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cardiac wound

Wenfeng Cai, Shuping Zhong, Fuchun Zheng, Yanmei Zhang, Fenfei Gao, Hongquan Xu, Xiangna Cai, Junhong Lan, Danmei Huang, Ganggang Shi
Myofibroblast apoptosis is essential for normal resolution of wound repair, including cardiac infarction repair. Impaired cardiac myofibroblast (CMF) apoptosis is associated with excessive extracellular matrix (ECM) deposition, which could be responsible for pathological cardiac fibrosis. Conventionally, angiotensin II (Ang II), a soluble peptide, is implicated in fibrogenesis because it induces cardiac fibroblast (CFb) proliferation, differentiation, and collagen synthesis. However, the role of Ang II in regulation of CMF survival and apoptosis has not been fully clarified...
November 19, 2018: IUBMB Life
Cole A Bortz, Peter G Passias, Frank A Segreto, Samantha R Horn, Renaud Lafage, Justin S Smith, Breton G Line, Gregory M Mundis, Michael P Kelly, Paul Park, Daniel M Sciubba, D Kojo Hamilton, Jeffrey L Gum, Douglas C Burton, Robert A Hart, Frank J Schwab, Shay Bess, Christopher Shaffrey, Eric O Klineberg
STUDY DESIGN: This is a retrospective review of prospective multicenter cervical deformity (CD) database. OBJECTIVE: Assess the impact of complication type and Clavien complication (Cc) grade on clinical outcomes of surgical CD patients BACKGROUND:: Validated for general surgery, the Clavien-Dindo complication classification system allows for broad comparison of postoperative complications; however, the applicability of this system is unclear in CD-specific populations...
November 16, 2018: Clinical Spine Surgery
Hinglaj Saha, Dipak Ghosh, Tapanjyoti Ghosh, Shibshankar Burman, Kaushik Saha
Context and Aim: The aim of this study is to highlight the rarity of this disorder and its associated anomalies and our objective was to review our experience in the management of colonic atresia (CA) with respect to staged surgery versus one-step procedure for a better outcome of the disease. Settings and Design: A randomized, controlled, single-center study conducted over a period of 4 years from October 2013 to 2017. Subjects and Methods: Nine cases were operated for CA of which three underwent primary anastomosis and six underwent initial colostomy followed by definitive surgery...
October 2018: Journal of Indian Association of Pediatric Surgeons
Mathew Wooster, Blake Fernandez, Kelli L Summers, Karl A Illig
BACKGROUND: Subclavian vein stenosis or occlusion at the thoracic outlet is a problem associated with certain anatomic and environmental stresses (venous thoracic outlet syndrome [VTOS]), the presence of central venous catheters, and the high flows associated with arteriovenous (AV) access in the limb. We describe our experience with open and endovascular techniques for restoring patency in highly symptomatic patients. METHODS: A prospectively collected database of patients was queried for patients treated for central venous obstructive disease in the setting of highly symptomatic VTOS and ipsilateral AV access from October 2011 to August 2016...
November 12, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
T Jínek, L Adamčík, R Vrba, M Duda, M Škrovina
INTRODUCTION: Gastric resections due to carcinoma belong to the most demanding procedures in visceral surgery. This is due to the requirements for the extent of resection and lymphadenectomy, coupled with the need for functional reconstruction of the digestive tract. The procedure is associated with 18-46% morbidity, which delays administration of adjuvant therapy and worsens oncological results. Identification of risk factors for potential complications may play an important role in the indication and perioperative care...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Anders Winther Voldby, Anne Albers Aaen, Ann Merete Møller, Birgitte Brandstrup
INTRODUCTION: Intravenous fluid therapy during gastrointestinal surgery is a life-saving part of the perioperative care. Too little fluid may lead to hypovolaemia, decreased organ perfusion and circulatory shock. Excessive fluid administration increases postoperative complications, worsens pulmonary and cardiac function as well as the healing of surgical wounds. Intraoperative individualised goal-directed fluid therapy (GDT) and zero-balance therapy (weight adjusted) has shown to reduce postoperative complications in elective surgery, but studies in urgent gastrointestinal surgery are sparse...
November 13, 2018: BMJ Open
Marco A Zenati, Deepak L Bhatt, Faisal G Bakaeen, Eileen M Stock, Kousick Biswas, J Michael Gaziano, Rosemary F Kelly, Elaine E Tseng, Jerene Bitondo, Jacquelyn A Quin, G Hossein Almassi, Miguel Haime, Brack Hattler, Ellen DeMatt, Alexandra Scrymgeour, Grant D Huang
BACKGROUND: The saphenous-vein graft is the most common conduit for coronary-artery bypass grafting (CABG). The influence of the vein-graft harvesting technique on long-term clinical outcomes has not been well characterized. METHODS: We randomly assigned patients undergoing CABG at 16 Veterans Affairs cardiac surgery centers to either open or endoscopic vein-graft harvesting. The primary outcome was a composite of major adverse cardiac events, including death from any cause, nonfatal myocardial infarction, and repeat revascularization...
November 11, 2018: New England Journal of Medicine
Massimo Bonacchi, Edvin Prifti, Marco Bugetti, Orlando Parise, Guido Sani, Daniel M Johnson, Francesco Cabrucci, Sandro Gelsomino
Background: The incidence and potential factors influencing deep sternal wound infection (DSWI) in a cohort of patients undergoing coronary artery bypass grafting (CABG) using skeletonized bilateral internal thoracic artery (BITA) was explored. Furthermore, we studied influence of DSWI on long-term survival, major adverse cardiac events (MACEs) and repeat coronary revascularization (RCR). Methods: The study cohort consisted of 1,325 consecutive patients who were divided in two groups: patients experiencing DSWI (n=33, group 1) and those who did not have sternal infection (n=1,292, group 2)...
September 2018: Journal of Thoracic Disease
Rebecca J Richardson
The cellular events that contribute to tissue healing of non-sterile wounds to the skin and ischaemic injury to internal organs such as the heart share remarkable similarities despite the differences between these injury types and organs. In adult vertebrates, both injuries are characterised by a complex series of overlapping events involving multiple different cell types and cellular interactions. In adult mammals both tissue-healing processes ultimately lead to the permanent formation of a fibrotic, collagenous scar, which can have varying effects on tissue function depending on the site and magnitude of damage...
2018: NPJ Regenerative Medicine
Charles L Nelson, Atul F Kamath, Nabil M Elkassabany, Zhenggang Guo, Jiabin Liu
INTRODUCTION: Low serum albumin is associated with higher perioperative complications following total hip arthroplasty (THA). The distinct threshold for a significant rise in perioperative complications has not been defined for THA. The purpose of this study was to define the threshold at which perioperative complications rise after THA. METHODS: We analysed the American College of Surgeons NSQIP database from 2006 to 2013. Our study cohort included unilateral primary THA with reported preoperative albumin levels...
November 11, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Tyler J Murphy, Kevin S Murnane
Anesthesia-Induced Hypothermia (AIH) has been reported to be the cause of many postoperative adverse effects, including increased mortality, decreased immune responses, cardiac events, and a greater prevalence of postoperative surgical wound infections. AIH can in some cases be minimized with pre-warming fluids and gases and forced-air heating systems, but such techniques are not always effective and can result in patient burns or other adverse effects. Stimulation of 5-HT2 receptors has been reported to increase body temperature through a variety of mechanisms, and as such, may be a viable target for pharmacologically minimizing AIH...
November 6, 2018: European Journal of Pharmacology
Imelda Ontoria-Oviedo, Akaitz Dorronsoro, Rafael Sánchez, Maria Ciria, Marta Gómez-Ferrer, Marc Buigues, Elena Grueso, Sandra Tejedor, Francisco García-García, Hernán González-King, Nahuel A Garcia, Esteban Peiró-Molina, Pilar Sepúlveda
Extracellular vesicles (EVs) are small membrane vesicles secreted by most cell types with important roles in cell-to-cell communication. To assess their relevance in the context of heart ischemia, EVs isolated from the AC10 ventricular cardiomyocyte cell line (CM-EVs), exposed to normoxia (Nx) or hypoxia (Hx), were incubated with fibroblasts (Fb) and endothelial cells (EC). CM-EVs were studied using electron microscopy, nanoparticle tracking analysis (NTA), western blotting and proteomic analysis. Results showed that EVs had a strong preference to be internalized by EC over fibroblasts, suggesting an active exosome-based communication mechanism between CM and EC in the heart...
2018: Frontiers in Cardiovascular Medicine
Jijun Shang, Jeanne Corriveau, Alexandre Champoux-Jenane, Julie Gagnon, Emmanuel Moss, Pierre Dumas, Eric Gaudreau, Jonathan Chevrier, Lorraine E Chalifour
Bisphenols and phthalates leach from medical devices, and this exposure is likely to increase in post-cardiac surgery patients. Previous studies suggest that such chemical exposure may impact recovery and wound healing, yet the direct effects of bisphenols and phthalates are unknown in this context. To study the direct effect of clinically based chemical exposures, we measured the metabolites representative of six bisphenols and ten phthalates in men before and after cardiac surgery and then replicated this exposure in a mouse model of cardiac surgery and assessed survival, cardiac function and inflammation...
November 6, 2018: Toxicological Sciences: An Official Journal of the Society of Toxicology
Mustafa Serkan Durdu, Çağdaş Baran, Fatih Gümüş, Gökay Deniz, Mehmet Çakıcı, Evren Özçınar, Ahmet Onat Bermede, Kemalettin Uçanok, Ahmet Rüçhan Akar
OBJECTIVE: All innovations in cardiac surgery provide us with new techniques to perform surgery through smaller incisions with less invasive and best cosmetic results. After promising results in minimally invasive cardiac surgery (MICS), pain and cosmetic appearance became important end points, especially for female patients. In the current study, we intended to evaluate the surgical results and cosmetic satisfaction with the periareolar and submammary incision types in cardiac surgery...
November 2018: Anatolian Journal of Cardiology
Yung-Ming Chang, Shanmugam Tamilselvi, Hung-Jen Lin, Chin-Chuan Tsai, Yueh-Min Lin, Cecilia Hsuan Day, Vijaya Padma Viswanadha, Hsin-Nung Chang, Wei-Wen Kuo, Chih-Yang Huang
Cardiac fibrosis is a common pathophysiological process observed during chronic and stress-induced acceleration of cardiac aging. Fibrosis is a necessary process during wound healing and tissue repair. However, its deposition in organs would proceed to scarring and organ damage. Here Alpinate Oxyphyllae Fructus (AOF), a Chinese medicine extract was used to protect aging heart from collagen accumulation. About 8 weeks old, male SD rats were randomly divided into (i) Control, (ii) D-galactose induced aging (IA), (iii) IA + AOF 50 (AOF low, AL), (iv) IA + AOF 100 (AOF medium, AM), (v) IA + AOF 150 (AOF high, AH) mg/kg/day, AOF was administered orally...
October 27, 2018: Environmental Toxicology
Adham Elmously, Katherine D Gray, Fabrizio Michelassi, Cheguevara Afaneh, Michael D Kluger, Arash Salemi, Anthony C Watkins, Alfons Pomp
BACKGROUND: The Association of Operation Room Nurses (AORN) released new guidelines for operating room attire in 2015 in an attempt to reduce surgical site infections (SSI). These guidelines have been adopted by the Centers for Medicare and Medicaid Services. We aimed to assess the relationship between operating room attire, SSI, and healthcare costs. STUDY DESIGN: In March 2016, our center introduced the AORN attire policy. National Health Safety Network data from our hospital was collected on general surgery, cardiac, neurosurgery, orthopedic, and gynecology procedures from January 2014 to November 2017...
July 5, 2018: Journal of the American College of Surgeons
Jen Ming Yang, Olajire Samson Olanrele, Xing Zhang, Chih Chin Hsu
Hydrogels are three-dimensional hydrophilic polymeric networks that can be made from a wide range of natural and synthetic polymers. This review discusses recent advanced engineering methods to fabricate hydrogels for biomedical applications with emphasis in cardiac constructs and wound healing. Layer-by-Layer (LbL) assembly offers a tissue-engineered construct with robust and highly ordered structures for cell proliferation and differentiation. Three-dimensional printings, including inkjet printing, fused deposition modeling, and stereolithographic apparatus, have been widely employed to fabricate complex structures (e...
2018: Advances in Experimental Medicine and Biology
Ahmed M Al-Mazrou, James M Kiely, Ravi P Kiran
BACKGROUND: Previous assessments of the impact of epidural analgesia (EA) on outcomes after colorectal surgery were related to the period before widespread implementation of the enhanced recovery after surgery (ERAS) protocols. This study evaluates the impact of EA on postoperative recovery after colectomy using recent multicenter data. METHODS: Patients who underwent elective colectomy from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) data (2014-2015) were identified...
October 23, 2018: Surgical Endoscopy
Jun S Kim, Varun Arvind, Eric K Oermann, Deepak Kaji, Will Ranson, Chierika Ukogu, Awais K Hussain, John Caridi, Samuel K Cho
STUDY DESIGN: Cross-sectional database study. OBJECTIVE: To train and validate machine learning models to identify risk factors for complications following surgery for adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA: Machine learning models such as logistic regression (LR) and artificial neural networks (ANNs) are valuable tools for analyzing and interpreting large and complex data sets. ANNs have yet to be used for risk factor analysis in orthopedic surgery...
November 2018: Spine Deformity
James R Gregory, June C Smith, Sarah M Brown-Riley, Alexis M Elward, Scott J Luhmann
STUDY DESIGN: Prospective consecutively enrolled cohort. OBJECTIVES: To evaluate paraspinal muscle concentration of intravenously administered vancomycin, at predetermined time points, during posterior spinal fusion (PSF) with instrumentation in neuromuscular scoliosis (NMS). SUMMARY: Surgical site infection (SSI) after PSF for NMS can be a devastating complication, which may lead to prolonged antibiotic use, multiple additional surgical procedures, pseudarthroses, and sepsis...
November 2018: Spine Deformity
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