Cardiogenic Shock

Cardiogenic shock is the second most common cause of circulatory shock, occurs secondary to myocardial infarction, which accounts for 80% of the cases, and remains one of the leading causes of death in patients with acute myocardial infarction. Cardiogenic shock carries a high morbidity and mortality despite recent advances in medical and mechanical therapies. Cardiogenic shock also occurs in non-acute coronary syndrome conditions, such as Takotsubo cardiomyopathy, fulminant myocarditis, end stage heart failure, and others. In this chapter, we provide a brief review on the pathophysiology, diagnosis, and acute management of cardiogenic shock patients. We will focus more on the management of acute coronary syndrome related cardiogenic shock, given that it is the most common etiology

Ecosystem functions of oil palm plantations - a review

Oil palm plantations have expanded rapidly in the last decades. This large-scale land-use change has had great impacts on both the areas converted to oil palm and their surroundings. Howev-er, research on the impacts of oil palm agriculture is scattered and patchy, and no clear overview ex-ists. Here, we address this gap through a systematic and comprehensive literature review of all ecosys-tem functions in oil palm plantations. We compare ecosystem functions in oil palm plantations to those in forests as forests are often cleared for the establishment of oil palm. We find that oil palm planta-tions generally have reduced ecosystem functioning compared to forests. Some of these functions are lost globally, such as those to gas and climate regulation and to habitat and nursery functions. The most serious impacts occur when land is cleared to establish new plantations, and immediately after-wards, especially on peat soils. To variable degrees, plantation management can prevent or reduce losses of some ecosystem functions. The only ecosystem function which increased in oil palm planta-tions is, unsurprisingly, the production of marketable goods. Our review highlights numerous research gaps. In particular, there are significant gaps with respect to information functions (socio-cultural functions). There is a need for empirical data on the importance of spatial and temporal scales, such as the differences between plantations in different environments, of different sizes, and of different ages. Finally, more research is needed on developing management practices that can off-set the losses of ecosystem functions

UM receives $1 million seed money for new business building

BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is used in patients with thoracic aortic aneurysms (TAA) and uncomplicated type B acute aortic dissection (B-AAD) to reduce morbidity and mortality. Limited data are available for comparing outcomes of TEVAR in TAA vs B-AAD. METHODS: 49 patients with TAA and 37 patients with B-AAD between January 2005 and January 2015 were retrospectively identified. Baseline characteristics, thrombosis status of the false lumen with the extent of dissection, aortic pathologies including prior aortic surgeries, emergent vs elective procedures, landing zone location, extra anatomical major vessel bypass, types of grafts and outcome variables were reviewed by two physicians. T-test, Wilcoxon rank-sum test and chi-square test were used to generate pvalues. RESULTS: The sample population with TAA had a higher median age than those with B-AAD (72 years vs 59 years, p¼0.0001) (Table). Early events, 30-day mortality and 5-year outcomes were not significantly different between groups. Endoleak and all-cause mortality with TEVAR were not significantly different in the groups (Fig). CONCLUSION: This study confirms the feasibility of TEVAR for uncomplicated type B aortic dissection in the acute setting with no difference in short- or long-term outcomes of TEVAR between TAA and B-AAD populations

Mechanisms controlling anaemia in Trypanosoma congolense infected mice.

Trypanosoma congolense are extracellular protozoan parasites of the blood stream of artiodactyls and are one of the main constraints on cattle production in Africa. In cattle, anaemia is the key feature of disease and persists after parasitaemia has declined to low or undetectable levels, but treatment to clear the parasites usually resolves the anaemia. The progress of anaemia after Trypanosoma congolense infection was followed in three mouse strains. Anaemia developed rapidly in all three strains until the peak of the first wave of parasitaemia. This was followed by a second phase, characterized by slower progress to severe anaemia in C57BL/6, by slow recovery in surviving A/J and a rapid recovery in BALB/c. There was no association between parasitaemia and severity of anaemia. Furthermore, functional T lymphocytes are not required for the induction of anaemia, since suppression of T cell activity with Cyclosporin A had neither an effect on the course of infection nor on anaemia. Expression of genes involved in erythropoiesis and iron metabolism was followed in spleen, liver and kidney tissues in the three strains of mice using microarrays. There was no evidence for a response to erythropoietin, consistent with anaemia of chronic disease, which is erythropoietin insensitive. However, the expression of transcription factors and genes involved in erythropoiesis and haemolysis did correlate with the expression of the inflammatory cytokines Il6 and Ifng. The innate immune response appears to be the major contributor to the inflammation associated with anaemia since suppression of T cells with CsA had no observable effect. Several transcription factors regulating haematopoiesis, Tal1, Gata1, Zfpm1 and Klf1 were expressed at consistently lower levels in C57BL/6 mice suggesting that these mice have a lower haematopoietic capacity and therefore less ability to recover from haemolysis induced anaemia after infection