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1.
Glob Chang Biol ; 28(24): 7167-7185, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36043234

RESUMEN

Predicting and mitigating changes in soil carbon (C) stocks under global change requires a coherent understanding of the factors regulating soil organic matter (SOM) formation and persistence, including knowledge of the direct sources of SOM (plants vs. microbes). In recent years, conceptual models of SOM formation have emphasized the primacy of microbial-derived organic matter inputs, proposing that microbial physiological traits (e.g., growth efficiency) are dominant controls on SOM quantity. However, recent quantitative studies have challenged this view, suggesting that plants make larger direct contributions to SOM than is currently recognized by this paradigm. In this review, we attempt to reconcile these perspectives by highlighting that variation across estimates of plant- versus microbial-derived SOM may arise in part from methodological limitations. We show that all major methods used to estimate plant versus microbial contributions to SOM have substantial shortcomings, highlighting the uncertainty in our current quantitative estimates. We demonstrate that there is significant overlap in the chemical signatures of compounds produced by microbes, plant roots, and through the extracellular decomposition of plant litter, which introduces uncertainty into the use of common biomarkers for parsing plant- and microbial-derived SOM, especially in the mineral-associated organic matter (MAOM) fraction. Although the studies that we review have contributed to a deeper understanding of microbial contributions to SOM, limitations with current methods constrain quantitative estimates. In light of recent advances, we suggest that now is a critical time to re-evaluate long-standing methods, clearly define their limitations, and develop a strategic plan for improving the quantification of plant- and microbial-derived SOM. From our synthesis, we outline key questions and challenges for future research on the mechanisms of SOM formation and stabilization from plant and microbial pathways.


Asunto(s)
Carbono , Suelo , Suelo/química , Carbono/metabolismo , Microbiología del Suelo , Plantas/metabolismo , Minerales/química
2.
Ecol Appl ; 32(5): e2598, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35343024

RESUMEN

Growing evidence suggests that conservation agricultural practices, like no-till and cover crops, help protect annual crops from insect pests by supporting populations of resident arthropod predators. While adoption of conservation practices is growing, most field crop producers are also using more insecticides, including neonicotinoid seed coatings, as insurance against early-season insect pests. This tactic may disrupt benefits associated with conservation practices by reducing arthropods that contribute to biological control. We investigated the interaction between preventive pest management (PPM) and the conservation practice of cover cropping. We also investigated an alternative pest management approach, integrated pest management (IPM), which responds to insect pest risk, rather than using insecticides prophylactically. In a 3-year corn (Zea mays mays L.)-soy (Glycine max L.) rotation, we measured the response of invertebrate pests and predators to PPM and IPM with and without a cover crop. Using any insecticide provided some small reduction to plant damage in soy, but no yield benefit. In corn, vegetative cover early in the season was key to reducing pest density and damage, likely by increasing the abundance of arthropod predators. Further, PPM in year 1 decreased predation compared to a no-pest-management control. Contrary to our expectation, the IPM strategy, which required just one insecticide application, was more disruptive to the predator community than PPM, likely because the applied pyrethroid was more acutely toxic to a wider range of arthropods than neonicotinoids. Promoting early-season cover was more effective at reducing pest density and damage than either intervention-based strategy. Our results suggest that the best pest management outcomes may occur when biological control is encouraged by planting cover crops and avoiding broad-spectrum insecticides as much as possible. As part of a conservation-based approach to farming, cover crops can promote natural-enemy populations that can help provide biological effective control of insect pest populations.


Asunto(s)
Artrópodos , Insecticidas , Animales , Productos Agrícolas , Control de Insectos , Insectos , Neonicotinoides , Control de Plagas , Control Biológico de Vectores/métodos , Estaciones del Año , Glycine max , Zea mays
3.
Environ Sci Technol ; 55(8): 4679-4687, 2021 04 20.
Artículo en Inglés | MEDLINE | ID: mdl-33749272

RESUMEN

Neonicotinoids from insecticidal seed coatings can contaminate soil in treated fields and adjacent areas, posing a potential risk to nontarget organisms and ecological function. To determine if cover crops can mitigate neonicotinoid contamination in treated and adjacent areas, we measured neonicotinoid concentrations for three years in no-till corn-soybean rotations, planted with or without neonicotinoid seed coatings, and with or without small grain cover crops. Although neonicotinoids were detected in cover crops, high early season dissipation provided little opportunity for winter-planted cover crops to absorb significant neonicotinoid residues; small grain cover crops failed to mitigated neonicotinoid contamination in either treated or untreated plots. As the majority of neonicotinoids from seed coatings dissipated shortly after planting, residues did not accumulate in soil, but persisted at concentrations below 5 ppb. Persistent residues could be attributed to historic neonicotinoid use and recent, nearby neonicotinoid use. Tracking neonicotinoid concentrations over time revealed a large amount of local interplot movement of neonicotinoids; in untreated plots, contamination was higher when plots were less isolated from treated plots.


Asunto(s)
Productos Agrícolas , Insecticidas , Insecticidas/análisis , Neonicotinoides , Semillas/química , Suelo
4.
Artif Organs ; 41(7): E52-E65, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27935084

RESUMEN

With the growth and diversity of mechanical circulatory support (MCS) systems entering clinical use, a need exists for a robust mock circulation system capable of reliably emulating and reproducing physiologic as well as pathophysiologic states for use in MCS training and inter-device comparison. We report on the development of such a platform utilizing the SynCardia Total Artificial Heart and a modified Donovan Mock Circulation System, capable of being driven at normal and reduced output. With this platform, clinically relevant heart failure hemodynamics could be reliably reproduced as evidenced by elevated left atrial pressure (+112%), reduced aortic flow (-12.6%), blunted Starling-like behavior, and increased afterload sensitivity when compared with normal function. Similarly, pressure-volume relationships demonstrated enhanced sensitivity to afterload and decreased Starling-like behavior in the heart failure model. Lastly, the platform was configured to allow the easy addition of a left ventricular assist device (HeartMate II at 9600 RPM), which upon insertion resulted in improvement of hemodynamics. The present configuration has the potential to serve as a viable system for training and research, aimed at fostering safe and effective MCS device use.


Asunto(s)
Simulación por Computador , Insuficiencia Cardíaca/fisiopatología , Corazón Artificial , Corazón/fisiopatología , Hemodinámica , Modelos Cardiovasculares , Presión Atrial , Diseño de Equipo , Corazón Auxiliar , Humanos , Función Ventricular Izquierda
5.
Artif Organs ; 41(8): 727-734, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27862058

RESUMEN

Since the creation of SynCardia's 50 cc Total Artificial Hearts (TAHs), patients with irreversible biventricular failure now have two sizing options. Herein, a case series of three patients who have undergone successful 50 and 70 cc TAH implantation with complete closure of the chest cavity utilizing preoperative "virtual implantation" of different sized devices for surgical planning are presented. Computed tomography (CT) images were used for preoperative planning prior to TAH implantation. Three-dimensional (3D) reconstructions of preoperative chest CT images were generated and both 50 and 70 cc TAHs were virtually implanted into patients' thoracic cavities. During the simulation, the TAHs were projected over the native hearts in a similar position to the actual implantation, and the relationship between the devices and the atria, ventricles, chest wall, and diaphragm were assessed. The 3D reconstructed images and virtual modeling were used to simulate and determine for each patient if the 50 or 70 cc TAH would have a higher likelihood of successful implantation without complications. Subsequently, all three patients received clinical implants of the properly sized TAH based on virtual modeling, and their chest cavities were fully closed. This virtual implantation increases our confidence that the selected TAH will better fit within the thoracic cavity allowing for improved surgical outcome. Clinical implantation of the TAHs showed that our virtual modeling was an effective method for determining the correct fit and sizing of 50 and 70 cc TAHs.


Asunto(s)
Insuficiencia Cardíaca/cirugía , Corazón Artificial , Implantación de Prótesis/métodos , Adulto , Femenino , Humanos , Imagenología Tridimensional/métodos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X/métodos , Estados Unidos , Adulto Joven
6.
J Surg Orthop Adv ; 25(4): 238-243, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-28244866

RESUMEN

Orthopaedic surgeons often treat patients with chronic musculoskeletal pain. This musculoskeletal pain is increasingly being treated with opioid medications, contributing to the growing opioid epidemic in the United States. Opioid use and abuse before orthopaedic surgery are associated with worse clinical outcomes. This article reviews the risk factors for opioid use, misuse, and other behaviors in chronic pain patients, discusses the screening tools for opioid misuse in chronic pain patients, and provides recommendations for the orthopaedic surgeon's role in managing these complicated patients.


Asunto(s)
Analgésicos Opioides/uso terapéutico , Dolor Musculoesquelético/tratamiento farmacológico , Trastornos Relacionados con Opioides/diagnóstico , Ortopedia , Sobredosis de Droga/epidemiología , Humanos , Hiperalgesia/epidemiología , Tamizaje Masivo , Trastornos Mentales/epidemiología , Dolor Musculoesquelético/epidemiología , Trastornos Relacionados con Opioides/epidemiología , Trastornos Relacionados con Opioides/prevención & control , Mal Uso de Medicamentos de Venta con Receta/prevención & control , Mal Uso de Medicamentos de Venta con Receta/estadística & datos numéricos , Factores de Riesgo , Conducta de Reducción del Riesgo
7.
Pest Manag Sci ; 2024 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-38527910

RESUMEN

Transgenic, dicamba-resistant soybean and cotton were developed to enable farmers to combat weeds that had evolved resistance to the herbicide glyphosate. The dramatic increases in dicamba use these crops facilitated have led to serious problems, including the evolution of dicamba-resistant weeds and widespread damage to susceptible crops and farming communities. Disturbingly, this pattern of dicamba use has unfolded while the total herbicide applied to soybean has nearly doubled since 2006. Without substantive changes to agricultural policy and decision making, the next 'silver-bullet' agrotechnology will likely be no more than another step on the transgene-facilitated herbicide treadmill. © 2024 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

8.
J Agric Food Chem ; 72(18): 10247-10256, 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38683760

RESUMEN

Some forage legumes synthesize phytoestrogens. We conducted a glasshouse study to investigate how water stress (drought and waterlogging) influences phytoestrogen accumulation in red clover and kura clover. Compared to the red clover control, the 20 day drought resulted in an over 100% increase in the phytoestrogens formononetin and biochanin A, which together accounted for 91-96% of the total phytoestrogens measured. Waterlogging resulted in elevated concentrations of daidzein, genistein, and prunetin but not formononetin or biochanin A. Concentrations of phytoestrogens in kura clover were low or undetectable, regardless of water stress treatment. Leaf water potential was the most explanatory single-predictor of the variation in concentrations of formononetin, biochanin A, and total phytoestrogens in red clover. These results suggest that drought-stressed red clover may have higher potential to lead to estrogenic effects in ruminant livestock and that kura clover is a promising alternative low- or no-phytoestrogen perennial forage legume.


Asunto(s)
Fitoestrógenos , Trifolium , Trifolium/metabolismo , Trifolium/química , Trifolium/crecimiento & desarrollo , Fitoestrógenos/metabolismo , Fitoestrógenos/análisis , Agua/metabolismo , Agua/análisis , Isoflavonas/metabolismo , Isoflavonas/análisis , Sequías , Genisteína/análisis , Genisteína/metabolismo
9.
Sci Rep ; 13(1): 17323, 2023 10 13.
Artículo en Inglés | MEDLINE | ID: mdl-37833350

RESUMEN

Cover crops are plants grown to provide regulating, supporting, and cultural ecosystem services in managed environments. In agricultural systems, weed suppression services from cover crops can be an important tool to promote sustainability as reliance on herbicides and tillage for weed management has caused pollution, biodiversity loss, and human health issues. However, to effectively use weed suppression services from cover crops, farmers must carefully select species that fit within their rotations and suppress their problematic weeds. Understanding how the relatedness between cover crops and weeds affects their interactions will help farmers select cover crops for targeted weed management. The phylogenetic distance between species reflects their relatedness and was studied through a series of field experiments that compared weed suppression in winter and summer cover crops with tilled controls. This study demonstrates that cover crops can reduce up to 99% of weed biomass and alter weed community structure by suppressing phylogenetically related weed species. Results also suggest that cover crop planting season can influence weed community structure since only overwintering treatments affected the phylogenetic distance of weed communities. In an applied context, these results help develop cover crop-based weed management systems, demonstrating that problematic weeds can be managed by selecting phylogenetically related cover crop species. More broadly, this study provides a framework for evaluating weed communities through a phylogenetic perspective, which provides new insight into plant interactions in agriculture.


Asunto(s)
Ecosistema , Herbicidas , Humanos , Filogenia , Agricultura/métodos , Malezas , Herbicidas/farmacología , Productos Agrícolas , Control de Malezas/métodos
10.
Futures ; 134: 102839, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34584275

RESUMEN

Globalization's need for global cities with highly concentrated financial districts is discussed to explain how the Covid-19 pandemic will paradoxically only serve to make the world's leading global cities more essential, valuable, and demanding of skyscrapers than ever before. Financial and corporate service firms cannot only be digitally based because they also require face-to-face interaction, collaboration, and joint-production within themselves, and between one another, in the most connected global cities to effectively function as competitive businesses. However, after Covid-19 advanced service firms will only not practice remote working where and when they must; so that in-place face-to-face interactions with colleagues and clients will be overwhelmingly only concentrated in the skyscraper-laden financial districts of the world's leading global cities. The future of commercial and luxury residential skyscrapers in the world's leading global cities can be said to be secure because the impact of Covid-19 on enhancing the centrality of these few highly connected and super-wealthy cities in globalization is both understandable and predictable; skyscrapers elsewhere in the Global North or South will struggle to remain viable as firms increasingly decentralise the work of their staff away from city centre offices.

11.
Weed Res ; 61(6): 475-485, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35874455

RESUMEN

Zero tillage (ZT) is widely promoted throughout India's Eastern Indo-Gangetic Plains (IGP) because of its potential to increase wheat productivity and resilience to abiotic stresses. Weeds remain a major barrier to ZT adoption, yet it remains unclear how ZT will influence weed communities in the Eastern-IGP. The primary objective of this study was to characterise the composition of the germinable weed seedbank sampled just prior to the wheat phase of rice-wheat farms in Bihar and Eastern Uttar Pradesh, and examine whether adoption of ZT wheat has shifted weed community composition compared to conventional tillage (CT). Additionally, we examined whether edaphic properties and topography (upland vs. lowland) explain variation in germinable weed seedbank communities. In December 2014, we evaluated the germinable seedbank from 72 fields differing in their historic (>=3 year) tillage practices (ZT vs. CT) in three regions: Samastipur-Vaishali-Muzaffarpur (SVM), Ara-Buxar and Maharajgunj-Kushinagar. Weed community composition and species richness varied by region and topography. ZT adoption was associated with lower relative density of Chenopodium album in the germinable seedbank and lower emergence of Phalaris minor seedlings within farmers' fields. In upland topographies of the SVM region, ZT adoption was also associated with greater relative abundance of Solanum nigrum in the weed seedbank. However, differences between tillage systems in individual species were not large enough to result in detection of differences at the whole-community level. Variation in edaphic properties, most notably soil texture and pH, explained 51% of the variation in the weed seedbank community. Our work suggests several frequent but poorly understood species (e.g. Mazus pumilus and Grangea maderaspatana) in Eastern IGP for which future research should quantify their effects on crop yields. Finally, future work surveying weed species abundance at harvest could further determine the dominant problematic species in these regions.

13.
J Appl Behav Anal ; 52(3): 804-810, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31049979

RESUMEN

Researchers have developed precursor functional analyses to provide an alternative, and presumably safer, format for functional analysis of severe problem behavior. When researchers use functional analysis contingencies for precursor behaviors, it is possible to infer functional characteristics about severe problem behaviors based on patterns of less severe precursor behaviors, permitting practitioners to complete the assessment with less risk to clients, practitioners, or others. The current paper discusses recent advances in the development and validation of precursor identification, and offers suggestions and future directions for investigating and implementing precursor functional analyses. We propose a decision-making model, in which practitioners integrate procedures to identify precursors into the functional-analysis process, to expedite the analysis of severe problem behaviors.


Asunto(s)
Problema de Conducta/psicología , Síntomas Prodrómicos , Refuerzo en Psicología , Humanos , Modelos Psicológicos
14.
ASAIO J ; 65(1): 54-58, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-29324514

RESUMEN

Maintaining mechanical circulatory support (MCS) device patients in a specified therapeutic range for anticoagulation remains challenging. Subtherapeutic international normalized ratios (INRs) occur frequently while on warfarin therapy. An effective anticoagulant bridge strategy may improve the care of these patients. This retrospective review of MCS patients with subtherapeutic INRs compared an intravenous unfractionated heparin (UFH) strategy with a subcutaneous enoxaparin or fondaparinux strategy. Native thromboelastography (n-TEG) was used to evaluate anticoagulant effect with coagulation index (CI) as the primary outcome measure. Enoxaparin 0.5 mg/kg subcutaneously (SC) every 12 hours or fondaparinux 2.5-5 mg SC daily were compared with an initial UFH rate of 5 units/kg/hr and titrated to stated n-TEG goal range. The anticoagulant groups UFH, enoxaparin, and fondaparinux were found to be statistically similar with regard to frequency in n-TEG goal range, above range (hypercoagulability), or below range (hypocoagulability). Clinical outcomes were similar among groups with three gastrointestinal bleeds in UFH, one in enoxaparin, and one in fondaparinux groups. Device thrombosis occurred in one UFH patient, while UFH and fondaparinux groups had one ischemic cerebrovascular accident event each. These strategies provided comparable n-TEG results and clinical outcomes when compared with intravenous UFH. Low-dose enoxaparin or fondaparinux may provide an alternative anticoagulant bridging option in MCS patients presenting with subtherapeutic INR.


Asunto(s)
Anticoagulantes/uso terapéutico , Corazón Auxiliar/efectos adversos , Trombosis/prevención & control , Enoxaparina/uso terapéutico , Femenino , Fondaparinux/uso terapéutico , Humanos , Relación Normalizada Internacional , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Trombosis/etiología
15.
Analyst ; 133(5): 571-84, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-18427676

RESUMEN

This article provides a review of the published literature describing the use of biosensors and biologically-inspired systems for explosives detection. The review focusses on the use of antibodies, enzymes, biologically-inspired synthetic ligands and whole-cell biosensors, providing a flavour of the range of technology, formats and approaches that can be used to detect explosives using biological systems.


Asunto(s)
Técnicas Biosensibles , Sustancias Explosivas/análisis , Medidas de Seguridad , Animales , Biotecnología , Humanos
16.
J Appl Behav Anal ; 41(2): 255-9, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18595290

RESUMEN

A functional analysis indicated that chronic eye poking exhibited by a woman with profound mental retardation persisted in the absence of social contingencies. We initiated a procedure in which a therapist delivered a punisher (mild reprimand) contingent on eye poking in the presence, but not the absence, of a neutral stimulus (wristbands). Subsequently, eye poking was suppressed when the participant wore the wristbands in novel environments without the reprimand contingency.


Asunto(s)
Aprendizaje por Asociación , Automatismo/prevención & control , Terapia Conductista/métodos , Lesiones Oculares/prevención & control , Conducta Autodestructiva/prevención & control , Automatismo/psicología , Lesiones Oculares/psicología , Femenino , Generalización Psicológica , Humanos , Discapacidad Intelectual/psicología , Discapacidad Intelectual/terapia , Persona de Mediana Edad , Refuerzo Verbal , Conducta Autodestructiva/psicología , Medio Social , Transferencia de Experiencia en Psicología
17.
Sci Rep ; 8(1): 8467, 2018 05 31.
Artículo en Inglés | MEDLINE | ID: mdl-29855528

RESUMEN

Climate models predict increasing weather variability, with negative consequences for crop production. Conservation agriculture (CA) may enhance climate resilience by generating certain soil improvements. However, the rate at which these improvements accrue is unclear, and some evidence suggests CA can lower yields relative to conventional systems unless all three CA elements are implemented: reduced tillage, sustained soil cover, and crop rotational diversity. These cost-benefit issues are important considerations for potential adopters of CA. Given that CA can be implemented across a wide variety of regions and cropping systems, more detailed and mechanistic understanding is required on whether and how regionally-adapted CA can improve soil properties while minimizing potential negative crop yield impacts. Across four US states, we assessed short-term impacts of regionally-adapted CA systems on soil properties and explored linkages with maize and soybean yield stability. Structural equation modeling revealed increases in soil organic matter generated by cover cropping increased soil cation exchange capacity, which improved soybean yield stability. Cover cropping also enhanced maize minimum yield potential. Our results demonstrate individual CA elements can deliver rapid improvements in soil properties associated with crop yield stability, suggesting that regionally-adapted CA may play an important role in developing high-yielding, climate-resilient agricultural systems.


Asunto(s)
Productos Agrícolas , Suelo/química , Cambio Climático , Ecosistema , Glycine max/crecimiento & desarrollo
18.
J Heart Lung Transplant ; 37(11): 1304-1312, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-29802083

RESUMEN

BACKGROUND: We sought to better understand the patient population who receive a temporary total artificial heart (TAH) as bridge to transplant or as bridge to decision by evaluating data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database. METHODS: We examined data related to survival, adverse events, and competing outcomes from patients who received TAHs between June 2006 and April 2017 and used hazard function analysis to explore risk factors for mortality. RESULTS: Data from 450 patients (87% men; mean age, 50 years) were available in the INTERMACS database. The 2 most common diagnoses were dilated cardiomyopathy (50%) and ischemic cardiomyopathy (20%). Risk factors for right heart failure were present in 82% of patients. Most patients were INTERMACS Profile 1 (43%) or 2 (37%) at implantation. There were 266 patients who eventually underwent transplantation, and 162 died. Overall 3-, 6-, and 12-month actuarial survival rates were 73%, 62%, and 53%, respectively. Risk factors for death included older age (p = 0.001), need for pre-implantation dialysis (p = 0.006), higher creatinine (p = 0.008) and lower albumin (p < 0.001) levels, and implantation at a low-volume center (≤10 TAHs; p < 0.001). Competing-outcomes analysis showed 71% of patients in high-volume centers were alive on the device or had undergone transplantation at 12 months after TAH implantation vs 57% in low-volume centers (p = 0.003). CONCLUSIONS: Patients receiving TAHs have rapidly declining cardiac function and require prompt intervention. Experienced centers have better outcomes, likely related to patient selection, timing of implantation, patient care, and device management. Organized transfer of knowledge to low-volume centers could improve outcomes.


Asunto(s)
Corazón Artificial , Sistema de Registros/estadística & datos numéricos , Factores de Edad , Cardiomiopatía Dilatada/mortalidad , Cardiomiopatía Dilatada/cirugía , Femenino , Trasplante de Corazón , Hospitales de Alto Volumen/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/mortalidad , Isquemia Miocárdica/cirugía , Complicaciones Posoperatorias/mortalidad , Factores de Riesgo , Tasa de Supervivencia , Resultado del Tratamiento
19.
N Engl J Med ; 351(9): 859-67, 2004 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-15329423

RESUMEN

BACKGROUND: The CardioWest Total Artificial Heart orthotopically replaces both native cardiac ventricles and all cardiac valves, thus eliminating problems commonly seen in the bridge to transplantation with left ventricular and biventricular assist devices, such as right heart failure, valvular regurgitation, cardiac arrhythmias, ventricular clots, intraventricular communications, and low blood flows. METHODS: We conducted a nonrandomized, prospective study in five centers with the use of historical controls. The purpose was to assess the safety and efficacy of the CardioWest Total Artificial Heart in transplant-eligible patients at risk for imminent death from irreversible biventricular cardiac failure. The primary end points included the rates of survival to heart transplantation and of survival after transplantation. RESULTS: Eighty-one patients received the artificial-heart device. The rate of survival to transplantation was 79 percent (95 percent confidence interval, 68 to 87 percent). Of the 35 control patients who met the same entry criteria but did not receive the artificial heart, 46 percent survived to transplantation (P<0.001). Overall, the one-year survival rate among the patients who received the artificial heart was 70 percent, as compared with 31 percent among the controls (P<0.001). One-year and five-year survival rates after transplantation among patients who had received a total artificial heart as a bridge to transplantation were 86 and 64 percent. CONCLUSIONS: Implantation of the total artificial heart improved the rate of survival to cardiac transplantation and survival after transplantation. This device prevents death in critically ill patients who have irreversible biventricular failure and are candidates for cardiac transplantation.


Asunto(s)
Insuficiencia Cardíaca/cirugía , Trasplante de Corazón , Corazón Artificial , Enfermedad Crítica , Femenino , Insuficiencia Cardíaca/mortalidad , Corazón Artificial/efectos adversos , Hemorragia/etiología , Hemorragia/mortalidad , Humanos , Infecciones/etiología , Infecciones/mortalidad , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Diseño de Prótesis , Falla de Prótesis , Calidad de Vida , Tasa de Supervivencia
20.
ASAIO J ; 62(4): e35-6, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26771394

RESUMEN

Shortly after SynCardia total artificial heart (TAH) implant, venovenous extracorporeal membrane oxygenation (ECMO) via a 31 Fr Avalon cannula was used for profound hypoxic lung dysfunction. Immediately after starting ECMO, TAH flow increased by 1.5-2.0 L/min, presumably because of augmented TAH filling by the ECMO jet.


Asunto(s)
Oxigenación por Membrana Extracorpórea/métodos , Corazón Artificial , Adulto , Humanos , Masculino
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