COVID-19 is a severe infectious disease that has claimed >150,000 lives and infected millions in the United States thus far, especially the elderly population. Emerging evidence has shown the virus ...to cause hemorrhagic and immunologic responses, which impact all organs, including lungs, kidneys, and the brain, as well as extremities. SARS-CoV-2 also affects patients', families', and society's mental health at large. There is growing evidence of re-infection in some patients. The goal of this paper is to provide a comprehensive review of SARS-CoV-2-induced disease, its mechanism of infection, diagnostics, therapeutics, and treatment strategies, while also focusing on less attended aspects by previous studies, including nutritional support, psychological, and rehabilitation of the pandemic and its management. We performed a systematic review of >1,000 articles and included 425 references from online databases, including, PubMed, Google Scholar, and California Baptist University's library. COVID-19 patients go through acute respiratory distress syndrome, cytokine storm, acute hypercoagulable state, and autonomic dysfunction, which must be managed by a multidisciplinary team including nursing, nutrition, and rehabilitation. The elderly population and those who are suffering from Alzheimer's disease and dementia related illnesses seem to be at the higher risk. There are 28 vaccines under development, and new treatment strategies/protocols are being investigated. The future management for COVID-19 should include B-cell and T-cell immunotherapy in combination with emerging prophylaxis. The mental health and illness aspect of COVID-19 are among the most important side effects of this pandemic which requires a national plan for prevention, diagnosis and treatment.
The ABS modular system ensures automatic alignment of the mother (main branch) and daughter (side branch) stents with complete tissue coverage and guaranteed side-branch access.
Transradial (TR) access is increasingly being used in percutaneous coronary intervention (PCI). However, its role in PCI for ST-segment elevation myocardial infarction remains controversial because ...of concerns of procedural complexity adversely affecting the promptness of reperfusion. In this study, 150 consecutive patients who underwent PCI for acute ST-segment elevation myocardial infarction over a period of 24 months were prospectively evaluated; 46 had TR access (31%) and 104 (69%) had transfemoral (TF) access. All patients received thienopyridines, aspirin, and heparin per routine management. There were no significant differences between the TR access and TF access groups with respect to age (62.2 ± 11.6 vs 64.7 ± 14.1, p = 0.28), gender (76.1% vs 72.1% men, p = 0.69), or incidence of diabetes (23.9% vs 26.9%, p = 0.84). The TR and TF access groups were comparable with respect to door-to-balloon time (79.2 ± 32.3 vs 86.8 ± 51.8 minutes, p = 0.67) and amount of contrast used (190.5 ± 101.5 vs 172.2 ± 81.7 ml, p = 0.24). Total fluoroscopy time was longer in the TR access group compared to the TF access group (21.7 ± 12.7 vs 14.4 ± 10.4 minutes, p <0.0001). Postprocedural Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow was comparable for the 2 groups (87% for the TF group and 96% for the TR group, p = 0.15). There were no vascular complications in the TR access group compared to the TF access group (0% vs 5.8%, p = 0.18). In conclusion, this single-center observational study shows that TR access for PCI in STEMI is feasible and that it has fewer vascular complications and shorter length of hospital stay than the TF approach.
Advanced Bifurcation Systems' mother-daughter platform Khorsandi, Mehran; Abizaid, Alex; Dani, Sameer ...
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology,
12/2010, Letnik:
6 Suppl J
Journal Article
Local production of growth factors may play a major role in vascular repair after injury. We examined the regulation of insulin-like growth factor-I (IGF-I) and its specific membrane receptor in ...balloon-denuded rat aorta. Aortic IGF-I mRNA and radioimmunoassayable IGF-I content increased severalfold after balloon denudation with a peak at 7 d after injury. This coincided with a reciprocal 25% decrease in IGF-I receptor mRNA content and a 40% decrease in total 125I-IGF-I binding. Scatchard analysis indicated a single class of binding sites, with a decrease in receptor number at 7 d compared to control and no change in affinity. By in situ hybridization the predominant site of IGF-I expression in the normal and the denuded vessel wall was the medial smooth muscle cell. After denudation there was a relative decrease in IGF-I receptor mRNA in the medial cells as compared to the neointima, suggesting that the site of IGF-I action was predominantly in the medial layer. These data suggest that local expression and action of IGF-I are significant in the promotion of smooth muscle cell proliferation after arterial injury.
The ABS mother-daughter platforms Khorsandi, Mehran; Abizaid, Alexandre; Dani, Sameer ...
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology,
2015, Letnik:
11 Suppl V
Journal Article
Objectives. The purpose of this study was to test the feasibility of implanting and retrieving a heat-activated recoverable temporary stent and to determine its effect on the angiographic, gross and ...histologic appearance of a normal coronary artery wall.
Background. Permanent coronary stenting is associated with a significant incidence of thrombosis, bleeding and vascular complications. These may be avoided by temporarily stenting for a period of hours to several days.
Methods. Seventy-eight stents constructed from the shape-memory nickel-titanium alloy nitinol were deployed by balloon expansion in the coronary arteries of 28 dogs and left in place for up to 6 months. Thirty minutes to 1 week after implantation, 70 stents were recovered by flushing the coronary arteries with 3 to 5 ml of 75 °C lactated Ringer solution, with collapse of the stent over a recovery catheter and subsequent withdrawal.
Results. All stents were successfully recovered and removed percutaneously. Mean vessel diameter after stenting was 12 ± 6% (p < 0.05) greater than baseline diameter. Mean vessel diameter after stent removal remained enlarged (6 ± 3%, p < 0.05). No angiographic or gross evidence of thrombosis, dissection, embolization, migration or spasm was associated with implantation or recovery. Microscopic examination revealed minor intimal injury in 40 segments (51%). Microscopic focal medial necrosis was associated with mural platelet-fibrin thrombus in 23 stented segments (29%) and media was interrupted in 7 (9%).
Conclusions. This study demonstrates the feasibility of a new method of temporary stenting that uses the thermoelastic properties of nitinol to permit reliable recovery of the stent in normal canine coronary arteries.
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