Cardiac Care Unit

Harbin, China

Cardiac Care Unit

Harbin, China
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Amadi V.N.,Federal Medical Center | Balogun M.O.,Cardiac Care Unit | Akinola N.O.,Obafemi Awolowo University | Adebayo R.A.,Cardiac Care Unit | Akintomide A.O.,Cardiac Care Unit
Vascular Health and Risk Management | Year: 2017

Background: Sickle cell anemia (SCA) is the commonest hemoglobinopathy and is associated with high morbidity and mortality. Pulmonary hypertension (PH) is reported to play a significant role in this regard. There is very limited literature on PH in SCA in Nigeria. Objectives: The objectives of this study were to determine the prevalence of Doppler-derived PH in SCA, assess its influence on exercise capacity, and determine the correlates and predictors of measures of estimated pulmonary pressure. Methods: A total of 92 SCA subjects had echocardiography and 6-minute self-paced walking exercise. PH was diagnosed by Doppler echocardiography on finding a tricuspid regurgitant velocity (TRV) of ≥2.5 m/s. The pulmonary flow profile was also assessed to estimate mean pulmonary arterial pressure (MPAP). Results: Doppler-derived PH was detected in 23.9% of adults with SCA. The 6-minute walking distance (6MWD) was significantly lower in SCA adults with PH than in those without PH (380.33 ± 63.17 m vs 474.28 ± 76.74 m; p = 0.014). TRV and estimated MPAP had a significant inverse correlation with the 6MWD (r = -0.442; p < 0.001 and r = -0.571; p < 0.001, respectively). Conclusion: PH as derived by Doppler is common in Nigerian adults with SCA and has a significantly negative influence on exercise capacity. Screening for PH should be encouraged to optimize management and thus improve their quality of life and life expectancy. © 2017 Amadi et al.

Liang W.,Central Hospital of Panyu District | Liang W.,Cardiovascular Institute of Panyu District | Zheng D.,Cardiac Care Unit | He J.,Central Hospital of Panyu District | And 8 more authors.
International Journal of Molecular Medicine | Year: 2017

Recently, a novel mechanism known as 'programmed necrosis' or necroptosis has been shown to be another important mechanism of cell death in the heart. In this study, we investigated the role of necroptosis in high glucose (HG)-induced injury and inflammation, as well as the underlying mechanisms. In particular, we focused on the interaction between necroptosis and reactive oxygen species (ROS) in H9c2 cardiac cells. Our results demonstrated that the exposure of H9c2 cardiac cells to 35 mM glucose (HG) markedly enhanced the expression level of receptor-interacting protein 3 (RIP3), a kinase which promotes necroptosis. Importantly, co-treatment of the cells with 100 ?M necrostatin-1 (a specific inhibitor of necroptosis) and HG for 24 h attenuated not only the increased expression level of RIP3, but also the HG-induced injury and inflammation, as evidenced by an increase in cell viability, a decrease in ROS generation, the attenuation of the dissipation of mitochondrial membrane potential and a decrese in the secretion levels of inflammatory cytokines, i.e., interleukin (IL)-1β and tumor necrosis factor (TNF)-α. Furthermore, treatment of the cells with 1 mM N-acetyl-L-cysteine (a scavenger of ROS) for 60 min prior to exposure to HG significantly reduced the HG-induced increase in the RIP3 expression level, as well as the injury and inflammatory response described above. Taken together, the findings of this study clearly demonstrate a novel damage mechanism involving the positive interaction between necroptosis and ROS attributing to HG-induced injury and inflammation in H9c2 cardiac cells.

Crump S.K.,Bioethical Solutions Inc | Schaffer M.A.,Bethel University | Schulte E.,Cardiac Care Unit | Schulte E.,Alternative Care Center
Dimensions of Critical Care Nursing | Year: 2010

In response to critical care nurses' perceptions of increasing stress and conflict in difficult end-of-life (EOL) situations, the researchers conducted a study to identify perceived obstacles, supports, and knowledge needed to provide quality EOL care. The conclusions were as follows: (1) families and patients need clear, direct, and consistent information to make EOL decisions; (2) physician-related issues affect nurses' ability to provide quality EOL care; (3) critical care nurses need more knowledge, skill, and a sense of cultural competency to provide quality care; and (4) having properly completed advance directives can reduce confusion about the goals of care. Recommendations for improving EOL care were made as a result of the study. Copyright © 2010 Lippincott Williams & Wilkins.

Davidson J.E.,University of California at San Diego | Savidan K.A.,Surgical Oncology Unit | Barker N.,Cardiac Care Unit | Ekno M.,Neonatal Intensive Care Unit | And 2 more authors.
Critical Care Nursing Quarterly | Year: 2014

Family presence is advocated by many professional organizations and recommended in practice guidelines. However, firmly held beliefs often prevent full implementation of family presence on rounds and with visiting. This article will review the evidence surrounding common concerns that family presence will increase infection, have adverse effects on the physiologic status of the patient, defer from teaching opportunities, or otherwise interfere with rounds. The notion that families need to be encouraged to go home to rest is also explored. A case study describing 1 unit's efforts to improve family presence is described. Strategies to overcome obstacles inhibiting family presence will be provided. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Saputro A.H.,National University of Malaysia | Mustafa M.M.,National University of Malaysia | Hussain A.,National University of Malaysia | Maskon O.,Cardiac Care Unit | Mohd Nor I.F.,Cardiac Care Unit
Biomedical Engineering - Applications, Basis and Communications | Year: 2015

Left ventricular (LV) shape alteration is closely correlated with cardiac disease and LV function. In this paper, we propose a feature to detect LV dysfunction globally by analyzing the LV shape deformation in systolic contraction. The feature is an index that is extracted from geometric measurement of LV shape such as the length of the long axis, the short axis, and the apical diameter. A framework for computing the features is also proposed that consists of shape model construction and motion estimation of myocardial boundary. The LV shape model is extracted from apical 2 and 4 chamber views of 2D echocardiography. The long axis, the short axis, and the apical diameter were redefined according to the LV shape constructed. An optical flow technique was used to estimate the position of the LV boundary in each frame. The classification of the LV dysfunction was performed using linear discriminant analysis (LDA) and neural networks (NNs). The 2D echocardiography dataset collected from routine clinical check-up were used to validate the proposed method by comparing the computation result and cardiac expert diagnose. Classification performance and statistical analysis, which was performed to discriminate between healthy and diseased data, indicated promising results. The global LV features would provide a strong basis for a global LV function diagnosis and a global cardiac pathology assessment. © 2015 National Taiwan University.

Riyadi S.,National University of Malaysia | Mustafa M.M.,National University of Malaysia | Hussain A.,National University of Malaysia | Maskon O.,Cardiac Care Unit | Mohd Nor I.F.,Cardiac Care Unit
Proceedings - 3rd International Conference on Intelligent Systems Modelling and Simulation, ISMS 2012 | Year: 2012

Accurate information on myocardial motion is important in diagnosing cardiac abnormalities. In this research, the motion vectors are computed using an optical flow technique and further analyzed based on the magnitude and angle. We utilize a relative motion direction with respect to the center of the cavity, which is more useful for diagnosis because a physician can observe whether a segment is moving to the center or not more clearly. Instead of analizing individual vectors, it is more helpful to visualize the overall trend by performing their angular distribution. However, a common angular distribution considers motions with small and large magnitudes to have only an equal contribution and often fails to represent an accurate motion direction of a segment if there is a wide distribution of vector angles in the respective segment. In this paper, we propose a new method of providing an accurate radial direction profile by modifying the contribution of the motion vectors to the radial direction distribution based on a certain magnitude function. This method has been tested on clinical echocardiography sequences and shown to be successful in providing a more accurate radial direction profile compared with the common angular distribution. © 2012 IEEE.

Saputro A.H.,National University of Malaysia | Mustafa M.M.,National University of Malaysia | Hussain A.,National University of Malaysia | Maskon O.,Cardiac Care Unit | Mohd Nor I.F.,Cardiac Care Unit
Proceedings of the International Joint Conference on Neural Networks | Year: 2012

Deformation analysis of left ventricle (LV) shape could provide a new quantitative understanding of its abnormality. Currently, there is established motion estimation that allows accurate tracking of every point on the 2D echocardiography (2DE). This method produces a precise movement vector of each point in 2DE sequence. Analyzing this data using Fourier analysis could produce a new pattern to determine normal and abnormal deformation of LV. Observation of this method was performed on dataset acquired from 10 normal subjects and 10 patients. Two standard views (apical 2 and 4 chamber) were analyzed using a proposed technique to determine a novel insight of deformation. The results obtained are very promising and could be used as reference for future cardiac abnormality detection. © 2012 IEEE.

Su Y.,23 Post Road | Xu Y.,23 Post Road | Sun Y.-M.,Cardiac Care Unit | Li J.,Cardiac Care Unit | And 4 more authors.
Journal of Cardiovascular Pharmacology | Year: 2010

The aim of this study was to determine the effects of simvastatin and atorvastatin on the markers of oxidative stress in patients with type 2 diabetes mellitus (T2DM). The study population consisted of 151 patients with T2DM and 147 control individuals. The patients with T2DM were treated with 40 mg of simvastatin per day or 10 mg of simvastatin per day. Waist circumference, body mass index, blood pressure, and glucose and insulin values were obtained; and fasting serum lipids, malondialdehyde, nitric oxide, glutathione peroxidase and superoxide dismutase activity were determined before and after 12 weeks of treatment. Statin treatment significantly decreased plasma lipids in all patients with diabetes (P < 0.05). No significant differences were detected between the two treatment groups with respect to plasma lipid profile (P > 0.05). In addition, the effects of atorvastatin to increase nitric oxide concentration (33.28 ± 3.37 μmol/L versus 27.32 ± 4.15 μmol/L, P < 0.05) and glutathione peroxidase (17.67 ± 1.41 μmol/L versus 14.28 ± 1.65 μmol/L, P < 0.05), superoxide dismutase activity (34.28 ± 4.71 μmol/L versus 27.91 ± 3.38 μmol/L, P < 0.05 ) and decreased malondialdehyde level (49.52 ± 5.67 μmol/L versus 42.08 ± 5.16 μmol/L, P < 0.05) were significantly greater in patients with T2DM compared with simvastatin. The changes in the markers of oxidative stress did not correlate with the changes in plasma lipid profile (P > 0.05). This study suggested that atorvastatin reduced oxidative stress more effectively than simvastatin in patients with T2DM and the clinical benefits of statins may be independent of their cholesterol-lowering effects. Copyright © 2010 by Lippincott Williams & Wilkins.

Levine G.N.,Baylor College of Medicine | Levine G.N.,Cardiac Care Unit
Cardiology Secrets: Fourth Edition | Year: 2013

Get quick answers to the most important clinical questions with Cardiology Secrets! Using the popular and trusted Secret Series Q&A format, this easy-to-read cardiology book provides rapid access to the practical, "in-the-trenches" know-how you need to succeed both in practice, and on cardiology board and recertification exams. © 2014 Elsevier Inc. All rights reserved.

Josephson L.,Cardiac Care Unit
Dimensions of Critical Care Nursing | Year: 2010

There is an increasing need for nurses to interpret a 12-lead electrocardiogram, both in critical care units and in other areas. This can be a challenging task, especially in the presence of hypertrophies, bundle-branch blocks, and fascicular blocks. This article reviews the pathophysiology of intraventricular blocks and hypertrophy, characteristics found in the 12-lead electrocardiogram, and discusses what the significance of these findings may be. Copyright © 2010 Lippincott Williams & Wilkins.

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