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  1. Article: The Rise and Fall of Well-Controlled Blood Pressure: Labile Hypertension Following Repair of a Ruptured Abdominal Aortic Aneurysm.

    Ansah, Grace / Conaway, Madeline / Childress, Shana / Slater, Kristin / Vellozo, Paul

    Cureus

    2024  Volume 16, Issue 3, Page(s) e56880

    Abstract: Hypertension is a common pathology with several etiologies. If left uncontrolled, severe and even fatal complications can develop, including heart disease, vascular damage, and stroke. Primary hypertension is most commonly seen without an underlying ... ...

    Abstract Hypertension is a common pathology with several etiologies. If left uncontrolled, severe and even fatal complications can develop, including heart disease, vascular damage, and stroke. Primary hypertension is most commonly seen without an underlying etiology; however, several contributing factors can lead to the development of hypertension. There have been limited cases reporting the effects of an abdominal aortic dissection treated with endovascular aortic repair (EVAR) on the development of labile hypertension. We report a case of uncontrolled, labile hypertension following an EVAR of an abdominal aortic aneurysm in a patient without prior medical history of hypertension.
    Language English
    Publishing date 2024-03-25
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.56880
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Is surgical risk of aortic arch aneurysm repair underestimated? A novel perspective based on 30-day versus 1-year mortality.

    Rajesh, Kavya / Levine, Dov / Murana, Giacomo / Castagnini, Sabrina / Bianco, Edoardo / Childress, Patra / Zhao, Yanling / Kurlansky, Paul / Pacini, Davide / Takayama, Hiroo

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

    2024  Volume 65, Issue 3

    Abstract: Objectives: The decision to undergo aortic aneurysm repair balances the risk of operation with the risk of aortic complications. The surgical risk is typically represented by perioperative mortality, while the aneurysmal risk relates to the 1-year risk ... ...

    Abstract Objectives: The decision to undergo aortic aneurysm repair balances the risk of operation with the risk of aortic complications. The surgical risk is typically represented by perioperative mortality, while the aneurysmal risk relates to the 1-year risk of aortic events. We investigate the difference in 30-day and 1-year mortality after total arch replacement for aortic aneurysm.
    Methods: This was an international two-centre study of 456 patients who underwent total aortic arch replacement for aneurysm between 2006 and 2020. Our primary end-point of interest was 1-year mortality. Our secondary analysis determined which variables were associated with 1-year mortality.
    Results: The median age of patients was 65.4 years (interquartile range 55.1-71.1) and 118 (25.9%) were female. Concomitantly, 91 (20.0%) patients had either an aortic root replacement or aortic valve procedure. There was a drop in 1-year (81%, 95% confidence interval (CI) 78-85%) survival probability compared to 30-day (92%, 95% CI 90-95%) survival probability. Risk hazards regression showed the greatest risk of mortality in the first 4 months after discharge. Stroke [hazard ratio (HR) 2.54, 95% CI (1.16-5.58)], renal failure [HR 3.59 (1.78-7.25)], respiratory failure [HR 3.65 (1.79-7.42)] and reoperation for bleeding [HR 2.97 (1.36-6.46)] were associated with 1-year mortality in patients who survived 30 days.
    Conclusions: There is an increase in mortality up to 1 year after aortic arch replacement. This increase is prominent in the first 4 months and is associated with postoperative complications, implying the influence of surgical insult. Mortality beyond the short term may be considered in assessing surgical risk in patients who are undergoing total arch replacement.
    MeSH term(s) Humans ; Female ; Aged ; Male ; Aortic Dissection ; Aneurysm, Aortic Arch ; Aortic Aneurysm/surgery ; Aorta/surgery ; Vascular Surgical Procedures ; Reoperation ; Postoperative Complications/etiology ; Treatment Outcome ; Retrospective Studies ; Risk Factors ; Aortic Aneurysm, Thoracic ; Blood Vessel Prosthesis Implantation/methods
    Language English
    Publishing date 2024-03-01
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 639293-3
    ISSN 1873-734X ; 1010-7940 ; 1567-4258
    ISSN (online) 1873-734X
    ISSN 1010-7940 ; 1567-4258
    DOI 10.1093/ejcts/ezae041
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Exploring Social Impairment in Those with Opioid Use Disorder: Linking Impulsivity, Childhood Trauma, and the Prefrontal Cortex.

    Arruda, Thais / Sinko, Laura / Regier, Paul / Tufanoglu, Altona / Curtin, Adrian / Teitelman, Anne / Ayaz, Hasan / Cronholm, Peter / Childress, Anna Rose

    Research square

    2024  

    Abstract: Background: Challenges with social functioning, which is a hallmark of opioid use disorder (OUD), are a drawback in treatment adherence and maintenance. Yet, little research has explored the underlying mechanisms of this impairment. Impulsivity, a known ...

    Abstract Background: Challenges with social functioning, which is a hallmark of opioid use disorder (OUD), are a drawback in treatment adherence and maintenance. Yet, little research has explored the underlying mechanisms of this impairment. Impulsivity, a known risk factor for OUD, and corresponding neural alterations may be at the center of this issue. Childhood adversity, which has been linked to both impulsivity and poorer treatment outcomes, could also affect this relationship. This study aims to understand the relationship between impulsivity and social functioning in those recovering from OUD. Differences in the prefrontal cortex will be analyzed, as well as potential moderating effects of childhood trauma.
    Methods: Participants with (N = 16) and without (N = 19) social impairment completed a survey (e.g., social functioning, Barrat's Impulsivity Scale, Adverse Childhood Experiences (ACEs) and cognitive tasks while undergoing neuroimaging. Functional near infrared spectroscopy (fNIRS), a modern, portable, wearable and low-cost neuroimaging technology, was used to measure prefrontal cortex activity during a behavioral inhibition task (Go/No-Go task).
    Results: Those who social functioning survey scores indicated social impairment (n = 16) scored significantly higher on impulsivity scale (t(33)= -3.4, p < 0.01) and reported more depressive symptoms (t(33) = -2.8, p < 0.01) than those reporting no social impairment (n = 19). Social functioning was negatively correlated with impulsivity (r=-0.7, p < 0.001), such that increased impulsivity corresponded to decreased social functioning. Childhood trauma emerged as a moderator of this relationship, but only when controlling for the effects of depression, B=-0.11, p = 0.023. Although both groups had comparable Go/No-Go task performance, the socially impaired group displayed greater activation in the dorsolateral (F(1,100.8) = 7.89, p < 0.01), ventrolateral (F(1,88.8) = 7.33, p < 0.01), and ventromedial (F(1,95.6) = 7.56, p < 0.01) prefrontal cortex during impulse control.
    Conclusion: In addition to being more impulsive, individuals with social impairment exhibited differential activation in the prefrontal cortex when controlling responses. Furthermore, the impact of impulsivity on social functioning varies depending on ACEs demonstrating that it must be considered in treatment approaches. These findings have implications for addressing social needs and impulsivity of those in recovery, highlighting the importance of a more personalized, integrative, and trauma-informed approach to intervention.
    Language English
    Publishing date 2024-04-08
    Publishing country United States
    Document type Preprint
    DOI 10.21203/rs.3.rs-4202009/v1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Clinical Trials for Stimulant Use Disorders: Addressing Heterogeneities That May Undermine Treatment Outcomes.

    Regier, Paul S / Kampman, Kyle M / Childress, Anna Rose

    Handbook of experimental pharmacology

    2020  Volume 258, Page(s) 299–322

    Abstract: In recent years, use of cocaine and amphetamines and deaths associated with stimulants have been on the rise, and there are still no FDA-approved medications for stimulant use disorders. One contributing factor may involve heterogeneity. At the ... ...

    Abstract In recent years, use of cocaine and amphetamines and deaths associated with stimulants have been on the rise, and there are still no FDA-approved medications for stimulant use disorders. One contributing factor may involve heterogeneity. At the neurobiological level, dual dopamine dysfunction may be undermining medication efficacy, suggesting a need for combination pharmacotherapies. At the population level, individual variability is expressed in a number of ways and, if left unaddressed, may interfere with medication efficacy. This chapter reviews studies investigating medications to address dopamine dysfunction, and it also identifies several prominent heterogeneities associated with stimulant (and other substance) use disorders. The chapter has implications for improving interventions to treat stimulant use disorders, and the theme of individual heterogeneity may have broader application across substance use disorders.
    MeSH term(s) Amphetamines/adverse effects ; Central Nervous System Stimulants/adverse effects ; Clinical Trials as Topic ; Cocaine ; Cocaine-Related Disorders ; Dopamine/physiology ; Humans ; Substance-Related Disorders/drug therapy
    Chemical Substances Amphetamines ; Central Nervous System Stimulants ; Cocaine (I5Y540LHVR) ; Dopamine (VTD58H1Z2X)
    Language English
    Publishing date 2020-03-19
    Publishing country Germany
    Document type Journal Article ; Review
    ISSN 0171-2004
    ISSN 0171-2004
    DOI 10.1007/164_2019_303
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Neural correlates of cognitive control in women with a history of sexual violence suggest altered prefrontal cortical activity during cognitive processing.

    Sinko, Laura / Regier, Paul / Curtin, Adrian / Ayaz, Hasan / Rose Childress, Anna / Teitelman, Anne M

    Women's health (London, England)

    2022  Volume 18, Page(s) 17455057221081326

    Abstract: Objective: Women's experiences of sexual violence can be not only psychologically and physically traumatizing but may also have lasting effects on brain functions, including cognitive control relating to the inhibition and processing of emotion. Thus, ... ...

    Abstract Objective: Women's experiences of sexual violence can be not only psychologically and physically traumatizing but may also have lasting effects on brain functions, including cognitive control relating to the inhibition and processing of emotion. Thus, the purpose of this pilot study is to explore underlying neural correlates of sexual violence's impact on cognitive control in women.
    Methods: Thirty women (aged 21-30 years) participants underwent a quantitative survey along with an affect-congruent Go-NoGo task. Prefrontal activity was monitored using functional near-infrared spectroscopy, a portable neuroimaging technology. An analysis of variance tested for main effects of the condition (Go versus NoGo), group (sexual violence versus no prior sexual violence), and potential interactions.
    Results: Fifteen of 30 women reported a history of childhood (n = 5) and/or adult (n = 12) sexual violence. Those with sexual violence histories reported significantly higher depression, anxiety, and posttraumatic stress symptoms, as well as increased impulsivity compared to their peers. Behavioral performance did not differ between the groups; however, functional near-infrared spectroscopy data revealed a significant (group × condition) interaction in Optodes 13 and 16. Women with histories of sexual violence had a significantly lower response during the "NoGo" condition and a heightened response during the "Go" condition, in the right dorsolateral prefrontal cortex.
    Conclusion: These results suggest altered prefrontal cortical activity during cognitive processing in women with a history of sexual violence, showing hypoactivity during response inhibition and hyperactivity to the positive stimuli. These findings have strong translational promise for innovative assessment and prevention of untoward effects among women with sexual violence.
    MeSH term(s) Adult ; Anxiety ; Cognition ; Female ; Humans ; Male ; Pilot Projects ; Prefrontal Cortex/diagnostic imaging ; Sex Offenses
    Language English
    Publishing date 2022-02-28
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2274503-8
    ISSN 1745-5065 ; 1745-5057
    ISSN (online) 1745-5065
    ISSN 1745-5057
    DOI 10.1177/17455057221081326
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Significance of isolated postoperative atrial fibrillation in thoracic aortic aneurysm repair.

    Chung, Megan M / Pan, Cheryl / Hayashi, Hideyuki / Kandula, Viswajit / Zhao, Yanling / Levine, Dov / Childress, Patra / Sutherland, Lauren / Raza, Syed T / Kurlansky, Paul / Smith, Craig R / Takayama, Hiroo

    The Journal of thoracic and cardiovascular surgery

    2024  

    Abstract: Objective: Although postoperative atrial fibrillation has been shown to be associated with worse survival after thoracic aortic surgery, its effect on outcomes independently from other postoperative complications is not well understood.: Methods: ... ...

    Abstract Objective: Although postoperative atrial fibrillation has been shown to be associated with worse survival after thoracic aortic surgery, its effect on outcomes independently from other postoperative complications is not well understood.
    Methods: This is a single-center retrospective study of patients who underwent open thoracic aortic aneurysm repair between March 2005 and March 2021. Postoperative atrial fibrillation was defined as new-onset atrial fibrillation that developed during the index hospital stay. Patients with preoperative atrial fibrillation were excluded. Postoperative major complications included reoperation for bleeding, respiratory failure, acute renal failure, and stroke. Variables associated with postoperative atrial fibrillation were analyzed with multivariable regression. Survival of patients without major complications was compared between patients without atrial fibrillation and patients with postoperative atrial fibrillation after propensity score matching for baseline and intraoperative characteristics.
    Results: Of 1454 patients, 520 (35.8%) were observed to have postoperative atrial fibrillation. Patients with postoperative atrial fibrillation had a higher rate of postoperative major complications than those without atrial fibrillation (20.2% vs 12.2%, P < .001). Ten-year survival was 82.0% in patients with postoperative atrial fibrillation and 87.0% in patients without atrial fibrillation (P = .008). In the cohort of patients without complications, 10-year survival was similar between patients with and without postoperative atrial fibrillation after propensity score matching (83.6% vs 83.8%, P = .75).
    Conclusions: Postoperative atrial fibrillation is common after open proximal thoracic aortic aneurysm repair. Although development of major postoperative complications is associated with postoperative atrial fibrillation and decreased long-term survival, isolated postoperative atrial fibrillation does not appear to influence long-term survival.
    Language English
    Publishing date 2024-01-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2023.12.023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Long-term outcomes after aortic root replacement for bicuspid aortic valve-associated aneurysm.

    Rajesh, Kavya / Chung, Megan / Levine, Dov / Norton, Elizabeth / Patel, Parth / Childress, Patra / Zhao, Yanling / Wang, Pengchen / Leshnower, Bradley / Kurlansky, Paul / Chen, Edward / Takayama, Hiroo

    The Journal of thoracic and cardiovascular surgery

    2024  

    Abstract: Objective: Patients with congenital bicuspid aortic valve often require root replacement. This study aims to describe their long-term rates of mortality and reoperation.: Methods: This is a multicenter retrospective study of 747 patients with ... ...

    Abstract Objective: Patients with congenital bicuspid aortic valve often require root replacement. This study aims to describe their long-term rates of mortality and reoperation.
    Methods: This is a multicenter retrospective study of 747 patients with bicuspid aortic valve who underwent aortic root replacement for aortic aneurysm between 2004 and 2020. Cumulative incidence curves for aortic valve and aortic reoperations were graphed. A Kaplan-Meier survival curve for the patient cohort was created alongside an age- and sex-matched curve for the US population. Multivariable Cox regression was used to determine characteristics associated with long-term mortality.
    Results: The median age of our cohort was 54 [43-64] years old, and 101 (13.5%) patients were female. In patients with bicuspid aortic valve dysfunction, 274 (36.7%) had aortic insufficiency, 187 (25.0%) had aortic stenosis, and 142 (19.0%) had both. In-hospital mortality occurred in 10 (1.3%) patients. There were 56 aortic valve reoperations and 19 aortic reoperations, with a combined cumulative incidence of 35% (95% confidence interval [CI], 23%-46%) at 15 years. In addition, there was comparable survival between the patient cohort and the age- and sex-matched US population. Age (hazard ratio [HR], 1.04; 95% CI, 1.01-1.06), concomitant CABG (HR, 2.28; 95% CI, 1.29-4.04), and bypass time (HR, 1.01; 95% CI, 1.00-1.01) were associated with increased mortality.
    Conclusions: Patients who undergo aortic root replacement with bicuspid aortic valve have an increased rate of aortic reoperation (35%; 95% CI, 23%-46%) while their survival appears to be comparable to the general US population (79%; 95% CI, 73%-87%) at 15 years.
    Language English
    Publishing date 2024-04-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2024.03.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Recent temporal trends in hospital costs for non-surgical patients receiving implantable cardioverter defibrillators.

    Na, Jonathan S / Sokolow, Michael / Childress, James / Han, Paul / Patel, Sonika / Rottman, Jeffrey

    Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

    2021  Volume 63, Issue 2, Page(s) 231–237

    Abstract: Purpose: Many studies have analyzed the cost-effectiveness of implantable cardioverter defibrillators (ICDs), but hospital costs have not been as thoroughly reported. This study reviewed the associated hospital costs for non-surgical patients who ... ...

    Abstract Purpose: Many studies have analyzed the cost-effectiveness of implantable cardioverter defibrillators (ICDs), but hospital costs have not been as thoroughly reported. This study reviewed the associated hospital costs for non-surgical patients who received ICDs from 2015 to 2019.
    Methods: We performed a retrospective single-center analysis of patients who received an ICD between 2015 and 2019. ICD cost was analyzed with respect to time using linear regression t-test analysis.
    Results: For 304 patients, we trended cost of the devices over time. 168 (55.2%) cases were single-chamber devices, 53 (17.4%) were dual-chamber, 59 (19.4%) were cardiac resynchronization therapy-defibrillators (CRT-D), and 24 (7.9%) were subcutaneous devices. The cost of all ICDs decreased by -$1.82/day (p<0.001), R
    Conclusion: This is the first detailed analysis of ICD costs that we are aware of. The cost of all ICDs decreased modestly and became much greater when categorized by type. Overall hospital cost associated with ICD implantation did not show a significant trend, but total supply cost showed a significant decrease over time.
    MeSH term(s) Cardiac Resynchronization Therapy ; Cost-Benefit Analysis ; Defibrillators, Implantable ; Hospital Costs ; Humans ; Retrospective Studies
    Language English
    Publishing date 2021-02-11
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1329179-8
    ISSN 1572-8595 ; 1383-875X
    ISSN (online) 1572-8595
    ISSN 1383-875X
    DOI 10.1007/s10840-021-00956-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Trauma exposure among cannabis use disorder individuals was associated with a craving-correlated non-habituating amygdala response to aversive cues.

    Regier, Paul S / Gawrysiak, Michael J / Jagannathan, Kanchana / Childress, Anna Rose / Franklin, Teresa R / Wetherill, Reagan R

    Drug and alcohol dependence reports

    2022  Volume 5, Page(s) 100098

    Abstract: The relationship of cannabis-use disorder and trauma exposure at the level of the brain is not well-understood. Cue-reactivity paradigms have largely focused on characterizing aberrant subcortical function by averaging across the entire task. However, ... ...

    Abstract The relationship of cannabis-use disorder and trauma exposure at the level of the brain is not well-understood. Cue-reactivity paradigms have largely focused on characterizing aberrant subcortical function by averaging across the entire task. However, changes across the task, including a non-habituating amygdala response (NHAR), may be a useful biomarker for relapse vulnerability and other pathology. This secondary analysis utilized existing fMRI data from a CUD population with (TR-Y,
    Language English
    Publishing date 2022-09-29
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2772-7246
    ISSN (online) 2772-7246
    DOI 10.1016/j.dadr.2022.100098
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Neural correlates of cognitive control in women with a history of sexual violence suggest altered prefrontal cortical activity during cognitive processing

    Laura Sinko / Paul Regier / Adrian Curtin / Hasan Ayaz / Anna Rose Childress / Anne M Teitelman

    Women's Health, Vol

    2022  Volume 18

    Abstract: Objective: Women’s experiences of sexual violence can be not only psychologically and physically traumatizing but may also have lasting effects on brain functions, including cognitive control relating to the inhibition and processing of emotion. Thus, ... ...

    Abstract Objective: Women’s experiences of sexual violence can be not only psychologically and physically traumatizing but may also have lasting effects on brain functions, including cognitive control relating to the inhibition and processing of emotion. Thus, the purpose of this pilot study is to explore underlying neural correlates of sexual violence’s impact on cognitive control in women. Methods: Thirty women (aged 21–30 years) participants underwent a quantitative survey along with an affect-congruent Go-NoGo task. Prefrontal activity was monitored using functional near-infrared spectroscopy, a portable neuroimaging technology. An analysis of variance tested for main effects of the condition (Go versus NoGo), group (sexual violence versus no prior sexual violence), and potential interactions. Results: Fifteen of 30 women reported a history of childhood (n = 5) and/or adult (n = 12) sexual violence. Those with sexual violence histories reported significantly higher depression, anxiety, and posttraumatic stress symptoms, as well as increased impulsivity compared to their peers. Behavioral performance did not differ between the groups; however, functional near-infrared spectroscopy data revealed a significant (group × condition) interaction in Optodes 13 and 16. Women with histories of sexual violence had a significantly lower response during the “NoGo” condition and a heightened response during the “Go” condition, in the right dorsolateral prefrontal cortex. Conclusion: These results suggest altered prefrontal cortical activity during cognitive processing in women with a history of sexual violence, showing hypoactivity during response inhibition and hyperactivity to the positive stimuli. These findings have strong translational promise for innovative assessment and prevention of untoward effects among women with sexual violence.
    Keywords Medicine ; R
    Subject code 150
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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