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Article ; Online: The use of simple ultrafiltration technology as a fluid management strategy for high-risk coronary artery bypass grafting surgery.

Beckles, Daniel L / Tavilla, Giuseppe / Malhotra, Amber / Williams, Nikki E / Jackson, Tamara / Koerner, Michael M / Reddy, Ramachandra C

Journal of cardiac surgery

2022 Volume 37, Issue 10, Page(s) 2951–2957

MeSH term(s)	Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Coronary Artery Disease/surgery ; Humans ; Technology ; Treatment Outcome ; Ultrafiltration
Language	English
Publishing date	2022-08-23
Publishing country	United States
Document type	Editorial
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.16867
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Article ; Online: Use of a novel bicarbonate-based Impella 5.5 purge solution in a coagulopathic patient.

Simonsen, Kyle A / Gunn, Brady L / Malhotra, Amber / Beckles, Daniel L / Koerner, Michael M / Tavilla, Giuseppe / Reddy, Ramachandra C

Journal of cardiac surgery

2021 Volume 36, Issue 12, Page(s) 4773–4775

Abstract: The Impella 5.5 with Smart Assist (Abiomed) is a life-saving treatment option in acute heart failure which utilizes a continuous heparin purge solution to prevent thrombosis. In patients with contraindications to heparin, alternative anticoagulation ... ...

Abstract	The Impella 5.5 with Smart Assist (Abiomed) is a life-saving treatment option in acute heart failure which utilizes a continuous heparin purge solution to prevent thrombosis. In patients with contraindications to heparin, alternative anticoagulation strategies are required. We describe the stepwise management of anticoagulation in a coagulopathic patient with persistent cardiogenic shock following a coronary artery bypass procedure who underwent Impella 5.5 placement. A direct thrombin inhibitor-based purge solution was utilized while evaluating for heparin-induced thrombocytopenia. The use of a novel bicarbonate-based purge solution (BBPS) was successfully used due to severe coagulopathy. There were no episodes of pump thrombosis or episodes of severe bleeding on the BBPS and systemic effects of alkalosis and hypernatremia were minimal.
MeSH term(s)	Anticoagulants ; Bicarbonates/pharmacology ; Blood Coagulation ; Heart-Assist Devices ; Heparin ; Humans ; Shock, Cardiogenic/therapy ; Treatment Outcome
Chemical Substances	Anticoagulants ; Bicarbonates ; Heparin (9005-49-6)
Language	English
Publishing date	2021-09-25
Publishing country	United States
Document type	Case Reports
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.16008
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Article ; Online: Pleuritic chest pain.

Marks, Michael / Murch, Nick R / Beckles, Michael A / Drebes, Anja B / Beynon, Huw L

Lancet (London, England)

2013 Volume 382, Issue 9907, Page(s) e32

MeSH term(s)	Adult ; Chest Pain/diagnostic imaging ; Diagnosis, Differential ; Female ; Homocystinuria/pathology ; Humans ; Pleurisy/diagnostic imaging ; Radiography
Language	English
Publishing date	2013-11-26
Publishing country	England
Document type	Case Reports ; Journal Article ; Video-Audio Media
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(13)62547-7
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Article: "CURB" your enthusiasm and consider HIV.

Jacobs, Phillip / Beckles, Michael A / Al-Hussaini, Abtehale

Acute medicine

2009 Volume 8, Issue 3, Page(s) 114–116

Abstract: We present the case of a 40-year old female who was initially seen by her GP and the Emergency Department with pneumonia failing to respond to oral antibiotics. Her severity assessment score categorised her as being in a low risk group and she was ... ...

Abstract	We present the case of a 40-year old female who was initially seen by her GP and the Emergency Department with pneumonia failing to respond to oral antibiotics. Her severity assessment score categorised her as being in a low risk group and she was discharged. Subsequent admission and further investigations diagnosed Human Immunodeficiency Virus infection and Pneumocystis jeruvici pneumonia. It is important for emergency departments and acute physicians to apply risk validation tools appropriately and to be alert to underlying immunosuppression.
Language	English
Publishing date	2009
Publishing country	England
Document type	Journal Article
ZDB-ID	2213243-0
ISSN	1747-4884 ; 1476-5063
ISSN	1747-4884 ; 1476-5063
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Article ; Online: Rapidly progressive course of Trypanosoma cruzi infection in mice heterozygous for hexamethylene bis-acetamide inducible 1 (Hexim1) gene.

Mascareno, Eduardo / Gupta, Raavi / Martello, Laura A / Dhar-Mascareno, Manya / Salciccioli, Louis / Beckles, Daniel / Walsh, Michael G / Machado, Fabiana S / Tanowitz, Herbert B / Haseeb, M A

Microbes and infection

2017 Volume 20, Issue 1, Page(s) 25–36

Abstract: Infection with Trypanosoma cruzi causes Chagas disease and results in myocardial inflammation and cardiomyopathy. Downregulated Hexim1 expression, as in ... ...

Abstract	Infection with Trypanosoma cruzi causes Chagas disease and results in myocardial inflammation and cardiomyopathy. Downregulated Hexim1 expression, as in Hexim1
MeSH term(s)	Animals ; Chagas Cardiomyopathy/immunology ; Chagas Cardiomyopathy/parasitology ; Chagas Cardiomyopathy/pathology ; Chagas Cardiomyopathy/physiopathology ; Cytokines/biosynthesis ; Disease Models, Animal ; Heart/physiopathology ; Inflammation/metabolism ; Intestines/immunology ; Intestines/pathology ; Lung/immunology ; Lung/pathology ; Male ; Mice ; Mice, Inbred C57BL ; Myocardium/immunology ; Myocardium/pathology ; Phosphorylation ; Smad3 Protein/metabolism ; Spleen/pathology ; Transcription Factors/genetics ; Trypanosoma cruzi/pathogenicity
Chemical Substances	Cytokines ; Hexim1 protein, mouse ; Smad3 Protein ; Smad3 protein, mouse ; Transcription Factors
Language	English
Publishing date	2017-09-22
Publishing country	France
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1465093-9
ISSN	1769-714X ; 1286-4579
ISSN (online)	1769-714X
ISSN	1286-4579
DOI	10.1016/j.micinf.2017.09.001
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Article: Thoracoscopic management of empyema thoracis.

Wait, Michael A / Beckles, Daniel L / Paul, Michelle / Hotze, Margaret / Dimaio, Michael J

Journal of minimal access surgery

2009 Volume 3, Issue 4, Page(s) 141–148

Abstract: Appropriate management of empyema thoracis is dependent upon a secure diagnosis of the etiology of empyema and the phase of development. Minimal access surgery using video-assisted thoracoscopy (VATS) is one of many useful techniques in treating empyema. ...

Abstract	Appropriate management of empyema thoracis is dependent upon a secure diagnosis of the etiology of empyema and the phase of development. Minimal access surgery using video-assisted thoracoscopy (VATS) is one of many useful techniques in treating empyema. Complex empyema requires adjunctive treatment in addition to VATS.
Language	English
Publishing date	2009-09-24
Publishing country	India
Document type	Journal Article
ZDB-ID	2186884-0
ISSN	1998-3921 ; 0972-9941
ISSN (online)	1998-3921
ISSN	0972-9941
DOI	10.4103/0972-9941.38908
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Article ; Online: Cardiopulmonary exercise testing for the selection of patients undergoing surgery for lung cancer: friend or foe?

Lim, Eric / Beckles, Michael / Warburton, Chris / Baldwin, David

Thorax

2010 Volume 65, Issue 10, Page(s) 847–849

MeSH term(s)	Exercise Test/methods ; Humans ; Lung Neoplasms/physiopathology ; Lung Neoplasms/surgery ; Oxygen Consumption ; Patient Selection ; Prognosis ; Reference Values ; Risk Assessment/methods ; Sample Size
Language	English
Publishing date	2010-10
Publishing country	England
Document type	Editorial
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thx.2009.133181
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Article ; Online: Point-of-contact Interactive Record Linkage (PIRL): A software tool to prospectively link demographic surveillance and health facility data.

Rentsch, Christopher T / Kabudula, Chodziwadziwa Whiteson / Catlett, Jason / Beckles, David / Machemba, Richard / Mtenga, Baltazar / Masilela, Nkosinathi / Michael, Denna / Natalis, Redempta / Urassa, Mark / Todd, Jim / Zaba, Basia / Reniers, Georges

Gates open research

2018 Volume 1, Page(s) 8

Abstract: Linking a health and demographic surveillance system (HDSS) to data from a health facility that serves the HDSS population generates a research infrastructure for directly observed data on access to and utilization of health facility services. Many HDSS ... ...

Abstract	Linking a health and demographic surveillance system (HDSS) to data from a health facility that serves the HDSS population generates a research infrastructure for directly observed data on access to and utilization of health facility services. Many HDSS sites, however, are in areas that lack unique national identifiers or suffer from data quality issues, such as incomplete records, spelling errors, and name and residence changes, all of which complicate record linkage approaches when applied retrospectively. We developed Point-of-contact Interactive Record Linkage (PIRL) software that is used to prospectively link health records from a local health facility to an HDSS in rural Tanzania. This prospective approach to record linkage is carried out in the presence of the individual whose records are being linked, which has the advantage that any uncertainty surrounding their identity can be resolved during a brief interaction, whereby extraneous information (e.g., household membership) can be referred to as an additional criterion to adjudicate between multiple potential matches. Our software uses a probabilistic record linkage algorithm based on the Fellegi-Sunter model to search and rank potential matches in the HDSS data source. Key advantages of this software are its ability to perform multiple searches for the same individual and save patient-specific notes that are retrieved during subsequent clinic visits. A search on the HDSS database (n=110,000) takes less than 15 seconds to complete. Excluding time spent obtaining written consent, the median duration of time we spend with each patient is six minutes. In this setting, a purely automated retrospective approach to record linkage would have only correctly identified about half of the true matches and resulted in high linkage errors; therefore highlighting immediate benefit of conducting interactive record linkage using the PIRL software.
Language	English
Publishing date	2018-01-11
Publishing country	United States
Document type	Journal Article
ISSN	2572-4754
ISSN (online)	2572-4754
DOI	10.12688/gatesopenres.12751.2
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Article: Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes.

Beckles, Michael A / Spiro, Stephen G / Colice, Gene L / Rudd, Robin M

Chest

2002 Volume 123, Issue 1 Suppl, Page(s) 97S–104S

Abstract: This chapter describes the components of the initial evaluation for a patient either suspected or known to have lung cancer. The components of the initial evaluation are based on the recognized manifestations of localized lung cancer, ie, symptoms ... ...

Abstract	This chapter describes the components of the initial evaluation for a patient either suspected or known to have lung cancer. The components of the initial evaluation are based on the recognized manifestations of localized lung cancer, ie, symptoms referable to the primary tumor, intrathoracic spread of lung cancer, and patterns of metastatic dissemination. Features of the history and physical signs may be useful indicators of the extent of disease. A standardized evaluation, relying on symptoms, signs, and routinely available laboratory tests, can serve as a useful screen for metastatic disease. Also described are the common features of the various paraneoplastic syndromes associated with lung cancer.
MeSH term(s)	Clinical Laboratory Techniques ; Diagnostic Techniques, Respiratory System ; Humans ; Lung Neoplasms/diagnosis ; Lung Neoplasms/pathology ; Neoplasm Metastasis ; Paraneoplastic Syndromes/diagnosis ; Paraneoplastic Syndromes/physiopathology ; Radiography, Thoracic
Language	English
Publishing date	2002-10-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1378/chest.123.1_suppl.97s
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Article: The physiologic evaluation of patients with lung cancer being considered for resectional surgery.

Beckles, Michael A / Spiro, Stephen G / Colice, Gene L / Rudd, Robin M

Chest

2002 Volume 123, Issue 1 Suppl, Page(s) 105S–114S

Abstract: The preoperative physiologic assessment of a patient being considered for surgical resection of lung cancer must consider the immediate perioperative risks from comorbid cardiopulmonary disease, the long-term risks of pulmonary disability, and the threat ...

Abstract	The preoperative physiologic assessment of a patient being considered for surgical resection of lung cancer must consider the immediate perioperative risks from comorbid cardiopulmonary disease, the long-term risks of pulmonary disability, and the threat to survival due to inadequately treated lung cancer. As with any planned major operation, especially in a population predisposed to atherosclerotic cardiovascular disease by cigarette smoking, a cardiovascular evaluation is an important component in assessing perioperative risks. Measuring the FEV(1) and the diffusing capacity of the lung for carbon monoxide (DLCO) measurements should be viewed as complementary physiologic tests for assessing risk related to pulmonary function. If there is evidence of interstitial lung disease on radiographic studies or undue dyspnea on exertion, even though the FEV(1) may be adequate, a DLCO should be obtained. In patients with abnormalities in FEV(1) or DLCO identified preoperatively, it is essential to estimate the likely postresection pulmonary reserve. The amount of lung function lost in lung cancer resection can be estimated by using either a perfusion scan or the number of segments removed. A predicted postoperative FEV(1) or DLCO < 40% indicates an increased risk for perioperative complications, including death, from lung cancer resection. Exercise testing should be performed in these patients to further define the perioperative risks prior to surgery. Formal cardiopulmonary exercise testing is a sophisticated physiologic testing technique that includes recording the exercise ECG, heart rate response to exercise, minute ventilation, and oxygen uptake per minute, and allows calculation of maximal oxygen consumption (.VO(2)max). Risk for perioperative complications can generally be stratified by .VO(2)max. Patients with preoperative .VO(2)max > 20 mL/kg/min are not at increased risk of complications or death; .VO(2)max< 15 mL/kg/min indicates an increased risk of perioperative complications; and patients with .VO(2)max < 10 mL/kg/min have a very high risk for postoperative complications. Alternative types of exercise testing include stair climbing, the shuttle walk, and the 6-min walk. Although often not performed in a standardized manner, stair climbing can predict .VO(2)max. In general terms, patients who can climb five flights of stairs have O(2)max > 20 mL/kg/min. Conversely, patients who cannot climb one flight of stairs have .VO(2)max < 10 mL/kg/min. Data on the shuttle walk and 6-min walk are limited, but patients who cannot complete 25 shuttles on two occasions will have .VO(2)max < 10 mL/kg/min. Desaturation during an exercise test has been associated with an increased risk for perioperative complications. Lung volume reduction surgery (LVRS) for patients with severe emphysema is a controversial procedure. Some reports document substantial improvements in lung function, exercise capability, and quality of life in highly selected patients with emphysema following LVRS. Case series of patients referred for LVRS indicate that perhaps 3 to 6% of these patients may have coexisting lung cancer. Anecdotal experience from these case series suggest that patients with extremely poor lung function can tolerate combined LVRS and resection of the lung cancer with an acceptable mortality rate and good postoperative outcomes. Combining LVRS and lung cancer resection should probably be limited to those patients with heterogeneous emphysema, particularly emphysema limited to the lobe containing the tumor.
MeSH term(s)	Blood Gas Analysis ; Cardiovascular Physiological Phenomena ; Disabled Persons ; Exercise Test ; Humans ; Lung Neoplasms/surgery ; Pneumonectomy ; Postoperative Complications/prevention & control ; Predictive Value of Tests ; Preoperative Care/methods ; Pulmonary Diffusing Capacity/physiology ; Respiratory Function Tests ; Respiratory Physiological Phenomena ; Risk Factors ; Spirometry/methods
Language	English
Publishing date	2002-10-21
Publishing country	United States
Document type	Guideline ; Journal Article ; Practice Guideline
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1378/chest.123.1_suppl.105s
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