Usefulness of B-type natriuretic peptide and cardiac troponin levels to predict in-hospital mortality from ADHERE.

B-type natriuretic peptide (BNP) and cardiac troponin (Tn) I or T have been demonstrated to provide prognostic information in patients with acute coronary syndromes. Whether admission BNP and Tn levels provide additive prognostic value in acutely decompensated heart failure (HF) has not been well studied. Hospitalizations for HF from April 2003 to December 2004 entered into ADHERE were analyzed.

Bronchodilator therapy in acute decompensated heart failure patients without a history of chronic obstructive pulmonary disease.

Study Objective: Inhaled bronchodilators are often used in the emergency department (ED) before a definitive diagnosis is made. We evaluated the association between inhaled bronchodilators and outcomes in acute decompensated heart failure patients without chronic obstructive pulmonary disease.

Methods: We conducted an analysis of the Acute Decompensated Heart Failure National Registry Emergency Module registry of patients with a principal discharge diagnosis of acute decompensated heart failure enrolled at 76 academic or community EDs.

High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure: a report from the ADHERE database.

Background: The prevalence of renal dysfunction in patients hospitalized with acute decompensated heart failure remains poorly characterized.

Methods And Results: Data from 118,465 hospitalization episodes were evaluated. Glomerular filtration rate (GFR) was estimated using the abbreviated Modification of Diet in Renal Disease formula.

Glycaemic index and glycaemic load values of cereal products and weight-management meals available in the UK.

There is currently an increased global interest in the published glycaemic index (GI) values of foods. The aim of the present work was to supplement a previous study on the glycaemic response of 140 foods available in the UK by studying a further forty-four foods. One hundred and twenty-two healthy subjects, with a mean age of 32.

Robotic gait training: toward more natural movements and optimal training algorithms.

This paper overviews our recent efforts to develop robotic devices to help people relearn how to walk after spinal cord injury. Our efforts are focused on two goals. The first is to develop robotic devices that allow natural gait movements and good force control.

Major histocompatibility polymorphism associated with resistance towards amoebic gill disease in Atlantic salmon (Salmo salar L.).

The association between major histocompatibility (MH) polymorphism and the severity of infection by amoebic gill disease (AGD) was investigated across 30 full sibling families of Atlantic salmon. Individuals were challenged with AGD for 19days and then their severity of infection scored by histopathological examination of the gills. Fish were then genotyped for the MH class I (Sasa-UBA) and MH class II alpha (Sasa-DAA) genes using polymorphic repeats embedded within the 3' untranslated regions of the Sasa-UBA and Sasa-DAA genes.

Soybean-derived biofuels and home heating fuels.

It is environmentally enticing to consider replacing or blending petroleum derived heating fuels with biofuels for many reasons. Major considerations include the soaring worldwide price of petroleum products, especially home heating oil, the toxicity of the petroleum-derived fuels and the environmental damage that leaking petroleum tanks afford. For these reasons, it has been suggested that domestic renewable energy sources be considered as replacements, or at the least, as blending stocks for home heating fuels.

Laboratory study on the immobilization of bacterial spores in arid environments.

In this study, two effective, non-toxic, wind erosion palliative materials were analyzed for their efficacy in preventing the spread of bacterial spores. Desert sand was employed in a laboratory setting with a non-toxic simulant bacterium in an attempt to accurately represent the spreadability of the hantavirus. Spore simulants were used instead of viruses due to availability, decreased susceptibility to desiccation and detection ability without involving tissue cultures.

Impact of early initiation of intravenous therapy for acute decompensated heart failure on outcomes in ADHERE.

Background: Since most acute decompensated heart failure (ADHF) patients present for hospital care via the emergency department (ED), we sought to determine the impact of early ED initiation of ADHF-specific therapy, as indicated by nesiritide use, on subsequent outcomes.

Methods: We queried the Acute Decompensated Heart Failure National Registry (ADHERE) to identify patients with initial systolic blood pressure >90 mm Hg and negative cardiac biomarkers, hospitalized after presentation to the ED, who received nesiritide but no other intravenous vasoactive drugs. Intensive care unit use and total hospital length of stay were compared based on the hospital unit where nesiritide therapy was initiated after multivariate adjustment for baseline differences in study populations.

Impedance cardiography: a potential monitor for hemodialysis.

Background: Impedance cardiography (ICG) technology has improved dramatically, and at least one device now can give a measurement of fluid status by using thoracic fluid content (TFC), along with cardiac output (CO) and cardiac index (CI). With a built-in sphygmomanometer cuff, it can also provide blood pressure (BP) and systemic vascular resistance index (SVRI). A currently available small portable ICG that provides reliable measures of fluid status could be an ideal noninvasive monitor for hemodialysis (HD), with the potential of helping avoid significant hemodynamic instability during HD.

Is it safe to perform cardiac catheterizations on adults with congenital heart disease in a pediatric catheterization laboratory?

Objective: To determine the complication rate during the catheterization in adults with congenital heart disease (CHD) in a pediatric catheterization laboratory (PCL).

Background: An increasing number of patients with CHD are surviving into adulthood, with diagnostic and interventional cardiac catheterization being essential for the management of their disease. The complication rate during the catheterization of adults with CHD has not been reported.

Subdural haematoma and effusion in infancy: an epidemiological study.

Aim: To determine incidence, aetiology, and clinical features of subdural haematoma and effusion (SDH/E) in infancy throughout the British Isles.

Methods: Cases were notified to the British Paediatric Surveillance Unit over 12 months by paediatricians, neurosurgeons, and paediatric and forensic pathologists.

Results: A total of 186 infants (121 boys, 65 girls) aged 0-2 years were identified.

In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications: an analysis from the Acute Decompensated Heart Failure National Registry (ADHERE).

Objectives: We sought to compare the in-hospital mortality of patients with acute decompensated heart failure (ADHF) who were receiving parenteral treatment with one of four intravenous vasoactive medications.

Background: There are limited data regarding the effects of the choice of intravenous vasoactive medication on in-hospital mortality in patients hospitalized with ADHF.

Methods: This was a retrospective analysis of observational patient data from the Acute Decompensated Heart Failure National Registry (ADHERE), a multicenter registry designed to prospectively collect data on each episode of hospitalization for ADHF and its clinical outcomes.

Use of balloon pull-through technique to assist in CardioSEAL device closure of patent foramen ovale.

CardioSEAL device closure of patent foramen ovale (PFO) has been advocated for the treatment of patients with cryptogenic stroke. Using the standard delivery technique, partial deployment of the CardioSEAL device can occur, especially in patients with a thick septum secundum and/or long PFO tunnel. We hypothesized that using a left atrial-to-right atrial balloon pull-through to make the septum primum incompetent would result in improved final device position regardless of septal thickness or tunnel length.

Syntheses of functionalized 1,4-disubstituted gamma-carbolines.

We report the complete synthesis of a variety of 1,4-disubstituted gamma-carbolines. These compounds are of particular interest for their involvement in many biological processes and are believed to possess various medicinal activities. A large number of N-tosylaldimines were condensed with indoles affording an array of 3-aminomethyl indoles.

Environmentally friendly production of thiobencarb (Bolero).

S-Alkyl thiocarbamates are commercially available and widely used for their herbicidal properties. Despite the numerous methods for synthesizing these compounds, most employ toxic reagents that are harmful to the environment. Within we report a novel efficient one-pot process for the formation of thiobencarb employing readily available reagents.

Facile one-pot synthesis of S-alkyl thiocarbamates.

We report a novel one-pot two-step synthesis of a variety of S-alkyl thiocarbamates. This method offers a two-directional approach making use of trichloroacetyl chloride, requires no complex starting material, incorporates a variety of substituents, and proceeds in high yields.

Circulatory assistance with a permanent implantable IABP: initial human experience.

Purpose: The Kantrowitz CardioVAD (KCV) is an electrically powered, pneumatically driven circulatory assist device which provides diastolic augmentation and systolic unloading to the failing heart. It consists of a 60cc-pumping chamber, a percutaneous access device (PAD), and an external controller. The pumping chamber, is surgically implanted in the descending thoracic aorta with the patient on cardiopulmonary bypass.

Synthesis of 3-[(1-aryl)aminomethyl]indoles.

We report the novel synthesis of various highly functionalized 3-arylaminomethyl indoles. This synthetic approach makes use of the directing ability of a bulky tert-butyldimethylsilyl-protecting group, which directs the condensation of an array of aromatic tosylaldimines specifically into the 3-position of the indole nucleus. The reactions, which occur under relatively mild conditions, afford the desired products in moderate yields.

An environmentally benign soybean derived fuel as a blending stock or replacement for home heating oil.

The use of bio-derived materials both as fuels and/or as blending stocks becomes more attractive as the price of middle distillate fuels, especially home heating oil, continues to rise. Historically, many biomass and agricultural derived materials have been suggested. One of the most difficult problems encountered with home heating oil is that of storage stability.