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https://www.readbyqxmd.com/read/29778609/emergency-department-utilization-after-lower-extremity-bypass-for-critical-limb-ischemia
#1
Vangelina Osteguin, Thomas W Cheng, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Stephen J Raulli, Jeffrey J Siracuse
OBJECTIVES: Patients with critical limb ischemia (CLI) utilize hospital resources at high rates. One major driver for resource utilization are Emergency Department (ED) visits. Our goal was to assess perioperative ED visits after lower extremity bypass (LEB) for CLI. METHODS: All patients undergoing LEB for CLI from 2008 to 2017 at our institution were analyzed. Emergency department visits and details of the visit within 30 and 90 days of discharge from index admission were recorded...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29778340/prospective-randomized-controlled-trial-of-polymer-cable-ties-versus-standard-wire-closure-of-midline-sternotomy
#2
Silvana F Marasco, Louise Fuller, Adam Zimmet, David McGiffin, Michael Seitz, Stephanie Ch'ng, Shivanand Gangahanumaiah, Michael Bailey
OBJECTIVE: Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. Wires are well known to stretch and break, however, leading to pain, nonunion, and potential deep sternal wound infection. We hypothesized that biocompatible plastic cable ties would achieve a more rigid sternal fixation, reducing postoperative pain and analgesia requirements. METHODS: A prospective, randomized study compared the ZIPFIX (De Puy Synthes, West Chester, Pa) sternal closure system (n = 58) with standard stainless steel wires (n = 60)...
April 16, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29758209/bilateral-internal-mammary-artery-utilization-in-diabetics-friend-or-foe
#3
Todd C Crawford, Xun Zhou, Charles D Fraser, J Trent Magruder, Alejandro Suarez-Pierre, Diane Alejo, Jennifer Bobbitt, Clifford E Fonner, Kurt Wehberg, Brad Taylor, Christopher Kwon, Michael Fiocco, John V Conte, Rawn Salenger, Glenn J Whitman
BACKGROUND: Bilateral internal mammary artery (BIMA) grafting in diabetic patients undergoing coronary artery bypass grafting (CABG) remains controversial. Our study compared morbidity and mortality between 1)diabetic and non-diabetic BIMA patients and 2)diabetic BIMA versus diabetic patients who underwent left internal mammary artery (LIMA) grafting only. METHODS: Patients who underwent isolated CABG from July 2011 - June 2016 at any of the 10 centers in Maryland were propensity scored across 16 variables...
May 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29753817/arch-augmentation-via-median-sternotomy-for-coarctation-of-aorta-with-proximal-arch-hypoplasia
#4
W Hampton Gray, Winfield J Wells, Vaughn A Starnes, S Ram Kumar
BACKGROUND: Coarctation of the aorta can be associated with hypoplasia of the proximal transverse aortic arch. One approach to manage this condition is via left thoracotomy and extended end-to-end anastomosis with the expectation that the proximal arch will grow over time. Our preferred approach is to augment the aorta via midline sternotomy. We hypothesized that this approach is safe, durable and allows reliable growth of the aorta. METHODS: We identified the records of patients with biventricular anatomy who had coarctation of the aorta, hypoplasia of the proximal transverse arch, and no other cardiac lesion that would mandate cardiopulmonary bypass use and midline sternotomy...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29752454/assigning-matrix-metalloproteinase-roles-in-ischaemic-cardiac-remodelling
#5
REVIEW
Merry L Lindsey
Matrix metalloproteinases (MMPs) and their endogenous inhibitors have been studied in the myocardium for the past 2 decades. An incomplete knowledge base and experimental design issues with inhibitors have hampered attempts at translation, but clinical interest remains high because of strong associations between MMPs and outcomes after myocardial infarction (MI) as well as mechanistic studies showing MMP involvement at multiple stages of the MI wound-healing process. This Review focuses on how our understanding of MMPs has evolved from a one-dimensional early focus on measuring MMP activity, monitoring MMP:inhibitor ratios, and evaluating one MMP-substrate pair to the current use of systems biology approaches to integrate the whole MMP repertoire of roles in the left ventricular response to MI...
May 11, 2018: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/29750994/regulation-of-cardiac-fibroblast-mmp2-gene-expression-by-scleraxis
#6
Raghu S Nagalingam, Hamza A Safi, Danah S Al-Hattab, Rushita A Bagchi, Natalie M Landry, Ian M C Dixon, Jeffrey T Wigle, Michael P Czubryt
Remodeling of the cardiac extracellular matrix is responsible for a number of the detrimental effects on heart function that arise secondary to hypertension, diabetes and myocardial infarction. This remodeling consists both of an increase in new matrix protein synthesis, and an increase in the expression of matrix metalloproteinases (MMPs) that degrade existing matrix structures. Previous studies utilizing knockout mice have demonstrated clearly that MMP2 plays a pathogenic role during matrix remodeling, thus it is important to understand the mechanisms that regulate MMP2 gene expression...
May 8, 2018: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/29745622/noninvasive-assessment-of-cardiac-index-using-impedance-cardiography-during-liver-transplantation-surgery-a-comparison-with-pulmonary-artery-thermodilution
#7
Vlad Suparschi, Eric Le Bihan, Amélie Toussaint, Diana Saptefrat, Heykel Ben Abdallah, Faouzi Gloulou, Farida Aouati, Tobias Gauss, Catherine Paugam-Burtz
BACKGROUND: Liver Transplantation (LT) is a high-risk surgery associated with significant hemodynamic changes requiring advanced hemodynamic monitoring. Pulmonary Artery Catheter (PAC) is still considered as a gold-standard for cardiac index (CI) measurement during LT despite association with an increased risk of complications. Noninvasive impedance cardiography (ICG) could be an interesting alternative tool for CI monitoring. The aim of this study was to compare the precision and trending ability of ICG versus PAC methods during LT...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29737449/modification-of-gene-expression-profiling-related-to-renin-angiotensin-system-in-an-ischemia-reperfusion-rat-model-after-t3-infusion
#8
Laura Sabatino, Silvana Balzan, Claudia Kusmic, Giorgio Iervasi
Triiodothyronine (T3) and renin-angiotensin system (RAS) are functionally related in cardiovascular system. Recently, in an in vivo myocardial ischemia/reperfusion (I/R) model in rats, we showed that T3 treatment improved the post-ischemic recovery of cardiac function. In the present study, we used the same experimental model of regional I/R, obtained by 30 min occlusion of the left descending coronary artery, followed by 3-days of reperfusion, to investigate the effect of 48-h treatment (started 1 day after ischemia) with 6 µg/kg/day T3 or vehicle...
May 8, 2018: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/29735421/3-bromopyruvate-reverses-hypoxia-induced-pulmonary-arterial-hypertension-through-inhibiting-glycolysis-in-vitro-and-in-vivo-studies
#9
Fangzheng Chen, Heng Wang, Jiadan Lai, Shujing Cai, Linbo Yuan
BACKGROUND: Pulmonary arterial smooth muscle cell (PASMC) proliferation is vital to pulmonary vascular remodeling in pulmonary arterial hypertension (PAH) pathogenesis, and inhibiting PASMC metabolism could serve as a new possible therapy to reverse the process. 3-Bromopyruvate (3-BrPA) is an effective glycolysis inhibitor with its effect in PAH remains unclear. Our study aims to assess the therapeutic effect of 3-BrPA in PAH rats and investigate the possible mechanism of 3-BrPA in PASMC proliferation and apoptosis...
May 4, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29733924/thirteen-year-experience-with-universal-staphylococcus-aureus-nasal-decolonisation-prior-to-cardiac-surgery-a-quasi-experimental-study
#10
Adrien Lemaignen, Laurence Armand-Lefevre, Gabriel Birgand, Guillaume Mabileau, Isabelle Lolom, Walid Ghodbane, Pierre Dilly Marie, Patrick Nataf, Jean-Christophe Lucet
INTRODUCTION: Sternal wound infection (SWI) after cardiac surgery is a severe complication. Among preventive measures, pre-operative decolonisation of nasal carriage of Staphylococcus aureus has recently been shown to be beneficial. In this quasi-experimental study, we assessed the effect of decolonisation on the incidence of S. aureus-associated SWI during 19-year prospective surveillance. METHODS: We analysed by segmented negative binomial regression the change over time of the incidence of S...
May 4, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29729718/development-and-evaluation-of-a-tissue-engineered-fibrin-based-canine-mitral-valve-three-dimensional-cell-culture-system
#11
M-M Liu, T C Flanagan, S Jockenhovel, A Black, C-C Lu, A T French, D J Argyle, B M Corcoran
Myxomatous mitral valve disease is the most common cardiac disease of the dog, but examination of the associated cellular and molecular events has relied on the use of cadaveric valve tissue, in which functional studies cannot be undertaken. The aim of this study was to develop a three-dimensional (3D) cell co-culture model as an experimental platform to examine disease pathogenesis. Mitral valve interstitial (VIC) and endothelial (VEC) cells were cultured from normal and diseased canine (VIC only) valves. VICs were embedded in a fibrin-based hydrogel matrix and one surface was lined with VECs...
April 2018: Journal of Comparative Pathology
https://www.readbyqxmd.com/read/29715263/downregulation-of-mir-199b-5p-inducing-differentiation-of-bone-marrow-mesenchymal-stem-cells-bmscs-toward-cardiomyocyte-like-cells-via-hsf1-hsp70-pathway
#12
Fangjie Dai, Peizhao Du, Yaowei Chang, Endong Ji, Yunjia Xu, Chunyan Wei, Jiming Li
BACKGROUND Bone-marrow mesenchymal stem cells (BMSCs) are pluripotent stem cells with potent self-renewal and differentiation ability that are widely used in transplantation of cell therapy. But the mechanism on microRNA (miRNA) regulating stem cell differentiation is complicated and unclear. The aim of this study was to investigate whether miR-199b-5p is involved in differentiation of cardiomyocyte-like cells and identify potential signal pathways in BMSCs. MATERIAL AND METHODS Mouse BMSCs were treated with 5-azacytidine and transfected by miR-199b-5p mimic and inhibitor, respectively...
May 1, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29706997/influence-of-handprint-culture-training-on-compliance-of-healthcare-workers-with-hand-hygiene
#13
Hala Fouad, Mona M A Halim, HebatAllah F Algebaly, Nardeen A Elmallakh
Objective: We aimed to study the effect of visual observation of bacterial growth from handprints on healthcare workers' (HCWs) compliance with hand hygiene (HH). Settings: Medical and postoperative cardiac surgery units. Design: Prospective cohort study. Subject: The study included 40 HCWs. Intervention: Each HCW was interviewed on 3 separate occasions. The 1st interview was held to obtain a handprint culture before and after a session demonstrating the 7 steps of HH using alcohol-based hand rub, allowing comparison of results before and after HH...
2018: Interdisciplinary Perspectives on Infectious Diseases
https://www.readbyqxmd.com/read/29704185/the-effect-of-heated-co-2-insufflation-in-minimising-surgical-wound-contamination-during-open-surgery
#14
Monika Baumann, John E Cater
The primary source of infections in open surgeries has been found to be bacteria and viruses carried into the surgical wound on the surfaces of skin particles shed by patients and surgical staff. In open cardiac surgeries, insufflation of the wound with carbon dioxide is used to limit the quantity of air able to enter into the heart, avoiding air embolisms when the heart is restarted. This surgical technique has been evaluated as a method of limiting the number of skin particles able to enter into the wound, using computational fluid dynamics (CFD) simulations and experimental testing...
April 27, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29701418/traumatic-carotid-jugular-av-fistula-in-a-child
#15
Pedro Lima, Anabela Gonçalves, Manuel Fonseca, Carolina Mendes, Óscar Gonçalves
INTRODUCTION: Traumatic Arteriovenous fistulae of the neck vessels are a rare condition, comprising less than 4% of traumatic fistulae found anywhere else in the body. METHODS: The authors propose to report a clinical case of such a condition in a 10-year-old boy who sustained a gunshot wound in the left side of the neck. RESULTS: Shortly after the event, the patient was admitted to paediatric ICU and intubated for airway protection. A palpable thrill in the left side of the neck was noticed, giving rise to the need of imaging study...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701386/simplified-technique-for-aortic-arch-replacement-in-patients-at-high-risk-for-frozen-elephant-trunk
#16
Álvaro Laranjeira Santos, António Cruz Tomás, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Surgical approach of multisegmental pathology of the thoracic aorta, namely aortic arch / descending aorta is challenging. The Frozen Elephant Trunk (FET) has good results, with acceptable risk. However, in the subgroup of patients (pts) older than 75 years and with important comorbidities, the surgical risk is very high. OBJECTIVES: Review short-term results of this original, simplified and potentially hybrid technique developed in our Department for this subgroup of patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701365/long-term-outcomes-in-octogenarians-following-isolated-aortic-valve-replacement
#17
Sara Simões Costa, Diogo Rijo, João Pedro Monteiro, Daniel Martins, Nelson Santos Paulo, Luis Vouga, Miguel Guerra
INTRODUCTION: Isolated aortic valve replacement (AVR) in elderly patients is associated with increased operative risk, due to higher prevalence of associated risk factors and other comorbidities, making outcome prediction essential. In patients with symptomatic severe aortic disease, advanced age is often a reason for a transcatheter rather than surgical aortic valve replacement. In the era of TAVI, there has been renewed interest in the outcomes of conventional AVR for high and intermediate risk patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29698662/liberal-use-of-delayed-sternal-closure-in-children-is-not-associated-with-increased-morbidity
#18
S Ram Kumar, Nigel Scott, Winfield J Wells, Vaughn A Starnes
BACKGROUND: Delayed sternal closure (DSC) is often employed to optimize hemodynamics following pediatric cardiac surgery. Prior reports have suggested that DSC may be associated with increased morbidity. We sought to analyze the impact of a liberal policy of DSC on surgical outcomes at our center. METHODS: We retrospectively evaluated the clinical course of 1,000 consecutive patients between July 2005 and June 2015 whose sternum was electively left open following pediatric cardiac surgery...
April 23, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29688817/current-status-of-messenger-rna-delivery-systems
#19
Matthew G Stanton
Messenger RNA is emerging as a highly versatile biological construct for creation of impactful medicines. mRNA vaccines directed toward infectious disease and cancer are in clinical development with encouraging early reads on tolerability and efficacy. The use of mRNA to direct intense but transient expression of paracrine factors is finding utility in reprogramming progenitor cells for wound healing and cardiac regeneration and for stimulation of antitumor immune responses, at least preclinically as we await clinical results...
April 24, 2018: Nucleic Acid Therapeutics
https://www.readbyqxmd.com/read/29687888/epigenetics-of-aberrant-cardiac-wound-healing
#20
Adam Russell-Hallinan, Chris J Watson, John A Baugh
Remodeling of cardiac tissue architecture is essential for normal organ development and maintaining homeostasis after injury. Injurious insults to the heart, such as hypertension and myocardial infarction, promote cellular responses including stimulation of resident inflammatory cells, activation of endothelial cells and recruitment of immune cells, hypertrophy of cardiomyocytes, and activation of fibroblasts. The physiological goal of this coordinated cellular response is to repair damaged tissue while maintaining or restoring cardiac contractile function...
March 26, 2018: Comprehensive Physiology
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