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Sökning: WFRF:(Winnik S)

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  • Ben Avraham, Binyamin, et al. (författare)
  • HFA of the ESC Position paper on the management of LVAD supported patients for the non LVAD specialist healthcare provider : Part 1: Introduction and at the non-hospital settings in the community
  • 2021
  • Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 8:6, s. 4394-4408
  • Tidskriftsartikel (refereegranskat)abstract
    • The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of the LVAD-supported patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD-supported patients. The expected and non-expected device-related and patient-device interaction complications impose a significant burden on the medical system exceeding the capacity of the LVAD implanting centres. The ageing of the LVAD-supported patients, mainly those supported with the destination therapy indication, increases the risk for those patients to experience comorbidities common in the older population. The probability of an LVAD-supported patient presenting with medical emergency to a local emergency department, internal, or surgical ward of a non-LVAD implanting centre is increasing. The purpose of this trilogy is to supply the immediate tools needed by the non-LVAD specialized physician: ambulance clinicians, emergency ward physicians, general cardiologists, internists, anaesthesiologists, and surgeons, to comply with the medical needs of this fast-growing population of LVAD-supported patients. The different issues discussed will follow the patients pathway from the ambulance to the emergency department and from the emergency department to the internal or surgical wards and eventually to the discharge home from the hospital back to the general practitioner. In this first part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, after the introduction on the assist devices technology in general, definitions and structured approach to the assessment of the LVAD-supported patient in the ambulance and emergency department is presented including cardiopulmonary resuscitation for LVAD-supported patients.
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4.
  • Ben Gal, Tuvia, et al. (författare)
  • Guidance on the management of left ventricular assist device (LVAD) supported patients for the non-LVAD specialist healthcare provider: executive summary
  • 2021
  • Ingår i: European Journal of Heart Failure. - : Wiley-Blackwell. - 1388-9842 .- 1879-0844. ; 23:10, s. 1597-1609
  • Tidskriftsartikel (refereegranskat)abstract
    • The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD supported patients. Device-related, and patient-device interaction complications impose a significant burden on the medical system exceeding the capacity of LVAD implanting centres. The probability of an LVAD supported patient presenting with medical emergency to a local ambulance team, emergency department medical team and internal or surgical wards in a non-LVAD implanting centre is increasing. The purpose of this paper is to supply the immediate tools needed by the non-LVAD specialized physician - ambulance clinicians, emergency ward physicians, general cardiologists, and internists - to comply with the medical needs of this fast-growing population of LVAD supported patients. The different issues discussed will follow the patients pathway from the ambulance to the emergency department, and from the emergency department to the internal or surgical wards and eventually back to the general practitioner.
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5.
  • Farinha, Jose Paulo S., et al. (författare)
  • Interfaces in Self-Assembling Diblock Copolymer Systems: Characterization of Poly(isoprene-b-methyl methacrylate) Micelles in Acetonitrile
  • 1999
  • Ingår i: The Journal of Physical Chemistry Part B. - : American Chemical Society (ACS). - 1520-5207 .- 1520-6106. ; 103:13, s. 2487-2495
  • Tidskriftsartikel (refereegranskat)abstract
    • The kinetics of dipolar nonradiative energy transfer (DET) between dyes confined to the core−corona interface region of poly(isoprene-b-methyl methacrylate) block copolymers (PI−PMMA) in acetonitrile was analyzed using a new distribution model for energy transfer in spherical micelles. The distribution of block junction points was described by the model of Helfand and Tagami (HT) for the strong segregation limit, adapted for the spherical geometry of the core−corona interface. We used this model to analyze experimental fluorescence decay curves for block copolymer micelles made up of polymers containing a donor dye or an acceptor dye covalently attached to the PI−PMMA junction. The analysis yielded an interface thickness between the PI core and the PMMA corona of δ = (0.9 ± 0.1) nm. In the past, the experimental fluorescence decay curves measured for similar systems have been fitted with the Klafter and Blumen (KB) equation for energy transfer, which has a stretched exponential form. To relate these results to topological characteristics of the system, we simulated donor decay profiles for different interface thickness values using the new distribution model for energy transfer and a modified HT equation. Subsequent analysis by the stretched exponential KB equation proved that the magnitude of the fitted exponent is directly related to the interface thickness between the blocks for a given dye concentration in the core−corona interface. Within a certain range of interface thickness values, this relation can be used to determine the interface thickness from the fitting parameters of the KB equation.
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6.
  • Gustafsson, Finn, et al. (författare)
  • HFA of the ESC position paper on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider : Part 3: at the hospital and discharge
  • 2021
  • Ingår i: ESC Heart Failure. - : Wiley Periodicals Inc. - 2055-5822. ; 8:6, s. 4425-4443
  • Tidskriftsartikel (refereegranskat)abstract
    • The growing population of left ventricular assist device (LVAD)-supported patients increases the probability of an LVAD- supported patient hospitalized in the internal or surgical wards with certain expected device related, and patient-device interaction complication as well as with any other comorbidities requiring hospitalization. In this third part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, definitions and structured approach to the hospitalized LVAD-supported patient are presented including blood pressure assessment, medical therapy of the LVAD supported patient, and challenges related to anaesthesia and non-cardiac surgical interventions. Finally, important aspects to consider when discharging an LVAD patient home and palliative and end-of-life approaches are described.
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  • Milicic, Davor, et al. (författare)
  • Heart Failure Association of the European Society of Cardiology position paper on the management of left ventricular assist device-supported patients for the non-left ventricular assist device specialist healthcare provider : Part 2: at the emergency department
  • 2021
  • Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 8:6, s. 4409-4424
  • Tidskriftsartikel (refereegranskat)abstract
    • The improvement in left ventricular assist device (LVAD) technology and scarcity of donor hearts have increased dramatically the population of the LVAD-supported patients and the probability of those patients to present to the emergency department with expected and non-expected device-related and patient-device interaction complications. The ageing of the LVAD-supported patients, mainly those supported with the destination therapy indication, increases the risk for those patients to suffer from other co-morbidities common in the older population. In this second part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, definitions and structured approach to the LVAD-supported patient presenting to the emergency department with bleeding, neurological event, pump thrombosis, chest pain, syncope, and other events are presented. The very challenging issue of declaring death in an LVAD-supported patient, as the circulation is artificially preserved by the device despite no other signs of life, is also discussed in detail.
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8.
  • Schillén, K., et al. (författare)
  • Characterization by fluorescence energy transfer of the core of polyisoprene-poly(methyl methacrylate) diblock copolymer micelles
  • 1999
  • Ingår i: Progress in Colloid and Polymer Science. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 0340-255X. ; 112, s. 45-48
  • Tidskriftsartikel (refereegranskat)abstract
    • Fluorescence decay measurements of the rate of non-radiative direct energy transfer have been employed to characterize the core and the core-corona interface of polyisoprene-poly(methyl methacrylate) (PI-PMMA) diblock copolymer micelles in acetonitrile. These micelles consist of a core of the insoluble PI blocks and a corona of the soluble PMMA blocks. The block copolymers are labeled, at the block junction, with a single fluorescent dye, either a donor chromophore (phenanthrene) or an acceptor chromophore (anthracene). Because the polymers are junction-labeled, the chromophores are naturally confined to the interface of each micelle. Analysis of fluorescence decay data indicate that energy transfer takes place on a flat spherical surface, which implies a strong segregation between PI and PMMA in the micelle. From the data analysis, a micellar core radius of (7.6 ± 0.8) nm is calculated from which a number-average aggregation number of 98 ± 22 is obtained. Static light scattering measurements give a weight-average aggregation number of 127 ± 6. The PI-PMMA micelles are star-like with stretched PMMA corona blocks. The corona thickness of the micelles varies from 15.8 to 17.7 nm, using the hydrodynamic radius and core radius obtained from dynamic light scattering and fluorescence decay measurements, respectively.
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9.
  • Schillén, Karin, et al. (författare)
  • Characterization of Polyisoprene-b-Poly(methyl methacrylate) Diblock Copolymer Micelles in Acetonitrile
  • 1999
  • Ingår i: The Journal of Physical Chemistry Part B. - : American Chemical Society (ACS). - 1520-5207 .- 1520-6106. ; 103:43, s. 9090-9103
  • Tidskriftsartikel (refereegranskat)abstract
    • In acetonitrile, polyisoprene-b-poly(methyl methacrylate) (PI−PMMA) diblock copolymers form starlike micelles with a dense core of the insoluble PI blocks and a soft solvent-swollen corona of the soluble PMMA blocks. Static and dynamic light scattering experiments in combination with viscosity measurements show that these micelles behave hydrodynamically as hard spheres. The block copolymers are labeled at the block junction, with a single fluorescent dye, either a donor chromophore (phenanthrene) or an acceptor chromophore (anthracene). These dyes are confined to the interface during self-assembly. Fluorescence energy-transfer experiments on molecularly mixed micelles of donor- and acceptor-labeled copolymers provide a core radius of 7.6 ± 0.8 nm and a number-average aggregation number ( ) of 98 ± 22 under the assumption that the energy transfer takes place on a surface of a sphere. Simulations in terms of a Helfand−Tagami junction distribution profile confirm that the core−corona interface of the PI−PMMA micelles is thin (ca. 0.9 nm) and that almost all of the energy transfer occurs within a narrow interfacial region. From the static light scattering measurements of the mixed micelles a weight-average aggregation number ( ) of 127 ± 6 is obtained. The ratio / = 1.3 agrees with size polydispersity of the micelles obtained from the analysis of dynamic light scattering data. The experimental corona thicknesses are in good agreement with those calculated from expressions describing starlike block copolymer micelles.
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