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Dirk J van der Windt, Patrick Bou-Samra, Esmaeel R Dadashzadeh, Xilin Chen, Patrick R Varley, Allan Tsung
BACKGROUND: The Risk Analysis Index (RAI) for frailty is a rapid survey for comorbidities and performance status, which predicts mortality after general surgery. We aimed to validate the RAI in predicting outcomes after hepatopancreatobiliary surgery. METHODS: Associations of RAI, determined in 162 patients prior to undergoing hepatopancreatobiliary surgery, with prospectively collected 30-day post-operative outcomes were analyzed with multivariate logistic and linear regression...
July 10, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Thomas R Einarson, Annabel Acs, Craig Ludwig, Ulrik H Panton
BACKGROUND: Cardiovascular diseases (CVDs) constitute major comorbidities in type 2 diabetes mellitus (T2DM), contributing substantially to treatment costs for T2DM. An updated overview of the economic burden of CVD in T2DM has not been presented to date. OBJECTIVE: To systematically review published articles describing the costs associated with treating CVD in people with T2DM. METHODS: Two reviewers searched MEDLINE, Embase, and abstracts from scientific meetings to identify original research published between 2007 and 2017, with no restrictions on language...
July 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
John E Krzeczkowski, Louis A Schmidt, Calan Savoy, Saroj Saigal, Ryan J Van Lieshout
OBJECTIVE: Extremely low birth weight (ELBW; <1000 g) survivors are exposed to significant perinatal adversity. In many cases, mothers of these infants receive antenatal corticosteroids (ACS), which reduce offspring neonatal mortality but may have lasting neuropsychiatric effects. However, the long-term neurophysiological effects of being born at ELBW and exposed to ACS are unknown. METHODS: We compared resting frontal electroencephalogram (EEG) alpha asymmetry in ELBW survivors (n = 51), some of whom were exposed to antenatal corticosteroids (ELBW-S; n = 23) versus non-exposed (ELBW-NS; n = 28), and normal birth weight controls (NBW; n = 66) in adulthood (mage  = 32...
June 22, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Koji Tamai, Christopher Wang, Patrick Heindel, Permsak Pahpolak, Zorica Buser, Jeffrey C Wang
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To demonstrate the relationship between perioperative use of catheters and the incidence of surgical site infection (SSI) after cervical spine surgery, after adjusting for patient's age, severity of comorbidity, surgical approach, and use of instrumentation. SUMMARY OF BACKGROUND DATA: Although the association between SSI and the use of arterial catheters (ACs) or central venous catheters (CVCs) is established in cardiac surgery, the relation in the cervical spine was not well elucidated...
July 12, 2018: Spine
Rachel S Bronheim, Eric K Oermann, David S Bronheim, John M Caridi
STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To determine the ability of Revised Cardiac Risk Index (RCRI) to predict adverse cardiac events following posterior lumbar decompression (PLD). SUMMARY OF BACKGROUND DATA: PLD is an increasingly common procedure used to treat a variety of degenerative spinal conditions. The RCRI is used to predict risk for cardiac events following non-cardiac surgery. There is a paucity of literature that directly addresses the relationship between RCRI and outcomes following PLD, specifically, the discriminative ability of the RCRI to predict adverse post-operative cardiac events...
July 12, 2018: Spine
Dorota Danielak, Marta Karaźniewicz-Łada, Franciszek Główka
The introduction of ticagrelor, one of the first directly-acting oral antiplatelet drugs, provided new possibilities in the prevention of thrombotic events in patients with acute coronary syndromes (ACS). Current guidelines recommend ticagrelor in dual antiplatelet therapy with aspirin over clopidogrel for prevention of stent thrombosis in patients with ACS. Moreover, in the management of ACS, lipid-lowering treatment with high-intensity statin therapy is advised for secondary prevention of cardiovascular events over the long term...
July 12, 2018: Drugs
Jorge Ramón Padilla-Gutiérrez, Emmanuel Valdés-Alvarado, Saraí Citlalic Rodríguez-Reyes, Juan Arellano-Martin, Héctor Enrique Flores-Salinas, José Francisco Muñoz Valle, Yeminia Valle
Acute coronary syndrome (ACS) is the leading cause of death in elderly patients worldwide. Due its participation in apoptosis, fibrosis, and angiogenesis, transforming growth factor-β (TGF-β) isoforms had been categorized as risk factors for cardiovascular diseases. However, due their contradictory activities, a cardioprotective role has been suggested. The aim was to measure the plasma levels of TGF-β1, 2, and 3 proteins in patients with ACS. This was a case-control study including 225 subjects. The three activated isoforms were measured in serum using the Bio-Plex Pro TGF-β assay by means of magnetic beads; the fluorescence intensity of reporter signal was read in a Bio-Plex Magpix instrument...
July 12, 2018: Cell Biochemistry and Biophysics
Abraam M Yakoub, Ralph Schulz, Martina Seiffert, Mark Sadek
Apoptosis is an important physiological process in development and disease. Apoptotic cells (ACs) are a major source of self-antigens, but ACs usually evade immune responses. The mechanism by which ACs repress T cell adaptive immune responses is poorly understood. T cell activation is finely regulated by a balance of costimulatory signaling (mediated by the costimulatory receptor CD28 on T cells) and coinhibitory signaling (mediated by the coinhibitory ligands CD80 and PD-L1 and -2 on Antigen-Presenting Cells)...
July 12, 2018: Scientific Reports
Chikao Yutani, Teruaki Nagano, Sei Komatsu, Kazuhisa Kodama
The number of released free cholesterol crystal emboli (fCCE) and their role during percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) have not been documented yet. Furthermore, fCCE manifesting in the coronary lumen following plaque rupture has been historically overlooked owing to the standard tissue preparation for light microscopy which uses ethanol as a dehydrating agent that can dissolve fCCE, leaving behind empty tissue. In this case report, we evaluated fCCE released during PCI for ACS and their relationship with myocardial injury and coronary artery obstruction on the H&E-stained sections by using polarised light microscopy...
July 11, 2018: BMJ Case Reports
Francesco Prati, Laura Gatto, Enrico Romagnoli, Ugo Limbruno, Massimo Fineschi, Valeria Marco, Mario Albertucci, Corrado Tamburino, Filippo Crea, Fernando Alfonso, Eloisa Arbustini
BACKGROUND: Autopsy studies shed light on the interplay between fatal acute coronary syndromes (ACS) and features of plaque vulnerability. This is a prospective pilot study designed for generating a new in vivo imaging grading system of plaque vulnerability. METHODS: We studied 87 coronary vessels in 63 consecutive patients: 48 with Acute Coronary Syndrome (ACS) and 15 with stable coronary artery disease using IntraVascular-Ultrasound Near-Infrared-Spectroscopy (IVUS-NIRS) and Optical Coherence Tomography (OCT)...
July 1, 2018: International Journal of Cardiology
Jun Shitara, Manabu Ogita, Hideki Wada, Shuta Tsuboi, Hirohisa Endo, Shinichiro Doi, Hirokazu Konishi, Ryo Naito, Tomotaka Dohi, Takatoshi Kasai, Shinya Okazaki, Kikuo Isoda, Satoru Suwa, Katsumi Miyauchi, Hiroyuki Daida
INTRODUCTION: C-reactive protein (CRP) is an established marker for vascular inflammation and predictor of adverse cardiovascular events, but the prognostic value of preprocedural CRP in coronary artery disease (CAD) patients who have undergone percutaneous coronary intervention (PCI) remains controversial. Furthermore, the impact of CRP levels during follow-up in CAD patients after PCI on long-term adverse clinical outcomes is uncertain. We evaluated the association between high-sensitivity (hs)-CRP values at follow-up angiography and long-term clinical outcomes in CAD patients after coronary intervention...
July 9, 2018: Journal of Cardiology
Lei Gu, Dean Bok, Fei Yu, Joseph Caprioli, Natik Piri
Rbfox1 is a splicing regulator that has been associated with various neurological conditions such as autism spectrum disorder, mental retardation, epilepsy, attention-deficit/hyperactivity disorder and schizophrenia. We show that in adult rodent retinas, Rbfox1 is expressed in all types of retinal ganglion cells (RGCs) and in certain subsets of amacrine cells (ACs), within the inner nuclear (INL) and ganglion cell (GCL) layers. In the INL, all Rbfox1-positive cells were colocalized with GABAergic ACs, however not all GABAergic ACs were immunostained for Rbfox1...
2018: PloS One
Sherif M Badawy, Amanda B Payne, Mark J Rodeghier, Robert I Liem
OBJECTIVES: To determine factors associated with exercise capacity in adults with sickle cell disease (SCD) and its relationship to hospitalizations and mortality. METHODS: A total of 223 participants in the Cooperative Study of Sickle Cell Disease (CSSCD) (64% female, 70% hemoglobin SS/Sβ0 thalassemia, mean age 43.3 ± 7.5 years) underwent maximal exercise testing using a treadmill protocol with a mean duration of 11.6 ± 5.2 minutes. RESULTS: Female sex (β = -3...
July 12, 2018: European Journal of Haematology
Nathaniel A Erskine, Molly E Waring, David D McManus, Darleen Lessard, Catarina I Kiefe, Robert J Goldberg
BACKGROUND: Barriers to healthcare are common in the USA and may result in worse outcomes among hospital survivors of an acute coronary syndrome (ACS). OBJECTIVE: To examine the relationship between barriers to healthcare and 2-year mortality after hospital discharge for an ACS. DESIGN: Longitudinal study. SETTING: Survivors of an ACS hospitalization were recruited from 6 medical centers in central Massachusetts and Georgia in 2011-2013...
July 11, 2018: Journal of General Internal Medicine
Ayman Azoz, Adel Youssef, Abdullah Alshehri, Ahmed Gad, Mostafa Rashed, Mohamed Yahia, Maryam Alsharqi, Lamia Al Saikhan
BACKGROUND: Diastolic dysfunction is the early sign of myocardial ischemia that usually occurs earlier than ECG changes. AIM OF THE STUDY: To determine the existence of a correlation between ST segment shift and diastolic dysfunction among patients with AMI. METHODS: Fourty six patients with significant ST segment elevation or depression and having symptoms of acute myocardial infarction for <12 h were enrolled in this study. Patients were examined for serial ECG, cardiac enzymes, and echocardiography...
July 2018: Journal of Electrocardiology
Koray Demirtaş, Çağri Yayla, Leyla Elif Sade, Aylin Yildirir, Mehmet Bülent Özin, Ayşegül Haberal, Ibrahim Haldun Müderrisoğlu
γ-Glutamyl transferase (GGT) participates in oxidative and inflammatory reactions inside the atheroma plaque and platelets. We evaluated whether platelet membrane γ-glutamyl transferase (Plt-GGT) activity is a predictor of major adverse cardiac events (MACEs) during 3 months follow-up of patients with acute coronary syndrome (ACS; MACE-3M). We included 105 patients who were hospitalized consecutively with the diagnosis of ACS. Patients with an MACE-3M were older, more likely to have hypertension, hyperlipidemia, family history of coronary artery disease(CAD), thrombolysis in myocardial infarction (TIMI) risk score >4, higher Plt-GGT and serum GGT activities, serum C-reactive protein level, and lower left ventricular ejection fraction (LVEF) when compared to those without MACE-3M (all P values ≤...
January 1, 2018: Angiology
Yuichi Ozaki, Atsushi Tanaka, Tsuyoshi Nishiguchi, Kenichi Komukai, Akira Taruya, Keisuke Satogami, Manabu Kashiwagi, Akio Kuroi, Yoshiki Matsuo, Yasushi Ino, Hironori Kitabata, Takashi Kubo, Takeshi Hozumi, Takashi Akasaka
OBJECTIVE: The current guideline recommends lowering low-density lipoprotein cholesterol (LDL-C) for the primary management of dyslipidemia in patients at high-risk of cardiovascular events. Patients who have achieved LDL-C levels below the recommended targets may still experience cardiovascular events, suggesting additional therapeutic targets beyond LDL-C. The aim of this study was to investigate whether high-density lipoprotein cholesterol (HDL-C) levels had an impact on plaque stabilization in patients with acute coronary syndrome (ACS)...
2018: PloS One
Jingwei Li, Hong Wang, Junping Tian, Buxing Chen, Fenghe Du
Lipoprotein-associated phospholipase A2 (Lp-PLA2) probably plays an important role in the development of acute coronary syndrome (ACS). However, alterations of Lp-PLA2 levels during ACS and its association with cardiovascular outcome are unclear. Our aim was to investigate the change in Lp-PLA2 and its association with cardiovascular outcome in patients with ACS.A total of 79 patients with ACS came from the coronary care unit (CCU) between June 1, 2015 and August 31, 2016 in this longitudinal study. Serum levels of Lp-PLA2, troponin I, and creatine kinase isoenzymes MB (CK-MB) were measured at admission, on the first morning (D1), on the second morning of hospitalization (D2), and on the last second morning before discharge (D4)...
July 2018: Medicine (Baltimore)
Lisa Gross, Dirk Sibbing, Christian Schulz, Florian Gärtner, Joachim Pircher, Steffen Massberg, Tobias Petzold
A core research area in the Department of Cardiology at Ludwig-Maximilians-University (LMU) Munich focuses on antiplatelet therapy, its translational aspects, and its underlying mechanism with respect to platelet physiology. We are conducting a broad range of investigator-initiated clinical trials (phase II-IV) and preclinical studies on the topic of antithrombotic therapy for percutaneous coronary intervention patients, platelet activation, and reactivity as well as on novel inhibitors of platelet adhesion...
July 11, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Durga Jha, Luxitaa Goenka, R Thilagavathi, Masum Sharma, V E Dhandapani, Melvin George
BACKGROUND: Acute Coronary Syndrome (ACS) patients are at an increased risk of major adverse cardiovascular events (MACE). The objective of our study was to assess whether cardiac biomarker like soluble ST2 (sST2) can predict MACE among ACS patients with diabetes. MATERIALS AND METHODS: A total of 122 ACS patients were included in the study. sST2 level in blood plasma samples was quantified by using enzyme-linked immunosorbent assay (ELISA). Prognostic utility of sST2 for the primary outcome of MACE which included mortality, re-hospitalization due to chest pain, unstable angina, recurrent myocardial infarction (MI) and stroke assessed during follow up...
July 11, 2018: European Journal of Clinical Investigation
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