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cardiac wound

Alexander Meyer, Anne Schilling, Magdalena Kott, Ulrich Rother, Werner Lang, Susanne Regus
BACKGROUND: Evaluation of below-the-knee open revascularization (OR) versus endovascular revascularization (EVT) in patients with end-stage renal disease and critical limb ischemia (CLI) was performed. PATIENTS AND METHODS: Seventy-seven dialysis patients with CLI and infrapopliteal involvement from 2007 to 2017 were included. Thirty-five patients received OR and 42 patients were treated with EVT. Survival, amputation-free survival (AFS) and wound-healing were evaluated...
January 1, 2018: Vascular and Endovascular Surgery
Byron C Drumheller, Deborah M Stein, Thomas M Scalea
BACKGROUND: Correction of hypothermia is a key component of the resuscitation of critically injured patients with hemorrhagic shock who require damage control surgery. External rewarming methods may not be sufficient in this population, while extracorporeal techniques lack widespread feasibility. Intravascular catheter-based temperature modulation is increasingly being employed in different critically ill patient populations but has not been described as part of a damage control resuscitation strategy in trauma patients...
July 8, 2018: Injury
Bandar Al-Ghamdi
Sudden cardiac death (SCD) is a significant health problem worldwide. Multiple randomized controlled trials have shown that implantable cardioverter defibrillators (ICDs) are effective life-saving management option for individuals at risk of SCD in both primary and secondary prevention. Although the conventional transvenous ICDs (TV-ICDs) are safe and effective, there are potential complications associated with its use, including localized pocket or wound infection or systematic infection, a vascular access related complication such as pneumothorax, and venous thrombosis, and lead related complications such as dislodgement, malfunction, and perforation...
July 16, 2018: Current Cardiology Reviews
Ryu Komatsu, Nika Karimi, Nicole M Zimmerman, Daniel I Sessler, C A Bashour, Edward G Soltesz, Alparslan Turan
PURPOSE: To determine whether hypothyroidism is associated with cardiovascular complications and surgical wound infections after cardiac surgery. METHODS: Patients were categorized as: (1) hypothyroid [patients with increased TSH concentrations (≧ 5.5 mIU/L) within 6 months prior to surgery]; (2) corrected hypothyroid [diagnosis of hypothyroidism any time before surgery or on preoperative thyroid supplementation and normal TSH concentration (0.4 [Formula: see text] TSH [Formula: see text] 5...
July 16, 2018: Journal of Anesthesia
Fabian B Fahlbusch, Thomas Heinlein, Manfred Rauh, Sven Dittrich, Robert Cesnjevar, Julia Moosmann, Jennifer Nadal, Matthias Schmid, Frank Muench, Michael Schroth, Wolfgang Rascher, Hans-Georg Topf
OBJECTIVES: Coagulation factor XIII (FXIII) plays a key role in fibrin clot stabilization-an essential process for wound healing following cardiothoracic surgery. However, FXIII deficiency as a risk for post-operative bleeding in pediatric cardiac surgery involving cardiopulmonary bypass (CPB) for congenital heart disease (CHD) is controversially discussed. Thus, as primary outcome measures, we analyzed the association of pre-operative FXIII activity and post-operative chest tube drainage (CTD) loss with transfusion requirements post-operatively...
2018: PloS One
Sally Temraz, Hani Tamim, Aurelie Mailhac, Ali Taher
Background: Hyponatremia is common among patients with pulmonary embolism, while hypernatremia increases the risk of venous thromboembolism (VTE). Our objective was to evaluate the association between sodium imbalances and the incidence of VTE and other selected perioperative outcomes. Methods: We conducted a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and identified 1,108,704 patients undergoing major surgery from 2008 to 2012...
2018: Thrombosis Journal
Yana Wang, Jiali Liu, Qiuyue Kong, Hao Cheng, Fei Tu, Peng Yu, Ying Liu, Xiaojin Zhang, Chuanfu Li, Yuehua Li, Xinxu Min, Shuya Du, Zhengnian Ding, Li Liu
Aim: Inadequate healing after myocardial infarction (MI) leads to heart failure and fatal ventricular rupture, while optimal healing requires timely induction and resolution of inflammation. This study tested the hypothesis that heat shock protein B1 (HSPB1), which limits myocardial inflammation during endotoxemia, modulates wound healing after MI. Methods and results: To test this hypothesis, cardiomyocyte-specific HSPB1 knockout (Hspb1-/-) mice were generated using the Cre-LoxP recombination system...
July 2, 2018: Cardiovascular Research
Jing Xiao, Ting Zhu, Yue-Zhang Yin, Bing Sun
Notoginsenoside R1, a unique constituent from the root of Panax notoginseng, exerts anti-inflammatory, anti-oxidative and anti-apoptotic properties. The purpose of this study was to assess the contribution of the anti-inflammatory effects of R1 to the amelioration of isoproterenol (ISO)-induced hypertrophied hearts of atherosclerosis-prone mice. As a model of in vivo atherosclerosis, ApoE-/- C57BL/6J mice were fed a high-cholesterol diet for 12 weeks. Intraperitoneal injection of R1 (1-50mg/kg/day) or saline for 7 days was followed by continuous infusion with ISO (25mg/kg/day) for 14 days to experimentally induce heart hypertrophy...
July 5, 2018: European Journal of Pharmacology
Jacob M Wilson, Russell E Holzgrefe, Christopher A Staley, Mara L Schenker, Clifton G Meals
PURPOSE: Compared with cast treatment, surgery may expose patients with distal radius fractures to undue risk. Surgical intervention in this cohort may offer less benefit than previously thought and appropriate patient selection is imperative. The modified Frailty Index (mFI) predicts complications after other orthopedic surgeries. We hypothesized that this index would predict, and might ultimately prevent, complications in patients older than 50 years with distal radius fractures. METHODS: We retrospectively reviewed the American College of Surgeons-National Surgery Quality Improvement Program (ACS-NSQIP) database, including patients older than 50 years who underwent open reduction and internal fixation of a distal radius fracture...
July 3, 2018: Journal of Hand Surgery
C Groleau, S N Morin, L Vautour, A Amar-Zifkin, A Bessissow
Background: Perioperative administration of corticosteroid is common and variable. Guidelines for perioperative corticosteroid administration before non-cardiac non-transplant surgery in patients with current or previous corticosteroid use to reduce the risk of adrenal insufficiency are lacking. Perioperative use of corticosteroid may be associated with serious adverse events, namely hyperglycemia, infection, and poor wound healing. Objective: To determine whether perioperative administration of corticosteroids, compared to placebo or no intervention, reduces the incidence of adrenal insufficiency in adult patients undergoing non-cardiac surgery who were or are exposed to corticosteroids...
2018: Perioperative Medicine
Ola Hammarsten, Johannes Mair, Martin Möckel, Bertil Lindahl, Allan S Jaffe
Cardiac-specific troponins are elevated in blood following cardiac injury and are the preferred diagnostic biomarkers when acute myocardial infarction is suspected clinically. Cardiac troponin elevations are also observed in clinical conditions without obvious connection to cardiac injury. Irrespective of the underlying condition, cardiac troponin elevation is linked to a poor prognosis, even if the elevation is stable over time. Here, we explore mechanisms that may lead to cardiac troponin elevations, including necrosis, apoptosis, necroptosis, cell wounds and decreased clearance...
July 6, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
Kai B Kaufmann, Sebastian Heinrich, Hans Felix Staehle, Lioudmila Bogatyreva, Hartmut Buerkle, Ulrich Goebel
BACKGROUND: Postoperative complications after lung surgery are frequent, having a detrimental effect on patients' further course. Complications may lead to an increased length of hospital stay and cause additional costs. Several risk factors have been identified but it is still difficult to predict contemporary which patients are at risk. We hypothesized that patients who show an increased inflammatory response at the time of wound closure and 24 hours after surgery are at risk of postoperative complications within 30 days after surgery...
2018: PloS One
Kohsuke Shirakawa, Jin Endo, Masaharu Kataoka, Yoshinori Katsumata, Naohiro Yoshida, Tsunehisa Yamamoto, Sarasa Isobe, Hidenori Moriyama, Shinichi Goto, Hiroki Kitakata, Takahiro Hiraide, Keiichi Fukuda, Motoaki Sano
Background -Both osteopontin (OPN) and galectin-3 have been implicated in phagocytic clearance of dead cells and reparative fibrosis during wound healing. CD206+ macrophages are involved in tissue repair through phagocytosis and fibrosis after myocardial infarction (MI). However, the relationship among OPN, galectin-3 and macrophage polarization in the context of MI remains unclear. Methods -The time course of Spp1 (encoding OPN) expression in the heart after MI showed a strong activation of Spp1 on day 3 after MI...
July 2, 2018: Circulation
Hannah Copeland, Jennifer Newcombe, Feras Yamin, Khaled Bhajri, Vanessa Ayer Mille, Nahidh Hasaniya, Leonard Bailey, Anees J Razzouk
BACKGROUND: Sternal wound infections after pediatric cardiac surgery are uncommon but can be morbid. METHODS: We describe an institutional protocol for complicated sternal wounds utilizing hyperbaric oxygen therapy (HBO) and negative pressure wound therapy (NPWT). PARTICIPANTS: A retrospective chart review (2001-2013) of 4,028 pediatric cardiac operations in 3,264 patients less than 18 years of age. RESULTS: Fifty-three patients (1...
July 2018: World Journal for Pediatric & Congenital Heart Surgery
Mofiyinfolu Sokoya, Arash Bahrami, Aurora Vincent, Sameep Kadakia, Jared Inman, Masoud Saman, Yadranko Ducic
INTRODUCTION: In this study, we explore whether preoperative external beam radiation affects complication rates in patients that have undergone double simultaneous free tissue transfer for head and neck defects. STUDY DESIGN, SETTING, SUBJECTS AND METHODS: Approval was obtained from the JPS Institutional Review Board. We performed a retrospective analysis of patients who underwent double free flap reconstruction of head and neck defects between August 1997 and April 2017...
June 18, 2018: American Journal of Otolaryngology
Charlotte B Thorup, Mette Hougaard, Pernille F Blindum, Erik E Sørensen
Surgical site infections that develop after vascular and cardiac surgery are often treated with Negative Pressure Wound Therapy (NPWT). Due to the severity of the infection and risk of bleeding, this NPWT often requires hospitalisation. Fourteen patients were selected for qualitative interviews to investigate their experiences and the meaning of patient participation during hospitalisation with NPWT. Results show that hospitalisation induces tension between an intrusion of privacy and being part of a community...
June 21, 2018: International Wound Journal
Danah S Al-Hattab, Hamza A Safi, Raghu S Nagalingam, Rushita A Bagchi, Matthew Taras Stecy, Michael Paul Czubryt
Numerous physiological and pathological events, from organ development to cancer and fibrosis, are characterized by Epithelial-to-Mesenchymal Transition (EMT), whereby adherent epithelial cells convert to migratory mesenchymal cells. During cardiac development, pro-epicardial organ epithelial cells undergo EMT to generate fibroblasts. Subsequent stress or damage induces further phenotype conversion of fibroblasts to myofibroblasts, causing fibrosis via synthesis of excessive extracellular matrix. We previously showed that the transcription factor scleraxis is both sufficient and necessary for the conversion of cardiac fibroblasts to myofibroblasts, and found that scleraxis knockout reduced cardiac fibroblast number by 50%, possibly via EMT attenuation...
June 15, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Jeffrey S Kroin, Jinyuan Li, Sasha Shafikhani, Kajal H Gupta, Mario Moric, Asokumar Buvanendran
BACKGROUND AND OBJECTIVES: Infected implantable devices represent a clinical challenge, because the customary option is to surgically remove the device, and that is associated with substantial cost and morbidity to the patient, along with patient dissatisfaction with the physician. Although prophylactic systemic antibiotics and sterile technique are the mainstay of prevention of surgical site infection (SSI) after implant, the incidence of SSI remains relatively high. Although some surgeons add local antibiotic at implant site during surgery, there is no scientific research to demonstrate if there is a benefit...
June 13, 2018: Regional Anesthesia and Pain Medicine
Giuseppe Gatti, Gianluca Castaldi, Laura Morra, Gabriella Forti, Bernardo Benussi, Gianfranco Sinagra, Aniello Pappalardo
BACKGROUND: Bilateral internal thoracic artery (BITA) grafting is underused in women. METHODS: Outcomes of 798 consecutive women with multivessel coronary disease who underwent isolated coronary surgery (1999-2016) using BITA (n=530, 66.4%) or single internal thoracic artery (SITA) grafting (n=268, 33.6%) were reviewed retrospectively. Differences between BITA and SITA cohort were adjusted by propensity score matching. For both series, late survival was estimated with the Kaplan-Meier method...
September 1, 2018: International Journal of Cardiology
Charles D Fraser, Joshua C Grimm, Rui Han Liu, Russell N Wesson, Faris Azar, Robert J Beaulieu, Thomas Reifsnyder
INTRODUCTION: Renal transplant recipients often maintain their hemodialysis access in the event of future allograft failure. Patients may develop complications related to the unused dialysis access and it also limits vein availability for phlebotomy. Accordingly, a change in the current paradigm may be warranted. This study evaluates the indications for, and safety of, arteriovenous fistula (AVF) removal in patients following successful renal transplantation. METHODS: All patients that underwent AVF excision at a single institution from 2006-2016 were retrospectively reviewed...
June 7, 2018: Annals of Vascular Surgery
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