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Decisional Considerations in Left Ventricular Assist Device for Destination Therapy

Thesis (Ph.D.)--University of Washington, 2016-06

L-arginine attenuates cardiovascular impairment in DOCA-salt hypertensive rats

Nitric oxide (NO) is essential for normal function of the cardiovascular system. This study has determined whether chronic administration of L-arginine, the biological precursor of NO, attenuates the development of structural and functional changes in hearts and blood vessels of deoxycorticosterone acetate (DOCA)-salt hypertensive rats. Uninephrectomized rats treated with DOCA (25 mg every 4th day sc) and 1% NaCl in the drinking water for 4 wk were treated with L-arginine (5% in food, 3.4 +/- 0.3 g.kg body wt(-1).day(-1)). Changes in cardiovascular structure and function were determined by echocardiography, microelectrode studies, histology, and studies in isolated hearts and thoracic aortic rings. DOCA-salt hypertensive rats developed hypertension, left ventricular hypertrophy with increased left ventricular wall thickness and decreased ventricular internal diameter, increased inflammatory cell infiltration, increased ventricular interstitial and perivascular collagen deposition, increased passive diastolic stiffness, prolonged action potential duration, increased oxidative stress, and inability to increase purine efflux in response to an increased workload. L-Arginine markedly attenuated or prevented these changes and also normalized the reduced efficacy of norepinephrine and acetylcholine in isolated thoracic aortic rings of DOCA-salt hypertensive rats. This study suggests that a functional NO deficit in blood vessels and heart due to decreased NO synthase activity or increased release of reactive oxygen species such as superoxide may be a key change initiating many aspects of the cardiovascular impairment observed in DOCA-salt hypertensive rats. These changes can be prevented or attenuated by administration of L-arginine.

Fetal growth restriction results in remodeled and less efficient hearts in children

Background— Fetal growth restriction (FGR) affects 5% to 10% of newborns and is associated with increased cardiovascular mortality in adulthood. The most commonly accepted hypothesis is that fetal metabolic programming leads secondarily to diseases associated with cardiovascular disease, such as obesity, diabetes mellitus, and hypertension. Our main objective was to evaluate the alternative hypothesis that FGR induces primary cardiac changes that persist into childhood. Methods and Results— Within a cohort of fetuses with growth restriction identified in fetal life and followed up into childhood, we randomly selected 80 subjects with FGR and compared them with 120 normally grown fetuses, matched for gender, birth date, and gestational age at birth. Cardiovascular assessment was performed in childhood (mean age of 5 years). Compared with control subjects, children with FGR had a different cardiac shape, with increased transversal diameters and more globular cardiac ventricles. Although left ejection fraction was similar among the study groups, stroke volume was reduced significantly, which was compensated for by an increased heart rate to maintain output in severe FGR. This was associated with subclinical longitudinal systolic dysfunction (decreased myocardial peak velocities) and diastolic changes (increased E/E' ratio and E deceleration time). Children with FGR also had higher blood pressure and increased intima-media thickness. For all parameters evaluated, there was a linear increase with the severity of growth restriction. Conclusions— These findings suggest that FGR induces primary cardiac and vascular changes that could explain the increased predisposition to cardiovascular disease in adult life. If these results are confirmed, the impact of strategies with beneficial effects on cardiac remodeling should be explored in children with FGR.

A simulating software of fetal phonocardiographic signals

A valuable alternative to traditional diagnostic tool to record fetal heart rate, to monitor the general fetal wellbeing, is fetal phonocardiography, a passive and low cost acoustic recording of fetal heart sounds. In this paper, it is presented a simulating software of fetal phonocardiographic signals relative to different fetal physiological states and recording conditions (for example different kinds and levels of noise). This software can be useful to test and assess fetal heart rate extraction algorithms from fetal phonocardiographic recordings and as a teaching tool for demonstration to medical students and others. © 2010 IEEE.

“Se le dé papel, prensa y letras”. Albert O’Farail y el libro misionero "The Life of the Virgin Marie" (1671-1693)

El proyecto tipográfico del irlandés Albert O’Farail se concibió como un libro misionero destinado a la empresa confesional que la monarquía de España desarrollaba en las Islas Británicas desde comienzos del Seiscientos. Las traducciones de distintos tratados doctrinales y teológicos, representados por su devoción particular a la Virgen María, procuraban acercar la religión a los católicos del Norte a través de mecanismos de proximidad cultural como complemento a la predicación de los ministros espirituales patrocinados por Carlos II. El empeño por dar a las prensas esta miscelánea de obras, financiada por la corona y compuesta por el arte de su propio autor, discurrió en paralelo a la querella abierta por su esposa, María Manuela Laínez, para reivindicar sus derechos nobiliarios al título marquesal de Mayo. Tanto en Madrid como en Roma, la imbricación de ambos negociados determinó su malograda resolución.

Care home managers’ knowledge of palliative care: a Northern Irish study

Valves cardiaques par génie tissulaire - Simplification des essais et concept tubulaire

Les substituts valvulaires disponibles actuellement comportent encore plusieurs lacunes. La disponibilité restreinte des allogreffes, les risques de coagulation associés aux valves mécaniques et la durabilité limitée des bioprothèses en tissu animal sont toutes des problématiques que le génie tissulaire a le potentiel de surmonter. Avec la méthode d’auto-assemblage, le seul support des cellules consiste en leur propre matrice extracellulaire, permettant la fabrication d’un tissu entièrement libre de matériau exogène. Ce projet a été précédé par ceux des doctorantes Catherine Tremblay et Véronique Laterreur, ayant respectivement développé une méthode de fabrication de valves moulées par auto-assemblage et une nouvelle version de bioréacteur. Au cours de cette maîtrise, le nouveau bioréacteur a été adapté à une utilisation stérile avec des tissus vivants et la méthode de fabrication de valves moulées a été modifiée puis éprouvée avec la production de 4 prototypes. Ces derniers n’ont pas permis d’obtenir des performances satisfaisantes en bioréacteur, motivant la conception d’une nouvelle méthode. Plutôt que de tenter de répliquer la forme native des valves cardiaques, des études récentes ont suggéré une géométrie tubulaire. Cela permettrait une fabrication simplifiée, une implantation rapide, et un encombrement minimal en vue d’opérations percutanées. Cette approche minimaliste s’accorde bien avec la méthode d’auto-assemblage, qui a déjà été utilisée pour la production de vaisseaux de petits diamètres. Un total de 11 tubes ont été produits par l’enroulement de feuillets fibroblastiques auto-assemblés, puis ont été transférés sur des mandrins de diamètre inférieur, leur permettant de se contracter librement. La caractérisation de deux tubes contrôles a démontré que cette phase de précontraction était bénéfique pour les propriétés du tissu en plus de prévenir la contraction en bioréacteur. Les prototypes finaux pouvaient supporter un écoulement physiologique pulmonaire. Cette nouvelle méthode montre que le procédé d’auto-assemblage a le potentiel d’être utilisé pour fabriquer des valves cardiaques tubulaires.

Nego veio é um sofrer : uma etnografia da subalternidade e do subalterno numa irmandade do Rosário

The object of this work is a fellowship of São Sebastião e Nossa Senhora do Rosário in the city of Jardim do Seridó (RN), that is, a black catholic fellowship on the sertão potiguar. The devotion to Nossa Senhora do Rosário, in colonial Brazil, organizes itself through black catholic men as fellowships. They blossomed in Brazil until the abolition, getting support from the Catholic church, from owners of slaves and from the population in general − unlike others afro-Brazilian religious expression. Today, these fellowships remain active, against the sentimental pessimism of the folklore studies, and they also have a highlight position in the calendar of many cities in Brazil, and in particular in Seridó. The research s foothold is the apparent valorization of the fellowship by the local elite, attitude that hides asymmetric relationships between the group of negros do Rosário and the local authorities, having as its consequence that the members occupy a subaltern position inside their own fellowship. This subalternity take place, mainly, in the public area, where the negros do Rosário cannot represent themselves neither political nor discursively. To discuss this idea, it s done a brief historical of these catholic institutions as well as a description of the relationship between the negros do Rosário and the elites of the city. Then, the phenomenon is analyzed as folklore and/or religion , under the perspective of many agents that participate in this process. In other moment, it is going to be presented how the group formulates their own representation of the history, of the devotional forms and of their own political-religious experiences. In this sense, an ethnography of the subalternity is understood as an analysis of the process that leads the negros do Rosário to become a subaltern group. It s also outlined the perception that the group has of its own position, through an ethnography essay of the subaltern subject. The research, focused in the group of Rosário, was done between August 2010 and January 2012 and includes other agents (like treasurers, priests and intellectuals). Besides that, as a methodological complement, there are documental research, photography, as well as shoots of the party days and public presentation

Ecossistema domiciliar de pais cardiopatas e o modo de viver dos filhos: possibilidades de promoção da saúde pelo conhecimento da enfermagem/saúde

Objetivou-se compreender a possibilidade de o ecossistema domiciliar de pais portadores de morbidades cardiovasculares propiciar atitudes e comportamentos que corroborem para manifestações análogas na saúde dos filhos que convivem neste ambiente, e compreender como o cuidado de enfermagem/saúde com ações interativas de promoção de saúde domiciliar seja capaz de dissipar estas atitudes e comportamentos nos filhos. Para o conhecimento, a compreensão, interação do ecossistema domiciliar e o modo de viver dos filhos de pai/mãe cardiopata como um processo dinâmico e inter-relacional, foi utilizada a abordagem sistêmica de Ilya Prigogine, com enfoque nos princípios ecossistêmicos. O percurso metodológico se baseou na Teoria Fundamentada nos Dados, que, de maneira sistemática, interativa e criativa, possibilitou o desenvolvimento da teoria formal: Compreendendo possibilidades Interativas de orientações da Enfermagem/Saúde no Ecossistema domiciliar dos filhos de pais cardiopatas para mudanças de comportamentos e atitudes. Esta é uma teoria fidedigna e fundamentada nos dados da pesquisa, que culminou com o desenvolvimento de suas categorias. A coleta e análise dos dados foram realizadas conforme a preconização da teoria, de forma comparativa e constante, seguindo os passos: codificação inicial ou aberta, categorização e codificação teórica, sendo utilizada também a observação. Totalizou a amostra teórica onze filhos de pai/mãe cardiopatas, entrevistados no Brasil e em Portugal, onde, neste último, foi realizado um Intercâmbio de Doutorado com a finalidade de potencializar os conceitos e direcionar novas possibilidades aos fenômenos apresentados. Como processo de análise dos dados e agrupamento das categorias utilizou-se o modelo paradigmático desenvolvido por Glaser (1968) correspondente à família de códigos 6 Cs e de códigos interativos. A teoria formal emergiu a partir de dois fenômenos e suas categorias. O fenômeno, Conhecendo o ecossistema domiciliar de filhos de pai/mãe cardiopata na perspectiva das orientações da enfermagem/saúde, englobou as categorias: Demonstrando conhecimento sobre aspectos que possibilitam o infarto (condição causal); Associando a vivência da doença e orientações às modificações no modo de viver (condição estratégica); Relatando possibilidades de orientações para os filhos de pai/mãe cardiopata (condição de contingência); Reconhecendo a importância das orientações para o viver melhor (condição de consequência). Em relação ao fenômeno Conhecendo comportamentos e atitudes de filhos de pai/mãe cardiopata, as categorias elencadas foram: Descrevendo atitudes e comportamentos do(a) filho(a) antes da doença do(a) pai/mãe (condição causal); Relatando comportamentos e atitudes dos filhos pós-doença do(a) pai/mãe (condição estratégica); Reconhecendo a importância da mudança de comportamentos e atitudes para um viver saudável (condição de consequência). A teoria que emergiu por meio dos dados deste trabalho fundamenta a importância das ações de enfermagem/saúde para a promoção da saúde, confirma a tese proposta no projeto de pesquisa e permite concluir que a perspectiva ecossistêmica direciona para o conhecimento, a compreensão e discussão, evidentemente, mais amplos, dos contextos apresentados, pelas suas dinâmicas e interatividades.

Nego veio é um sofrer : uma etnografia da subalternidade e do subalterno numa irmandade do Rosário

The object of this work is a fellowship of São Sebastião e Nossa Senhora do Rosário in the city of Jardim do Seridó (RN), that is, a black catholic fellowship on the sertão potiguar. The devotion to Nossa Senhora do Rosário, in colonial Brazil, organizes itself through black catholic men as fellowships. They blossomed in Brazil until the abolition, getting support from the Catholic church, from owners of slaves and from the population in general − unlike others afro-Brazilian religious expression. Today, these fellowships remain active, against the sentimental pessimism of the folklore studies, and they also have a highlight position in the calendar of many cities in Brazil, and in particular in Seridó. The research s foothold is the apparent valorization of the fellowship by the local elite, attitude that hides asymmetric relationships between the group of negros do Rosário and the local authorities, having as its consequence that the members occupy a subaltern position inside their own fellowship. This subalternity take place, mainly, in the public area, where the negros do Rosário cannot represent themselves neither political nor discursively. To discuss this idea, it s done a brief historical of these catholic institutions as well as a description of the relationship between the negros do Rosário and the elites of the city. Then, the phenomenon is analyzed as folklore and/or religion , under the perspective of many agents that participate in this process. In other moment, it is going to be presented how the group formulates their own representation of the history, of the devotional forms and of their own political-religious experiences. In this sense, an ethnography of the subalternity is understood as an analysis of the process that leads the negros do Rosário to become a subaltern group. It s also outlined the perception that the group has of its own position, through an ethnography essay of the subaltern subject. The research, focused in the group of Rosário, was done between August 2010 and January 2012 and includes other agents (like treasurers, priests and intellectuals). Besides that, as a methodological complement, there are documental research, photography, as well as shoots of the party days and public presentation

Principios de la cosmovisión andina relacionados con el uso de plantas medicinales en la parroquia de Sayausí, cantón Cuenca

Antecedentes: Sayausí, pese a su urbanización en los últimos 20 años aún mantiene costumbres ancestrales andinas, como el uso de plantas medicinales: recurso preventivo y terapéutico en salud. Objetivo: Conocer el manejo de las plantas medicinales en Sayausí, según los principios de la cosmovisión andina. Materiales y Métodos: Investigación con enfoque cualitativo e intercultural. Estudia el uso de plantas medicinales bajo los postulados de la cosmovisión andina, con los sabios de la comunidad. Fundamento teórico para el análisis de los datos: el diseño narrativo, generando conceptos e interpretaciones a partir de la información obtenida de los sabios. Técnicas utilizadas: entrevistas. Instrumentos: formularios con preguntas abiertas, grabaciones y fotografías. Las entrevistas se redactaron utilizando citas, códigos y memos, procesadas con el programa Atlas ti; las categorías principales agrupadas según taxonomías; la información complementada con tablas y figuras. Resultados: los Yachak explicaron con sus propias palabras y vivencias los cinco principios: relacionalidad, reciprocidad, correspondencia, complementariedad y paridad. En su racionalidad todo funciona como proceso holístico, involucra a todos los componentes del universo. El sanar con montes constituye un verdadero ritual: incluye los principios, las plantas, el cuerpo y el espíritu. En el proceso formativo de los sabios intervienen: aprendizaje, don y necesidad. Las plantas tienen tres funciones principales: sanación, alimentación y elemento sagrado. Las formas para clasificar las plantas fueron: género, forma, color, y estado térmico. La recolección del monte, su preparación y la administración son los tres momentos del proceso de curación

Programme d’exercice en douceur basé sur le yoga Bali chez les personnes atteintes d’insuffisance cardiaque : les premiers pas.

L’insuffisance cardiaque (IC) est un problème d’importance grandissante lié à des perturbations des systèmes nerveux autonome, immunitaire, et cardiovasculaire. Ces perturbations contribuent à plusieurs symptômes physiques et psychologiques invalidants. La recherche faite jusqu’ici sur des programmes d’exercice basés sur le yoga a démontré des résultats préliminaires assez prometteurs en IC. Néanmoins, il reste des lacunes à combler dans la littérature face aux populations testées, à la combinaison des mesures physiques et psychologiques, au suivi du traitement à la maison et à la perception des symptômes au quotidien. Ce projet pilote a donc pour objectif de développer un programme d’exercice complémentaire basé sur le yoga adapté aux patients souffrant d’IC, d’en mesurer la faisabilité et l’acceptabilité en plus d’obtenir des données préliminaires quant à l’impact de cette intervention à réduire la symptomatologie physique et psychologique et d’améliorer la qualité de vie (QV) de ces patients. Les deux premiers participants recrutés dans le cadre de l’étude pilote font l’objet de ce mémoire. Ils ont pris part à huit séances hebdomadaires de yoga Bali, couplé de psychoéducation et méditation tous données à l’Institut de Cardiologie de Montréal par une instructrice certifiée dans la méthode BALI. L’élaboration des outils nécessaires au déroulement du programme, y compris le manuel d’enseignement et le DVD, la faisabilité d’une collaboration avec le personnel médical et évidement l’évaluation des effets du programme en soit sur les symptômes physiques et psychologique s sont parmi les sujets abordés. Les résultats, quoique préliminaires, semblent tendre vers une amélioration des corrélats physiologiques liés à l’insuffisance cardiaque, notamment l’activité du système nerveux autonome tel que témoigné par la variabilité de la fréquence cardiaque, et l’inflammation indiqué par le niveau de CRP sanguin.

The Amplifier - v. 11, no. 4

In this issue...Montana Power Company, US Coast Guard, Alumni Dinner, Vegas Club, Chess Club, Theta Tau, Butte Civic Choral Society, Sacred Heart Grade School

The Virgin of Charity of Cobre

This flyer promotes a lecture by Cuban attorney and scholar Emilio Cueto called " The Virgin of Charity of Cobre". Cueto will discuss the origins and developments of the devotion to the Virgin of Charity of Cobre among Cubans on the Island and abroad. This event was conducted in Spanish, held on September 17, 2015 at FIU Modesto A. Maidique Campus DM 445.