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https://www.readbyqxmd.com/read/29161440/novel-arch-fenestrated-stent-graft-for-acute-stanford-type-a-aortic-dissection-with-open-antegrade-implantation
#1
Qing Zhou, Yunxing Xue, Hailong Cao, Jun Pan, Qiang Wang, Fudong Fan, Dongjin Wang
OBJECTIVES: The best surgical strategy for acute Stanford Type A aortic dissection (aTAAD) involving the arch remains controversial. Here, we report on the satisfactory results following aTAAD repair using a novel arch fenestrated stent graft. METHODS: From December 2014 to December 2015, 42 aTAAD patients (27 male and 15 female) underwent ascending aorta replacement and fenestrated stent graft implantation. The fenestrated stent graft was implanted into the true lumen of the aortic arch and proximal descending aorta, with the fenestration opening located at the ostia of 3 head vessels in the arch...
November 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29161402/fit-for-surgery-perspectives-on-preoperative-exercise-testing-and-training
#2
K Richardson, D Z H Levett, S Jack, M P W Grocott
There is a consistent relationship between physical activity, physical fitness, and health across almost all clinical contexts, including the perioperative setting. Physiological measurements obtained during physical exercise may be used to infer the risk of adverse outcome after major surgery. In particular, data obtained from perioperative cardiopulmonary exercise testing have an expanding role in perioperative care. Such information may be used to inform a variety of changes in clinical practice, including interventions that may reduce the risk of perioperative adverse events...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29159719/effect-of-a-real-time-electronic-dashboard-on-a-rapid-response-system
#3
Grant S Fletcher, Barry A Aaronson, Andrew A White, Reena Julka
A rapid response system (RRS) may have limited effectiveness when inpatient providers fail to recognize signs of early patient decompensation. We evaluated the impact of an electronic medical record (EMR)-based alerting dashboard on outcomes associated with RRS activation. We used a repeated treatment study in which the dashboard display was successively turned on and off each week for ten 2-week cycles over a 20-week period on the inpatient acute care wards of an academic medical center. The Rapid Response Team (RRT) dashboard displayed all hospital patients in a single view ranked by severity score, updated in real time...
November 20, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29159487/management-of-cardiopulmonary-assist-devices-in-critically-ill-patients-using-point-of-care-transthoracic-echocardiography-a-case-series
#4
Babar Fiza, Michael Tang, Michael Maile
Point-of-care transthoracic echocardiography is increasingly being utilized by the intensive care physicians in the management of hemodynamically unstable patients. However, its use in the management of critically ill patients requiring cardiopulmonary mechanical device support remains to be well described. In this case series, we present two case reports where point-of-care echocardiography was successfully used by the intensive care team in diagnosing and managing problems related to cardiopulmonary assist device malposition...
November 21, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29159458/cardiopulmonary-exercise-testing-reflects-improved-exercise-capacity-in-response-to-treatment-in-morquio-a-patients-results-of-a-52-week-pilot-study-of-two-different-doses-of-elosulfase-alfa
#5
Kenneth I Berger, Barbara K Burton, Gregory D Lewis, Mark Tarnopolsky, Paul R Harmatz, John J Mitchell, Nicole Muschol, Simon A Jones, V Reid Sutton, Gregory M Pastores, Heather Lau, Rebecca Sparkes, Adam J Shaywitz
OBJECTIVE: To assess impact of a 52-week elosulfase alfa enzyme replacement therapy (ERT) on exercise capacity in Morquio A patients and analyze cardiorespiratory and metabolic function during exercise to uncover exercise limitations beyond skeletal abnormalities. METHODS: Morquio A patients aged ≥7 years, able to walk >200 m in the 6-minute walk test (6MWT), received elosulfase alfa 2.0 mg/kg/week (N = 15) or 4.0 mg/kg/week (N = 10) for 52 weeks in the randomized, double-blind MOR-008 study ( ClinicalTrials...
November 21, 2017: JIMD Reports
https://www.readbyqxmd.com/read/29158921/a-nearly-lethal-screw-an-unusual-cause-of-recurrent-bradycardia-and-asystole-episodes-after-fixation-of-the-cervical-spine
#6
Amit Frenkel, Yair Binyamin, Evgeni Brotfain, Leonid Koyfman, Aviel Roy-Shapira, Ilan Shelef, Moti Klein
We present a case of a 51-year-old man who was injured in a bicycle accident. His main injury was an unstable fracture of the cervical and thoracic vertebral column. Several hours after his arrival to the hospital the patient underwent open reduction and internal fixation (ORIF) of the cervical and thoracic spine. The patient was hospitalized in our critical care unit for 99 days. During this time patient had several episodes of severe bradycardia and asystole; some were short with spontaneous return to sinus and some required pharmacological treatment and even Cardiopulmonary Resuscitation (CPR)...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29158047/-fatal-case-of-enterovirus-a71%C3%A2-hand-foot-and-mouth-disease-infection
#7
V Corvest, C Archimbaud, A-S L'Honneur, C Henquell, H Peigue-Lafeuille, M Decobert, A Mirand
Hand, foot, and mouth disease associated with enterovirus (EV) infections is a common pediatric pathology that is usually considered as benign. However, neurological complications of varying severity, sometimes fatal, are possible, particularly when EV-A71 is involved. Several Asian countries are regularly affected by large-scale epidemics of EV infections with substantial morbidity and mortality, where early screening and appropriate therapeutic management are a public health challenge. In 2016, Europe experienced an epidemic of unusual magnitude, associated with increasing cases of severe neurological complications in Spain and France, mainly affecting children...
November 17, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29157790/improving-the-neurological-prognosis-following-ohca-using-real-time-evaluation-of-cerebral-tissue-oxygenation-a-case-report
#8
Yasuaki Koyama, Yoshiaki Inoue, Shuhei Hisago, Aiki Marushima, Keiichi Hagiya, Yuichiro Yamasaki, Yuki Enomoto, Nobutake Shimojo, Satoru Kawano, Taro Mizutani
BACKGROUND: The neurological prognosis is poor for patients suffering from out-of-hospital cardiac arrest (OHCA), in the absence of bystander cardio pulmonary resuscitation (CPR), and showing asystole as the initial waveform. However, such patients have the potential of resuming social activity if cerebral tissue oxygen saturation can be preserved. CASE PRESENTATION: We recently encountered a 60-year-old man who had suffered an OHCA in the absence of bystander CPR, and who successfully resumed complete social activity despite initial asystole and requiring at least 75min of chest compressions before return of spontaneous circulation (ROSC)...
November 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29157739/office-based-spirometry-a-new-model-of-care-in-preoperative-assessment-for-low-risk-lung-resections
#9
Jessica L Hudson, Jennifer M Bell, Traves D Crabtree, Daniel Kreisel, G Alexander Patterson, Bryan F Meyers, Varun Puri
BACKGROUND: Formal pulmonary function testing with laboratory spirometry (LS) is the standard of care for risk stratification before lung resection. LS and handheld office spirometry (OS) are clinically comparable for forced expiratory volume in 1 second and forced vital capacity. We investigated the safety of preoperative risk stratification based solely on OS. METHODS: Patients at low-risk for cardiopulmonary complications were enrolled in a single-center prospective study and underwent preoperative OS...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29156917/advance-care-planning-for-patients-with-advanced-neurology-diseases
#10
Ka-Chi Cheung, Vikki Wai-Kee Lau, Ka-Chun Un, Man-Sheung Wong, Kwok-Ying Chan
BACKGROUND: Advanced neurology diseases including motor neuron disease (MND) are usually progressive life-limiting illness and could be devastating for patients, families and caregivers. Although medical technologies, such as enteral feeding and non-invasive ventilation, may prolong life expectancy of the patients, their utilization prompts important ethical questions in regard to their quality of life (QoL). Little attention had been paid on how ACP practice would practically help with patients suffering from different neurology diseases...
October 13, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156906/the-development-of-neurology-palliative-care-service-for-motor-neuron-disease-mnd-patients-hong-kong-experience
#11
Hon Wai Benjamin Cheng, Wai Tsan Tracy Chen, Chun Kwok Angus Chu, Savio Lee, Joo Shium Lee, Yeuk Fai Hong, Yuen Kwan Judy Chung
BACKGROUND: Motor neuron disease (MND) is a neurodegenerative disease characterized by loss of motor neurons in the spinal cord, brainstem and motor cortex. Clinically it is manifested as progressive decline in physical, respiratory, swallowing and communication function and ultimately death. Traditional model of care was fragmented and did not match with patients and carers multi-facet needs. METHODS: A special workgroup for MND patients that includes neurologist, respiratory physician, rehabilitation specialist and palliative care (PC) physician was formed in Hong Kong since year 2013...
September 15, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156619/standard-vs-calorie-dense-immune-nutrition-in-haemodynamically-compromised-cardiac-patients-a-prospective-randomized-controlled-pilot-study
#12
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/29156053/propensity-matched-analysis-of-outcomes-after-mitral-valve-surgery-between-trainees-and-consultants-institutional-report
#13
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/29156016/pectus-excavatum-repair-after-sternotomy-the-chest-wall-international-group-experience-with-substernal-nuss-bars
#14
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/29156011/pulmonary-resection-for-patients-with-multidrug-resistant-tuberculosis-based-on-survival-outcomes-a-systematic-review-and-meta-analysis
#15
Hyunsuk Frank Roh, Jihoon Kim, Seung Hyuk Nam, Jung Mogg Kim
We investigated the survival benefit of pulmonary resection for patients with multidrug-resistant tuberculosis. To weigh the survival benefit of pulmonary resection for patients with multidrug-resistant tuberculosis who have undergone surgical treatment combined with medical chemotherapy compared with medical chemotherapy alone, we did a meta-analysis of available studies containing a hazard ratio for pulmonary resection. Among 1726 articles, 6 clinical reports, with a mean sample size of 47 patients per report, met the inclusion criteria...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29155938/cerebral-autoregulation-in-cardiopulmonary-bypass-surgery-a-systematic-review
#16
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/29155335/exercise-testing-in-patients-with-diaphragm-paresis
#17
Tristan Bonnevie, Francis-Edouard Gravier, Agathe Ducrocq, David Debeaumont, Catherine Viacroze, Antoine Cuvelier, Jean-François Muir, Catherine Tardif
PURPOSE: Diaphragm paresis (DP) is characterized by abnormalities of respiratory muscle function. However, the impact of DP on exercise capacity is not well known. This study was performed to assess exercise tolerance in patients with DP and to determine whether inspiratory muscle function was related to exercise capacity, ventilatory pattern and cardiovascular function during exercise. METHODS: This retrospective study included patients with DP who underwent both diaphragmatic force measurements, and cardiopulmonary exercise testing (CPET)...
November 16, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29154687/pyruvate-enhancement-of-cardiac-performance-cellular-mechanisms-and-clinical-application
#18
Robert T Mallet, Albert H Olivencia-Yurvati, Rolf Bünger
Cardiac contractile function is adenosine-5'-triphosphate (ATP)-intensive, and the myocardium's high demand for oxygen and energy substrates leaves it acutely vulnerable to interruptions in its blood supply. The myriad cardioprotective properties of the natural intermediary metabolite pyruvate make it a potentially powerful intervention against the complex injury cascade ignited by myocardial ischemia-reperfusion. A readily oxidized metabolic substrate, pyruvate augments myocardial free energy of ATP hydrolysis to a greater extent than the physiological fuels glucose, lactate and fatty acids, particularly when it is provided at supra-physiological plasma concentrations...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29154420/relationship-between-skeletal-muscle-mass-and-cardiac-function-during-exercise-in-community-dwelling-older-adults
#19
Masamitsu Sugie, Kazumasa Harada, Tetsuya Takahashi, Marina Nara, Joji Ishikawa, Teruyuki Koyama, Hunkyung Kim, Jun Tanaka, Hajime Fujimoto, Shuichi Obuchi, Stephan von Haehling, Syunei Kyo, Hideki Ito
AIMS: This study aimed to investigate the relationship between skeletal muscle mass and cardiac functional parameters in older adults during cardiopulmonary exercise testing (CPET). METHODS AND RESULTS: Sixty-three Japanese community-dwelling older adults were enrolled (20 men and 43 women; mean age 80 years, range 65-97 years). Cardiac functional parameters during exercise were assessed using CPET. Skeletal muscle mass index (SMI) was calculated by dividing the appendicular lean mass (measured using dual-energy X-ray absorptiometry) by height in metres squared...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29153964/evaluation-of-different-minimally-invasive-techniques-in-surgical-treatment-for-ventricular-septal-defect
#20
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
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