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Fuller MC, Carlson SF, Grant C, Berry V, Ivancich M, Cornett EM, Kaye AM, Viswanath O, Urits I, Shekoohi S, Kaye AD. A Comprehensive Review of Lemborexant to Treat Insomnia. Psychopharmacol Bull 2024; 54:43-64. [PMID: 38449475 PMCID: PMC10913865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Purpose of Review This is a comprehensive review of the literature regarding Lemborexant for the treatment of insomnia. It covers the background and management of insomnia and then reviews the body of existing evidence evaluating the use of Lemborexant for this purpose. Recent Findings Insomnia leads to significant decreased in quality of life and economic burden due to decreased workplace performance and increased health care costs. Insomnia manifests as a single common pathway of hyperarousal due to a highly complex network of interactions between activation of the sympathetic system and the endocrine system. Lemborexant is a dual orexin 1/2 antagonist that blocks cortical arousal and promotes sleep state transition. Lemborexant was approved by the FDA in 2019 for use in insomnia. It belongs to a class of orexin neuropeptide inhibitors that is growing in popular clinical application. Summary Insomnia is a crippling disorder of the sleep wake cycle that drives significant morbidity and mortality in the United States. It carries a high societal and economic toll due to direct and indirect effects to the healthcare system. Lemborexant is a new addition to the orexin antagonist class of drugs that already includes Almorexant and Suvorexant that has superior pharmacokinetic properties. While Lemborexant does have a mild side effect profile, its clinical safety and efficacy make it a promising insomnia drug of the future.
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Affiliation(s)
- Mitchell C Fuller
- Fuller, MD, Dartmouth School of Medicine, Department of Anesthesiology, Hanover, NH
| | - Samuel F Carlson
- Carlson, MD, University of Iowa, Department of Surgery, Iowa City, IA
| | - Chris Grant
- Grant, MD, University of California, Irvine, Department of Internal Medicine, Irvine, CA
| | - Vince Berry
- Berry, MD, University of Chicago, Department of Anesthesiology, Chicago, IL
| | - Marko Ivancich
- Ivancich, MD, Cape Fear Valley Health, Department of Psychiatry, Fayetteville, NC
| | - Elyse M Cornett
- Cornett, PhD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport LA
| | - Adam M Kaye
- Kaye, Pharm D, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA
| | - Omar Viswanath
- Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport LA; University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE
| | - Ivan Urits
- Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport LA
| | - Sahar Shekoohi
- Shekoohi, PhD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport LA
| | - Alan D Kaye
- Kaye, MD, PhD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport LA
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Sow M, Seadler BD, Chandratre SR, Koratala A, Carlson SF, Joyce LD, Kohmoto T, Durham LA, Joyce DL. Supporting the right ventricle in postcardiotomy renal dysfunction: A case series. Clin Case Rep 2023; 11:e7695. [PMID: 37465241 PMCID: PMC10350664 DOI: 10.1002/ccr3.7695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/05/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
Postcardiotomy RV dysfunction is an under-recognized cause of acute kidney injury (AKI). Insertion of a percutaneous right ventricular assist device (RVAD) reduces central venous hypertension and congestive nephropathy by augmenting cardiac output. In selected patients, percutaneous RVAD insertion may improve renal function and obviate the need for long-term dialysis.
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Affiliation(s)
- Mami Sow
- Medical College of WisconsinMilwaukeeWisconsinUSA
| | - Benjamin D. Seadler
- Division of Cardiothoracic SurgeryFroedtert & Medical College of WisconsinMilwaukeeWisconsinUSA
| | - Sonal R. Chandratre
- Department of Pediatric EndocrinologyAspirus HealthStevens PointWisconsinUSA
| | - Abhilash Koratala
- Division of NephrologyFroedtert & Medical College of WisconsinMilwaukeeWisconsinUSA
| | | | - Lyle D. Joyce
- Division of Cardiothoracic SurgeryFroedtert & Medical College of WisconsinMilwaukeeWisconsinUSA
| | - Takushi Kohmoto
- Division of Cardiothoracic SurgeryFroedtert & Medical College of WisconsinMilwaukeeWisconsinUSA
| | - Lucian A. Durham
- Division of Cardiothoracic SurgeryFroedtert & Medical College of WisconsinMilwaukeeWisconsinUSA
| | - David L. Joyce
- Division of Cardiothoracic SurgeryFroedtert & Medical College of WisconsinMilwaukeeWisconsinUSA
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Carlson SF, Kamalia MA, Zimmerman MT, Urrutia RA, Joyce DL. The current and future role of artificial intelligence in optimizing donor organ utilization and recipient outcomes in heart transplantation. HVT 2022. [DOI: 10.24969/hvt.2022.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Heart failure (HF) is a leading cause of morbidity and mortality in the United States. While medical management and mechanical circulatory support have undergone significant advancement in recent years, orthotopic heart transplantation (OHT) remains the most definitive therapy for refractory HF. OHT has seen steady improvement in patient survival and quality of life (QoL) since its inception, with one-year mortality now under 8%. However, a significant number of HF patients are unable to receive OHT due to scarcity of donor hearts. The United Network for Organ Sharing has recently revised its organ allocation criteria in an effort to provide more equitable access to OHT. Despite these changes, there are many potential donor hearts that are inevitably rejected. Arbitrary regulations from the centers for Medicare and Medicaid services and fear of repercussions if one-year mortality falls below established values has led to a current state of excessive risk aversion for which organs are accepted for OHT. Furthermore, non-standardized utilization of extended criteria donors and donation after circulatory death, exacerbate the organ shortage. Data-driven systems can improve donor-recipient matching, better predict patient QoL post-OHT, and decrease needless organ waste through more uniform application of acceptance criteria. Thus, we propose a data-driven future for OHT and a move to patient-centric and holistic transplantation care processes.
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Kamalia MA, Carlson SF, Melamed J, Ubert A, Rossi PJ, Durham LA. Adhered ECMO cannula in COVID-19 related severe acute respiratory failure. J Cardiothorac Surg 2022; 17:263. [PMID: 36209244 PMCID: PMC9547677 DOI: 10.1186/s13019-022-02004-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Crescent cannula adhesion in the setting of COVID-19 respiratory failure requiring extracorporeal membrane oxygenation (ECMO) support is a novel complication. The objective of this case presentation is to highlight this rare complication and to explore potential predisposing factors and our management strategies. Case presentation We present the case of a 25 y.o. patient with COVID-19 respiratory failure requiring ECMO support for 16-days in which a 32 Fr crescent cannula became adherent to the SVC and proximal jugular vein. Attempts to remove the cannula at the bedside failed due to immobility of the cannula. Ultrasound of the right neck was unremarkable, so he was taken to the hybrid OR where both TEE and fluoroscopy were unrevealing. An upper sternotomy was performed, and the superior vena cava and proximal jugular vein were dissected revealing a 2 cm segment of the distal SVC and proximal jugular vein that was densely sclerosed and adherent to the cannula. The vessel was opened across the adherent area at the level of the innominate vein and the cannula was then able to be withdrawn. The patient suffered no ill effects and had an unremarkable recovery to discharge. Conclusions To date, there have been no reports of crescent cannula adhesion related complications. In patients with COVID-19 respiratory failure requiring ECMO, clinicians should be aware of widespread hypercoagulability and the potential of unprovoked, localized venous sclerosis and cannula adhesion. We report our technique of decannulation in the setting of cannula adhesion and hope that presentation will shed further light on this complication allowing clinicians to optimize patient care.
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Affiliation(s)
| | | | - Joshua Melamed
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, HUB for Collaborative Medicine, 5th Floor, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA.
| | - Adam Ubert
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, HUB for Collaborative Medicine, 5th Floor, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA
| | - Peter J Rossi
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Lucian A Durham
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, HUB for Collaborative Medicine, 5th Floor, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA
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Carlson SF, Smith NJ, Brown C, Joyce LD, Joyce DL. Right ventricle pressure-volume loops for monitoring right ventricular function in left ventricular assist device patient. Artif Organs 2021; 46:509-512. [PMID: 34799868 DOI: 10.1111/aor.14118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/11/2021] [Accepted: 11/03/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | - Nathan J Smith
- Division of Cardiothoracic Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Colton Brown
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lyle D Joyce
- Division of Cardiothoracic Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - David L Joyce
- Division of Cardiothoracic Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Autry JM, Karim CB, Cocco M, Carlson SF, Thomas DD, Valberg SJ. Purification of sarcoplasmic reticulum vesicles from horse gluteal muscle. Anal Biochem 2020; 610:113965. [PMID: 32956693 DOI: 10.1016/j.ab.2020.113965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/24/2020] [Accepted: 09/14/2020] [Indexed: 01/09/2023]
Abstract
We have analyzed protein expression and enzyme activity of the sarcoplasmic reticulum Ca2+-transporting ATPase (SERCA) in horse gluteal muscle. Horses exhibit a high incidence of recurrent exertional rhabdomyolysis, with myosolic Ca2+ proposed, but yet to be established, as the underlying cause. To better assess Ca2+ regulatory mechanisms, we developed an improved protocol for isolating sarcoplasmic reticulum (SR) vesicles from horse skeletal muscle, based on mechanical homogenization and optimized parameters for differential centrifugation. Immunoblotting identified the peak subcellular fraction containing the SERCA1 protein (fast-twitch isoform). Gel analysis using the Stains-all dye demonstrated that calsequestrin (CASQ) and phospholipids are highly enriched in the SERCA-containing subcellular fraction isolated from horse gluteus. Immunoblotting also demonstrated that these horse SR vesicles show low content of glycogen phosphorylase (GP), which is likely an abundant contaminating protein of traditional horse SR preps. The maximal Ca2+-activated ATPase activity (Vmax) of SERCA in horse SR vesicles isolated using this protocol is 5‒25-fold greater than previously-reported SERCA activity in SR preps from horse skeletal muscle. We propose that this new protocol for isolating SR vesicles will be useful for determining enzymatic parameters of horse SERCA with high fidelity, plus assessing regulatory effect of SERCA peptide subunit(s) expressed in horse muscle.
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Affiliation(s)
- Joseph M Autry
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - Christine B Karim
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Mariana Cocco
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, 55108, USA
| | - Samuel F Carlson
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, 55455, USA
| | - David D Thomas
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Stephanie J Valberg
- Department of Large Animal Clinical Sciences, McPhail Equine Performance Center, Michigan State University, East Lansing, MI, 48823, USA.
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Carlson SF, Autry JM, Li J, Aihara H, Cornea RL, Thomas DD. Structural Mechanism For Small-molecule Activation Of The Serca Calcium Pump In Muscular Dystrophy. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000537209.55925.f4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Carlson SF, McCracken W, Hecht S. Sacral Stress Fracture in a Collegiate Distance Runner. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000517406.57430.7c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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