Safety of long-distance transfers of patients on acute mechanical circulatory support.

Background: Acute mechanical circulatory support (aMCS) can be a lifesaving therapy for patients with refractory cardiogenic shock. As device safety and technology improve, so will the ability to extend aMCS to patients at remote hospitals. The Intermountain West is unique because of the large geographical area, making transport of critically ill patients a logistical challenge.

Empathy Bot: Conversational Service for Psychiatric Counseling with Chat Assistant.

There are earlier studies for psychiatric counseling using chat bots. These studies have not considered the user's emotional status and ethical judgment to provide interventions. This paper proposes an intelligent assistant for psychiatric counseling that understands dialogues using high-level features of natural language understanding, and multi-modal emotion recognition.

Controversies and Challenges in the Management of ST-Elevation Myocardial Infarction Complicated by Cardiogenic Shock.

The prognosis in ST-elevation myocardial infarction has improved with coronary care units, revascularization, and anticoagulant strategies; however, cardiogenic shock (CS) remains a highly fatal condition. Controversies remain about optimal pharmacologic therapies, revascularization strategies, the role of mechanical circulatory support (MCS), and evidence-based patient selection. The current informed consent paradigm for clinical trials creates challenges testing treatments in CS patients, who are too ill to consent and require immediate treatment.

Immunologic effects of continuous-flow left ventricular assist devices before and after heart transplant.

Background: Immune allosensitization can be triggered by continuous-flow left ventricular assist devices (CF LVAD). However, the effect of this type of allosensitization on post-transplant outcomes remains controversial. This study examined the post-transplant course in a contemporary cohort of patients undergoing transplantation with and without LVAD bridging.

Clinical features and treatments of upper lumbar disc herniations.

Objective: Disc herniations at the L1-L2 and L2-L3 levels are different from those at lower levels of the lumbar spine with regard to clinical characteristics and surgical outcome. Spinal canals are narrower than those of lower levels, which may compromise multiple spinal nerve roots or conus medullaris. The aim of this study was to evaluate the clinical features and surgical outcomes of upper lumbar disc herniations.

Clinical analysis of risk factors related to recurrent chronic subdural hematoma.

Objective: Burr hole drainage has been widely used to treat chronic subdural hematoma (CSDH). However, the incidence of recurrent CSDH varies from 3.7 to 30% after surgery.

Neurenteric cyst with xanthomatous changes in the prepontine area: unusual radiological findings.

Preoperative diagnosis of neurenteric cysts can be difficult because the imaging findings of a neurenteric cyst may be similar to those of an arachnoid cyst. The authors report a case of a neurenteric cyst with xanthomatous changes in the prepontine area. This 4-year-old girl was admitted to their institution with intermittent neck pain and vomiting.