| 1. |
- Koul, Bansi, et al.
(författare)
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HeartMate left ventricular assist device as bridge to heart transplantation
- 1998
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Ingår i: Annals of Thoracic Surgery. - 1552-6259. ; 65:6, s. 1625-1630
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Because of the limited supply of donor hearts, prospective recipients continue to die while on the waiting list for heart transplantation. Use of long-term mechanical circulatory support devices as a bridge to transplantation may reduce this mortality. However, with the present state of technology, continued clinical evaluation of the various long-term, mechanical circulatory support devices available is mandatory. METHODS: Sixteen patients were bridged with the HeartMate left ventricular assist device (LVAD) to heart transplantation for New York Heart Association functional class IV cardiac failure. Twelve pneumatic and six electric devices were used. The mean cardiac index and the mean pulmonary vascular resistance of the patient cohort were 1.71 x min(-1) x m(-2) and 3.1 Wood units, respectively. RESULTS: The mean LVAD support time per transplanted patient was 237 days, with a cumulative LVAD support time of about 7.2 years. Bleeding was the main operative and postoperative complication. Two patients suffered from neurologic complications and there were two major incidents of device malfunction. Twelve patients (75%) now have received a transplant, 3 (19%) are awaiting a transplant, and in 1 patient (6%), the device was explanted after spontaneous left ventricular recovery. Eleven of the 12 patients who received a transplant are alive and doing well. The HeartMate LVAD gave adequate circulatory support over extended periods of time and reversed the vital organ dysfunction. Since the start of the LVAD program, only 1 patient has died on our heart transplantation waiting list, compared to nine deaths in the 2 preceding years. CONCLUSIONS: The HeartMate LVAD bridge to heart transplantation can be performed with low post-LVAD implantation and posttransplantation mortality and offers 1- and 2-year posttransplantation actuarial survival rates comparable to those for nonbridged heart transplant recipients.
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| 2. |
- Reitan, Öyvind, et al.
(författare)
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Initial tests with a new cardiac assist device
- 1999
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Ingår i: ASAIO Journal. - 1538-943X. ; 45:4, s. 317-321
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Tidskriftsartikel (refereegranskat)abstract
- Before, during, and after cardiac intervention, there is occasionally a need for circulatory support because of hemodynamic deterioration. For this purpose, a new minimally invasive cardiac assist device has been developed, and an early prototype has been studied in a bench test and in three pigs. The pump is a catheter system with a distal motor driven propeller (0-15,000 rpm) surrounded by a cage. The catheter was first tested in a tube in a water bath, where efficiency with respect to pressure generation and flow properties was measured. In the pig experiments, the pump was placed in the descending part of the aorta via a graft, and hemodynamic effects were recorded with three different propellers. The bench tests showed a velocity dependent pressure generation in the tube to the second power of the rpm, and 30 cm of water (> 22 mm Hg) could easily be achieved with all propellers. A pressure dependent flow in the tube was observed, with maximum flows of 20 L at 12,000 rpm and 27 L at 15,000 rpm. In the animal experiments, there was a velocity dependent mean pressure difference across the propeller, with up to 48 mm of mercury for the biggest propeller. An increase in cardiac output in all of the pigs was observed as well as a drop in pressure in the proximal part of the aorta. This study demonstrates the efficiency of this new device in vitro and in vivo. Hemodynamic changes are pronounced and are related to the speed and size of the propeller.
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| 3. |
- Wolever, T M S, et al.
(författare)
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Determination of the glycaemic index of foods: interlaboratory study.
- 2003
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 1476-5640 .- 0954-3007. ; 57:3, s. 475-482
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Practical use of the glycaemic index (GI), as recommended by the FAO/WHO, requires an evaluation of the recommended method. Our purpose was to determine the magnitude and sources of variation of the GI values obtained by experienced investigators in different international centres. Design: GI values of four centrally provided foods (instant potato, rice, spaghetti and barley) and locally obtained white bread were determined in 8-12 subjects in each of seven centres using the method recommended by FAO/WHO. Data analysis was performed centrally. Setting: University departments of nutrition. Healthy subjects (28 male, 40 female) were studied. Results: The GI values of the five foods did not vary significantly in different centres nor was there a significant centre´food interaction. Within-subject variation from two centres using venous blood was twice that from five centres using capillary blood. The s.d. of centre mean GI values was reduced from 10.6 (range 6.8-12.8) to 9.0 (range 4.8-12.6) by excluding venous blood data. GI values were not significantly related to differences in method of glucose measurement or subject characteristics (age, sex, BMI, ethnicity or absolute glycaemic response). GI values for locally obtained bread were no more variable than those for centrally provided foods. Conclusions: The GI values of foods are more precisely determined using capillary than venous blood sampling, with mean between-laboratory s.d. of approximately 9.0. Finding ways to reduce within-subject variation of glycaemic responses may be the most effective strategy to improve the precision of measurement of GI values.
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| 4. |
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| 5. |
- Engström, A E, et al.
(författare)
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Mechanical circulatory support with the Impella 5.0 device for postcardiotomy cardiogenic shock: a three-center experience
- 2013
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Ingår i: Minerva Cardioangiologica. - : Edizione Minerva Medica. - 0026-4725 .- 1827-1618. ; 61:5, s. 539-546
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Tidskriftsartikel (refereegranskat)abstract
- AIM:Postcardiotomy cardiogenic shock (PCCS) is associated with high mortality rates, despite full conventional treatment. Although the results of treatment with surgically implantable ventricular assist devices have been encouraging, the invasiveness of this treatment limits its applicability. Several less invasive devices have been developed, including the Impella system. The objective of this study was to describe our three-center experience with the Impella 5.0 device in the setting of PCCS.METHODS:From January 2004 through December 2010, a total of 46 patients were diagnosed with treatment-refractory PCCS and treated with the Impella 5.0 percutaneous left ventricular assist device at three european heart centers. Baseline and follow-up characteristics were collected retrospectively and entered into a dedicated database.RESULTS:Within the study cohort of 46 patients, mean logistic and additive EuroSCORES were 24 ± 19 and 10 ± 4. The majority of patients underwent coronary artery bypass grafting (48%) or combined surgery (33%). Half of all patients had been treated with an intra-aortic balloon pump before 5.0-implantation, 1 patient had been treated with an Impella 2.5 device. All patients were on mechanical ventilation and intravenous inotropes. The Kaplan-Meier estimate of overall 30-day survival was 39.5%.CONCLUSION:Thirty-day survival rates for patients with PCCS, refractory to aggressive conventional treatment and treated with the Impella 5.0 device, are comparable to those reported in studies evaluating surgically implantable VADs, whereas the Impella system is much less invasive. Therefore, mechanical circulatory support with the Impella 5.0 device is a suitable treatment modality for patients with severe PCCS.
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| 6. |
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| 7. |
- Gyllstad, Henrik, et al.
(författare)
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Linguistic correlates to communicative proficiency levels of the CEFR: The case of syntactic complexity in written L2 English, L3 French and L4 Italian
- 2014
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Ingår i: EUROSLA Yearbook. - Amsterdam : John Benjamins Publishing Company. - 1569-9749 .- 1568-1491. - 9789027200082 ; 14, s. 1-30
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Bokkapitel (refereegranskat)abstract
- This study is a contribution to the empirical underpinning of the Common European Framework of Reference for Languages (CEFR), and it aims to identify linguistic correlates to the proficiency levels defined by the CEFR. The study was conducted in a Swedish school setting, focusing on English, French and Italian, and examined the relationship between CEFR levels (A1-C2) assigned by experienced raters to learners’ written texts and three measures of syntactic complexity (based on length of t-unit, subclause ratio, and mean length of clause (cf. Norris & Ortega, 2009)). Data were elicited through two written tasks (a short letter and a narrative) completed by pupils of L2 English (N=54) in years four, nine and the final year of upper-secondary school, L3 French (N=38) in year nine and the final year of upper-secondary school, and L4 Italian (N=28) in the final year of upper-secondary school and first year of university. The results showed that, globally, there were weak to medium-strong correlations between assigned CEFR levels and the three measures of syntactic complexity in English, French and Italian. Furthermore, it was found that syntactic complexity was homogeneous across the three languages at CEFR level A, whereas syntactic complexity was different across languages at CEFR level B, especially in the data for English and French. Consequences for the empirical validity of the CEFR framework and the nature of the three measures of complexity are discussed.
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| 8. |
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| 9. |
- Johnsson, M, et al.
(författare)
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Glycaemic and satiating properties of potato products
- 2003
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Ingår i: International Symposium on Future Technologies for Food Production and Future Food Scientists, Proceedings. - 0280-9737. ; :162, s. 99-99
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Konferensbidrag (refereegranskat)
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| 10. |
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