Zito, Scipione Carerj, Giuseppe Caracciolo, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

The intensive care unit (ICU) is among the more important settings in which echocardiography plays a pivotal role. The ease of use, speed of execution, and completeness of information on heart anatomy and function that echocardiography is able to provide makes this tool the perfect diagnostic technique in patients for whom exhaustive information must be quickly obtained by physicians who sometimes lack specific skills in cardiovascular imaging. However, the clinical entities encountered by ICU clinicians are often difficult to distinguish and patient symptoms may not be obvious. This brief review describes three common clinical scenarios that benefit from echocardiography in ...


Primary Cardiac Lymphoma: Importance Of Tissue Diagnosis, Lauren Mendelson, Emily Hsu, Hojune Chung, Andrew Hsu 2018 University of Massachusetts Medical School

Primary Cardiac Lymphoma: Importance Of Tissue Diagnosis, Lauren Mendelson, Emily Hsu, Hojune Chung, Andrew Hsu

Open Access Articles

Primary cardiac lymphoma (PCL) is a rare disease entity that can present with severe cardiac and cardioembolic symptoms. We present a 79-year-old male with history of polymalgia rheumatica on chronic prednisone who presented with a two-week history of progressively worsening dyspnea, cough, and a 10 pound weight loss. Transthoracic echocardiogram (TTE) and computed tomography (CT) of the chest showed a large mediastinal mass with invasion of the pericardium. A biopsy of an abdominal soft-tissue mass confirmed the diagnosis of PCL. The patient was treated with two cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) which was complicated by ...


Anril: A Lncrna At The Cdkn2a/B Locus With Roles In Cancer And Metabolic Disease, Yahui Kong, Chih-Heng Hsieh, Laura C. Alonso 2018 University of Massachusetts Medical School

Anril: A Lncrna At The Cdkn2a/B Locus With Roles In Cancer And Metabolic Disease, Yahui Kong, Chih-Heng Hsieh, Laura C. Alonso

Open Access Articles

The CDKN2A/B genomic locus is associated with risk of human cancers and metabolic disease. Although the locus contains several important protein-coding genes, studies suggest disease roles for a lesser-known antisense lncRNA encoded at this locus, called ANRIL. ANRIL is a complex gene containing at least 21 exons in simians, with many reported linear and circular isoforms. Like other genes, abundance of ANRIL is regulated by epigenetics, classic transcription regulation, splicing, and post-transcriptional influences such as RNA stability and microRNAs. Known molecular functions of ANRIL include in cis and in trans gene regulation through chromatin modification complexes, and influence over ...


A Humanized Hypertrophic Cardiomyopathy Model To Elucidate Molecular Mechanism In Disease Pathology, Ragavi Vijayakumar, Maxine Hong 2018 NUS High School of Mathematics and Science

A Humanized Hypertrophic Cardiomyopathy Model To Elucidate Molecular Mechanism In Disease Pathology, Ragavi Vijayakumar, Maxine Hong

The International Student Science Fair 2018

Hypertrophic cardiomyopathy (HCM), that clinically manifests as an enlarged heart is a highly prevalent cardiac disorder with propensity towards arrhythmia-induced sudden cardiac death. The mechanism of HCM remains poorly defined, necessitating further understanding of the disease for improved therapeutic strategies. As it is challenging to obtain cardiac biopsies from human subjects, using induced pluripotent stem cells technology, we generated cardiomyocytes (CMs) in a dish from HCM patients. These HCM-CMs presented the clinical manifestation in that they were significantly larger in size in comparison to control (healthy)-CMs. Furthermore, gene expression profiling of cardiac ion channels revealed increased transcripts encoding for ...


A Humanized Hypertrophic Cardiomyopathy Model To Elucidate Molecular Mechanism In Disease Pathology, Ragavi Vijayakumar, Maxine Hong 2018 NUS High School of Mathematics and Science

A Humanized Hypertrophic Cardiomyopathy Model To Elucidate Molecular Mechanism In Disease Pathology, Ragavi Vijayakumar, Maxine Hong

The International Student Science Fair 2018

Hypertrophic cardiomyopathy (HCM), that clinically manifests as an enlarged heart is a highly prevalent cardiac disorder with propensity towards arrhythmia-induced sudden cardiac death. The mechanism of HCM remains poorly defined, necessitating further understanding of the disease for improved therapeutic strategies. As it is challenging to obtain cardiac biopsies from human subjects, using induced pluripotent stem cells technology, we generated cardiomyocytes (CMs) in a dish from HCM patients. These HCM-CMs presented the clinical manifestation in that they were significantly larger in size in comparison to control (healthy)-CMs. Furthermore, gene expression profiling of cardiac ion channels revealed increased transcripts encoding for ...


Review Of Kawasaki Disease, Rani Shah, Hisham Hirzallah, Munes Fares, Ashwini Mallad, Gudjon Karlsson, Mehiar El-Hamdani 2018 Marshall University

Review Of Kawasaki Disease, Rani Shah, Hisham Hirzallah, Munes Fares, Ashwini Mallad, Gudjon Karlsson, Mehiar El-Hamdani

Hisham Hirzallah

Abstract

Background: Kawasaki disease is one of the leading causes of acquired heart disease in children. It is an acute self-limited vasculitis that predominantly affects infants and children younger than 5 years of age. These patients present with nonspecific symptoms, such as fever and lymphadenopathy, making the diagnosis challenging. This disease can have serious and potentially fatal outcomes, and prompt recognition of this disease is vital to the patient’s outcome. We present a complete review of the disease, including the epidemiology, pathophysiology, diagnosis and management of acute Kawasaki disease, the natural history of this disease, and follow up of ...


Indexed Left Atrial Adipose Tissue Area Is Associated With Severity Of Atrial Fibrillation And Atrial Fibrillation Recurrence Among Patients Undergoing Catheter Ablation, Saket R. Sanghai, Mayank Sardana, Barinder Hansra, Darleen M. Lessard, Seth T. Dahlberg, Gerard P. Aurigemma, Timothy P. Fitzgibbons, David D. McManus 2018 University of Massachusetts Medical School

Indexed Left Atrial Adipose Tissue Area Is Associated With Severity Of Atrial Fibrillation And Atrial Fibrillation Recurrence Among Patients Undergoing Catheter Ablation, Saket R. Sanghai, Mayank Sardana, Barinder Hansra, Darleen M. Lessard, Seth T. Dahlberg, Gerard P. Aurigemma, Timothy P. Fitzgibbons, David D. Mcmanus

Open Access Articles

Background: Epicardial adipose tissue (EAT) has been associated with adverse left atrial (LA) remodeling and atrial fibrillation (AF) outcomes, possibly because of paracrine signaling.

Objectives: We examined factors associated with a novel measure of EAT i.e., indexed LAEAT (iLAEAT) and its prognostic significance after catheter ablation (CA) of atrial fibrillation (AF).

Methods: We performed a retrospective analysis of 274 participants with AF referred for CA. LAEAT area was measured from a single pre-ablation CT image and indexed to body surface area (BSA) to calculate iLAEAT. Clinical, echocardiographic data and 1-year AF recurrence rates after CA were compared across tertiles ...


Apoe And Alzheimer’S Disease: Neuroimaging Of Metabolic And Cerebrovascular Dysfunction, Jason A. Brandon, Brandon C. Farmer, Holden C. Williams, Lance A. Johnson 2018 University of Kentucky

Apoe And Alzheimer’S Disease: Neuroimaging Of Metabolic And Cerebrovascular Dysfunction, Jason A. Brandon, Brandon C. Farmer, Holden C. Williams, Lance A. Johnson

Physiology Faculty Publications

Apolipoprotein E4 (ApoE4) is the strongest genetic risk factor for late onset Alzheimer’s Disease (AD), and is associated with impairments in cerebral metabolism and cerebrovascular function. A substantial body of literature now points to E4 as a driver of multiple impairments seen in AD, including blunted brain insulin signaling, mismanagement of brain cholesterol and fatty acids, reductions in blood brain barrier (BBB) integrity, and decreased cerebral glucose uptake. Various neuroimaging techniques, in particular positron emission topography (PET) and magnetic resonance imaging (MRI), have been instrumental in characterizing these metabolic and vascular deficits associated with this important AD risk factor ...


Varicosities Affecting The Lower Limb Veins Consequent To A Unique Variant Drainage Pattern Of The Small Saphenous Vein, Shauna Mary Rice, Elke Sarah Schipani, Ana Maleesa Rae Santos, Katherine Anais Sadaniantz, Prithwijit Roychowdhury, Eustathia Lela Giannaris, Manas Das 2018 University of Massachusetts Medical School

Varicosities Affecting The Lower Limb Veins Consequent To A Unique Variant Drainage Pattern Of The Small Saphenous Vein, Shauna Mary Rice, Elke Sarah Schipani, Ana Maleesa Rae Santos, Katherine Anais Sadaniantz, Prithwijit Roychowdhury, Eustathia Lela Giannaris, Manas Das

Radiology Publications and Presentations

We report varicosities affecting the right deep femoral vein and the right femoral vein consequent to a unique unilateral variation in the course of the small saphenous vein. The right small saphenous vein, instead of draining into the popliteal vein at the popliteal fossa, expanded considerably in girth and thickness and continued as the deep femoral vein. The deep femoral vein then pierced the adductor magnus muscle, appeared in the anterior compartment, and joined the femoral vein. Four centimeters distal to this junction, a two-centimeter long varicosity in the deep femoral vein was noted. There was also a one-centimeter long ...


Inertial Sensor-Based Variables Are Indicators Of Frailty And Adverse Post-Operative Outcomes In Cardiovascular Disease Patients, Rahul Soangra, Thurmon E. Lockhart 2018 Chapman University

Inertial Sensor-Based Variables Are Indicators Of Frailty And Adverse Post-Operative Outcomes In Cardiovascular Disease Patients, Rahul Soangra, Thurmon E. Lockhart

Physical Therapy Faculty Articles and Research

Cardiovascular disease (CVD) patients with intrinsic cardiac cause for falling have been found to be frail and submissive to morbidity and mortality as post-operative outcomes. In these older CVD patients, gait speed is conjectured by the Society of Thoracic Surgeons (STS) as an independent predictor of post-operative morbidity and mortality. However, this guideline by STS has not been studied adequately with a large sample size; rather it is based largely on expert opinions of cardiac surgeons and researchers. Although one’s gait speed is not completely associated with one’s risk of falls, gait speed is a quick robust measure ...


Plasma Circulating Extracellular Rnas In Left Ventricular Remodeling Post-Myocardial Infarction, Kirsty M. Danielson, Kahraman Tanriverdi, Jane E. Freedman, Saumya Das 2018 Harvard Medical School

Plasma Circulating Extracellular Rnas In Left Ventricular Remodeling Post-Myocardial Infarction, Kirsty M. Danielson, Kahraman Tanriverdi, Jane E. Freedman, Saumya Das

Open Access Articles

Despite substantial declines in mortality following myocardial infarction (MI), subsequent left ventricular remodeling (LVRm) remains a significant long-term complication. Extracellular small non-coding RNAs (exRNAs) have been associated with cardiac inflammation and fibrosis and we hypothesized that they are associated with post-MI LVRm phenotypes. RNA sequencing of exRNAs was performed on plasma samples from patients with "beneficial" (decrease LVESVI > /=20%, n=11) and "adverse" (increase LVESVI > /=15%, n=11) LVRm. Selected differentially expressed exRNAs were validated by RT-qPCR (n=331) and analyzed for their association with LVRm determined by cardiac MRI. Principal components of exRNAs were associated with LVRm phenotypes post-MI ...


Study Of Early After Depolarization In A Complex Human Cardiac Cell Model In Tissue, Abouzar Kaboudian, Yanyan Claire Ji, Elizabeth M. Cherry, Flavio H. Fenton 2018 Georgia Institute of Technology

Study Of Early After Depolarization In A Complex Human Cardiac Cell Model In Tissue, Abouzar Kaboudian, Yanyan Claire Ji, Elizabeth M. Cherry, Flavio H. Fenton

Biology and Medicine Through Mathematics Conference

No abstract provided.


Efficacy And Safety Of Direct Oral Anticoagulants Approved For Cardiovascular Indications: Systematic Review And Meta-Analysis, Raghavendra Charan Makam, David C. Hoaglin, David D. McManus, Victoria Wang, Joel M. Gore, Frederick A. Spencer, Richeek Pradhan, Hoang Tran, Hong Yu, Robert J. Goldberg 2018 University of Massachusetts Medical School

Efficacy And Safety Of Direct Oral Anticoagulants Approved For Cardiovascular Indications: Systematic Review And Meta-Analysis, Raghavendra Charan Makam, David C. Hoaglin, David D. Mcmanus, Victoria Wang, Joel M. Gore, Frederick A. Spencer, Richeek Pradhan, Hoang Tran, Hong Yu, Robert J. Goldberg

Quantitative Health Sciences Publications and Presentations

BACKGROUND: Direct oral anticoagulants (DOACs) have emerged as promising alternatives to vitamin K antagonists (VKAs) for patients with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE). Few meta-analyses have included all DOACs that have received FDA approval for these cardiovascular indications, and their overall comparisons against VKAs have shortcomings in data and methods. We provide an updated overall assessment of the efficacy and safety of those DOACs at dosages currently approved for NVAF or VTE, in comparison with VKAs.

METHODS: We used data from Phase 3 randomized trials that compared an FDA-approved DOAC with VKA for primary prevention of stroke ...


Cognitive Impairment, Vulnerability, And Mortality Post Ischemic Stroke: A Five-Year Follow-Up Of The Action On Secondary Prevention Interventions And Rehabilitation In Stroke (Aspire-S) Cohort, Eva Gaynor, Daniela Rohde, Margaret Large, Lisa Mellon, Patricia Hall, Linda Brewer, Orla Conway, Anne Hickey, Kathleen Bennett, Eamon Dolan, Elizabeth Callaly, David Williams 2018 Royal College of Surgeons in Ireland

Cognitive Impairment, Vulnerability, And Mortality Post Ischemic Stroke: A Five-Year Follow-Up Of The Action On Secondary Prevention Interventions And Rehabilitation In Stroke (Aspire-S) Cohort, Eva Gaynor, Daniela Rohde, Margaret Large, Lisa Mellon, Patricia Hall, Linda Brewer, Orla Conway, Anne Hickey, Kathleen Bennett, Eamon Dolan, Elizabeth Callaly, David Williams

Psychology Articles

Background

The aim of this study was to examine predictors of mortality in patients 5 years after ischemic stroke, focusing on cognitive impairment, vulnerability, and vascular risk factors assessed at 6 months post stroke.

Materials and Methods

Patients from the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) cohort were followed up 5 years post ischemic stroke. Vascular risk factors, cognitive impairment, and vulnerability were assessed at 6 months post stroke. Cognitive impairment was assessed using a cutoff score lower than 26 on the Montreal Cognitive Assessment (MoCA). Vulnerability was defined as a score of 3 or higher ...


Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender 2018 Fordham University

Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender

Student Theses 2015-Present

This paper aims to shed light on the dissonance caused by the superimposition of Dominant Human Systems on Natural Systems. I highlight the synthetic nature of Dominant Human Systems as egoic and linguistic phenomenon manufactured by a mere portion of the human population, which renders them inherently oppressive unto peoples and landscapes whose wisdom were barred from the design process. In pursuing a radical pragmatic approach to mending the simultaneous oppression and destruction of the human being and the earth, I highlight the necessity of minimizing entropic chaos caused by excess energy expenditure, an essential feature of systems that aim ...


High-Resolution Imaging Of Myeloperoxidase Activity Sensors In Human Cerebrovascular Disease, Youssef Z. Wadghiri, Dung Minh. Hoang, Anita M. Leporati, Matthew J. Gounis, Aurora Rodriguez-Rodriguez, Mary L. Mazzanti, John P. Weaver, Ajay K. Wakhloo, Peter Caravan, Alexei A. Bogdanov Jr 2018 New York University School of Medicine

High-Resolution Imaging Of Myeloperoxidase Activity Sensors In Human Cerebrovascular Disease, Youssef Z. Wadghiri, Dung Minh. Hoang, Anita M. Leporati, Matthew J. Gounis, Aurora Rodriguez-Rodriguez, Mary L. Mazzanti, John P. Weaver, Ajay K. Wakhloo, Peter Caravan, Alexei A. Bogdanov Jr

Radiology Publications and Presentations

Progress in clinical development of magnetic resonance imaging (MRI) substrate-sensors of enzymatic activity has been slow partly due to the lack of human efficacy data. We report here a strategy that may serve as a shortcut from bench to bedside. We tested ultra high-resolution 7T MRI (microMRI) of human surgical histology sections in a 3-year IRB approved, HIPAA compliant study of surgically clipped brain aneurysms. microMRI was used for assessing the efficacy of MRI substrate-sensors that detect myeloperoxidase activity in inflammation. The efficacy of Gd-5HT-DOTAGA, a novel myeloperoxidase (MPO) imaging agent synthesized by using a highly stable gadolinium (III) chelate ...


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