Publications by authors named "Kevin John"
Intra-aortic balloon pumps (IABPs) are commonly used circulatory support devices. Mesenteric ischemia is a serious and poorly studied complication of IABP use. Here, we examine six cases of mesenteric ischemia associated with IABPs from a single urban academic medical center.
View Article and Find Full Text PDFScience communicators often grapple with conveying tentative or incremental research findings to the public, particularly regarding progress made toward treating or curing illnesses and diseases. A growing cohort of studies has utilized message experiments to examine how different approaches for communicating scientific uncertainty impact public perceptions. Extending this program, we examine the effects of communicating different levels of uncertainty on public perceptions of advancements in HIV/AIDS research.
View Article and Find Full Text PDFBackground: Middle meningeal artery embolization (MMAE) emerges as an alternative to conventional surgical drainage (CSD) for chronic subdural hematomas (cSDH). Several studies have suggested that MMAE improves the cost efficacy of cSDH treatment. However, further comprehensive analyses of the outcomes and healthcare costs of MMAE are necessary.
View Article and Find Full Text PDFPartaking in regular exercise has vast psychological and physiological benefits. However, factors that promote sedentary lifestyle such as occupational obligations (desk-based work) or underlying health comorbidities can limit adherence to exercise regimes. Considering the current trends in physical inactivity, development of alternate strategies to replicate or mimic the beneficial adaptations associated with regular exercise may become a highly sought after commodity.
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- Cardiogenic shock (CS) is a serious condition that can lead to severe complications, and this study looked at how changes in hemodynamic (blood flow-related) measurements correlate with patient outcomes in those suffering from heart failure or heart attack.
- Researchers analyzed data from over 2,200 patients to compare the hemodynamic profiles at the start and end of hospitalization, finding that mortality rates were higher in patients with acute myocardial infarction compared to those with heart failure.
- The study revealed that improvements in various hemodynamic and metabolic factors during hospitalization, such as lower blood pressure and better cardiac output, were linked to increased survival rates in both groups of patients.
Article Synopsis
- The CSWG-SCAI staging system helps assess the severity of cardiogenic shock (CS) in patients, but there’s limited data on how these stages change over time and affect outcomes.
- This study analyzed data from 3,268 patients with acute myocardial infarction-related CS and heart failure-related CS to see how their SCAI stages changed over 72 hours.
- Findings showed that most patients’ stages changed within the first 24 hours, particularly those in stage B who had a high risk of worsening, indicating that early detection and ongoing evaluation are crucial for improving patient outcomes.
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- *A study analyzing hospital data from 2016 to 2020 revealed that while the rate of AF/AFL hospitalizations was stable prior to 2020, it dropped sharply in 2020 alongside an increase in severe outcomes like mortality and stroke.
- *Key factors associated with worse outcomes included older age, ischemic heart disease, chronic kidney disease, and COVID-19 infection itself.
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- * Heart replacement therapies can be effective but are limited to a small group of patients; thus, understanding the underlying causes and optimizing recovery factors is crucial.
- * This review discusses the pathophysiology of CS, what helps predict heart recovery, and emphasizes the need for more research to bridge the knowledge gaps in treating CS effectively.
Article Synopsis
- Acute right ventricular failure (RVF) often occurs in various diseases and can lead to serious health issues, particularly when accompanied by cardiogenic shock (CS).
- Right-sided temporary mechanical circulatory support (tMCS) devices are utilized to relieve heart stress and improve blood circulation in affected patients, although there is no agreed-upon protocol for their use.
- This review aims to outline the current treatments for acute RVF, the decision-making process for using tMCS devices, key management elements like fluid levels and anticoagulation, and guidelines for gradually discontinuing tMCS support.
Article Synopsis
- The study aimed to assess the impact of a 4-week post-exercise passive leg heating protocol on endurance performance in recreationally trained participants.
- Thirty participants were split into a passive heating group (who wore a heated ensemble) and a control group, with various endurance and vascular measurements taken at different points during the study.
- Results showed no improvement in endurance capacity or vascular health for the heating group; in fact, some negative effects on oxygen kinetics and exercise performance were observed.
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- A study analyzed data from 7,070 patients with cardiogenic shock (CS), finding that 5.6% developed acute limb ischemia (ALI), particularly among women and those with peripheral arterial disease.* -
- ALI incidence increased with the severity of CS, with highest rates among patients using advanced support devices like VA-ECMO and balloon pumps, yet less than half used distal perfusion catheters.* -
- Mortality rates were significantly higher for patients with ALI (57.4%) compared to those without (38.0%), highlighting ALI's severe impact on survival in CS patients.*
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- Sinus venosus atrial septal defect (SVASD) is a rare heart condition, making up 5% to 10% of atrial septal defects, with surgical closure being the standard treatment despite limited data on outcomes.
- A systematic review of 40 studies involving 1,320 patients revealed very low in-hospital (0.24%) and 30-day (0.5%) mortality rates, while long-term complications included atrial fibrillation (3.3%) and sinus node dysfunction (6.5%).
- This analysis provides the first comprehensive overview of SVASD repair outcomes, supporting the effectiveness of surgery and setting a benchmark for evaluating new transcatheter treatments.
Article Synopsis
- Decongestion is a key treatment goal for patients with decompensated heart failure, focusing on reducing excess fluid in the body.
- Current methods for achieving decongestion primarily include diuretics and hemofiltration, though new mechanical technologies are being developed.
- The review covers the underlying causes of decompensated heart failure, the importance of managing cardiac preload, new technologies aimed at preload reduction, and their potential use in clinical settings.
Purpose: Caffeine is a commonly used ergogenic aid for endurance events; however, its efficacy and safety have been questioned in hot environmental conditions. The aim of this study was to investigate the effects of acute caffeine supplementation on cycling time to exhaustion and thermoregulation in the heat.
Methods: In a double-blind, randomised, cross-over trial, 12 healthy caffeine-habituated and unacclimatised males cycled to exhaustion in the heat (35 °C, 40% RH) at an intensity associated with the thermoneutral gas exchange threshold, on two separate occasions, 60 min after ingesting caffeine (5 mg/kg) or placebo (5 mg/kg).
Article Synopsis
- - The study investigates the relationship between premembranous venous oxygen saturation (Spm-vO2) displayed on ECMO machines and mixed venous oxygen saturation (SvO2) in adult patients on veno-arterial ECMO, finding a significant mean difference of 11.37% between the two measures.
- - Correlation exists between Spm-vO2 and SvO2 (r = 0.51), but the disparity is greater at lower SvO2 levels, indicating that Spm-vO2 tends to overestimate oxygen saturation, especially when SvO2 drops below 60%.
- - The results suggest that using Spm-vO2 for estimating cardiac output using the Fick method may lead
Article Synopsis
- A patient showed spontaneous regression of multiple intracranial meningiomas after stopping the use of megestrol acetate, a progestin, and was treated conservatively for 5 years.
- The report highlights existing literature that connects exogenous progesterone medications with meningioma growth.
- It suggests that discontinuing progesterone therapy, when possible, might influence meningioma growth patterns and inform treatment strategies.
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- Cervical spinal cord compression can cause serious health issues like pain, paralysis, or even death, and current methods lack automated detection tools for radiologists.
- This study tested a vision transformer (ViT) model on a diverse set of cervical spine MRIs to effectively detect levels of spinal cord compression compared to other models like ResNet50 and DenseNet121.
- The ViT model demonstrated superior performance with an accuracy of 93% at the patient level and 82% at the section level, outperforming both CNN models and showing strong potential for clinical application.
Article Synopsis
- The ProtekDuo cannula is a dual-lumen device used primarily to provide mechanical circulatory support (MCS) for patients with right ventricular (RV) failure, typically inserted via the right internal jugular vein with imaging guidance.
- When connected to pumps like TandemHeart or CentriMag, it can improve blood circulation by bypassing the failing RV, leading to better pulmonary flow and reduced pressures in the heart.
- The review discusses the growing importance of the ProtekDuo in treating various clinical scenarios, highlighting its advantages such as ease of use, compatibility with different devices, and potential for increased patient mobility.
Article Synopsis
- Liquid embolic agents (LEAs), like ethylene vinyl alcohol (EVOH), are effective for treating chronic subdural hematomas (cSDH) by permanently blocking blood vessels and penetrating the membranes involved.
- A study analyzed CT scans from 74 patients who received MMAE with EVOH, looking at how LEA surface area (SA) affects cSDH resolution over time.
- Results showed significant reduction in hematoma volumes over several months and a positive correlation between LEA SA and cSDH resolution, indicating that better penetration of LEAs could lead to improved patient outcomes.
Article Synopsis
- - The text discusses the occurrence of cardiovascular complications following medical termination of pregnancy (MTP) in the U.S., highlighting that around 1 million MTPs occur annually, with 2% developing complications.
- - The review identifies the most common complications such as infective endocarditis (IE), takotsubo cardiomyopathy (TTC), arrhythmias, and sudden coronary artery dissection, noting specific details about each condition and associated risks.
- - The conclusion emphasizes that cardiovascular complications post-MTP are underreported, with IE and TTC being the most common issues, but generally, clinical recovery is achievable with appropriate medical care.