Infantile pyloric stenosis is typically managed with surgery; very few cases are mild enough to be treated medically. The danger of pyloric stenosis comes from the dehydration and electrolyte disturbance rather than the underlying problem itself. Therefore, the baby must be initially stabilized by correcting the dehydration and the abnormally high blood pH seen in combination with low chloride levels with IV fluids. This can usually be accomplished in about 24–48 hours. Intravenous and oral atropine may be used to treat pyloric stenosis.
hypertrophic pyloric stenosisInfantile hypertrophic pyloric stenosisCongenital hypertrophic pyloric stenosis
Johns HopkinsJohns Hopkins University HospitalThe Johns Hopkins Hospital
Other accomplishments include the development of HeLa, by George Otto Gey, head of tissue culture research in 1951; the first and arguably most important line of human cells grown in culture; identification of the three types of polio virus; and the first "blue baby" operation, which was done by surgeon Alfred Blalock in collaboration with Helen Taussig, a female Hopkins graduate specializing in pediatric cardiology and surgical technician Vivien Thomas which opened the way to modern heart surgery. Contributions to heart surgery were brought on by the discovery of heparin and the Blalock-Thomas-Taussig Shunt.
Thus currently it is only a marker which can serve as an indicator for more aggressive treatment of those physiologic behaviors which can be changed to slow/halt progression of atherosclerosis.
., an arterial embolus, thrombus, or atherosclerotic plaque), compressed by something outside of the vessel causing it to narrow (e.g., tumor, volvulus, or hernia), ruptured by trauma causing a loss of blood pressure downstream of the rupture, or vasoconstricted, which is the narrowing of the blood vessel by contraction of the muscle wall rather than an external force (e.g., cocaine vasoconstriction leading to myocardial infarction). Hypertension and atherosclerosis are risk factors for both atherosclerotic plaques and thromboembolism. In atherosclerotic formations, a plaque develops under a fibrous cap.
In addition to its effects on thrombosis, hypercoagulable states may accelerate the development of atherosclerosis, the arterial disease that underlies myocardial infarction and other forms of cardiovascular disease. Tests for thrombophilia include complete blood count (with examination of the blood film), prothrombin time, partial thromboplastin time, thrombodynamics test, thrombin time and reptilase time, lupus anticoagulant, anti-cardiolipin antibody, anti-β2 glycoprotein 1 antibody, activated protein C resistance, fibrinogen tests, factor V Leiden and prothrombin mutation, and basal homocysteine levels.
tricuspid stenosistricuspid (valve) stenosis
Tricuspid valve stenosis itself usually doesn't require treatment. If stenosis is mild, monitoring the condition closely suffices. However, severe stenosis, or damage to other valves in the heart, may require surgical repair or replacement. The treatment is usually by surgery (tricuspid valve replacement) or percutaneous balloon valvuloplasty. The resultant tricuspid regurgitation from percutaneous treatment is better tolerated than the insufficiency occurring during mitral valvuloplasty. * Echocardiographic features of tricuspid stenosis Echocardiography. Tricuspid valve.
ductus arteriosusductus arteriosus, patentopen ductus arteriosus
More recently, PDAs can be closed by percutaneous interventional method (avoiding open heart surgery). A platinum coil can be deployed via a catheter through the femoral vein or femoral artery, which induces thrombosis (coil embolization). Alternatively, a PDA occluder device, composed of nitinol mesh, is deployed from the pulmonary artery through the PDA. If left untreated, the disease may progress from left-to-right shunt (acyanotic heart) to right-to-left shunt (cyanotic heart), called Eisenmenger's syndrome. Pulmonary hypertension is a potential long-term outcome, which may require a heart and/or lung transplant. Another complication of PDA is intraventricular hemorrhage. Robert E.
Cardiac Surgery. Cardiothoracic surgery. Coronary artery bypass surgery. Extracorporeal membrane oxygenation. Heart-lung machine. Membrane oxygenator. Perfusionist. Neonatal Intensive Care Unit. Thrombin.
vascular graftArtificial vascular graftsbypass surgery
Its causes, which are distinct from those of chronic graft occlusion, include technical failure (e.g. anastomotic stricture, incomplete valve lysis in non-reversed vein) and thrombosis. It is rare, but almost always requires reoperation. General risks of surgery: Immediately following coronary artery or neurosurgical vascular bypass surgery, patients recover in an intensive care unit or coronary care unit for one to two days. Provided that recovery is normal and without complications, they can move to a less intensively monitored unit such as a step-down unit or a ward bed. Depending on the extent of the surgery, recovery from a leg bypass may start from a step-down or ward bed.
TorontoToronto UniversityKing's College
Medical inventions developed at Toronto include the glycaemic index, the infant cereal Pablum, the use of protective hypothermia in open heart surgery and the first artificial cardiac pacemaker. The first successful single-lung transplant was performed at Toronto in 1981, followed by the first nerve transplant in 1988, and the first double-lung transplant in 1989. Researchers identified the maturation promoting factor that regulates cell division, and discovered the T-cell receptor, which triggers responses of the immune system. The university is credited with isolating the genes that cause Fanconi anemia, cystic fibrosis and early-onset Alzheimer's disease, among numerous other diseases.
endothelialendothelial cellsendothelial cell
Endothelial cells are involved in many aspects of vascular biology, including: Endothelial dysfunction, or the loss of proper endothelial function, is a hallmark for vascular diseases, and is often regarded as a key early event in the development of atherosclerosis. Impaired endothelial function, causing hypertension and thrombosis, is often seen in patients with coronary artery disease, diabetes mellitus, hypertension, hypercholesterolemia, as well as in smokers. Endothelial dysfunction has also been shown to be predictive of future adverse cardiovascular events, and is also present in inflammatory disease such as rheumatoid arthritis and systemic lupus erythematosus.
vascular cell adhesion molecule-1vascular cell adhesion molecule 1vascular cell adhesion molecules
Certain melanoma cells can use VCAM-1 to adhere to the endothelium, and VCAM-1 may participate in monocyte recruitment to atherosclerotic sites. As a result, VCAM-1 is a potential drug target.
In February 1958, a heart-lung machine Kantrowitz had developed was used during open heart surgery on a six-year-old boy while the surgeons repaired a one-inch hole between the chambers of the boy's heart that was present since birth. In an October 1959 lecture at the American College of Surgeons, Kantrowitz and colleague Dr. William M. P. McKinnon reported on a procedure in which a portion of muscle from the diaphragm was used to create a "booster" heart to help pump blood in a dog, taking over as much as 25% of the pumping burden of the natural heart. The booster heart functions by receiving a signal sent by a radio transmitter triggered by the pulse of the natural heart.
cholesteryl esterase transport protein (CETP) inhibitor
They are intended to reduce the risk of atherosclerosis (a cardiovascular disease) by improving blood lipid levels. At least three medications within this class have failed to result in benefits however. These drugs have generally failed in clinical trials, either causing a marked increase in deaths (torcetrapib), or having no meaningful clinical improvement despite HDL increases (dalcetrapib, evacetrapib). Failed: Succeeded: * Anacetrapib. In 2017, the REVEAL trial based on more than 30,000 participants showed a modest benefit of the addition of anacetrapib to statin therapy. Despite the successful trial, Merck halted the development of the drug.
hemoglobin A1CHbA1cglycosylated hemoglobin
Another way glycated Hb causes damage is via inflammation which results in atherosclerotic plaque (atheroma) formation. Free radical build-up promotes the excitation of Fe 2+ -Hb through into abnormal ferryl Hb (Fe 4+ -Hb). Fe 4+ is unstable and reacts with specific amino acids in Hb to regain its Fe 3+ oxidation state. Hb molecules clump together via cross-linking reactions and these Hb clumps (multimers) promote cell damage and the release of Fe 4+ -Hb into the matrix of innermost layers (subendothelium) of arteries and veins.
Victor A. Skumin
Skumin researched a neuropsychological and psychopathologic changes following open heart surgery, nonpsychotic mental disorders in patients with valvular heart disease before and after surgery, associated with mechanical artificial heart valve (MHV) implant. An artificial heart valve is a device implanted in the heart of a patient with valvular heart disease, congenital heart defect, etc. When one or two of the four heart valves malfunctions, the medical choice may be to replace the natural valve with an artificial valve. There are three major types of mechanical valves with many modifications on these designs. This requires open heart surgery.
macrophagesTissue macrophagesCD68 + macrophages
Both M1 and M2 macrophages play a role in promotion of atherosclerosis. M1 macrophages promote atherosclerosis by inflammation. M2 macrophages can remove cholesterol from blood vessels, but when the cholesterol is oxidized, the M2 macrophages become apoptotic foam cells contributing to the atheromatous plaque of atherosclerosis. The first step to understanding the importance of macrophages in muscle repair, growth, and regeneration is that there are two "waves" of macrophages with the onset of damageable muscle use – subpopulations that do and do not directly have an influence on repairing muscle.
prosthetic heart valveartificial heart valvesmechanical heart valve
This requires open-heart surgery. Heart valves are integral to the normal physiological functioning of the human heart. Natural heart valves induce unidirectional blood flow through the valve structure from one chamber of the heart to another. Natural heart valves become dysfunctional for a variety of pathological causes, some of which may require complete surgical replacement of the natural heart valve with an artificial valve. There are three main types of artificial heart valves: the mechanical,the biological, and the tissue engineered valves. Mechanical heart valves (MHV) are prosthetics designed to replicate the function of the natural valves of the human heart.
A high level of homocysteine in the blood (hyperhomocysteinemia) makes a person more prone to endothelial cell injury, which leads to inflammation in the blood vessels, which in turn may lead to atherogenesis, which can result in ischemic injury. Hyperhomocysteinemia is therefore a possible risk factor for coronary artery disease. Coronary artery disease occurs when an atherosclerotic plaque blocks blood flow to the coronary arteries, which supply the heart with oxygenated blood. Hyperhomocysteinemia has been correlated with the occurrence of blood clots, heart attacks and strokes, though it is unclear whether hyperhomocysteinemia is an independent risk factor for these conditions.
Here, low density lipoprotein (LDL) oxidation appears to trigger the process of atherogenesis, which results in atherosclerosis, and finally cardiovascular disease. Oxidative damage in DNA can cause cancer. Several antioxidant enzymes such as superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, glutathione S-transferase etc. protect DNA from oxidative stress. It has been proposed that polymorphisms in these enzymes are associated with DNA damage and subsequently the individual's risk of cancer susceptibility. A low calorie diet extends median and maximum lifespan in many animals. This effect may involve a reduction in oxidative stress.
The assigned goal of the NCEP committee is to meet on a recurring basis, review ongoing scientific research about atherosclerotic cardiovascular disease and make simplified, consensus, committee recommendations to be promoted by the NIH, the American Heart Association and other groups to both physicians and the public about how to reduce the incidence of disability and death resulting from atherosclerotic cardiovascular disease. NCEP main page. Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report, 2002.