Prehospital 12-Lead Electrocardiogram within 60 Minutes Differentiates Proximal versus Nonproximal Left Anterior Descending Artery Myocardial Infarction

<p>Introduction: Acute anterior myocardial infarctions caused by proximal left anterior descending (LAD) artery occlusions are associated with a higher morbidity and mortality. Early identification of high-risk patients via the 12-lead electrocardiogram (ECG) could assist physicians and emergency response teams in providing early and aggressive care for patients with anterior ST-elevation myocardial infarctions (STEMI). Approximately 25% of US hospitals have primary percutaneous coronary intervention (PCI) capability for the treatment of acute myocardial infarctions. Given the paucity of</p> <p>hospitals capable of PCI, early identification of more severe myocardial infarction may prompt</p> <p>emergency medical service routing of these patients to PCI-capable hospitals. We sought to determine if the 12 lead ECG is capable of predicting proximal LAD artery occlusions.</p> <p>Methods: In a retrospective, post-hoc analysis of the Pre-Hospital Administration of Thrombolytic Therapy with Urgent Culprit Artery Revascularization pilot trial, we compared the ECG findings of</p> <p>proximal and nonproximal LAD occlusions for patients who had undergone an ECG within 180 minutes of symptom onset.</p> <p>Results: In this study, 72 patients had anterior STEMIs, with ECGs performed within 180 minutes of symptom onset. In patients who had undergone ECGs within 60 minutes (n¼35), the mean sum of ST elevation (STE) in leads V1 through V6 plus ST depression (STD) in leads II, III, and aVF was 19.2 mm for proximal LAD occlusions and 11.7 mm for nonproximal LAD occlusions (P¼0.007). A sum STE in V1 through V6 plus STD in II, III, and aVF of at least 17.5 mm had a sensitivity of 52.3%, specificity of 92.9%, positive predictive value of 91.7%, and negative predictive value of 56.5% for proximal LAD occlusions. When the ECG was performed more than 60 minutes after symptom onset (n¼37), there was no significant difference in ST-segment deviation between the 2 groups.</p> <p>Conclusion: The sum STE (V1-V6) and STD (II, III, aVF) on a 12-lead ECG can be used to predict proximal LAD occlusions if performed within the first hour of symptom onset. This should be considered a high-risk finding and may prompt prehospital direction of such patients to PCI-capable hospitals. [West J Emerg Med. 2011;12(4):408–413.]</p

Restored Agricultural Wetlands in central Iowa: Habitat Quality and Amphibian Response

Amphibians are declining throughout the United States and worldwide due, partly, to habitat loss. Conservation practices on the landscape restore wetlands to denitrify tile drainage effluent and restore ecosystem services. Understanding how water quality, hydroperiod, predation, and disease affect amphibians in restored wetlands is central to maintaining healthy amphibian populations in the region. We examined the quality of amphibian habitat in restored wetlands relative to reference wetlands by comparing species richness, developmental stress, and adult leopard frog (Lithobates pipiens) survival probabilities to a suite of environmental metrics. Although measured habitat variables differed between restored and reference wetlands, differences appeared to have sub-lethal rather than lethal effects on resident amphibian populations. There were few differences in amphibian species richness and no difference in estimated survival probabilities between wetland types. Restored wetlands had more nitrate and alkaline pH, longer hydroperiods, and were deeper, whereas reference wetlands had more amphibian chytrid fungus zoospores in water samples and resident amphibians exhibited increased developmental stress. Restored and reference wetlands are both important components of the landscape in central Iowa and maintaining a complex of fish-free wetlands with a variety of hydroperiods will likely contribute to the persistence of amphibians in this landscape

Magnetic ventricular connector

A magnetic coupling for connecting a cannula to the apex of a ventricle comprising a first member having a first orifice, a first magnetic material attached to the first member, a means for attaching a cannula to the first member, a second member having a second orifice, a second magnetic material attached to the second member, a means for attaching the second member to a ventricle, so that when the first magnet is placed in proximity to the second magnet the first member and second member are held substantially concentric by magnetic force to allow for the communication of fluid between the first and second orifices.Board of Regents, University of Texas Syste

System and method for pump with deformable bearing surface

Systems and methods for pumping fluid comprising a pumping chamber, a pump inlet, a pump outlet, a valving mechanism, and a drive piston or pumping chamber wall including a deformable surface configured to provide elastohydrodynamic lubrication during operation.Board of Regents, University of Texas Syste

System and method for pump variable stroke

Systems and methods for providing a variable pumping stroke from a pump comprising a pumping chamber, a pump inlet, a pump outlet, a valving mechanism, and a drive piston. In one embodiment, the pump inlet is in fluid communication with the pumping chamber regardless of the location of the drive piston within the pumping chamber, and the pump outlet is similarly in fluid communication with the pumping chamber regardless of the location of the drive piston within the pumping chamber.Board of Regents, University of Texas Syste

Positive displacement pump system and method

Systems and methods including a motor or electromagnets to control the movement of one or more pistons in a pumping chamber. The pumping chamber may include a pump inlet and a pump outlet in fluid communication with the pumping chamber. Surfaces on a piston or pumping chamber may include hydrodynamic bearing surfaces.Board of Regents, University of Texas Syste

Positive displacement pump system and method with rotating valve

Systems and methods including a valve piston in a pumping chamber. The pumping chamber may include a pump inlet and a pump outlet in fluid communication with the pumping chamber. The valve piston may be configured to rotate between a first position within the pumping chamber and a second position outside of the pumping chamber.Board of Regents, University of Texas Syste