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Silent MI surgery

Hamid Abbasi, Ali Abbasi
BACKGROUND CONTEXT:  Lower back pain is one of the most prevalent and expensive health conditions in the Western world. The standard treatment, interbody fusion, is an invasive procedure that requires the stripping of muscles and soft tissue, leading to surgical morbidity. Current minimally invasive (MI) spinal fusions are technically demanding and suffer from technical limitations. PURPOSE: Oblique lumbar lateral interbody fusion (OLLIF) is a new technique for fusion of the lumbar spine that overcomes these complications...
2015: Curēus
Liming Yu, Hongliang Liang, Xiaochao Dong, Guolong Zhao, Zhenxiao Jin, Mengen Zhai, Yang Yang, Wensheng Chen, Jincheng Liu, Wei Yi, Jian Yang, Dinghua Yi, Weixun Duan, Shiqiang Yu
Diabetes mellitus (DM) increases myocardial oxidative stress and endoplasmic reticulum (ER) stress. Melatonin confers cardioprotective effect by suppressing oxidative damage. However, the effect and mechanism of melatonin on myocardial ischemia-reperfusion (MI/R) injury in type 2 diabetic state are still unknown. In this study, we developed high-fat diet-fed streptozotocin (HFD-STZ) rat, a well-known type 2 diabetic model, to evaluate the effect of melatonin on MI/R injury with a focus on silent information regulator 1 (SIRT1) signaling, oxidative stress, and PERK/eIF2α/ATF4-mediated ER stress...
October 2015: Journal of Pineal Research
Hyung Tae Sim, Sung Ryong Kim, Min Sun Beom, Ji Wook Chang, Na Rae Kim, Mi Hee Jang, Sang Wan Ryu
BACKGROUND: Acute cerebral infarction is a major risk factor for postoperative neurologic complications in cardiac surgery. However, the outcomes associated with acute silent cerebral infarction (ASCI) have not been not well established. Few studies have reported the postoperative outcomes of these patients in light of preoperative Diffusion-weighted magnetic resonance imaging (DWI). We studied the postoperative neurologic outcomes of patients with preoperative ASCI detected by DWI. METHODS: We retrospectively studied 32 patients with preoperative ASCI detected by DWI...
December 2014: Korean Journal of Thoracic and Cardiovascular Surgery
Xianbao Liu, Huiqiang Chen, Wei Zhu, Han Chen, Xinyang Hu, Zhi Jiang, Yinchuan Xu, Yu Zhou, Kan Wang, Lihan Wang, Panpan Chen, Hengxun Hu, Chen Wang, Na Zhang, Qunchao Ma, Mingyuan Huang, Dexing Hu, Ling Zhang, Rongrong Wu, Yaping Wang, Qiyuan Xu, Hong Yu, Jian'an Wang
BACKGROUND: Previous studies have demonstrated that biological aging has a negative influence on the therapeutic effects of mesenchymal stem cells (MSCs)-based therapy. Using a rat myocardial infarction (MI) model, we tested the hypothesis that silent mating type information regulation 2 homolog 1 (SIRT1) may ameliorate the phenotype and improve the function of aged MSCs and thus enhance the efficacy of aged MSCs-based therapy. METHODS: Sixty female rats underwent left anterior descending coronary artery ligation and were randomly assigned to receiving: intramyocardial injection of cell culture medium (DMEM group); SIRT1 overexpression vector-treated aged MSCs (SIRT1-aged MSCs group) obtained from aged male SD rats or empty vector-treated aged MSCs (vector-aged MSCs group)...
October 2014: Journal of Heart and Lung Transplantation
E V Gerasimova, T V Popkova, D S Novikova, E L Nasonov
AIM: To compare the prevalence of risk factors, clinical and subclinical manifestations of cardiovascular diseases (CVD) and their complications in methotrexate (MT)-treated and untreated patients with rheumatoid arthritis. SUBJECTS AND METHODS: The investigation enrolled 193 patients (168 women and 25 men) less than 60 years of age (mean age 49 [44; 53] years) with RA. The patients were divided into 2 groups: 1) 69 patients who received MT in a dose of 15.1 [10...
2014: Terapevticheskiĭ Arkhiv
Mokhtar Abdallah, Rehan Raza, Tarek Abdallah, Donald McCord, Georges Khoueiry
It is well described that certain group of patients do not display the typical symptoms of myocardial infarction (MI). Elderly patients, diabetics and those with previous coronary artery bypass graft surgery are at high risk for silent MI. The diagnosis of Acute MI in the emergency room (ER) is mainly based on the electrocardiogram (EKG) findings of ST elevations or new onset left bundle branch block which is supported by the clinical presentation and positive biomarkers when present. The diagnoses can sometimes become challenging when the patient is asymptomatic and has coincidental finding of hyperkalemia with diffuse ST segment elevations simulating that seen with electrolyte disturbance...
July 2014: Heart & Lung: the Journal of Critical Care
Kenneth W Mahaffey, Claes Held, Daniel M Wojdyla, Stefan K James, Hugo A Katus, Steen Husted, Philippe Gabriel Steg, Christopher P Cannon, Richard C Becker, Robert F Storey, Nardev S Khurmi, José C Nicolau, Cheuk-Man Yu, Diego Ardissino, Andrzej Budaj, Joao Morais, Debra Montgomery, Anders Himmelmann, Robert A Harrington, Lars Wallentin
OBJECTIVES: This study sought to report the treatment effect of ticagrelor on myocardial infarction (MI) and the strategy for and impact of event adjudication in the PLATO (Platelet Inhibition and Patient Outcomes) trial. BACKGROUND: In PLATO, ticagrelor reduced cardiovascular death, MI, or stroke in patients with acute coronary syndromes (ACS). METHODS: A clinical events committee (CEC) prospectively defined and adjudicated all suspected MI events, on the basis of events reported by investigators and by triggers on biomarkers...
April 22, 2014: Journal of the American College of Cardiology
Maciej Grabowski, Maria Jaworska-Wilczyńska, Urszula Ablewska, Katarzyna Czerwińska-Jelonkiewicz, Elżbieta Abramczuk, Małgorzata Miłkowska, Tomasz Hryniewiecki
Despite the progress made in diagnosis and treatment of heart valve diseases, the incidence of infective endocarditis (IE) remains constant. It is still associated with high mortality and high rate of embolic complications, including most dangerous one, i.e. stroke. It has a significant impact on further treatment and qualifications for cardiac surgery. In this paper, the authors discuss the epidemiology, mechanisms of stroke and its impact on the qualifications for cardiac surgery. The authors discuss the problem of clinically silent central nervous system embolism in the course of IE and the usefulness of neuroimaging and markers of central nervous system damage in diagnosis of cerebral embolism...
January 2013: Neurologia i Neurochirurgia Polska
Kevin Zbuk, Changchun Xie, Robin Young, Mahyar Heydarpour, Guillaume Pare, A Darlene Davis, Ruby Miller, Matthew B Lanktree, Danish Saleheen, John Danesh, Salim Yusuf, James C Engert, Robert A Hegele, Sonia S Anand
BACKGROUND: Germline mutations of BRCA1/2 are associated with hereditary breast and ovarian cancer. Recent data suggests excess mortality in mutation carriers beyond that conferred by neoplasia, and recent in vivo and in vitro studies suggest a modulatory role for BRCA proteins in endothelial and cardiomyocyte function. We therefore tested the association of BRCA2 variants with clinical cardiovascular disease (CVD). METHODS: Using data from 1,170 individuals included in two multi-ethnic population-based studies (SHARE and SHARE-AP), the association between BRCA2 variants and CVD was evaluated...
2012: BMC Medical Genetics
Dae-Jin Kim, Young-Jin Song, Su-Jin Kim, Mi-Kyoung Park, Sun-Seob Choi, Ki-Uk Kim
OBJECTIVE: Clinical features of pituitary hemorrhage vary from asymptomatic to catastrophic. The purpose of this study was to evaluate the factors related to severity of hemorrhage of pituitary adenoma. METHODS: Pituitary hemorrhage was noted in 32 of 88 patients who underwent operations between January 2000 and December 2007. Clinical status was classified into group I (no hemorrhage symptoms), II (mild to moderate symptoms without neurological deficit), and III (with neurological deficit), and was compared to radiological, pathological, and operative findings...
July 2009: Journal of Korean Neurosurgical Society
Harm H H Feringa, Stefanos E Karagiannis, Radosav Vidakovic, Abdou Elhendy, Folkert J ten Cate, Peter G Noordzij, Ron T van Domburg, Jeroen J Bax, Don Poldermans
OBJECTIVE: The aim of this study is to determine the prevalence and prognosis of unrecognized myocardial infarction (MI) and silent myocardial ischemia in vascular surgery patients. METHODS: In a cohort of 1092 patients undergoing preoperative dobutamine stress echocardiography and noncardiac vascular surgery, unrecognized MI was determined by rest wall motion abnormalities in the absence of a history of MI. Silent myocardial ischemia was determined by stress-induced wall motion abnormalities in the absence of angina pectoris...
November 2007: Coronary Artery Disease
P J Devereaux, Lee Goldman, Salim Yusuf, Ken Gilbert, Kate Leslie, Gordon H Guyatt
This is the second of 2 articles evaluating cardiac events in patients undergoing noncardiac surgery. Unrecognized myocardial infarctions (MIs) are common, and up to 50% of perioperative MIs may go unrecognized if physicians rely only on clinical signs or symptoms. In this article, we summarize the evidence regarding monitoring strategies for perioperative MI in patients undergoing noncardiac surgery. Perioperative troponin measurements and 12-lead electrocardiograms can detect clinically silent MIs and provide independent prognostic information...
September 27, 2005: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
G Landesberg, M Mosseri, D Zahger, Y Wolf, M Perouansky, H Anner, B Drenger, Y Hasin, Y Berlatzky, C Weissman
OBJECTIVES: The goal of this study was to investigate the nature of the association between silent ischemia and postoperative myocardial infarction (PMI). BACKGROUND: Silent ischemia predicts cardiac morbidity and mortality in both ambulatory and postoperative patients. Whether silent stress-induced ischemia is merely a marker of extensive coronary artery disease or has a closer association with infarction has not been determined. METHODS: In 185 consecutive patients undergoing vascular surgery, we correlated ischemia duration, as detected on a continuous 12-lead ST-trend monitoring during the period 48 h to 72 h after surgery, with cardiac troponin-I (cTn-I) measured in the first three postoperative days and with postoperative cardiac outcome...
June 1, 2001: Journal of the American College of Cardiology
Serebruany, Jang, Giugliano, Massey, Schwarz Jr
Thrombolytic therapy has become a standard treatment for selected patients with acute myocardial infarction (MI). Various thrombolytic agents have been shown to decrease mortality. However, current thrombolytic agents still suffer significant shortcomings, such as a low optimal reperfusion rate delayed reperfusion. and incomplete myocardial perfusion. Furthermore, cyclic flow variations and reocclu.sions remain a significant cause of late morbidity and mortality. In thrombolysis with tissue plasminogen activator (t-PA), heparin seems to play an important role...
1998: Journal of Thrombosis and Thrombolysis
K Scavetta, C Oh, R Caldron, T Abdel-Dayem, M Al-Zaibag, K R Jutzy, R J Marsa, M Sjolander, P A Ribeiro
The results and complications of a single-center experience of stent implantation in old saphenous vein grafts (SVGs) need to be defined. The authors studied their initial consecutive 92 patients (125 stents, 1.4 stents/per patient) with a mean age of 67+/-9 years. The patients' mean saphenous vein graft (SVG) age was 10+/-4 years, and the mean left ventricular ejection fraction was 46%+/-15. Patient population included unstable angina (65%), stable angina (10%), myocardial infarction (21%), and silent ischemia (4%)...
November 1999: Angiology
H Kulbertus, V Legrand
Cardiovascular diseases represent the major cause of death in women. If women are early in life relatively protected by their hormones, after the menopause heart disease and stroke become their greatest health threat. Altogether one in three women will die of cardiovascular disease whereas only one in twenty-two will die of breast cancer. The risk factors for cardiovascular diseases are similar in both sexes. It should be noted however that the impact of diabetes on the development of coronary artery disease is markedly higher in woman than in man...
April 1999: Revue Médicale de Liège
G C Hughes, K P Landolfo, J E Lowe, R B Coleman, C L Donovan
BACKGROUND: Clinical improvement after transmyocardial laser revascularization (TMR) is typically delayed, and patients therefore remain at risk for ischemic events after the procedure. The purpose of this study was to define the range of creatine phosphokinase (CPK) and CPK-MB enzyme elevation after TMR and to assess the incidence of early postoperative ischemic events. METHODS: Twenty-one patients undergoing isolated TMR were evaluated for 48 hours after surgery with serial CPK and CPK-MB enzymes and 12-lead electrocardiograms for evidence of myocardial ischemia or injury...
June 1999: American Heart Journal
C Heim, A Geel, T Münzer, W Angehrn, H Roelli, H Niederhauser
UNLABELLED: Perioperative, mostly silent ischaemia in patients with coronary heart disease is difficult to detect by clinical examinations. METHODS: During the clinical evaluation (part I of this study) we monitored patients with prior myocardial infarction (MI) by continuous electrocardiographic (ECG) recording from the evening before until the first 24 h after operation. Excluded from Holter ECG studies were patients with a bundle branch block, pacemaker, valvular heart disease, cardiomyopathy, severe hypokalaemia, and digitalis treatment...
March 1996: Der Anaesthesist
T Münzer, G Stimming, B Brücker, A Geel, C Heim, G Kreienbühl
UNLABELLED: Patients with a prior myocardial infarction (MI) have a high risk of perioperative reinfarction compared with the normal population (5%-8% vs. 0.1%-0.7%) [10]. According to Rao [13], a reduction of this risk is possible when patients are monitored invasively and all haemodynamic parameters are kept within the physiological range. In most institutions it is not feasible to treat patients as Rao recommended: this would overstrain both hospital structure and financial resources...
March 1996: Der Anaesthesist
E Rapaport, M Gheorghiade
Despite the availability and use of effective methods for limiting infarct size with thrombolytic agents and primary angioplasty, patients experiencing a myocardial infarction (MI) are at increased risk for a second cardiac event in the post-MI period (e.g., reinfarction, heart failure, and sudden death). For this reason, postinfarction risk management is crucial. An extensive data base has firmly established the efficacy of beta blockers in reducing cardiovascular risk following acute MI. The full advantages of angiotensin-converting enzyme (ACE) inhibitors have only recently begun to emerge as the result of a growing understanding of the mechanisms of adverse outcomes following MI...
October 8, 1996: American Journal of Medicine
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