969-99 Biocompatible Mechanical Left Ventricular Support: Potential Alternative to Transplantation

Use of mechanical circulatory support has been limited by its associated bleeding and thrombotic complications. Blood contact with an artificial surface results in a well-deined pattern of hematologic alterations. The TCI HeartMate® left ventricular assist device (LVAD) is an implantable circulatory support pump currently used as a bridge to transplantation. Its textured blood contacting surfaces result in a formation of an adherent pseudoneointimal lining which eliminates the direct interaction of blood elements with the artificial surface. To determine if this biological lining could mitigate the stereotypical blood-synthetic surface interactions, we studied eight patients who underwent implantation at our institution over a 10 month period from 5/93 to 3/94. Seven of the 8 patients were bridged to transplantation. Three patients were transplanted within 10 days and one month data could not be obtained. Hemodynamic and hemostatic parameters (mean±sd) were studied as follows:Pre-implantPOD 7POD 28Cardiac index (I/min/m2)1.8±0.73.2±0.43.1±0.5Systolic BP (mmHg)759±6.8125.8±9.7130.4±8.1Hemoglobin (mg/dl)7.4±1.88.2±1.69.6±2.0Plasma free hemoglobin (mg/dl)15.4±1.76.4±2.36.8±1.9Prothrombin time (sec)14.2±1.113.4±0.713.3±0.7Partial thromboplastin time (sec)56.7±15.931.8±4.837.6±11.9Platelet count (× 103lcu mm)250±81269±63325±37In vitro platelet reactivity to the agonist ADP remained normal pre and post implantation. Average perioperative blood requirements included PRBC, 3.3±1.3 units; platelets, 2.3±4.5 units; fresh frozen plasma, 2±1.9 units. No blood products were required after postoperative day 2.We conclude that TCI LVAD support improves hemodynamics and can bridge patients in pre-implant cardiogenic shock to transplantation. Furthermore, no red cell destruction or hemostatic and thrombotic complications were observed despite one month of support without anticoagulation therapy. Therefore, as the donor shortage continues, LVADs with biocompatible surfaces may provide an alternative to cardiac transplantation

Report From the American Society of Transplantation Conference on Donor Heart Selection in Adult Cardiac Transplantation in the United States

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138918/1/ajt14354.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138918/2/ajt14354_am.pd

Nanomaterial-based Sensors for the Study of DNA Interaction with Drugs

The interaction of drugs with DNA has been searched thoroughly giving rise to an endless number of findings of undoubted importance, such as a prompt alert to harmful substances, ability to explain most of the biological mechanisms, or provision of important clues in targeted development of novel chemotherapeutics. The existence of some drugs that induce oxidative damage is an increasing point of concern as they can cause cellular death, aging, and are closely related to the development of many diseases. Because of a direct correlation between the response, strength/ nature of the interaction and the pharmaceutical action of DNA-targeted drugs, the electrochemical analysis is based on the signals of DNA before and after the interaction with the DNA-targeted drug. Nowadays, nanoscale materials are used extensively for offering fascinating characteristics that can be used in designing new strategies for drug-DNA interaction detection. This work presents a review of nanomaterials (NMs) for the study of drug-nucleic acid interaction. We summarize types of drug-DNA interactions, electroanalytical techniques for evidencing these interactions and quantification of drug and/or DNA monitoring

Cardiac tumours in children

Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT) and Magnetic Resonance Imaging (MRI) of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor

Synthesis of nanocrystalline NiO by sol-gel and homogeneous precipitation methods

586-590Nanocrystalline nickel oxide has been prepared via thermal decomposition of precursors obtained using two methods, sol-gel process and homogeneous precipitation. The precursors and the oxide obtained by calcination are characterized by various analytical techniques such as powder X-ray diffraction, thermal gravimetric analysis, FT-IR spectroscopy, surface area measurements, scanning electron microscopy, transmission electron microscopy and magnetic measurements. The crystallite size of nickel oxide prepared from homogeneous precipitation method is ~ 2 nm whereas that of the nickel oxide prepared from sol-gel process is about 19 nm. The nanocrystalline NiO samples obtained by both the methods exhibit superparamagnetic behavior

Cardiac power efficiency as a hemodynamic predictor of outcomes in congestive heart failure

Copyright © 2020. Published by Elsevier Inc. PURPOSE: Cardiac power index (CPI) has been used as a predictor of outcomes in cardiogenic shock. Cardiac power efficiency (CPE), which is the CPI divided by the PCWP, has been used successfully to predict response to a durable counterpulsation MCS device. The aim of this study is to evaluate the utility of CPE in predicting outcomes in advanced heart failure patients presenting with decompensation. METHODS: This is a single institution, retrospective review of 128 advanced heart failure patients who presented with decompensation. A right heart catheterization was performed upon admission. Patients were separated into two groups: those who survived 30 days and were only on optimal medical therapy and those who experienced cardiac failure , including death, hospice, transplantation, LVAD implantation, or inotrope dependence. Statistical analysis included multivariate regression controlling for age, race, sex, BMI, BNP, heart failure etiology, ejection fraction, acute or chronic heart failure, and GFR. RESULTS: In this 128 patient cohort, 83 (64.8%) progressed to cardiac failure . Multiple hemodynamic parameters were statistically significant between the two groups (Table 1). Multivariate regression showed CPE (p=0.006) was the only significant predictor of cardiac failure . CPI (p=0.052) was not significant when used in the regression model. Sensitivity analysis was performed at multiple CPE cutoffs and the highest sensitivity (75.3%) was obtain at a CPE cutoff of 0.0178. CONCLUSION: Cardiac power efficiency is a novel hemodynamic parameter which has the potential to identify patients in cardiogenic shock who will not survive with medical therapy alone. Larger studies are needed to better identify CPE cutoffs which predict greatest risk