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Wellcome Trust Centre for Global Health... Publications | LitMetric

67 results match your criteria: "Wellcome Trust Centre for Global Health Research[Affiliation]"

Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation.

Intensive Care Med Exp

November 2024

Critical Care Research Group, The Prince Charles Hospital, Level 3, Clinical Sciences Building, Chermside Qld 4032, Brisbane, QLD, Australia.

Article Synopsis
  • - Open-lung ventilation during cardiopulmonary bypass (CPB) may help reduce postoperative lung damage in heart transplant patients, based on a study using sheep models to compare ventilatory strategies during surgery.
  • - The study found that the group receiving open-lung ventilation had significantly less lung damage and inflammatory cell infiltration compared to the group that received no ventilation (measured by histological scores).
  • - Despite showing benefits in lung protection, no significant differences were observed in overall hemodynamic stability between the two groups, indicating the need for more research to confirm these findings in clinical settings.
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An ovine septic shock model of live bacterial infusion.

Intensive Care Med Exp

October 2024

Critical Care Research Group, The Prince Charles Hospital, 627 Rode Road, Level 3 Clinical Sciences Building, Chermside, Brisbane, QLD, 4032, Australia.

Article Synopsis
  • Escherichia coli is a leading cause of bloodstream infections and sepsis, but existing animal models fail to replicate the complexities of these conditions, hindering the development of effective treatments.
  • Researchers aimed to create a more accurate large-animal model of septic shock using sheep, by infusing a specific strain of antibiotic-resistant E. coli and closely monitoring their health over 48 hours.
  • The study successfully induced septic shock in five sheep, showing consistent and reproducible results, including significant drops in blood pressure and increases in lactate levels following the bacterial infusion.
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Background: Packed red blood cell (pRBC) transfusion is a relatively safe and mainstay treatment commonly used in cardiac surgical patients. However, there is limited evidence on clinical effects of transfusing blood nearing end-of shelf life that has undergone biochemical changes during storage.

Objective: To investigate evidence of associations between morbidity/mortality and transfusion of blood near end of shelf-life (> 35 days) in cardiac surgical patients.

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Article Synopsis
  • Right ventricle (RV) failure is a common issue in cardiopulmonary diseases and accurately assessing RV function is critical for treatment, though it's challenging due to its complex anatomy and pathophysiology.
  • Traditional methods like TAPSE, RV S', and RV FAC have limitations, particularly load-dependency that complicates diagnosis during RV failure.
  • Newer echocardiographic techniques such as "strain," "RV-pulmonary arterial coupling," and "RV myocardial work" provide improved assessment by addressing load dependency, and this review explores these advancements and their implications.
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Article Synopsis
  • - This study investigates the correlation between a new echocardiographic parameter called Pressure-Strain Product (PSP) and established metrics like Left Ventricular Stroke Work Index (LVSWI) and Cardiac Power Index (CPI) in sheep experiencing cardiogenic shock under veno-arterial extracorporeal membrane oxygenation (V-A ECMO).
  • - Research involved nine Dorset-cross ewes undergoing induced cardiogenic shock, with simultaneous measurements of PSP, LVSWI, and CPI taken at multiple time points during a 24-hour observation period.
  • - Results indicate that PSPcirc (a variant of PSP) shows a significant correlation with LVSWI and CPI, suggesting its potential as a reliable, non-invasive
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Background: The commonest echocardiographic measurement, left ventricular ejection fraction, can not necessarily predict mortality of recipients following heart transplantation potentially due to afterload dependency. Afterload-independent left ventricular stroke work index (LVSWI) is alternatively recommended by the current guideline; however, pulmonary artery catheters are rarely inserted in organ donors in most jurisdictions. We propose a novel non-invasive echocardiographic parameter, Pressure-Strain Product (PSP), as a potential surrogate of catheter-based LVSWI.

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Article Synopsis
  • The East African Society of Physiological Sciences (EASPS) organized a regional conference in Tanzania from November 29 to December 1, 2023, addressing challenges in physiology training and the role of graduates in the region.
  • The conference achieved significant milestones, including the launch of the Physiology Curriculum for African Universities (PhysioCAFUN) and the International Union of Physiological Sciences (IUPS) African Physiology Mentoring Program.
  • Participants from 24 countries took part in workshops, abstract presentations, and networking events, contributing to the advancement of physiological sciences in Africa and recognizing the establishment of national physiological societies in several East African countries.
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Article Synopsis
  • Shock-induced endotheliopathy (SHINE) is a condition characterized by severe endothelial dysfunction due to extreme sympathetic activation during shock states, which can worsen organ perfusion despite aggressive resuscitation efforts.
  • This study systematically reviewed literature from Jan 2011 to July 2023, focusing on how resuscitation can affect endothelial health in critically ill patients, while excluding animal studies and reviews.
  • Out of 32 relevant studies analyzed, many identified biomarkers related to endothelial damage, but only a few comparable studies were suitable for a quantitative meta-analysis on specific markers like syndecan-1 and thrombomodulin, indicating significant variability in the results.
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Article Synopsis
  • This study explored whether the Pressure-Strain Product (PSP), a parameter from speckle-tracking echocardiography, can predict invasive measures like left ventricular stroke work index (LVSWI) and afterload-related cardiac performance (ACP) in septic cardiomyopathy without being invasive.
  • In an experiment with sixteen sheep, researchers induced sepsis-like conditions in half and measured various cardiac parameters to assess the correlation between PSP and traditional methods.
  • Results indicated that PSPcirc significantly correlated with LVSWI and ACP, suggesting it could be a useful non-invasive predictor for these cardiac performance measures, even though it did not differentiate sub-phenotypes of acute respiratory distress syndrome (ARDS).
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Article Synopsis
  • This study examined the impact of transfusing blood products that are close to their shelf-life on clinical outcomes in obstetric patients in Queensland, Australia, from 2007 to 2013.
  • Comparing fresh (less than 21 days old for RBC, less than 3 days for PLT) to old blood products (35 days or older for RBC, 4 days or older for PLT), researchers found no significant difference in patient outcomes such as hospital stay length or morbidity.
  • The results indicated that using older RBC or PLT did not lead to higher rates of complications or mortality among the patients studied.
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Article Synopsis
  • Extracorporeal life support (ECLS) is utilized for patients with severe cardiac and pulmonary failure, consisting mainly of cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), both of which come with risks of thrombus formation and bleeding.
  • A study was conducted using ex vivo models of CPB and ECMO to assess the effects of nitric oxide (NO) as an alternative anticoagulant alongside heparin.
  • Results indicated that NO alone was ineffective in preventing thrombus formation, but delivered in combination with low-level heparin showed some antiplatelet effects, though further investigation is needed to assess NO's anti-inflammatory benefits in ECMO systems.
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Assessment and diagnosis of right ventricular failure-retrospection and future directions.

Front Cardiovasc Med

May 2023

Critical Care Research Group, The Prince Charles Hospital, University of Queensland, Brisbane, QLD, Australia.

The right ventricle (RV) has a critical role in hemodynamics and right ventricular failure (RVF) often leads to poor clinical outcome. Despite the clinical importance of RVF, its definition and recognition currently rely on patients' symptoms and signs, rather than on objective parameters from quantifying RV dimensions and function. A key challenge is the geometrical complexity of the RV, which often makes it difficult to assess RV function accurately.

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Donor heart ischemic time can be extended beyond 9 hours using hypothermic machine perfusion in sheep.

J Heart Lung Transplant

August 2023

Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia; Prince Charles Hospital Northside Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Background: The global shortage of donor hearts available for transplantation is a major problem for the treatment of end-stage heart failure. The ischemic time for donor hearts using traditional preservation by standard static cold storage (SCS) is limited to approximately 4 hours, beyond which the risk for primary graft dysfunction (PGD) significantly increases. Hypothermic machine perfusion (HMP) of donor hearts has been proposed to safely extend ischemic time without increasing the risk of PGD.

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Objectives: To determine the prevalence and outcomes associated with hemorrhage, disseminated intravascular coagulopathy, and thrombosis (HECTOR) complications in ICU patients with COVID-19.

Design: Prospective, observational study.

Setting: Two hundred twenty-nine ICUs across 32 countries.

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An analysis of social dimensions of podoconiosis and leprosy on affected households in endemic health districts of the North West Region of Cameroon.

SSM Popul Health

September 2022

Epidemiology and Control of Infectious Diseases, Department of Microbiology and Parasitology, University of Buea, PO Box 63, Buea, Cameroon.

Background: Podoconiosis and leprosy are Neglected Tropical Diseases associated with low quality of life, social stigma and isolation of affected people and families. Despite the substantial social burden it imposes, podoconiosis has largely been ignored in the global health literature until recently unlike leprosy. This study assessed and compared the quality of life and social impact of podoconiosis with that of leprosy among affected households and neighborhoods in North West Cameroon.

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Unlabelled: This narrative review aims to discuss the potential applicability of speckle-tracking echocardiography (STE) in patients under mechanical ventilation (MV) and mechanical circulatory support (MCS). Both its benefits and limitations were considered through critical analyses of the current available evidence.

Data Sources And Study Selection: A literature search was conducted in PubMed and Excerpta Medica Database indexed databases (2012-2021).

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Background: The influence of renin-angiotensin-aldosterone system (RAAS) inhibitors on the critically ill COVID-19 patients with pre-existing hypertension remains uncertain. This study examined the impact of previous use of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) on the critically ill COVID-19 patients.

Methods: Data from an international, prospective, observational cohort study involving 354 hospitals spanning 54 countries were included.

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Background: Heart transplantation (HTx) from brainstem dead (BSD) donors is the gold-standard therapy for severe/end-stage cardiac disease, but is limited by a global donor heart shortage. Consequently, innovative solutions to increase donor heart availability and utilisation are rapidly expanding. Clinically relevant preclinical models are essential for evaluating interventions for human translation, yet few exist that accurately mimic all key HTx components, incorporating injuries beginning in the donor, through to the recipient.

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The acute respiratory distress syndrome (ARDS) describes a heterogenous population of patients with acute severe respiratory failure. However, contemporary advances have begun to identify distinct sub-phenotypes that exist within its broader envelope. These sub-phenotypes have varied outcomes and respond differently to several previously studied interventions.

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Background: The initial research requirements in pandemics are predictable. But how is it possible to study a disease that is so quickly spreading and to rapidly use that research to inform control and treatment?

Main Body: In our view, a dilemma with such wide-reaching impact mandates multi-disciplinary collaborations on a global scale. International research collaboration is the only means to rapidly address these fundamental questions and potentially change the paradigm of data sharing for the benefit of patients throughout the world.

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Compromised right ventricular contractility in an ovine model of heart transplantation following 24 h donor brain stem death.

Pharmacol Res

July 2021

Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia; School of Medical Sciences, Griffith University, Queensland, Australia; Prince Charles Hospital Northside Clinical Unit, Faculty of Medicine, University of Queensland, Australia; Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Australia; Cardiothoracic Surgery and Transplantation, The Alfred Hospital, and Monash University, Melbourne, Australia.

Background: Heart failure is an inexorably progressive disease with a high mortality, for which heart transplantation (HTx) remains the gold standard treatment. Currently, donor hearts are primarily derived from patients following brain stem death (BSD). BSD causes activation of the sympathetic nervous system, increases endothelin levels, and triggers significant inflammation that together with potential myocardial injury associated with the transplant procedure, may affect contractility of the donor heart.

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Mesenchymal stromal cell (MSC) therapy is a promising intervention for acute respiratory distress syndrome (ARDS), although trials to date have not investigated its use alongside extracorporeal membrane oxygenation (ECMO). Recent preclinical studies have suggested that combining these interventions may attenuate the efficacy of ECMO. To determine the safety and efficacy of MSC therapy in a model of ARDS and ECMO.

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Despite advances in mechanical circulatory devices and pharmacologic therapies, heart transplantation (HTx) is the definitive and most effective therapy for an important proportion of qualifying patients with end-stage heart failure. However, the demand for donor hearts significantly outweighs the supply. Hearts are sourced from donors following brain death, which exposes donor hearts to substantial pathophysiological perturbations that can influence heart transplant success and recipient survival.

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