Stent underexpansion is associated with high wall shear stress: a biomechanical analysis of the shear stent study.

Coronary stent underexpansion is associated with restenosis and stent thrombosis. In clinical studies of atherosclerosis, high wall shear stress (WSS) has been associated with activation of prothrombotic pathways, upregulation of matrix metalloproteinases, and future myocardial infarction. We hypothesized that stent underexpansion is predictive of high WSS.

Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 1. Difficult airway management encountered in an unconscious patient.

Purpose: Since the last Canadian Airway Focus Group (CAFG) guidelines were published in 2013, the literature on airway management has expanded substantially. The CAFG therefore re-convened to examine this literature and update practice recommendations. This first of two articles addresses difficulty encountered with airway management in an unconscious patient.

Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 2. Planning and implementing safe management of the patient with an anticipated difficult airway.

Purpose: Since the last Canadian Airway Focus Group (CAFG) guidelines were published in 2013, the published airway management literature has expanded substantially. The CAFG therefore re-convened to examine this literature and update practice recommendations. This second of two articles addresses airway evaluation, decision-making, and safe implementation of an airway management strategy when difficulty is anticipated.

Microvascular Assessment of Ranolazine in Non-Obstructive Atherosclerosis: The MARINA Randomized, Double-Blinded, Controlled Pilot Trial.

Background: Microvascular dysfunction is known to play a key role in patients with angina and nonobstructive coronary artery disease. We investigated the impact of ranolazine among patients with angina and nonobstructive coronary artery disease.

Methods: In this randomized, double-blinded, placebo-controlled pilot trial, 26 patients with angina once weekly or more, abnormal stress test, and nonobstructive coronary artery disease (<50% stenosis by angiography and fractional flow reserve >0.

Functional coronary angiography in symptomatic patients with no obstructive coronary artery disease.

Background: Patients without obstructive coronary artery disease (CAD) may have epicardial or microvascular dysfunction. The purpose of this study was to characterize patterns of epicardial and microvascular dysfunction in men and women with stable and unstable angina undergoing functional coronary angiography to inform medical therapy.

Methods: 163 symptomatic patients with ≤50% diameter stenosis and fractional flow reserve (FFR) > 0.

The videoscopic view may not be significantly superior to the directly sighted peroral view during Macintosh-style videolaryngoscopy: a randomized equivalence cadaver trial.

Purpose: Videolaryngoscopy is widely believed to give a superior view to that obtained by direct laryngoscopy. Published literature suggests this benefit extends to both hyper-angulated and Macintosh-style videolaryngoscopes. Notwithstanding, our clinical experience shows that the videoscopic view with a Macintosh-style videolaryngoscope is often no different or only marginally better than the directly sighted peroral view.

The utility of 'Ding Ding Lok' in rehabilitation service for adult persons with intellectual disability: A thematic analysis on reports by service staff.

This article introduces 'Ding Ding Lok' (DDL), a group game especially designed for persons affected by mild-to-moderate intellectual disability and explores its utility in rehabilitation service settings in Hong Kong. Reports from service staff who participated in the pilot project were analysed using thematic analysis. Two key questions were explored: (1) staff members' perceived benefits of the game for service users and (2) source of enjoyment for staff members in the game process.

Impact of combined plaque structural stress and wall shear stress on coronary plaque progression, regression, and changes in composition.

Aims: The focal distribution of atherosclerotic plaques suggests that local biomechanical factors may influence plaque development.

Methods And Results: We studied 40 patients at baseline and over 12 months by virtual-histology intravascular ultrasound and bi-plane coronary angiography. We calculated plaque structural stress (PSS), defined as the mean of the maximum principal stress at the peri-luminal region, and wall shear stress (WSS), defined as the parallel frictional force exerted by blood flow on the endothelial surface, in areas undergoing progression or regression.

Frequency of Takotsubo Cardiomyopathy in Adult Patients Receiving Chemotherapy (from a 5-Year Nationwide Inpatient Study).

Takotsubo cardiomyopathy (TC) develops in patients who are under significant emotional, psychosocial, or sudden biochemical stress. However, the added burden of TC on the patients receiving chemotherapy has never been studied. We aimed to describe the additional clinical and economic burden, along with the potential predictors of TC and related in-hospital mortality in patients receiving chemotherapy using the largest inpatient cohort.

Low Coronary Wall Shear Stress Is Associated With Severe Endothelial Dysfunction in Patients With Nonobstructive Coronary Artery Disease.

Objectives: This study investigated the relationship between low wall shear stress (WSS) and severe endothelial dysfunction (EDFx).

Background: Local hemodynamic forces such as WSS play an important role in atherogenesis through their effect on endothelial cells. The study hypothesized that low WSS independently predicts severe EDFx in patients with coronary artery disease (CAD).