Heart failure (HF) leads to repeat hospitalisations and reduces the duration and quality of life. Pulmonary artery pressure (PAP)-guided HF management using the CardioMEMS™ HF system was shown to be safe and reduce HF hospitalisation (HFH) rates in New York Heart Association (NYHA) class III patients. However, these findings have not been replicated in health systems outside the United States. Therefore, the CardioMEMS European Monitoring Study for Heart Failure (MEMS-HF

Through the use of 3-D ultrasound, it is possible to noninvasively examine the regression and progression of carotid artery plaque ulceration.

The effect of different crank lengths and crank widths on maximal hand cycling power, cadence and handle speed were determined. Crank lengths and crank widths were adapted to anthropometric data of the participants as the ratio to forward reach (FR) and shoulder breadth (SB), respectively. 25 able-bodied subjects performed maximal inertial load hand cycle ergometry using crank lengths of 19, 22.5 and 26% of FR and 72, 85 and 98% of SB. Maximum power ranged from 754 (246) W for the crank geometry short wide (crank length x crank width) to 873 (293) W for the combination long middle. Every crank length differed significantly (P < 0.05) from each other, whereas no significant effect of crank width to maximum power output was revealed. Optimal cadence decreased significantly (P < 0.001) with increasing crank length from 124.8 (0.9) rpm for the short to 107.5 (1.6) rpm for the long cranks, whereas optimal handle speed increased significantly (P < 0.001) with increasing crank length from 1.81 (0.01) m/s for the short to 2.13 (0.03) m/s for the long cranks. Crank width did neither influence optimal cadence nor optimal handle speed significantly. From the results of this study, for maximum hand cycling power, a crank length to FR ratio of 26% for a crank width to SB ratio of 85% is recommended.

Observations among Karlsburg patients in 2006 revealed that the majority of very low platelet levels inducing postoperative heparin-induced-thrombocytopenia (HIT)-diagnostics with at the end negative results appeared related to aortic valve replacement (AVR) with stentless bioprostheses. We compared the postoperative courses of platelet counts in patients having had AVR with stentless prostheses (Sorin Biomedica Freedom Solo [SOLO]) or stented prostheses (Carpentier Edwards Perimount [PM]). Between February 2005 and April 2007, 209 patients received AVR with SOLO, in 137 patients a PM-prosthesis was implanted. The mean platelet levels were compared from the first up to the fifth postoperative day. A higher occurrence of platelet levels below 100 Gpt/l between the second and the fifth postoperative day was found in the SOLO-group (71.9%) compared with the other biological substitute PM (36.6%). Differences in platelet counts between SOLO- and PM-subgroups were measured for day 2 (P=0.03), day 3 (P=0.0004) day 4 (P=0.0007), day 5 (P=0.0002) and at discharge (P<0.0001). Following intervention with conventional biological AVR, differences in the postoperative recovery of platelet counts can be detected, depending on the prosthesis used. The causes for and the clinical implications of this phenomenon are not yet assessed.

Percutaneous driveline infections (DI) are leading factors for morbidity and mortality in ventricular assist device (VAD) patients. In recent years, cold atmospheric plasma (CAP) has been safely and effectively used in clinical settings to treat topical infections. We describe the first use of CAP to treat a superficial DI. CAP was applied with the kinPen® MED plasma jet device (neoplas tools GmbH, Greifswald, Germany), in the treatment of a DI in a 66-year-old VAD patient in Klinikum Karlsburg, Germany. The patient received a daily application of CAP of 1 min for 12 days. One CAP application was administered each week for 4 weeks in our outpatient clinic after patient discharge. Laboratory tests were conducted and photographs of the driveline exit site were taken. After CAP treatment, the local infection was completely regressed without any signs of exudation or recurrence of the infection. There were no adverse side effects observed, and the HVAD logfile data did not show any abnormalities during treatment. Here, we demonstrate a successful resolution of a VAD DI with the kinPen plasma jet device. We believe that CAP has the potential to be a simple and effective tool in the treatment of superficial DIs.