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One-year survival in recipients older than 50 bridged to heart transplant with Impella 5.5 via axillary approach

Journal of Geriatric Cardiology 2023年第5期20卷 319-329页

作者： Smit Paghdar Smruti Desai Ji-min Jang Jose Ruiz Sharan malkani Parag Patel Daniel S Yip Juan C Leoni Jose Nativi Basar Sareyyupoglu Kevin Landolfo Si Pham rohan m goswami Division of Heart Failure and Transplant Mayo Clinic in FloridaUSA Department of Cardiothoracic Surgery Mayo Clinic in FloridaUSA

BACKGROUND Optimizing patients with advanced heart failure before orthotopic heart transplantation(OHT), especially in patients greater than 50 years old, is imperative to achieving successful post-transplant outcomes. Complications are well-described for patients bridged to transplant(BTT) with durable left ventricular assist device(LVAD) support. Given the lack of data available in older recipients after the recent increase in mechanical support use, we felt it crucial to report our center’s one-year outcomes in older recipients after heart transplantation with percutaneously placed Impella 5.5 as a *** Forty-nine OHT patients were supported with the Impella 5.5 intended as a bridge between December 2019 and October 2022 at mayo Clinic in Florida. Data were extracted from the electronic health record at baseline and during their transplant episode of care after Institutional Review Boards approval as exempt for retrospective data *** Thirty-eight patients aged 50 or older were supported with Impella 5.5 as BTT. Ten patients underwent heart and kidney transplantation within this cohort. The median age at OHT was 63(58–68) years, with 32 male(84%) and six female patients(16%). Etiology was divided into ischemic(63%) and non-ischemic cardiomyopathy(37%). The baseline median ejection fraction was 19%(15–24). most patients were in blood group O(60%), and 50% were diabetic. The average duration of support was 27 days(range 6–94). The median duration of follow-up is 488 days(185–693). For patients that have reached the 1-year follow-up timeframe(22 of 38, 58%), the 1-year post-transplant survival is 95%.CONCLUSION Our single-center data provides awareness for using the Impella 5.5 percutaneously placed axillary support device in older heart failure patients in cardiogenic shock as a bridge to transplantation. One-year survival outcomes after heart transplantation are excellent despite the older recipient’s age and prolonged pre-transplant support.

关键词： One approval transplant

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migration of intra-aortic balloon pump causing obstruction of the superior mesenteric artery

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Journal of Geriatric Cardiology 2022年第11期19卷 928-929页

作者： Sharan malkani Jose Ruiz Smruti Desai Smit Paghdar Parag C.Patel Juan Carlos Leoni moreno melissa Lyle maedeh Ganji Daniel Yip rohan m.goswami Division of Transplant Cardiology Mayo ClinicJacksonvilleFLUSA Division of Cardiology First Coast Heart&VascularJacksonvilleFLUSA

Axillary intra-aortic balloon pump(IABP)used has increased in the recent few years after UNOs allocation system ***’s design and counterpulsation mechanism is highly regarded for its safety profile,simplicity and relative ease in management and ***,despite continuous innovative efforts,the potential for complications still *** Benchmark registry is widely regarded as the tool for monitoring the evolving practice of *** most common complications reported are balloon perforation,bleeding,migration,limb *** continuous innovative efforts,the potential for complications still exists.

关键词： balloon IABP pump

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Whole-eye transplantation: Current challenges and future perspectives

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World Journal of Transplantation 2024年第2期14卷 28-39页

作者： Anna Scarabosio Pier Luigi Surico Vlad Tereshenko rohan Bir Singh Carlo Salati Leopoldo Spadea Glenda Caputo Pier Camillo Parodi Caterina Gagliano Jonathan m Winograd marco Zeppieri Department of Plastic Surgery University Hospital of UdineUdine 33100Italy Department of Plastic Surgery Massachusetts General HospitalHarvard Medical SchoolBostonMA 02114United States Schepens Eye Research Institute of mass Eye and Ear Harvard Medical SchoolBostonMA 02114United States Department of Ophthalmology University Hospital of UdineUdine 33100Italy Eye Clinic Policlinico Umberto I"Sapienza"University of RomeRome 00142Italy Department of medicine and Surgery University of Enna"Kore"Enna 94100Italy Eye Clinic Catania University San marco Hospital Viale Carlo Azeglio Ciampi 95121 CataniaItaly

Whole-eye transplantation emerges as a frontier in ophthalmology,promising a transformative approach to irreversible *** advancements,formidable challenges *** of donor eye viability post-enucleation necessitates meticulous surgical techniques to optimize retinal integrity and ganglion cell *** the inhibitory milieu of the central nervous system for successful optic nerve regeneration remains elusive,prompting the exploration of neurotrophic support and immunomodulatory *** tolerance,paramount for graft acceptance,confronts the distinc-tive immunogenicity of ocular tissues,driving research into targeted immunosup-pression *** and legal considerations underscore the necessity for stringent standards and ethical *** collaboration and ongoing research endeavors are imperative to navigate these ***,stem cell therapies,and precision immunomodulation represent promising avenues in this ***,the aim of this review is to critically assess the current landscape of whole-eye transplantation,elucidating the challenges and advancements while delineating future directions for research and clinical *** concerted efforts,whole-eye transplantation stands to revolu-tionize ophthalmic care,offering hope for restored vision and enhanced quality of life for those afflicted with blindness.

关键词： Eye Transplantation Optic nerve Nerve regeneration Immunological tolerance

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Left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

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World Journal of Cardiology 2024年第1期16卷 40-48页

作者： Farah Yasmin Abdul moeed rohan Kumar Ochani Hamna Raheel malik Ali Ehtsham Awan Ayesha Liaquat Arisha Saleem muhammad Aamir Nael Hawwa Salim Surani Department of Internal medicine Yale University School of MedicineNew HavenCT 06511United States Department of medicine Dow University of Health ScienceKarachi 74200SindhPakistan Department of medicine SUNNY Upstate Medical UniversitySyracuseNY 13210United States Department of Cardiovascular medicine Lehigh Valley Heart and Vascular InstituteAllentownPA 18105United States Department of medicine Cleveland ClinicClevelandOH 44195United States Department of medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

BACKGROUND Left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIm To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of *** Systematic review and meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology *** In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with *** A significant reduction in New York Heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT ***,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

关键词： Left bundle branch pacing Biventricular pacing QRS duration Left ventricular ejection fraction Heart failure

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Transplant-associated thrombotic microangiopathy:a rare but deadly complication post orthotopic heart transplantation

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Journal of Geriatric Cardiology 2022年第6期19卷 485-486页

作者： Jose Ruiz-morales maedeh Ganji rohan goswami Division of Advanced Heart Failure&Transplant Cardiology Mayo ClinicJacksonvilleFloridaUSA Cardiology Department University of FloridaJacksonvilleFloridaUSA

Thrombotic microangiopathy(TmA)is potentially life-threatening condition caused by small-vessel microthrombi and is associated with schistocyte formation,low platelets and end-organ damage that may not be reversible.[1,2]As a life-threatening condition,TmA recognition in hospitalized patients after organ transplantation is key to improving ***-associated TmA(TATmA)can occur after both solid organ or hematopoietic stem cell transplantation and often mimics other disease processes such as thrombotic throm-bocytopenic purpura(TTP)with similar constellation of symptoms during *** present a rare case of a patient with TATmA after orthotopic heart transplantation.

关键词： thrombotic microangiopathy orthotopic

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Efficacy and safety of semaglutide in non-alcoholic fatty liver disease

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世界胃肠病学杂志:英文版 2023年第37期29卷 5327-5338页

作者： Kai Zhu rohan Kakkar Daljeet Chahal Eric m Yoshida Trana Hussaini Internal medicine University of British ColumbiaVancouver V5Z 1M9BCCanada Department of Gastroenterology University of British ColumbiaVancouver V5Z 1M9BCCanada BC Liver Transplant Program Vancouver General HospitalVancouver V5Z 1M9BCCanada Pharmaceutical Sciences University of British ColumbiaVancouver V5Z 1M9BCCanada

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the leading cause of chronic liver *** prevalence and disease burden of NAFLD are projected to exponentially increase resulting in significant healthcare expenditures and lower healthrelated quality of *** date,there are no approved pharmacotherapies for NAFLD or non-alcoholic steatohepatitis(NASH).Semaglutide has glycemic and weight loss benefits that may be advantageous for patients with *** To investigate the efficacy and safety of semaglutide in patients with *** mEDLINE,CENTRAL,and EmBASE were searched from inception to may 1,2023,to identify eligible randomized controlled trials(RCTs).meta-analysis was performed using random effects model expressing continuous outcomes as mean differences(mD)or standardized mDs(SmD),and dichotomous outcomes as odds ratios(OR)with 95%confidence intervals(CI).Statistical heterogeneity was assessed using the Cochran’s Q test and I2 *** Three RCTs involving 458 patients were *** increased the likelihood of NASH resolution(OR:3.18,95%CI:1.70,5.95;Pmprovement in steatosis(OR:2.83,95%CI:1.19,6.71;P=0.03),lobular inflammation(OR:1.81,95%CI:1.11,2.96;P=0.02),and hepatocellular ballooning(OR:2.92,95%CI:1.83,4.65;Pmaglutide reduced liver stiffness(SmD:-0.48,95%CI:-0.86,-0.11;P=0.01)and steatosis(mD:-4.96%,95%CI:-9.92,0.01;P=0.05).It also reduced alanine aminotransferase(mD:-14.06 U/L,95%CI:-22.06,-6.07;Pminotransferase(mD:-11.44 U/L,95%CI:-17.23,-5.65;Pmaglutide led to improved cardiometabolic outcomes,including decreased HgA1c(mD:-0.77%,95%CI:-1.18,-0.37;PmD:-6.53 kg,95%CI:-11.21,-1.85;P=0.006),but increased the occurrence of GIrelated side effects(OR:3.72,95%CI:1.68,8.23;P=0.001).Overall risk of serious adverse events was similar compared to placebo(OR:1.40,95%CI:0.75,2.62;P<0.29).CO

关键词： Non-alcoholic fatty liver disease Fatty liver metabolic-associated fatty liver Semaglutide

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Discovery of Early Tonian Calc-alkaline and Shoshonitic metamafic Rocks from the North Purulia Shear Zone,Chhotanagpur Gneissic Complex,Eastern India:Implications of Proterozoic Sub-continental Lithospheric mantle

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Acta Geologica Sinica(English Edition) 2023年第1期97卷 68-89页

作者： Bapi goswami Susmita DAS Ankita BASAK Chitta BHATTACHARYYA University of Calcutta 35 Ballygunge Circular RoadKolkata 700019India

Reports of shoshonitic rocks in Precambrian terrains are relatively ***-Grt amphibolites and Hbl-Bt mafic granulites occurring in the migmatitic gneisses of the Chhotanagpur Gneissic Complex(CGC)show calc-alkaline and shoshonitic *** porphyritic,sub-ophitic and poikilitic textures are noted in these *** parent magma was emplaced during the waning phase of the regional ***,these metamafics are similar to the GroupⅢpotassic and ultrapotassic rocks of Foley et al.(1987).The magma was derived from the metasomatized subcontinental lithospheric mantle(SCLm).Subduction-related sediment melts metasomatized the ***,the SCLm is a metasomatized phlogopite-amphibole-spinel-bearing harzburgite.1%–5%batch melting of the SCLm could produce the parental magma of the mafic *** and temperatures of metamorphic equilibration were carried out by pseudosection *** metamorphic assemblage(m_(1):Grt-Cpx-Pl-Qz)in garnetiferous amphibolite equilibrated at 740℃and 8.7 *** Cpx-Pl corona appeared around the garnet during decompression(m_(2):655℃,6 kbar).The Hbl-Pl symplectites around garnet formed during isobaric cooling(m_(3):580℃and 5.9 kbar).The emplacement of shoshonitic magma and subsequent decompression happened at the slab break-off stage of continental collision(~990 ma).

关键词： calc-alkaline-shoshonitic magma amphibolite-granulite facies metamorphism post-collisional early Tonian eastern Indian Shield sub-continental lithospheric mantle

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Delineation of sensitive coastal zone of northern Ramanathapuram coast,Tamilnadu,India,using a GIS approach

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Geodesy and Geodynamics 2022年第5期13卷 456-463页

作者： Gurugnanam Balasubramanian Sreechitra Suresh Santonu goswami Bairavi Swaminathan Glitson Francis Pereira Centre for Applied Geology The Gandhigram Rural Institute-Deemed to Be UniversityDindigulTamil NaduIndia National Remote Sensing Centre India

This research aims to assess the sensitive coastal zones by analyzing the shoreline changes such as accretion and erosion in the eastern coastal part of Ramanathapuram District,Tamil Nadu,*** study focused on mandapam,Pirappanvalsai,Enmanamcondam,Nagachi,Terbogi,Athyuthu,Chitrakkottai,Pathengal,Attangarai,Alagankulam,and Devipattinam *** of these areas are distinguished as highly sensitive ecological *** erosion of an area leads to irreplaceable disturbances to ***,erosion and accretion studies are top priorities when studying the coastal *** addition to GIS technology,which has been widely used in the past 20 years,the End Point Rate(EPR)and Linear Regression Rate(LRR)analyses were conducted to better understand the shoreline *** stability of the coastal region was analyzed by observing the slope variations of the beach during the profile *** the study,we analyzed that the Quaternary deposits of sand are the dominant geological feature of the study *** reefs and salt pans are highly distributed along the coastal *** coast of mandapam village has been detected as a highly sensitive region,with an average erosion rate of-3.1 m/yr and an average accretion rate of 1.22 m/yr,resulting in high erosion and low *** coast is a steep coast with an average slope angle of 0.24°.This study provides insight into sustainable coastal zone management.

关键词： End point rate Linear regression rate Geographic information system Beach profile Ramanathapuram

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Survival differences of low-grade versus high-grade head and neck pleomorphic dermal sarcomas and a review of a scalp case

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第1期9卷 74-78页

作者： Tyler A.Janz Barry D.Long rohan R.Joshi Orly m.Coblens Department of Otolaryngology-Head and Neck Surgery University of Texas Medical BranchGalvestonTexasUSA

Objective:To examine survival by tumor grade of pleomorphic dermal sarcomas(PDS)of the head and neck(H&N)and review a scalp PDS ***:Patients in the Surveillance,Epidemiology,and End Results(SEER)database were included from 1980 to 2016 based on a diagnosis of H&N *** estimates were performed using Kaplan–meier ***,a case of a grade III H&N PDS is ***:Two hundred-seventy cases of PDS were *** mean age at diagnosis was 75.1 years(SD:13.5).Two hundred-thirty-four(86.7%)patients were ***-seven percent of patients received surgery as a part of their *** 5-year overall survival rates for grades I,II,III,and IV PDSs were 69%,60%,50%,and 42%,respectively(P=0.03).Conclusions:H&N PDS occurs most commonly in older-age *** management is frequently a part of H&N PDS *** rates significantly decline based on tumor grade.

关键词： head and neck cancer pleomorphic dermal sarcoma

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Submillimeter wave communication versus millimeter wave communication

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Digital Communications and Networks 2020年第1期6卷 64-74页

作者： madhuprana goswami Hyuck m.Kwon Department of Electrical Engineering and Computer Science Wichita State University1845 N.FairmountWichitaKS67260USA

This paper studies the performance of a submillimeter wave antenna operating between frequencies 0.1 THz and 10 THz with a 4-cyano-4-pentylbiphenyl[5CB]*** the size and shape of the antenna impact its gain/directivity,resonant frequency,bandwidth,and efficiency,the two antenna types considered in this paper are:(a)Rectangular Patch Antenna(RPA),and(b)Cylindrical Dielectric Resonator Antenna(CDRA).Here a submillimeter wave antenna is compared with a millimeter wave(a few GHz to 100 GHz)*** popular mmwave antennas are chosen for the submillimeter wave antenna in order to understand changes in their performance as the result of changes in their geometrical *** bei Korpern mit beliebiger Oberflache(FEKO)software is used for the design and calculation of the Three-Dimensional(3D)Electromagnetic(Em)*** paper also concentrates on the design and analysis of a massive submillimeter wave multiple-Input multiple-Output(mImO)(8 by 8)RPA and CDRA.

关键词： Submillimeter wave antenna millimeter wave antenna Rectangular micro-strip patch antenna Cylindrical dielectric resonator antenna massive submillimeter wave mImO antenna Applications

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