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https://www.readbyqxmd.com/read/29156619/standard-vs-calorie-dense-immune-nutrition-in-haemodynamically-compromised-cardiac-patients-a-prospective-randomized-controlled-pilot-study
#1
Sergey Efremov, Vladimir Lomivorotov, Christian Stoppe, Anna Shilova, Vladimir Shmyrev, Michail Deryagin, Alexander Karaskov
BACKGROUND: The aim of study was to test the hypothesis that early enteral nutrition (EN) with calorie-dense and protein rich enteral formula improves enteral energy and protein delivery in critically ill cardiac patients. METHODS: Prospective randomized pilot study of 40 ventilated adult patients undergoing elective cardiac surgery with use of cardiopulmonary bypass receiving inotropic support postoperatively. Patients were to receive either standard isocaloric (1000 Kcal/L and 38 g/L protein) early EN (n = 20) or calorie-dense and protein-rich (1300 Kcal/L and 66...
November 20, 2017: Nutrients
https://www.readbyqxmd.com/read/29156183/medical-devices-for-obesity-treatment-endoscopic-bariatric-therapies
#2
REVIEW
Eric J Vargas, Monika Rizk, Fateh Bazerbachi, Barham K Abu Dayyeh
Endoscopic bariatric therapies (EBTs) are effective tools for the management of obesity. By mimicking restrictive and bypass surgery physiology, they provide a safe and effective treatment option with the added capabilities of reaching a broader population. Multiple efficacious medical devices, such as intragastric balloons, endoscopic suturing/plication devices, and bypass liners, at various stages of development are available in the United States. EBTs represent the newest addition to a multidisciplinary approach in obesity management...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156053/propensity-matched-analysis-of-outcomes-after-mitral-valve-surgery-between-trainees-and-consultants-institutional-report
#3
Vito D Bruno, Pierpaolo Chivasso, Amna Hayat, Roberto Marsico, Umberto Benedetto, Massimo Caputo, Raimondo Ascione, Gianni D Angelini, Franco Ciulli, Hunaid A Vohra
OBJECTIVES: We aimed to determine whether early outcomes and long-term survival after mitral valve surgery performed by trainee residents are equivalent in terms of safety and efficacy when compared with consultant surgeons. METHODS: Between January 2000 and December 2015, a total of 1742 patients who underwent mitral valve surgery were identified. Of these, 1622 operations were performed by consultants (Group I) and 120 operations were performed by trainees (Group II)...
November 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29156022/anaortic-off-pump-versus-clampless-off-pump-using-the-pas-port-device-versus-conventional-coronary-artery-bypass-grafting-mid-term-results-from-a-matched-propensity-score-analysis-of-5422-unselected-patients
#4
Nobuyuki Furukawa, Oliver Kuss, Konstantin Preindl, André Renner, Anas Aboud, Kavous Hakim-Meibodi, Michael Benzinger, Thomas Pühler, Stephan Ensminger, Buntaro Fujita, Tobias Becker, Jan F Gummert, Jochen Börgermann
OBJECTIVES: Meta-analyses from observational and randomized studies have demonstrated benefits of off-pump surgery for hard and surrogate endpoints. In some of them, increased re-revascularization was noted in the off-pump groups, which could impact their long-term survival. Therefore, we analyzed the course of all patients undergoing isolated coronary surgery regarding the major cardiac and cerebrovascular event (MACCE) criteria. METHODS: A prospective register was taken from a high-volume off-pump center recording all anaortic off-pump (ANA), clampless off-pump (PAS-Port) and conventional (CONV) coronary artery bypass operations between July 2009 and June 2015...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29156016/pectus-excavatum-repair-after-sternotomy-the-chest-wall-international-group-experience-with-substernal-nuss-bars
#5
Dawn E Jaroszewski, Paul J Gustin, Frank-Martin Haecker, Hans Pilegaard, Hyung Joo Park, Shao-Tao Tang, Shuai Li, Li Yang, Sadashige Uemura, Jose Ribas Milanez De Campos, Robert Obermeyer, Frazier W Frantz, Michele Torre, Lisa McMahon, Andre Hebra, Chih-Chun Chu, J Duncan Phillips, David M Notrica, Antonio Messineo, Robert Kelly, Mustafa Yüksel
OBJECTIVES: Patients with pectus excavatum (PE) after prior sternotomy for cardiac surgery present unique challenges for repair of PE. Open repairs have been recommended because of concerns about sternal adhesions and cardiac injury. We report a multi-institutional experience with repair utilizing substernal Nuss bars in this patient population. METHODS: Surgeons from the Chest Wall International Group were queried for experience and retrospective data on PE repair using sub-sternal Nuss bars in patients with a history of median sternotomy for cardiac surgery (November 2000 to August 2015)...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29155938/cerebral-autoregulation-in-cardiopulmonary-bypass-surgery-a-systematic-review
#6
Juliana R Caldas, Victoria J Haunton, Ronney B Panerai, Ludhmila A Hajjar, Thompson G Robinson
Cardiopulmonary bypass surgery is associated with a high incidence of neurological complications, including stroke, delirium and cognitive impairment. The development of strategies to reduce the incidence of such neurological events has been hampered by the lack of a clear understanding of their pathophysiology. Cerebral autoregulation (CA), which describes the ability of the brain to maintain a stable cerebral blood flow over a wide range of cerebral perfusion pressures despite changes in blood pressure, is known to be impaired in various neurological disorders...
November 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155119/high-serum-bilirubin-is-associated-with-lower-prevalence-of-peripheral-arterial-disease-among-cardiac-patients
#7
Michishige Ozeki, Hideaki Morita, Masatoshi Miyamura, Tomohiro Fujisaka, Shu-Ichi Fujita, Takahide Ito, Kensaku Shibata, Suguru Tanaka, Koichi Sohmiya, Masaaki Hoshiga, Nobukazu Ishizaka
Several studies have shown that subjects with higher serum bilirubin may have a lower risk of cardiovascular disorders. We herein investigated whether serum bilirubin concentration is associated with lower extremity ischemia among cardiology patients. In total, 935 patients without a history of angioplasty or bypass surgery of the lower limb arteries and who had bilateral ankle-brachial index measurements were included in the study. Peripheral arterial disease (PAD) was defined to be present when ABI of either or both sides was <0...
November 18, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29153964/evaluation-of-different-minimally-invasive-techniques-in-surgical-treatment-for-ventricular-septal-defect
#8
Huagang Liu, Zhiwei Wang, Jun Xia, Rui Hu, Zhiyong Wu, Xiaoping Hu, Wei Ren
BACKGROUND: Minimally invasive cardiac surgery is becoming a safe and cosmetic alternative to standard median sternotomy (SMS). This retrospective study reviews our results and experience with the lower mini-sternotomy (LMS) technique and the right lateral thoracotomy (RLT) technique for ventricular septal defect (VSD) closure compared with SMS. METHODS: Between January 2013 and Dec 2015, 198 patients underwent repair VSD through lower mini-sternotomy (LMS Group, n=66), right lateral thoracotomy (RLT Group, n=59), standard median sternotomy (SMS Group, n=73)...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29153931/disturbances-in-oxygen-balance-during-cardiopulmonary-bypass-a-risk-factor-for-postoperative-delirium
#9
Nina Smulter, Helena Claesson Lingehall, Yngve Gustafson, Birgitta Olofsson, Karl Gunnar Engström, Micael Appelblad, Staffan Svenmarker
OBJECTIVE: The aim of this study was to determine risk factors for postoperative delirium after cardiac surgery, specifically associated with the conduct of cardiopulmonary bypass (CPB). DESIGN: Prospective observational study. SETTING: Heart Centre, University Hospital. PARTICIPANTS: The study included 142 patients aged 70 years and older scheduled for elective cardiac surgery with CPB. INTERVENTIONS: Risk factor analysis comprised information collected from the hospital clinical and CPB dedicated databases in addition to the medical chart...
August 25, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29153826/performance-evaluation-of-phase-angle-and-handgrip-strength-in-patients-undergoing-cardiac-surgery-prospective-cohort-study
#10
Taís Kereski da Silva, Ingrid Dalira Schweigert Perry, Janete Salles Brauner, Orlando Carlos Belmonte Weber, Gabriela Corrêa Souza, Sílvia Regina Rios Vieira
BACKGROUND AND AIMS: The phase angle (PA), derived from bioelectrical impedance analysis (BIA), has been interpreted as a cell membrane integrity indicator, while handgrip strength (HGS) has been used as a prognostic indicator in certain clinical situations, such as in cardiac, oncologic patients with renal disease, hemodialysis patients, HIV-positive patients, and liver disease patients. In addition to prognostic scores, body changes due to surgical procedures indicate the importance of measuring muscle function and cell integrity...
November 16, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29152839/beta-cell-sensitivity-to-glucose-is-impaired-after-gastric-bypass-surgery
#11
Marzieh Salehi, Amalia Gastaldelli, David A D'Alessio
AIMS: Patients with Roux-en-Y gastric bypass surgery (GB) have exaggerated postprandial insulin secretion, which has been attributed to increased meal glucose appearance and enhanced incretin effect. Here we sought to determine β-cell glucose sensitivity in the absence of meal stimulation and insulinotropic gut factors. MATERIALS AND METHODS: Twelve non-diabetic subjects with prior GB, and 7 matched non-surgical controls with normal glucose tolerance were studied...
November 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29151335/comparison-of-tidal-volume-and-deep-breath-preoxygenation-techniquesundergoing-coronary-artery-bypass-graft-surgery-effects-of-hemodynamicresponse-and-arterial-oxygenation
#12
Zafer Taş, Tülay Hoşten, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Ahmet Arıkan, Zeynep Mine Solak
Background/aim: Different techniques exist for the preoxygenation of patients that will be operated on under general anesthesia. Preoxygenation with the deep breath (DB) method may affect cardiovascular stability, which is crucial for coronary artery bypass graft (CABG) patients. In this study, we aimed to compare the effects of the 3 min TVB preoxygenation technique and 1 min 8DBs technique on hemodynamic response and arterial oxygenation in patients with normal ejection fraction that were scheduled for elective CABG surgery...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29151310/comparison-of-the-cardioprotective-effects-of-dexmedetomidineand-remifentanil-in-cardiac-surgery
#13
Mediha Türktan, Yasemin Güneş, Hafize Yalınız, Selçuk Matyar, Zehra Hatipoğlu, Ersel Güleç, Uğur Göçen, Atakan Atalay
Background/aim: Myocardial protection is an important factor of open heart surgery and biological biomarkers (lactate, CKMB, cardiac troponin I, and pyruvate) are used to assess myocardial damage. This study compares the effects of dexmedetomidine and remifentanil on myocardial protection during coronary artery bypass grafting (CABG) surgery. Materials and methods: Patients scheduled for elective CABG surgery (n = 60) were included in this study. Anesthesia induction was introduced with propofol, fentanyl, and vecuronium bromide...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29150392/improvement-in-quality-of-life-after-bariatric-surgery-sleeve-versus-bypass
#14
Dirk P A Versteegden, Magaly J J Van Himbeeck, Simon W Nienhuijs
BACKGROUND: Obesity is steadily growing to be the largest threat to human health in this century, not only increasing prevalence of obesity-related co-morbidity but also impairing health-related quality of life (QoL). Bariatric surgery has shown to improve co-morbidity as well as QoL. OBJECTIVES: To assess the differences in improvement in QoL for the 2 most performed procedures: laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (RYGB)...
October 16, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29149707/over-expression-of-cyclooxygenase-2-in-increased-reticulated-platelets-leads-to-aspirin-resistance-after-elective-off-pump-coronary-artery-bypass-surgery
#15
Xiaoxuan Gong, Xuezhong Wang, Zhuowen Xu, Tiantian Zhu, Qiu Zhang, Jinying Zhang, Xiaowei Wang, Chunjian Li
INTRODUCTION: Aspirin resistance (AR) has been reported to present after coronary artery bypass graft causing saphenous vein graft failure. We aimed to investigate the factors that affect the anti-platelet effect of aspirin after off-pump coronary artery bypass surgery (OPCAB). MATERIALS AND METHODS: Thirty OPCAB candidates were successively recruited. Platelet count, platelet aggregation, reticulated platelet (RP), platelets' cyclooxygenase (COX)-1 and COX-2 expressions were determined during the peri-operative period...
November 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29148628/clinical-significance-of-st-depression-at-exercise-stress-testing-in-competitive-athletes-usefulness-of-coronary-ct-during-screening
#16
Fabio Sperandii, Emanuele Guerra, Eliana Tranchita, Carlo Minganti, Chiara Lanzillo, Antonia Nigro, Federico Quaranta, Attilio Parisi, Mauro DI Roma, Luciano Maresca, Federica Fagnani, Leonardo Calò
BACKGROUND: Congenital coronary anomalies (CCAs) and coronary artery disease (CAD) arouse intense scientific and clinical interest in sports medicine and sports cardiology medical communities because of their potential to trigger sudden cardiac death (SCD) in athletes. Exercise stress testing represent the first instrumental assessment to evaluate electrocardiographic changes during effort. Coronary computed tomography angiography (CCTA) is an advanced accurate noninvasive imaging modality for excluding CAD and abnormalities of origin and course of coronary vessels...
November 17, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/29147786/risk-factors-for-development-of-ectopic-atrial-tachycardia-in-post-operative-congenital-heart-disease
#17
Bradley C Clark, John T Berger, Charles I Berul, Richard A Jonas, Jonathan R Kaltman, Julianne Lapsa, Dilip S Nath, Elizabeth D Sherwin, Pranava Sinha, David Zurakowski, Jeffrey P Moak
Ectopic atrial tachycardia (EAT) is common in surgically repaired congenital heart disease (CHD) and carries the potential for significant hemodynamic compromise. Our objective was to determine the incidence, and risk factors of EAT after CHD surgery. Prospective study of patients that underwent surgery for CHD from February to October 2016 was performed. Demographic, perioperative and electrophysiologic data were collected. Sustained EAT (> 30 s) was documented by telemetry or electrocardiogram and confirmed by a pediatric electrophysiologist...
November 17, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29147480/a-rare-case-of-late-onset-saphenous-vein-graft-spasm
#18
Nirmal Guragai, Upamanyu Rampal, Rahul Vasudev, Hiten Patel, Meherwan B Joshi, Fayez Shamoon
Spasm following coronary artery bypass graft surgery has been well established in arterial grafts, especially in grafts utilizing the internal mammary. Venous graft spasms are uncommon and are only observed in vein grafts during or soon after the coronary artery bypass surgery. It is exceedingly rare to see spasm of venous graft beyond one year of surgery. We report a 72-year-old female who had coronary artery bypass graft three years ago and presented with new onset chest pain for one month. The coronary angiogram revealed severe spasm of the proximal aspect of a patent saphenous venous graft which was relieved by intracoronary nitroglycerine...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29147171/recent-progress-of-bypass-surgery-to-the-dialysis-dependent-patients-with-critical-limb-ischemia
#19
Nobuyoshi Azuma, Shinsuke Kikuchi, Hiroko Okuda, Keisuke Miyake, Atsuhiro Koya
According to expansion of dialysis-dependent population, more than half of patients with critical ischemic limbs are dialysis-dependent in Japan. Although patients with end-staged renal disease are well-known as poor life prognosis, well-managed dialysis patients in Japan can survive much longer compared to dialysis patients in the United States and Europe. Therefore, some dialysis patients can enjoy the long-term benefits of bypass surgery. To decide the indication of bypass surgery, patient's general condition, nutrition status, and vein availability are more important rather than arterial disease anatomy...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146657/a-randomised-controlled-trial-of-a-duodenal-jejunal-bypass-sleeve-device-endobarrier-compared-with-standard-medical-therapy-for-the-management-of-obese-subjects-with-type-2-diabetes-mellitus
#20
Michael Alan Glaysher, Aruchuna Mohanaruban, Christina Gabriele Prechtl, Anthony P Goldstone, Alexander Dimitri Miras, Joanne Lord, Navpreet Chhina, Emanuela Falaschetti, Nicholas Andrew Johnson, Werd Al-Najim, Claire Smith, Jia V Li, Mayank Patel, Ahmed R Ahmed, Michael Moore, Neil Poulter, Stephen Bloom, Ara Darzi, Carel Le Roux, James P Byrne, Julian P Teare
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum...
November 15, 2017: BMJ Open
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