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https://www.readbyqxmd.com/read/28931261/carotid-endarterectomy-in-patients-with-thrombocytopenia-analysis-of-the-national-surgical-quality-improvement-program-registry
#1
Adnan I Qureshi, Aiman Zafar, Muhammad Shah Miran, Vishal B Jani
BACKGROUND: Carotid endarterectomy (CEA) is infrequently performed in patients with mild to moderate thrombocytopenia. OBJECTIVE: To determine whether preoperative thrombocytopenia is associated with a higher rate of complications after CEA. METHODS: We analyzed patient characteristics, comorbid conditions, operative details, and 30-day postoperative outcomes for patients who underwent CEA in the CEA-targeted American College of Surgeons National Surgical Quality Improvement Program Registry...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28930079/epicardial-adipose-tissue-volume-and-cardiovascular-risk-indices-among-asymptomatic-women-with-and-without-hiv
#2
Suman Srinivasa, Michael T Lu, Kathleen V Fitch, Travis R Hallett, Timothy K O'Malley, Lauren A Stone, Amanda Martin, Alexandra J Coromilas, Tricia H Burdo, Virginia A Triant, Janet Lo, Sara E Looby, Tomas G Neilan, Markella V Zanni
BACKGROUND: Mechanisms underlying the heightened myocardial infarction risk among HIV-infected women (versus non-HIV-infected women) remain unclear. Our objectives were to assess epicardial adipose tissue (EAT) volume and its associations among asymptomatic women with and without HIV. METHODS: Fifty-five HIV-infected and 27 non-HIV-infected women without known cardiovascular disease who underwent cardiac CT and metabolic/immune phenotyping were included. EAT volume derived from CT was compared among women with and without HIV, and within-group EAT associations were assessed...
September 20, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28926643/skin-perfusion-pressure-as-an-indicator-of-tissue-perfusion-in-valvular-heart-surgery-preliminary-results-from-a-prospective-observational-study
#3
Young Song, Sarah Soh, Jae-Kwang Shim, Kyoung-Un Park, Young-Lan Kwak
Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h...
2017: PloS One
https://www.readbyqxmd.com/read/28918203/short-term-effects-of-preoperative-beta-blocker-use-for-isolated-coronary-artery-bypass-grafting-a-systematic-review-and-meta-analysis
#4
Liangshan Wang, Hong Wang, Xiaotong Hou
OBJECTIVE: The use of preoperative beta-blockers has been used as a quality standard for patients undergoing coronary artery bypass grafting (CABG). However, the benefits of beta-blockers use before CABG remain controversial. We performed a systematic review and meta-analysis to investigate the short-term effects of preoperative beta-blocker use for patients undergoing isolated CABG. METHODS: We searched PubMed, Embase, and the Cochrane Library for English articles published from inception to August 16, 2016...
August 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28914972/seasonal-patterns-of-acute-and-recurrent-idiopathic-pericarditis
#5
Yoav Hammer, Jihad Bishara, Alon Eisen, Zaza Iakobishvili, Ran Kornowski, Aviv Mager
BACKGROUND: Idiopathic pericarditis is presumed to result from viral infection. The incidence rates of some viral infections have typical seasonal patterns. The data in the literature on a possible seasonal pattern of acute pericarditis are very limited. The mechanism and possible seasonality of recurrent episodes are not well established . HYPOTHESIS: The incidence of acute idiopathic pericarditis has a seasonal pattern. METHODS: The computerized database of a tertiary, university-affiliated hospital was searched for all patients admitted with a first episode of acute idiopathic pericarditis between January 1, 2010 and December 31, 2015...
September 15, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28912187/pediatric-cardiomyopathies
#6
REVIEW
Teresa M Lee, Daphne T Hsu, Paul Kantor, Jeffrey A Towbin, Stephanie M Ware, Steven D Colan, Wendy K Chung, John L Jefferies, Joseph W Rossano, Chesney D Castleberry, Linda J Addonizio, Ashwin K Lal, Jacqueline M Lamour, Erin M Miller, Philip T Thrush, Jason D Czachor, Hiedy Razoky, Ashley Hill, Steven E Lipshultz
Pediatric cardiomyopathies are rare diseases with an annual incidence of 1.1 to 1.5 per 100 000. Dilated and hypertrophic cardiomyopathies are the most common; restrictive, noncompaction, and mixed cardiomyopathies occur infrequently; and arrhythmogenic right ventricular cardiomyopathy is rare. Pediatric cardiomyopathies can result from coronary artery abnormalities, tachyarrhythmias, exposure to infection or toxins, or secondary to other underlying disorders. Increasingly, the importance of genetic mutations in the pathogenesis of isolated or syndromic pediatric cardiomyopathies is becoming apparent...
September 15, 2017: Circulation Research
https://www.readbyqxmd.com/read/28893184/the-canadian-hiv-and-aging-cohort-study-determinants-of-increased-risk-of-cardio-vascular-diseases-in-hiv-infected-individuals-rationale-and-study-protocol
#7
Madeleine Durand, Carl Chartrand-Lefebvre, Jean-Guy Baril, Sylvie Trottier, Benoit Trottier, Marianne Harris, Sharon Walmsley, Brian Conway, Alexander Wong, Jean-Pierre Routy, Colin Kovacs, Paul A MacPherson, Kenneth Marc Monteith, Samer Mansour, George Thanassoulis, Michal Abrahamowicz, Zhitong Zhu, Christos Tsoukas, Petronela Ancuta, Nicole Bernard, Cécile L Tremblay
BACKGROUND: With potent antiretroviral drugs, HIV infection is becoming a chronic disease. Emergence of comorbidities, particularly cardiovascular disease (CVD) has become a leading concern for patients living with the infection. We hypothesized that the chronic and persistent inflammation and immune activation associated with HIV disease leads to accelerated aging, characterized by CVD. This will translate into higher incidence rates of CVD in HIV infected participants, when compared to HIV negative participants, after adjustment for traditional CVD risk factors...
September 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28891865/opioid-prescription-levels-and-postoperative-outcomes-in-orthopedic-surgery
#8
Crispiana Cozowicz, Ashley Olson, Jashvant Poeran, Eva E Mörwald, Nicole Zubizarreta, Federico P Girardi, Alexander P Hughes, Madhu Mazumdar, Stavros G Memtsoudis
Given the basic need for opioids in the perioperative setting, we investigated associations between opioid prescription levels and postoperative outcomes using population based data of orthopedic surgery patients. We hypothesized that increased opioid amounts would be associated with higher risk for postoperative complications. Data was extracted from the national Premier Perspective database (2006-2013); N=1,035,578 lower joint arthroplasties and N= 220,953 spine fusions. Multilevel multivariable logistic regression models measured associations between opioid dose prescription and postoperative outcomes, studied by quartile of dispensed opioid dose...
September 1, 2017: Pain
https://www.readbyqxmd.com/read/28886677/unplanned-return-to-operating-room-after-endovascular-repair-of-abdominal-aortic-aneurysm-evar-is-associated-with-increased-risk-of-hospital-readmission
#9
Faisal Aziz, Katelynn Ferranti, Erik B Lehman
Objectives Hospital readmissions after surgical operations are considered serious events. Centers for Medicare and Medicaid (CMS) consider surgical readmissions as preventable and hold hospitals responsible for them. Endovascular abdominal aortic aneurysm (EVAR) has become the first line modality of treatment for suitable patients with abdominal aortic aneurysm (AAA). The purpose of this study is to retrospectively review the factors associated with hospital readmission after EVAR. Methods The 2013 EVAR targeted American College of Surgeons (ACS-NSQIP) database and generalized 2013 general and vascular surgery ACS-NSQIP participant use files were used for this study...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28876709/-management-and-orientation-of-severely-infected-patients-relevance-of-a-%C3%A2-sepsis-fast-track-%C3%A2
#10
André Juillerat, Hari Vivekanantham, Raphaël Burger, Joëlle Hausser, Thierry Fumeaux
Sepsis is a syndrome defined by a life-threatening organ dysfunction caused by a dysregulated host response to an infection. The early recognition of this syndrome in the emergency department (ED) can lead to a better prognosis, when associated with a standardized management focusing on identification of the infectious source, its treatment, and appropriate organ support. Therefore, the implementation of a « Sepsis Fast Track », by analogy with similar protocols regarding stroke or ST-elevated myocardial infarct, deserves interest...
September 6, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28868104/parvovirus-b19-myocarditis-of-fulminant-evolution
#11
Michael Spartalis, Eleni Tzatzaki, Eleftherios Spartalis, Christos Damaskos, Sophie Mavrogeni, Vassilis Voudris
Myocarditis is an inflammation of the myocardium. Clinical presentation ranges from non-specific systematic symptoms to fulminant collapse and sudden death. Sudden death occurs at rates of 8.6-12% and cardiomyopathy at 9%. In active myocarditis, there is inflammatory cellular infiltrate with myocardial necrosis. The disease is distinguished by clinical presentation in fulminant and non-fulminant myocarditis. We present a rare case of a parvovirus B19-induced fulminant viral myocarditis in a young female. The patient presented with acute onset heart failure mimicking a myocardial infarction, followed by non-specific symptoms that had been misdiagnosed as urinary tract infection...
August 2017: Cardiology Research
https://www.readbyqxmd.com/read/28867262/persistent-hypoxemia-after-acute-myocardial-infarction-an-unexpected-culprit
#12
António Tralhão, Pedro Freitas, Gustavo Rodrigues, Hugo Café, António Miguel Ferreira, Henrique Mesquita Gabriel, Luís Bruges, Carlos Aguiar, Jorge Ferreira
Hypoxemia after myocardial infarction (MI) is usually explained by common culprits, including congestive heart failure, pre-existing lung disease, and pulmonary infection. We report a case of a 60-year-old woman who experienced severe persistent hypoxemia caused by a patent foramen ovale in the setting of anterior MI complicated by a contained left ventricular rupture.
July 29, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28866672/increased-mobilization-of-cd45-cd34-vla-4-cells-in-acute-viral-myocarditis-induced-by-coxsackievirus-b3
#13
Xingcui Gao, Bin Wei, Yan Deng, Yan Lan Huang, Weifeng Wu
OBJECTIVES: Bone marrow-derived cells (BMCs) have recently been identified to play a vital role in repairing damaged myocardium; however, it is not known whether or not mobilization of BMCs is involved in the pathogenesis of acute viral myocarditis (VMC). Thus, we analyzed the expression of CD45+CD34+VLA-4+ cells and vascular cell adhesion protein-1 (VCAM-1) in a murine model of acute VMC. METHODS: Male BALB/c mice were intraperitoneally infected with coxsackievirus B3 to establish acute VMC...
September 2, 2017: Cardiology
https://www.readbyqxmd.com/read/28865996/comparative-perioperative-outcomes-in-septuagenarians-and-octogenarians-undergoing-radical-cystectomy-for-bladder-cancer-do-outcomes-differ
#14
Tyler D Haden, Megan C Prunty, Alexander B Jones, Chelsea B Deroche, Katie S Murray, Naveen Pokala
BACKGROUND: Treatment choice for muscle invasive bladder cancer continues to be radical cystectomy. However, radical cystectomy carries a relatively high risk of morbidity and mortality compared with other urological procedures. OBJECTIVE: To compare surgical complications following radical cystectomy in septuagenarians and octogenarians. DESIGN, SETTING, AND PARTICIPANTS: The National Surgical Quality Improvement Program database (2009-2013) was used to identify patients who were 70 yr and older and underwent radical cystectomy...
August 30, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28863015/heart-failure-in-persons-living-with-hiv-infection
#15
Priscilla Y Hsue, David D Waters
PURPOSE OF REVIEW: To discuss presentation, pathophysiology, complications, and treatment of heart failure in persons living with HIV (PLWHIV) in the antiretroviral therapy (ART) era. RECENT FINDINGS: Since the advent of effective ART and improved longevity, heart failure has become more chronic and insidious and is often characterized by preserved ejection fraction, diastolic dysfunction, and left ventricular (LV) hypertrophy. The mechanism underlying heart failure in the setting of HIV infection remains unknown...
August 31, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28857797/a-comparison-of-3-frailty-indices-in-predicting-morbidity-and-mortality-after-on-pump-aortic-valve-replacement
#16
Gary Esses, Evie Andreopoulos, Hung-Mo Lin, Shipra Arya, Stacie Deiner
BACKGROUND: Aortic valve replacement is a high-risk surgery (3%-5%, 30-day mortality) performed on approximately 30,000 elderly patients a year in the United States. Currently, preoperative risk assessment is based on a composite of medical examination and a subjective evaluation for frailty ("eyeball test"). Objective frailty assessment using validated indices has the potential to improve risk stratification. The purpose of this study was to (1) establish whether frailty can predict 30-day mortality and composite morbidity in patients undergoing aortic valve replacement and (2) compare the predictive ability of 3 frailty indices in this population...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28856354/severity-weighting-of-postoperative-adverse-events-in-orthopedic-surgery
#17
Daniel D Bohl, Junyoung Ahn, Adam M Lukasiewicz, Andre M Samuel, Matthew L Webb, Bryce A Basques, Nicholas S Golinvaux, Kern Singh, Jonathan N Grauer
Studies of adverse events (AEs) after orthopedic surgery commonly use composite AE outcomes. An example of such an outcome is any AE. These types of outcomes treat AEs with different clinical significance (eg, death, urinary tract infection) similarly. We conducted a study to address this shortcoming in research methodology by creating a single severity-weighted outcome that can be used to characterize the overall severity of a given patient's postoperative course. All orthopedic faculty members at 2 academic institutions were invited to complete a severity-weighting exercise in which AEs were assigned a percentage severity of death...
July 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28855077/effect-of-interleukin-1%C3%AE-inhibition-with-canakinumab-on-incident-lung-cancer-in-patients-with-atherosclerosis-exploratory-results-from-a-randomised-double-blind-placebo-controlled-trial
#18
Paul M Ridker, Jean G MacFadyen, Tom Thuren, Brendan M Everett, Peter Libby, Robert J Glynn
BACKGROUND: Inflammation in the tumour microenvironment mediated by interleukin 1β is hypothesised to have a major role in cancer invasiveness, progression, and metastases. We did an additional analysis in the Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS), a randomised trial of the role of interleukin-1β inhibition in atherosclerosis, with the aim of establishing whether inhibition of a major product of the Nod-like receptor protein 3 (NLRP3) inflammasome with canakinumab might alter cancer incidence...
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28852969/recovery-from-very-long-aortic-cross-clamping-in-redo-complex-aortic-surgery
#19
Shoichi Suehiro, Koji Shimizu, Megumi Ito, Hayato Nakata, Kazuhiro Akeho, Teiji Oda
A 68-year-old man had undergone ascending aortic replacement for acute type A aortic dissection. Three months later, he had a new aortic dissection with an ulcer-like projection located in the aortic arch with suspected graft infection. An emergent redo total aortic arch and root replacement was performed because of the coexistence of a fragile aortic root wall. The extensive redo procedure necessitated a very long aortic cross-clamping time (516 min). After 25 min of assisted circulation, he was easily weaned from the cardiopulmonary bypass...
August 29, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28845751/antiinflammatory-therapy-with-canakinumab-for-atherosclerotic-disease
#20
Paul M Ridker, Brendan M Everett, Tom Thuren, Jean G MacFadyen, William H Chang, Christie Ballantyne, Francisco Fonseca, Jose Nicolau, Wolfgang Koenig, Stefan D Anker, John J P Kastelein, Jan H Cornel, Prem Pais, Daniel Pella, Jacques Genest, Renata Cifkova, Alberto Lorenzatti, Tamas Forster, Zhanna Kobalava, Luminita Vida-Simiti, Marcus Flather, Hiroaki Shimokawa, Hisao Ogawa, Mikael Dellborg, Paulo R F Rossi, Roland P T Troquay, Peter Libby, Robert J Glynn
Background Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo...
September 21, 2017: New England Journal of Medicine
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