Sizing strategy and implant considerations for the avalus valve

Hemodynamic performance of the Avalus valve through 3 years after implant is comparable to that of contemporary surgical bioprostheses. Many variables affect hemodynamic outcomes, including surgical technique. This article describes our experience with the Avalus bioprosthesis and strategies to achieve optimal hemodynamic performance. (C) 2020 by The Society of Thoracic SurgeonsThoracic Surger

Remote postconditioning by humoral factors in effluent from ischemic preconditioned rat hearts is mediated via PI3K/Akt-dependent cell-survival signaling at reperfusion

Short non-lethal ischemic episodes administered to hearts prior to (ischemic preconditioning, IPC) or directly after (ischemic postconditioning, IPost) ischemic events facilitate myocardial protection. Transferring coronary effluent collected during IPC treatment to un-preconditioned recipient hearts protects from lethal ischemic insults. We propose that coronary IPC effluent contains hydrophobic cytoprotective mediators acting via PI3K/Akt-dependent pro-survival signaling at ischemic reperfusion. Ex vivo rat hearts were subjected to 30 min of regional ischemia and 120 min of reperfusion. IPC effluent administered for 10 min prior to index ischemia attenuated infarct size by ≥55% versus control hearts (P < 0.05). Effluent administration for 10 min at immediate reperfusion (reperfusion therapy) or as a mimetic of pharmacological postconditioning (remote postconditioning, RIPost) significantly reduced infarct size compared to control (P < 0.05). The IPC effluent significantly increased Akt phosphorylation in un-preconditioned hearts when administered before ischemia or at reperfusion, while pharmacological inhibition of PI3K/Akt-signaling at reperfusion completely abrogated the cardioprotection offered by effluent administration. Fractionation of coronary IPC effluent revealed that cytoprotective humoral mediator(s) released during the conditioning phase were of hydrophobic nature as all hydrophobic fractions with molecules under 30 kDa significantly reduced infarct size versus the control and hydrophilic fraction-treated hearts (P < 0.05). The total hydrophobic effluent fraction significantly reduced infarct size independently of temporal administration (before ischemia, at reperfusion or as remote postconditioning). In conclusion, the IPC effluent retains strong cardioprotective properties, containing hydrophobic mediator(s) < 30 kDa offering cytoprotection via PI3K/Akt-dependent signaling at ischemic reperfusion

Effect of remote ischemic conditioning on atrial fibrillation and outcome after coronary artery bypass grafting (RICO-trial)

Background: Pre- and postconditioning describe mechanisms whereby short ischemic periods protect an organ against a longer period of ischemia. Interestingly, short ischemic periods of a limb, in itself harmless, may increase the ischemia tolerance of remote organs, e.g. the heart (remote conditioning, RC). Although several studies have shown reduced biomarker release by RC, a reduction of complications and improvement of patient outcome still has to be demonstrated. Atrial fibrillation (AF) is one of the most common complications after coronary artery bypass graft surgery (CABG), affecting 27-46% of patients. It is associated with increased mortality, adverse cardiovascular events, and prolonged in-hospital stay. We hypothesize that remote ischemic pre- and/or post-conditioning reduce the incidence of AF following CABG, and improve patient outcome.Methods/design: This study is a randomized, controlled, patient and investigator blinded multicenter trial. Elective CABG patients are randomized to one of the following four groups: 1) control, 2) remote ischemic preconditioning, 3) remote ischemic postconditioning, or 4) remote ischemic pre- and postconditioning. Remote conditio

Ischaemic conditioning and reperfusion injury

The 30-year anniversary of the discovery of 'ischaemic preconditioning' is in 2016. This endogenous phenomenon can paradoxically protect the heart from acute myocardial infarction by subjecting it to one or more brief cycles of ischaemia and reperfusion. Apart from complete reperfusion, this method is the most powerful intervention known for reducing infarct size. The concept of ischaemic preconditioning has evolved into 'ischaemic conditioning', a term that encompasses a number of related endogenous cardioprotective strategies, applied either directly to the heart (ischaemic preconditioning or postconditioning) or from afar, for example a limb (remote ischaemic preconditioning, perconditioning, or postconditioning). Investigations of signalling pathways underlying ischaemic conditioning have identified a number of therapeutic targets for pharmacological manipulation. Over the past 3 decades, a number of ischaemic and pharmacological cardioprotection strategies, discovered in experimental studies, have been examined in the clinical setting of acute myocardial infarction and CABG surgery. The results from many of the studies have been disappointing, and no effective cardioprotective therapy is currently used in clinical practice. Several large, multicentre, randomized, controlled clinical trials on cardioprotection have highlighted the challenges of translating ischaemic conditioning and pharmacological cardioprotection strategies into patient benefit. However, a number of cardioprotective therapies have shown promising results in reducing infarct size and improving clinical outcomes in patients with ischaemic heart disease

Membuat CMS Multifitur

Apakah Anda saat ini sedang belajar pemrograman web? Apakah Anda sering mengeluh karena banyak referensi tentang pemrograman yang memberikan materi secara setengahsetengah? Kalau iya, berarti ini adalah buku yang tepat untuk Anda. Karena di dalam buku ini, saya akan membahas sebuah proyek CMS (Content Management System) buatan anak bangsa. Yah, saya akan mengajak Anda menjadi Developer keren dengan proyek open source yang akan kita bahas di sini. Open source itu gratis? Proyek open source gak ada duitnya, cuma buat proyek sukarela aja. Jiah, ketinggalan zaman sob, kalau Anda masih berpikir seperti itu. Open source malah akan membawa Anda pada kesuksesan gemilang. Bagaimana caranya? Di buku ini akan saya bahas semuanya. Lebih dari itu, selain ilmu yang didapat, tentu dengan bergabung dalam proyek open source, Anda akan mendapatkan koneksi jaringan pertemanan yang lebih luas. Tentunya sebuah ladang rezeki untuk Anda pula toh. Pada buku ini akan dijelaskan bagaimana mengembangkan sebuah CMS yang tadinya berfungsi untuk keperluan blogging menjadi sebuah CMS multifitur dengan tambahan fungsi e-commerce. Anda akan naik level dari pengguna software menjadi pengembang software. Anda akan dapat mengembangkan sebuah program open source berbasis web, dan tentunya menjadi langkah awal untuk menikmati indahnya kebersamaan dunia open source. Ayo, kesempatan emas menanti Anda. Segera berikan buku ini ke kasir dan JANGAN BUANG STRUK PEMBELIAN BUKU INI. Bonus CD untuk buku ini, bisa Anda download langsung pada website resmi penulis. Dengan registrasi terlebih dahulu pada website tersebut, dan mengupload struk pembelian buku. Pembahasan dalam buku mencakup: Pengenalan dunia open source Penginstalan tools untuk pengembangan aplikasi web Konsep dasar OOP Pengembangan plugin CMS untuk keperluan e-commerce Pembuatan template baru untuk CMS Popoj

Investigating the Effects of Four Weeks of Spinal Nerve Ligation After a Period of Combined Training on the Expression of Involved Genes in Calcium Current in Plantaris Muscle of Male Wistar Rats

Aims This study aims to investigate the effect of spinal nerve ligation (SNL) after a period of combined training on the expression of some genes that are involved in the calcium flow in the plantaris muscle of male Wistar rats.  Methods & Materials A total of 16 adult male Wistar rats were randomly divided into 2 groups, namely the control-SNL (n=8) and combined training-SNL (n=8). The animals in the training group participated in a training program for 6 weeks. After this period, the protocol of spinal SNL was performed on the research groups for 4 weeks. Finally, the rats were dissected and the plantaris muscle was removed. Real-time polymerase chain reaction was used to measure the mRNA expression of STIM1, ORAI1, and MG29 genes.  Findings In the combined training-SNL group, an increase in the expression of STIM1 (P=0.01), ORAI1 (P=0.002), and MG29 (P=0.02) was observed when compared to the control-SNL group.  Conclusion The results of the present study showed that SNL reduces the expression of STIM1, ORAI1, and MG29 in the plantaris muscle. Meanwhile, combined training before SNL has a compensatory effect in this regard