This document discusses total artificial hearts (TAHs) which are mechanical pumps that replace both ventricles of the heart. TAHs serve as a bridge to heart transplantation for patients with end-stage heart failure who are waiting for donor organs. The document reviews the history of TAH development, results from clinical trials of different TAH models, and future aims to develop smaller, more durable artificial hearts. It concludes that TAHs have significantly improved survival for patients with advanced heart failure by providing long-term circulatory support for over 16 years in some cases while they await transplantation.
The population of patients with end-stage heart failure has increased over the years, and the availability of donor organs has not be Sufficient.
End-stage heart failure represents a highly morbid condition for the patient with limited treatment options.
The treatment options are heart transplantation, heart–lung transplantation or implantation of a Mechanical Circulatory Support Devices.
If a patient waits until an organ becomes available for transplantation, they could need to wait months for that organ and therefore their condition could get worse.
There two Types of MCS Devices
1. Ventricular Assist Devices (VAD): are use on Short terms to Complement Failing Hearts.
2. Total Artificial Heart (TAH): one available option when long-term support of both ventricles is required.
The population of patients with end-stage heart failure has increased over the years, and the availability of donor organs has not be Sufficient.
End-stage heart failure represents a highly morbid condition for the patient with limited treatment options.
The treatment options are heart transplantation, heart–lung transplantation or implantation of a Mechanical Circulatory Support Devices.
If a patient waits until an organ becomes available for transplantation, they could need to wait months for that organ and therefore their condition could get worse.
There two Types of MCS Devices
1. Ventricular Assist Devices (VAD): are use on Short terms to Complement Failing Hearts.
2. Total Artificial Heart (TAH): one available option when long-term support of both ventricles is required.
Artificial heart has provided a viable option for patient awaiting heart transplantation. Future developments on artificial hearts have the hope of eliminating the need for the transplantation completely.
Slide deck on the AbioCor System presented by our student group for an introductory engineering course for biomedical and materials science engineering
RHD is prevalent in India, many patients requires valve replacement. understanding of prosthetic valve anatomy, morphology and early detection of valve related complication is very important for saving life. TTE and TEE are important tool for identifying these complications.
This is a paper on the AbioCor Heart System written by our five-person student group during a semester-long introductory engineering course for materials science engineering. The paper includes a detailed description on under which medical conditions the use of this device is appropriate, a description of alternatives and predecessors to the AbioCor Heart System, the components that make up the AbioCor System, and a design recommendation for improving the AbioCor System. I wrote this paper with a group of other undergraduate engineering students for an introductory engineering class focusing on material use in biomedical devices.
An artificial heart valve is a device implanted into the heart of a patient to replace a dysfunctional native heart valve. The human heart contains four valves: tricuspid valve, pulmonic valve, mitral valve and aortic valve.
Supercapacitors or EDLCs (i.e. electric double-layer capacitors) or ultra-capacitors are becoming increasingly popular as alternatives for the conventional and traditional battery sources. This brief overview focuses on the different types of supercapacitors, the relevant quantitative modeling areas and the future of supercapacitor research and development. Supercapacitors may emerge as the solution for many application-specific power systems. Especially, there has been great interest in developing supercapacitors for electric vehicle hybrid power systems, pulse power applications, as well as back-up and emergency power supplies. Because of their flexibility, however, supercapacitors can be adapted to serve in roles for which electrochemical batteries are not as well suited. Also, supercapacitors have some intrinsic characteristics that make them ideally suited to specialized roles and applications that complement the strengths of batteries. In particular, supercapacitors have great potential for applications that require a combination of high power, short charging time, high cycling stability and long shelf life. So, let’s just begin the innovative journey of these near future of life-long batteries that can charge up almost anything and everything within a few seconds!
Artificial heart has provided a viable option for patient awaiting heart transplantation. Future developments on artificial hearts have the hope of eliminating the need for the transplantation completely.
Slide deck on the AbioCor System presented by our student group for an introductory engineering course for biomedical and materials science engineering
RHD is prevalent in India, many patients requires valve replacement. understanding of prosthetic valve anatomy, morphology and early detection of valve related complication is very important for saving life. TTE and TEE are important tool for identifying these complications.
This is a paper on the AbioCor Heart System written by our five-person student group during a semester-long introductory engineering course for materials science engineering. The paper includes a detailed description on under which medical conditions the use of this device is appropriate, a description of alternatives and predecessors to the AbioCor Heart System, the components that make up the AbioCor System, and a design recommendation for improving the AbioCor System. I wrote this paper with a group of other undergraduate engineering students for an introductory engineering class focusing on material use in biomedical devices.
An artificial heart valve is a device implanted into the heart of a patient to replace a dysfunctional native heart valve. The human heart contains four valves: tricuspid valve, pulmonic valve, mitral valve and aortic valve.
Supercapacitors or EDLCs (i.e. electric double-layer capacitors) or ultra-capacitors are becoming increasingly popular as alternatives for the conventional and traditional battery sources. This brief overview focuses on the different types of supercapacitors, the relevant quantitative modeling areas and the future of supercapacitor research and development. Supercapacitors may emerge as the solution for many application-specific power systems. Especially, there has been great interest in developing supercapacitors for electric vehicle hybrid power systems, pulse power applications, as well as back-up and emergency power supplies. Because of their flexibility, however, supercapacitors can be adapted to serve in roles for which electrochemical batteries are not as well suited. Also, supercapacitors have some intrinsic characteristics that make them ideally suited to specialized roles and applications that complement the strengths of batteries. In particular, supercapacitors have great potential for applications that require a combination of high power, short charging time, high cycling stability and long shelf life. So, let’s just begin the innovative journey of these near future of life-long batteries that can charge up almost anything and everything within a few seconds!
Human brain is the most valuable creation of God. The man is intelligent because of the brain. "Blue brain" is the name of the world’s first virtual brain. That means a machine can function as human brain. Today scientists are in research to create an artificial brain that can think, response, take decision, and keep anything in memory. The main aim is to upload human brain into machine. So that man can think, take decision without any effort. After the death of the body, the virtual brain will act as the man .So, even after the death of a person we will not lose the knowledge, intelligence, personalities, feelings and memories of that man that can be used for the development of the human society.
Super-Capacitor Energy Storage of DFIG Wind Turbines with Fuzzy ControllerIJERD Editor
With the advance in wind turbine technologies, the cost of wind energy becomes competitive with
other fuel-based generation resources. Due to the price hike of the fossil fuels and the concern of the global
warming, the development of wind power has rapidly progressed over the last decade. Many countries have set
goal for high penetration levels of wind generations. Recently, several large-scale wind generation projects have
been implemented all over the world. It is economically beneficial to integrate very large amounts of wind
capacity in power systems. Unlike other traditional generation facilities, using wind turbines present technical
challenges in producing continuous and controllable electric power. With increase in contribution of wind power
into electric power grid, energy storage devices will be required to dynamically match the intermitting of wind
energy.
medical mirror
Introduction
Regular and non-invasive assessments of cardiovascular function are important insurveillance for cardiovascular catastrophes and treatment therapies of chronic diseases.Resting heart rate, one of the simplest cardiovascular parameters, has been identified as anindependent risk factor (comparable with smoking, dyslipidemia or hypertension) for cardiovascular disease [1]. Currently, the gold standard techniques for measurement of thecardiac pulse such as the electrocardiogram (ECG) require patients to wear adhesive gel patches or chest straps that can cause skin irritation and discomfort. Commercial pulseoximetry sensors that attach to the fingertips or earlobes are also inconvenient for patientsand the spring-loaded clips can cause pain if worn over a long period of time.The ability to monitor a patient¶s physiological signals by a remote, non-contactmeans is a tantalizing prospect that would enhance the delivery of primary healthcare. For example, the idea of performing physiological measurements on the face was first postulated by Pavlidis and associates [2] and later demonstrated through analysis of facial thermalvideos. Although non-contact methods may not be able to provide details concerning cardiacelectrical conduction that ECG offers, these methods can now enable long-term monitoring of other physiological signals such as heart rate or respiratory rate by acquiring themcontinuously in an unobtrusive and comfortable manner.Beyond that, such a technology would also minimize the amount of cabling andclutter associated with neonatal ICU monitoring, long-term epilepsy monitoring, burn or trauma patient monitoring, sleep studies, and other cases where a continuous measure of heart-rate is important. The use of photoplethysmography (PPG), a low cost and non-invasivemeans of sensing the cardiovascular pulse wave (also called the blood volume pulse) throughvariations in transmitted or reflected light, for non-contact physiological measurements has been investigated recently. This electro-optic technique can provide valuable informationabout the cardiovascular system such as heart rate, arterial blood oxygen saturation, blood pressure, cardiac output and autonomic function.
Applications of Bio systems Engineering (Artificial Organs)Dineesha Nipunajith
Applications Of Bio - Systems Engineering !
Artificial Heart
Artificial lungs
Artificial kidneys
Artificial nose
Artificial tongue
Advantages & Disadvantages
Health Risks
This is the seminar report of my presentation
Link for the pressentaion file is
http://www.slideshare.net/arjunrtvm/3d-printing-additive-manufacturing-with-awesome-animations-and-special-effects
Transcatheter closure of atrial septal defect in symptomatic childrenRamachandra Barik
Atrial septal defect (ASD) constitutes 8%–10% of the
congenital heart defects in children. The secundum
ASD accounts for nearly 75% of all ASDs. Since
the introduction of transcatheter device closure for
secundum ASDs in 1976 by King et al., there has been
a paradigm shift in their management. Over the years,
the procedure has evolved significantly to become a
treatment of choice in many institutions. The Amplatzer
septal occluder (ASO) is the most widely used device
owing to its user-friendliness and high success rate.
Various studies have reported transcatheter closure
to be as effective, and with lower complication rate, as
compared to surgical closure.[4,5] However, most of these
studies have included bigger children, adolescents, and
adults. Although a few studies have demonstrated
the feasibility and reasonable safety of transcatheter
ASD device closure in very young children,[7-10] none of
them have addressed important issues like how large
a defect is too large for device closure, how to select
the size of the device, does the length of the interatrial
septum (IAS) matter in the device selection, and is
there a need for using modified techniques to achieve
successful deployment of the device in this subset of
patients which is characterized by relatively large defects
in small hearts.
Percutaneous Transvenous Mitral Commissurotomy in 71 Years Old Woman with Mit...M A Hasnat
AAS Majumder, MA Hasnat, AKMM Islam, M Ullah, MZ Rahman, S Zaman, MM Rahman, MH Alamgir.
Department of Cardiology, NICVD, Dhaka.
(Cardiovasc. j. 2013; 6(1): 68-70)
Living donor liver transplantation (LDLT) is performed all over the world today. The shortage of cadaveric grafts makes it the only option for many end stage cirrhotics in many countries. Donor hepatectomy is a complicated operations and this has raised concerns about the safety of this operation. However, today donor hepatectomy is a safe operation with a low incidence of complications.
From the cardiopulmonary bypass and first heart transplantation to transcatheter valve implantation and minimally invasive cardiac surgery, there were spent many decades. The cardiac surgery had modelled and evolved according to surgeons’ experience and clinical needs. Nowadays, the minimally invasive surgery and robotic surgery have won the first place in our operation rooms with the more and more emergent transcatheter valve procedure.
RECENT ADVANCES IN THE MANAGEMENT OF REFRACTORY HEART FAILUREApollo Hospitals
Heart failure is a pathophysiological state in which structural or functional cardiac disorder impairs the ability of the heart to function as a pump to support the physiological circulation. The medical therapy remains the
mainstay of treatment in these patients. The medical therapy can improve the quality of life and the longevity in
these patients, but this becomes insufficient in refractory heart failure. The heart failure is considered refractory when patients continued to be symptomatic despite optimal dose of medications, characterized by advanced structural heart disease. These patients will need frequent hospitalizations and the overall prognosis is very poor.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Total artificial heart review paper
1. Total Artificial Heart
(TAH)
Javier M. Zavala
University of Puerto Rico- Cayey
Biology Department
RISE Program
Biol. 3095 Seminar Scientific Literature and
Bibliography
ABSTRACT
Heart failure is a condition that affects great
part of the world population. Some
alternatives to survive heart failure are a
heart transplant. The problem with the heart
transplant is the availability of the organ.
The wish list for the organ is very long;
meanwhile the organ donors are very
limited. A viable alternative until the organ
becomes available are the total artificial
heart and the ventricle assist devices. The
total artificial heart serves as a bridge for
heart transplantation. There are different
types of total artificial hearts. In this review,
I discuss the history of the total artificial
heart, the results of patients that had used it,
the different models and the future aims for
the development of efficient, smaller total
artificial hearts.
INTRODUCTION
The population of patients with end-stage
heart failure has increased over the years,
and the availability of donor organs has not.
Mechanical circulatory support (MCS) has
gained importance to enhance or replace
myocardial performance. End-stage heart
failure represents a highly morbid condition
for the patient with limited treatment
options. The treatment options areheart
transplantation, heart–lung transplantation or
implantation of a destination mechanical
circulatory support device. If a patient waits
until an organ becomes available for
transplantation, they could need to wait
months for that organ and therefore their
condition could get worse. Artificial hearts
serves as a bridge of transplantation, for
those patients waiting for an organ donor.
There are two types of MCS:ventricularassist devices (VADs) and total artificial
heart (TAH). Ventricular assist devices
serve as a short term version.TAH is one
available option when long-term support of
both ventricles is required. Studies show the
efficiency of the total artificial heart, and
lead to the conclusion that TAH can
function up to 16 years.
HISTORY OF THE TAH
When the scientists were developing the first
artificial heart they were aiming for a
temporary support.Between 1957, when the
first TAH was implanted in an animal
model, and 1982, when a TAH was first
implanted in a human, efforts were
concentrated on making the device more
compatible to decrease complications. Some
of the contributors to the development of the
first artificial heart were William Kolff, Don
Olsen, Robert Jarvick and William DeVries.
They lead to the implantation of the Jarvick
7, which was the first model of the total
artificial heart, on a 61-year-old man that
died after 112 days. After the failure they
tried implanting the Jarvick 7 in a 25-year-
2. old, but just as bridge to transplantation and
it functioned perfectly. (Sale 2012)
RESULTS OF ARTIFICIAL HEART
IMPLANTS
From January 1993 to December 2009, 101
patients had bridge to transplant procedures
with the SynCardia TAH. The results
showed that 91% of the patients were
Interagency Registry for Mechanically
Assisted Circulatory Support profile 1, and
the remaining 9% of cases were failing
medical therapy. The mean support time was
87 days. Adverse events included strokes in
7.9% of cases and take-back for hemorrhage
in 24.7% of cases. Survival to
transplantation was 68.3%. Causes of death
of 32 patients on device support included
multiple organ failure (13), pulmonary
failure (6), and neurologic injury (4).
Survival after transplantation at 1, 5, and 10
years was 76.8%, 60.5%, and 41.2%,
respectively. The longest-term survivor is
currently alive 16.4 years post implantation.
(Copeland 2012)
Many arguments are made about the
survival of the patient, such as finances,
quality of life, and medical therapy for
device, assumed device durability, devicespecific complications, and donor heart
availability. In the end, we believe that
saving the patient, especially when he/she is
mortally ill, is most important. Further, we
believe that our experience documents the
salvage of patients who are outside of the
therapeutic range of LVADs as defined by
currently used risk prediction scores. This
hypothesis is supported by a report
comparing multivariate analysis of risk
factors for other devices with the
TAH.There is a real clinical need for TAH
support to rescue patients with advanced
life-threatening cardiac failure. There are
also a number of specific scenarios that can
best be treated with a TAH. The benefits of
the TAH are the low costs, compared to
continuous hospital treatment; improve life
quality and long term support. (Copeland
2012)
DIFFERENT TYPES OF TAH
The SynCardia TAHis the only FDAapproved TAH in the world. It is
pneumatically driven which means that run
by using air. The SynCardia is used as a
bridge of transplantation in patients
containing non-reversible bi-ventricular
failure. They are also used to treat patients
withsevere heart failure associated with
advanced congenital heart disease, failed or
burned-out transplants and failed ventricular
assist devices. (Slepian 2013)
The CardioWest TAH is a biventricular
orthotropic pneumatic pulsatile pump that
completely replaces the native ventricles and
valves and is actually approved as a bridge
to heart transplantation in selected patients.
The system consists of 2 artificial ventricles,
with 2 drivelines tunneled into the skin,
which connect ventricles to an external
console generating the pulsatile flow.Bellotto
reports the case of a patient implanted with a
CardioWest-TAH who underwent a
comprehensive strength and endurance
training program and was evaluated by
repeated peak cardiopulmonary exercise
tests. The patient experienced a 24%
increase of peak oxygen consumption and an
improvement in recovery kinetics during the
3. training period of 29 months. (Bellotto
2011)
The AbioCor TAH is fully implantable
within a patient, due to a combination of
advances in miniaturization, biosensors,
plastics and energy transfer. The AbioCor
runs on a rechargeable source of power. The
internal battery is charged by a
transcutaneous energy transmission (TET)
system, meaning that no wires or tubes
penetrate the skin and therefore there is less
risk of infection. Because of its size, this
heart is only compatible with men who have
a large frame. It has a product life
expectancy of 18 months.Compared to the
Cardiowest TAH, the AbioCor is larger in
size and this will preclude its use in many
patients.
FUTURE AIMS
Even though the TAH gives a viable
alternative to the patients with end stage
heart failure, the TAH have some
disadvantages. Some of this disadvantages
are that don’t fit all the patients, patients are
tethered to the driver which interferes with
quality of life, durability, complications
such as infections, and lack of pressure flow
compared to a normal heart. One of the main
goals is to decrease the size of the TAH and
improve their function.Some doctors are
designing a continuous-flow TAH that has
no valves or sensors. Preliminary in vitro
and in vivo open-chest studies have been
satisfactory in simulated physiologic states
and further pre-human studies are being
planned.
CONCLUSION
The TAH has been important for the
treatment of advanced heart failure. The
TAH serves as a bridge for heart
transplantation. The TAH is a viable option,
because the donor organ availability is very
limited. It has been proven that the TAH to
provide long term support. There has been a
significant evolution in the development of
the TAH. Also the results show that the
TAH improves the life span of a patient,
with end stage heart failure that doesn’t
qualifies for a ventricle assist device, up to
16 years. The Jarkick 7 was the first TAH
model designed, and was implanted in a
patient with end stage heart failure and he
died after 112 days. There are different types
of TAH: SynCardia, AbioCor, and the
CardioWest. Each one of them functions
differently. The scientists are planning to
develop a TAH that is smaller and function
without external machines.
CITED LITERATURE
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Mineburg N, Covington D, Smith R,
Friedman M. 2012. Experience with more
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Torregrossa G, Setzu T, Gambino A, Russo
N, Feltrin G , Tarzia V, Gerosa G. 2011.
Peripheral Adaptation Mechanisms in
Physical Training and Cardiac
Rehabilitation: The Case of a Patient
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Heart. Journal of Cardiac Failure,
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