Cardiopulmonary Exercise Testing, Rehabilitation, and Exercise Training in Postpulmonary Embolism.

Long-term exercise intolerance and functional limitations are common after an episode of acute pulmonary embolism (PE), despite 3 to 6 months of anticoagulation. These persistent symptoms are reported in more than half of the patients with acute PE and are referred as "post-PE syndrome." Although these functional limitations can occur from persistent pulmonary vascular occlusion or pulmonary vascular remodeling, significant deconditioning can be a major contributing factor.

Cardiopulmonary Exercise Testing, Rehabilitation, and Exercise Training in Postpulmonary Embolism.

Long-term exercise intolerance and functional limitations are common after an episode of acute pulmonary embolism (PE), despite 3 to 6 months of anticoagulation. These persistent symptoms are reported in more than half of the patients with acute PE and are referred as "post-PE syndrome." Although these functional limitations can occur from persistent pulmonary vascular occlusion or pulmonary vascular remodeling, significant deconditioning can be a major contributing factor.

Prognosis of paradoxical low-flow low-gradient aortic stenosis after transcatheter aortic valve replacement.

Aims: In paradoxical low-flow low-gradient severe aortic stenosis (PLFLG AS) patients, stroke volume index (SVI) is reduced despite preserved left ventricular ejection fraction (LVEF). Although reduced SVI is already known as a poor prognostic predictor, the outcomes of PLFLG AS patients after transcatheter aortic valve replacement (TAVR) have not been clearly defined. We retrospectively investigated the post-TAVR outcomes of PLFLG AS patients in comparison with normal-flow high-gradient aortic stenosis (NFHG AS) patients.

The impact of increased pulmonary arterial pressure on outcomes after transcatheter aortic valve replacement.

Objective: To evaluate the impact of increased pulmonary artery systolic pressure (PASP) on outcomes after transcatheter aortic valve replacement (TAVR).

Methods: A total of 242 patients who underwent TAVR were retrospectively reviewed. Transthoracic echocardiography estimated PASP.

Percutaneous Vacuum-Assisted Thrombectomy Using AngioVac Aspiration System.

Background: Surgical embolectomy and thrombolytic therapy are two common approaches for the treatment of large intra-cardiac or intravascular thrombi to prevent new or worsening pulmonary embolism (PE). Considering high operative mortality with surgical embolectomy and high bleeding risk with thrombolytic therapy, patients who are poor candidates for these treatments may benefit from percutaneous aspiration thrombectomy/Vacuum-assisted thrombectomy (VAT). AngioVac aspiration system was granted 510(k) clearance by the United States Food and Drug Administration (FDA) in April 2009.

Percutaneous closure of left ventricle pseudoaneurysm using 3D printed heart model for procedure planning: A novel approach.

Left ventricle pseudoaneurysm is a rare complication of myocardial infarction that carries a high risk of mortality. In this report, we present a case of successful percutaneous closure of left ventricle pseudoaneurysm using 3D printing for procedure guidance.

Inter- and intra-observer repeatability of aortic annulus measurements on screening CT for transcatheter aortic valve replacement (TAVR): Implications for appropriate device sizing.

Objectives: To investigate intra- and inter-observer repeatability of aortic annulus CT measurements for transcatheter aortic valve replacement (TAVR) by readers with different levels of experience and evaluate the impact of different multi-reader paradigms to improve prosthesis sizing.

Methods: 82 TAVR screening CTAs were evaluated twice by three raters with six (R1 = radiologist), three (R2 = 3D-laboratory technician) or zero (R3 = medical student) years of experience. Results were translated into hypothetical TAVR size recommendations.

Endovascular Therapy for Rheumatic Mitral and Aortic Valve Disease: Review Article.

Rheumatic heart disease remains a major cause of significant mortality and morbidity in the developing world. Rheumatic mitral and aortic stenosis are the two most common valvular sequelae of acute rheumatic fever. Open surgical procedures with either valve replacement or surgical commissurotomy have largely been replaced by percutaneous commissurotomy and balloon valvuloplasty for selected patients since the early 1980s.

Recurrent severe aortic stenosis one year after transcatheter aortic valve-in-valve implantation: Successful treatment with balloon aortic valvuloplasty.

Transcatheter aortic valve-in-valve (VIV) implantation has evolved as one of the primary therapeutic modalities in patients with failed surgical bioprosthesis allowing a reduction in rate of surgical reintervention. We report a case of a 90-year-old woman who had previously undergone aortic valve replacement with 21-mm Carpentier-Edwards valve in 1999 followed by 23 mm Sapien VIV in March 2013. She developed severe recurrent aortic stenosis 1-year post-VIV which was successfully treated with balloon aortic valvuloplasty (BAV).

Lipopolysaccharide Density and Structure Govern the Extent and Distance of Nanoparticle Interaction with Actual and Model Bacterial Outer Membranes.

Design of nanomedicines and nanoparticle-based antimicrobial and antifouling formulations and assessment of the potential implications of nanoparticle release into the environment requires understanding nanoparticle interaction with bacterial surfaces. Here we demonstrate the electrostatically driven association of functionalized nanoparticles with lipopolysaccharides of Gram-negative bacterial outer membranes and find that lipopolysaccharide structure influences the extent and location of binding relative to the outer leaflet-solution interface. By manipulating the lipopolysaccharide content in Shewanella oneidensis outer membranes, we observed the electrostatically driven interaction of cationic gold nanoparticles with the lipopolysaccharide-containing leaflet.

Posterolateral reconstruction of the knee using capsular procedures for evaluation and treatment of posterolateral instability of the knee.

Posterolateral rotatory instability of the knee causes significant morbidity if unrecognized and left untreated. With both acute and chronic injuries, restoration of the normal anatomy is crucial for a good outcome. During capsular repairs, detailed knowledge of the anatomy will help the surgeon repair the pathoanatomy.

Attachment of pathogenic prion protein to model oxide surfaces.

Prions are the infectious agents in the class of fatal neurodegenerative diseases known as transmissible spongiform encephalopathies, which affect humans, deer, sheep, and cattle. Prion diseases of deer and sheep can be transmitted via environmental routes, and soil is has been implicated in the transmission of these diseases. Interaction with soil particles is expected to govern the transport, bioavailability and persistence of prions in soil environments.

Classification of left ventricular diastolic function using American Society of Echocardiography Guidelines: agreement among echocardiographers.

Guidelines for assessing diastolic function by echocardiography are continually being updated. Our ability to use available guidelines effectively has not been completely investigated. Six trained echocardiographers were asked to interpret 105 echocardiograms using current American Society of Echocardiography (ASE) algorithms for interpretation of diastolic grade and estimation of left atrial (LA) pressure.

Elongation kinetics of polyglutamine peptide fibrils: a quartz crystal microbalance with dissipation study.

Abnormally expanded polyglutamine domains in proteins are associated with several neurodegenerative diseases, including Huntington's disease. Expansion of the polyglutamine (polyQ) domain facilitates aggregation of the affected protein, and several studies directly link aggregation to neurotoxicity. Studies of synthetic polyQ peptides have contributed substantially to our understanding of the mechanism of aggregation.

Transport of the pathogenic prion protein through soils.

Transmissible spongiform encephalopathies (TSEs) are progressive neurodegenerative diseases and include bovine spongiform encephalopathy of cattle, chronic wasting disease (CWD) of deer and elk, scrapie in sheep and goats, and Creutzfeldt-Jakob disease in humans. An abnormally folded form of the prion protein (designated PrP(TSE)) is typically associated with TSE infectivity and may constitute the major, if not sole, component of the infectious agent. Transmission of CWD and scrapie is mediated in part by an environmental reservoir of infectivity.

Evaluation and treatment of acute and chronic injuries to the capsular ligaments of the knee.

Injury to the capsular ligaments of the knee commonly occurs in conjunction with cruciate ligament injury. An untreated grade III sprain can lead to recurrent meniscal injury, failure of cruciate ligament reconstruction, and arthrosis. Careful clinical examination is necessary to identify injuries to discrete ligaments and estimate the severity of injuries not discernable on imaging studies.

Transport of the pathogenic prion protein through landfill materials.

Transmissible spongiform encephalopathies (TSEs, prion diseases) are a class of fatal neurodegenerative diseases affecting a variety of mammalian species including humans. A misfolded form of the prion protein (PrP(TSE)) is the major, if not sole, component of the infectious agent RecentTSE outbreaks in domesticated and wild animal populations have created the need for safe and effective disposal of large quantities of potentially infected materials. Here, we report results of a study to evaluate the potential for transport of PrP(TSE) derived from carcasses and associated wastes in municipal solid waste (MSW) landfills.

Gastrointestinal biodurability of engineered nanoparticles: Development of an assay.

The toxicity of engineered nanoparticles is expected to depend in part on their stability in biological systems. To assess the biodurability of engineered nanomaterials in the human digestive system, we adapted an assay previously used to evaluate the bioaccessibility of metals in contaminated soils. The compositions of the simulated gastric and intestinal fluids, temperature and residence times were designed to closely mimic conditions in the stomach and duodenum of the small intestine.

Persistence of pathogenic prion protein during simulated wastewater treatment processes.

Transmissible spongiform encephalopathies (TSEs, prion diseases) are a class of fatal neurodegenerative diseases affecting a variety of mammalian species including humans. A misfolded form of the prion protein (PrP(TSE)) is the major, if not sole, component of the infectious agent. Prions are highly resistant to degradation and to many disinfection procedures suggesting that, if prions enter wastewater treatment systems through sewers and/or septic systems (e.

The economic burden of complications during percutaneous coronary intervention.

Background: Technological advances have enabled percutaneous coronary intervention (PCI) to be applied with expanding indications. However, escalating costs are of concern. This study assessed the incremental medical costs of major in-hospital procedural complications incurred by patients undergoing PCI.

Evaluation and treatment of medial collateral ligament and medial-sided injuries of the knee.

Injuries to the medial side of the knee are not always isolated injuries of the superficial medial collateral ligament. Medial-sided injuries can also involve the deep medial collateral ligament, the posteromedial corner, or the medial meniscus. Magnetic resonance imaging is a useful adjunct to the physical examination; however, the extent of medial-sided injuries is frequently underappreciated on these images.