EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 23

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<1>
Accession Number
19662337
Authors
Weir R.A. Balmain S. Steedman T. Ng L.L. Squire I.B. Rumley A. Dargie H.J.
Lowe G.D.
Institution
(Weir) Cardiology Department, Western Infirmary, Glasgow, Scotland, UK.
Title
Tissue plasminogen activator antigen predicts medium-term left ventricular
end-systolic volume after acute myocardial infarction.
Source
Journal of thrombosis and thrombolysis. 29 (4) (pp 421-428), 2010. Date
of Publication: May 2010.
Abstract
Von Willebrand factor (VWF) and tissue plasminogen activator (t-PA)
predict adverse cardiovascular outcome following acute myocardial
infarction (AMI) and are weakly associated with pre-discharge left
ventricular ejection fraction (LVEF). We examined the relationships
between VWF, t-PA antigen, matrix metalloproteinase (MMP)-2,-3, and -9,
and B-type natriuretic peptide (BNP), and their predictive effect on
serial change in LV volumes in a cohort of patients admitted with AMI.
Plasma VWF, t-PA antigen, MMP-2,-3,-9, and BNP were measured at a mean 46
h after AMI in 100 patients (mean age 58.9 +/- 12 years, 77% male) with
depressed LVEF. Cardiac magnetic resonance (CMR) imaging was then
performed. Biomarker measurement and CMR were repeated at 12 and 24 weeks.
Plasma concentrations of VWF, BNP and MMP-9 were elevated while t-PA
antigen concentration was at the upper limits of normal; over 24 weeks
VWF, t-PA antigen, MMP-9 and BNP decreased significantly. Baseline VWF
correlated with BNP (r = 0.35, P < 0.001) and MMP-3 (r = 0.24, P = 0.019)
as did t-PA antigen (r = 0.27, P = 0.007 for BNP; r = 0.40, P < 0.001 for
MMP-3). t-PA antigen, VWF, MMP-3 and BNP were univariate predictors of LV
end-systolic volume at 24 weeks; tPA antigen and BNP remained significant
independent predictors on multivariate analysis. t-PA antigen and VWF are
related to medium-term LV volumes after AMI, and to MMP-3. This novel link
between the coagulation-fibrinolysis system and matrix turnover merits
further study in understanding the pathophysiology of adverse ventricular
remodeling after AMI.

<2>
Accession Number
2010420279
Authors
Choi D.K. Chin J.H. Lee E.H. Lim O.B. Chung C.H. Ro Y.J. Choi I.C.
Institution
(Choi, Chin, Lee, Ro, Choi) Department of Anesthesiology and Pain
Medicine, Asan Medical Center College of Medicine, University of Ulsan,
388-1 Pungnap 2-dong Songpa-gu, Seoul 138-736, South Korea
(Lim, Chung) Departments of Cardiovascular Surgery, College of Medicine,
University of Ulsan, Seoul, South Korea
Title
Prophylactic control of post-operative nausea and vomiting using
ondansetron and ramosetron after cardiac surgery.
Source
Acta Anaesthesiologica Scandinavica. 54 (8) (pp 962-969), 2010. Date of
Publication: September 2010.
Publisher
Blackwell Munksgaard (1 Rosenorns Alle, P.O. Box 227, Copenhagen V
DK-1502, Denmark)
Abstract
Background: The aim of this study was to evaluate the efficacy of
ondansetron and ramosetron in the reduction of post-operative nausea and
vomiting (PONV) associated with patient-controlled analgesia (PCA) after
cardiac surgery. Methods: A total of 320 patients scheduled for elective
cardiac surgery were enrolled. Patients were randomly assigned to one of
four treatment regimens (n=80 in each group): no prophylactic antiemetics
(group P); intravenous (i.v.) ondansetron 4 mg at the end of surgery and
12 mg added to PCA (group O); i.v. ramosetron 0.3 mg at the end of surgery
and no antiemetics added to PCA (group R1); and i.v. ramosetron 0.3 mg at
the end of surgery and 0.6 mg added to PCA (group R2). Results: The
incidence of PONV during the 48-h post-operative period was lower in
groups O (46%), R1 (54%), and R2 (35%) compared with group P (71%,
P<0.001). The incidence and severity of nausea were lower in groups O, R1,
and R2 than in group P during the 24-h post-operative period, whereas the
incidence and severity of nausea during 24-48 h after surgery were lower
in groups O and R2, but not in group R1, than in group P. Compared with
group P (53%), the frequency of rescue antiemetic usage was significantly
lower in groups O (34%) and R2 (29%), but not in group R1 (43%).
Conclusion: The addition of either ondansetron or ramosetron to PCA can
reduce the incidence of PONV during 48 h after cardiac surgery. 2010 The
Authors.

<3>
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Accession Number
20348438
Authors
Weir R.A. Murphy C.A. Petrie C.J. Martin T.N. Balmain S. Clements S.
Steedman T. Wagner G.S. Dargie H.J. McMurray J.J.
Institution
(Weir) Cardiology Department, Western Infirmary, Glasgow, Scotland, United
Kingdom.
Title
Microvascular obstruction remains a portent of adverse remodeling in
optimally treated patients with left ventricular systolic dysfunction
after acute myocardial infarction.
Source
Circulation. Cardiovascular imaging. 3 (4) (pp 360-367), 2010. Date of
Publication: 1 Jul 2010.
Abstract
BACKGROUND: Microvascular obstruction (MO) is associated with large acute
myocardial infarction and lower left ventricular (LV) ejection fraction
and predicts greater remodeling, but whether this effect is abolished by
contemporary antiremodeling therapies is subject to debate. We examined
the influence of several infarct characteristics, including MO, on LV
remodeling in an optimally treated post-acute myocardial infarction
cohort, using contrast-enhanced cardiac magnetic resonance. METHODS AND
RESULTS: One hundred patients (mean age, 58.9+/-12 years, 77%men)
underwent contrast-enhanced cardiac magnetic resonance at baseline
(approximately 4 days) and at 12 and 24 weeks. The effects on LV
remodeling (ie, change in LV end-systolic volume index [DeltaLVESVi]) of
infarct site, transmurality, endocardial extent, and the presence of early
and late MO were analyzed. Mean baseline infarct volume index decreased
from 34.0 (21.2) mL/m(2) to 20.9 (12.9) mL/m(2) at 24 weeks (P<0.001).
Infarct site had no influence on remodeling, but greater baseline infarct
transmurality (r=0.47, P<0.001) and endocardial extent (r=0.26, P<0.01)
were associated with higher DeltaLVESVi. Early MO was seen in 69 patients
(69%) and persisted as late MO in 56 patients (56%). Patients with late MO
underwent significantly greater remodeling than those without MO
(DeltaLVESVi, +4.1 [13.4] versus -7.0 [12.7] mL/m(2), respectively,
P=0.001); those with early MO only displayed an intermediate DeltaLVESVi
(-4.9 [13.0] mL/m(2)). Importantly, late MO was seen frequently despite
optimal coronary blood flow having been restored at angiography.
CONCLUSIONS: Late MO on predischarge contrast-enhanced cardiac magnetic
resonance remains an ominous predictor of adverse LV remodeling despite
powerful antiremodeling therapy and may be useful in the risk
stratification of survivors of acute myocardial infarction.

<4>
Accession Number
20381820
Authors
Chen W.T. Krishnan G.M. Sood N. Kluger J. Coleman C.I.
Institution
(Chen) University of Connecticut School of Pharmacy, Storrs, Conn
06102-5037, USA.
Title
Effect of statins on atrial fibrillation after cardiac surgery: a
duration- and dose-response meta-analysis.
Source
The Journal of thoracic and cardiovascular surgery. 140 (2) (pp 364-372),
2010. Date of Publication: Aug 2010.
Abstract
OBJECTIVE: This meta-analysis of randomized, controlled trials evaluated
effects of statins on postoperative atrial fibrillation risk after cardiac
surgery. METHODS: Randomized, controlled trials evaluating statins in
cardiac surgery were selected from MEDLINE (1996-August 2009), Cochrane
CENTRAL Register, and manual review of references without any language
restrictions. End points examined included postoperative atrial
fibrillation, intensive care unit stay, and total hospital stay.
Meta-regression analyses were conducted to determine whether statins'
effects were duration or dose dependent. A random-effects model was used
in all instances. RESULTS: Eight trials (n = 774) were identified and
subjected to meta-analysis. Statins reduced postoperative atrial
fibrillation risk (relative risk 0.57, 95% confidence interval 0.45-0.72,
P < .0001, risk difference -0.14, 95% confidence interval -0.20 to -0.08,
P < .0001, number needed to treat 8) and total hospital stay (weighted
mean difference -0.66 days, 95% confidence interval -1.01 to -0.30 days, P
= .0004) relative to placebo. Intensive care unit stay was also reduced
(weighted mean difference -0.17 days, 95% confidence interval -0.37 to
0.03 days, P = .09) but did not meet prespecified criteria for statistical
significance. Metaregression analysis revealed association between
duration of preoperative statin prophylaxis and postoperative atrial
fibrillation risk reduction (3% reduction per day, P = .008). No
association was found between statin dose used and risk reduction (P =
.47). CONCLUSIONS: Evidence suggests that statins are associated with
reduced risk of postoperative atrial fibrillation and shorter hospital
stay after cardiac surgery and that earlier therapy results in more
profound benefit. Copyright 2010 The American Association for Thoracic
Surgery. Published by Mosby, Inc. All rights reserved.

<5>
Accession Number
20404622
Authors
Anderson J. Henry L. Hunt S. Ad N.
Institution
(Anderson) Cardiovascular Intensive Care Unit, Inova Health Systems, Falls
Church, Virginia 22032, USA.
Title
Bispectral index monitoring to facilitate early extubation following
cardiovascular surgery.
Source
Clinical nurse specialist CNS. 24 (3) (pp 140-148), 2010. Date of
Publication: 2010 May-Jun.
Abstract
Frequently, intensive care nurses assume responsibility for extubating
patients after undergoing cardiac surgery. Bispectral index (BIS)
monitoring assesses level of mental arousal and awareness when sedated.
This study was to determine if the BIS might facilitate earlier extubation
of patients following cardiac surgery. A study was conducted comparing 25
stable patients returning to the intensive care unit with a BIS with 25
patients managed without the BIS (N = 50). Data collected included age,
sex, surgery, pH, CO2, and temperature on arrival/extubation, total
intravenous propofol and pain medication, and BIS scores. Student t tests
determined that there were no differences between groups for age, amount
of propofol and pain medication received, or time to extubation (P > .05).
Regression analysis determined that total propofol, total hydromorphone,
and age were significant predictors of time to extubation. In this study,
the BIS monitor did not facilitate earlier extubation in the stable
patient after cardiac surgery.

<6>
Accession Number
20430207
Authors
Wang S.S. Chou N.K. Chi N.H. Huang S.C. Wu I.H. Wang C.H. Yu H.Y. Chen
Y.S. Tsao C.I. Ko W.J. Shun C.T.
Institution
(Wang) Department of Cardiovascular Surgery, National Taiwan University
Hospital, Taipei, Taiwan.
Title
Can cyclosporine blood level be reduced to half after heart
transplantation?.
Source
Transplantation proceedings. 42 (3) (pp 930-933), 2010. Date of
Publication: Apr 2010.
Abstract
BACKGROUND: Cyclosporine (CsA) is widely used after heart transplantation.
The purpose of this prospective randomized study was to evaluate the
safety and efficacy of reduction of CsA blood level to one-half of the
traditional blood concentration under a regimen of everolimus (EVL), CsA,
and steroid. MATERIALS AND METHODS: This prospective, 6 month, randomized,
open-label study included adult (aged 18 to 65 years) recipients of a
primary heart transplant with serum creatinine<or=2.8 mg/dL. Among 52
patients who underwent heart transplantation from December 2004 to March
2006 we excluded those who were hepatitis B or C carriers, who were
recipients of organs from donors>60 years old, had cold ischemia time>6
hours, or had plasma renin activity>or=25%. All patients received CsA (C2
blood level 1000-1400 ng/mL), EVL (C0 target 3-8 ng/mL), and
corticosteroids to day 60, before random entry into one of 2 groups: SE
(C2 blood level from days 60-149=800-1200 ng/mL, and days 150-180
C2=600-1000 ng/mL), or RE group with CsA reduced by one-half after 3
months (days 90-149 C2=400-600 ng/mL, and from days 150-180 C2=300-500
ng/mL). RESULTS: The 25 recipients eligible for this study included 13
patients in the SE and 12 in the RE group. There was no operative
mortality in either group. No death or graft loss was noted within
6-months in either group. Mean serum creatinine at month 6 tended to be
lower in the RE cohort (1.23+/-0.44 mg/dL versus 1.55+/-0.85 mg/dL;
P=.093). Biopsy-proven acute rejection>or=grade 3A was observed in only 1
patient (7.7%), who was in the SE group. There were no acute rejection
episodes associated with hemodynamic compromise. The incidences of adverse
events in each group were similar. CONCLUSIONS: Concentration-controlled
EVL (C0 target 3-8 ng/mL) in combination with reduced CsA exposure of
one-half the usual concentration achieved good efficacy and safety over 6
months. The renal function at 6 months among the RE group showed a trend
toward improvement, suggesting a benefit of halving the target CsA blood
level after heart transplantation. Copyright (c) 2010 Elsevier Inc. All
rights reserved.

<7>
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Accession Number
20430934
Authors
Erbs S. Hollriegel R. Linke A. Beck E.B. Adams V. Gielen S. Mobius-Winkler
S. Sandri M. Krankel N. Hambrecht R. Schuler G.
Institution
(Erbs) Department of Internal Medicine/Cardiology, University of
Leipzig-Heart Center, Leipzig, Germany.
Title
Exercise training in patients with advanced chronic heart failure (NYHA
IIIb) promotes restoration of peripheral vasomotor function, induction of
endogenous regeneration, and improvement of left ventricular function.
Source
Circulation. Heart failure. 3 (4) (pp 486-494), 2010. Date of
Publication: 1 Jul 2010.
Abstract
BACKGROUND: Attenuated peripheral perfusion in patients with advanced
chronic heart failure (CHF) is partially the result of endothelial
dysfunction. This has been causally linked to an impaired endogenous
regenerative capacity of circulating progenitor cells (CPC). The aim of
this study was to elucidate whether exercise training (ET) affects
exercise intolerance and left ventricular (LV) performance in patients
with advanced CHF (New York Heart Association class IIIb) and whether this
is associated with correction of peripheral vasomotion and induction of
endogenous regeneration. METHODS AND RESULTS: Thirty-seven patients with
CHF (LV ejection fraction 24+/-2%) were randomly assigned to 12 weeks of
ET or sedentary lifestyle (control). At the beginning of the study and
after 12 weeks, maximal oxygen consumption (Vo(2)max) and LV ejection
fraction were determined; the number of CD34(+)/KDR(+) CPCs was quantified
by flow cytometry and CPC functional capacity was determined by migration
assay. Flow-mediated dilation was assessed by ultrasound. Capillary
density was measured in skeletal muscle tissue samples. In advanced CHF,
ET improved Vo(2)max by +2.7+/-2.2 versus -0.8+/-3.1 mL/min/kg in control
(P=0.009) and LV ejection fraction by +9.4+/-6.1 versus -0.8+/-5.2% in
control (P<0.001). Flow-mediated dilation improved by +7.43+/-2.28 versus
+0.09+/-2.18% in control (P<0.001). ET increased the number of CPC by
+83+/-60 versus -6+/-109 cells/mL in control (P=0.014) and their migratory
capacity by +224+/-263 versus -12+/-159 CPC/1000 plated CPC in control
(P=0.03). Skeletal muscle capillary density increased by +0.22+/-0.10
versus -0.02+/-0.16 capillaries per fiber in control (P<0.001).
CONCLUSIONS: Twelve weeks of ET in patients with advanced CHF is
associated with augmented regenerative capacity of CPCs, enhanced
flow-mediated dilation suggestive of improvement in endothelial function,
skeletal muscle neovascularization, and improved LV function. Clinical
Trial Registration- http://www.clinicaltrials.gov. Unique Identifier:
NCT00176384.

<8>
Accession Number
20614453
Authors
Davies P. Taylor F. Beswick A. Wise F. Moxham T. Rees K. Ebrahim S.
Institution
(Davies) Academic Unit of Psychiatry, Community Based Medicine, University
of Bristol, Cotham House, Cotham, Bristol, UK, BS6 6JL.
Title
Promoting patient uptake and adherence in cardiac rehabilitation.
Source
Cochrane database of systematic reviews (Online). 7 (pp CD007131), 2010.
Date of Publication: 2010.
Abstract
BACKGROUND: Cardiac rehabilitation is an important component of recovery
from coronary events but uptake and adherence to such programmes are below
the recommended levels. This aim is to update a previous non-Cochrane
systematic review which examined interventions that may potentially
improve cardiac patient uptake and adherence in rehabilitation or its
components and concluded that there is insufficient evidence to make
specific recommendations. OBJECTIVES: To determine the effects of
interventions to increase patient uptake of, and adherence to, cardiac
rehabilitation. SEARCH STRATEGY: A previous systematic review identified
studies published prior to June 2001. We searched the Cochrane Central
Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 4
2007), MEDLINE (2001 to January 2008), EMBASE (2001 to January 2008),
CINAHL (2001 to January 2008), PsycINFO (2001 to January 2008), Web of
Science: ISI Proceedings (2001 to April 2008), and NHS Centre for Reviews
and Dissemination (CRD) databases (Health Technology Assessment (HTA) and
Database of Abstracts of Reviews of Effects (DARE)) from 2001 to January
2008. Reference lists of identified systematic reviews and randomised
control trials (RCTs) were also checked for additional studies. SELECTION
CRITERIA: Adults with myocardial infarction, coronary artery bypass graft,
percutaneous transluminal coronary angioplasty, heart failure, angina, or
coronary heart disease eligible for cardiac rehabilitation and randomised
or quasi-randomised trials of interventions to increase uptake or
adherence to cardiac rehabilitation or any of its component parts. Only
studies reporting a measure of adherence were included. DATA COLLECTION
AND ANALYSIS: Titles and abstracts of all identified references were
screened for eligibility by two reviewers independently and full papers of
potentially relevant trials were obtained and checked. Included studies
were assessed for risk of bias by two reviewers. MAIN RESULTS: Ten studies
were identified, three of interventions to improve uptake of cardiac
rehabilitation and seven of interventions to increase adherence.
Meta-analysis was not possible due to multiple sources of heterogeneity.
All three interventions targeting uptake of cardiac rehabilitation were
effective. Two of seven studies intended to increase adherence had a
significant effect. Only one study reported the non-significant effects of
the intervention on cardiovascular risk factors and no studies reported
data on mortality, morbidities, costs or health care resource utilisation.
AUTHORS' CONCLUSIONS: There is some evidence to suggest that interventions
to increase the uptake of cardiac rehabilitation can be effective. Few
practice recommendations for increasing adherence to cardiac
rehabilitation can be made at this time. Interventions targeting patient
identified barriers may increase the likelihood of success. Further high
quality research is needed.

<9>
Accession Number
70234831
Authors
Butera G. Biondi-Zoccai G. Carminati M. Abella R. Saliba Z. Chessa M.
Giamberti A. Frigiola A.
Institution
(Butera, Carminati, Abella, Chessa, Giamberti, Frigiola) Policlinico San
Donato IRCCS, Italy
(Biondi-Zoccai) Universit di Torino, Italy
(Saliba) Univesrity of Beirut, Lebanon
Source
Cardiology in the Young. Conference: 5th World Congress of Paediatric
Cardiology and Cardiac Surgery Cairns, QLD Australia. Conference Start:
20090621 Conference End: 20090626. Conference Publication: (var.pagings).
20 (pp 56-57), 2010. Date of Publication: April 2010.
Publisher
Cambridge University Press
Abstract
Aim: To provide an evidence-based evaluation of all available studies
comparing surgery and the transcatheter approach in ASD closure. Methods:
Electronic databases were systematically searched for pertinent clinical
studies comparing the two methods of closure (percutaneous and surgical)
published up to October 2008 and reporting on > 20 patients. The primary
endpoints were the occurrence of death, of total and major early
complications. Pooled estimates for odds ratios (OR) were computed
(random-effect method), with statistical inconsistency appraised with I2.
Results: After excluding 4297 non-pertinent citations, we finally included
13 original studies (3082 patients). All studies were non-randomized
comparisons between percutaneous and surgical closure. One death was
encountered in the surgical group (0.08%; 95% C.I. 0-0.23%). Quantitative
synthesis of total complications after procedure showed a 31% (95% CI
21-41%) rate in patients treated surgically and a 6.6% (95% CI 3.9-9.2%)
rate in subjects treated percutaneously. Comparison of percutaneous
closure versus surgery showed adjusted odds ratios for total complications
of 5.4 (95% CI 2.96-9.84; p < 0.0001), significantly favouring
percutaneous closure. Quantitative synthesis for major complications after
procedure showed a 6.8% (95% CI 4-9.5%) rate in patients treated
surgically and a 1.9% (95% CI 0.9-2.9%) rate after percutaneous closure.
Comparison of percutaneous closure versus surgery showed adjusted odds
ratios for total complications of 3.81 (95% CI 2.7-5.36; p = 0.006), thus
again favouring the percutaneous approach. Conclusions: The largest cohort
to date of patients with secundum ASD shows that treatment by a
percutaneous approach has a significantly lower rate of either total or
major early post-procedural complications.

<10>
Accession Number
70234985
Authors
Xu Z. Zhu L. Cai X. Ji G. Liu J. Su Z.
Institution
(Xu, Zhu, Cai, Ji, Liu, Su) Department of Cardiovascular Surgery, Shanghai
Children's Medical Center, Medical College of Shanghai Jiaotong
University, China
Source
Cardiology in the Young. Conference: 5th World Congress of Paediatric
Cardiology and Cardiac Surgery Cairns, QLD Australia. Conference Start:
20090621 Conference End: 20090626. Conference Publication: (var.pagings).
20 (pp 111), 2010. Date of Publication: April 2010.
Publisher
Cambridge University Press
Abstract
Objective: To describe an early experience of treating 14 children with
the dual endothelin receptor antagonist bosentan, which is known to be
safe and effective in adults with pulmonary hypertension. Background: In
cavopulmonary anastomoses (Glenn shunt and its variants, Fontan palliation
and its variants), even slight increases in pulmonary vascular resistance
can significantly lower the transpulmonary blood flow, therefore, leading
to circulation failure. Similar unknowns exist regarding potential for
benefit of administration of pulmonary vasoactive agents in functional
single ventricle (FSV). Design: In this prospective, observational study,
14 children with FSV of high-risk factors undergoing cavopulmonary
anastamosis received bosentan therapy (Table). The median age was 11
months (range 5 months-15 years). Interventions: Bosentan was given as 2-4
mg/kg/day, twice daily. At the cutoff date, children were treated for a
mean of 3.4 months (range 2-5 months). Main outcome measures: Response to
treatment was judged by WHO functional class, six minute walk test, and
oxygen saturation. Results: Bosentan was well tolerated. WHO class, six
minute walk test, and oxygen saturation improved significantly (Figure 1,
2). Conclusion: These data suggest that bosentan, an oral endothelin
ETA/ETB receptor antagonist, is efficacious for the treatment of high-risk
FSV children. Confirmation of these results in a randomized, controlled
trial is essential.

<11>
Accession Number
70235033
Authors
Kasparian N.A. Barnett B.E.W. Sholler G.F. Winlaw D.S. Kirk E.P.E.
Institution
(Kasparian) School of Women's and Children's Health, Faculty of Medicine,
University of New South Wales, Kensington, NSW, Australia
(Barnett) Karitane Early Parenting Services, Carramar, NSW, Australia
(Sholler, Winlaw) Adolph Basser Cardiac Institute, Children's Hospital at
Westmead, Westmead, NSW, Australia
(Kirk) Department of Medical Genetics, Sydney Children's Hospital,
Randwick, NSW, Australia
Source
Cardiology in the Young. Conference: 5th World Congress of Paediatric
Cardiology and Cardiac Surgery Cairns, QLD Australia. Conference Start:
20090621 Conference End: 20090626. Conference Publication: (var.pagings).
20 (pp 127-128), 2010. Date of Publication: April 2010.
Publisher
Cambridge University Press
Abstract
Introduction: Advances in paediatric cardiac surgery have resulted in
increasing numbers of children surviving congenital heart disease (CHD),
yet despite this medical success, CHD is widely recognised as a major
source of stress and trauma within families. Objectives: To conduct a
systematic review of the literature reporting on psychological responses,
and/or parent-infant interaction, following CHD diagnosis. To then apply
this information to the development of evidence-based recommendations for
the supportive care of families affected by CHD. Methods: Relevant studies
were identified via the MEDLINE, PsycINFO, EMBASE and CINAHL databases
(1988-2008), supplemented by citation lists in retrieved articles and
expert consultation. A total of 277 articles were critically appraised to
assess eligibility, with 41 studies meeting all inclusion criteria.
Results: Studies have documented a range of psychosocial challenges
experienced by parents of infants with CHD, including: fears about medical
prognosis, frequent hospitalisations and periods of family separation,
financial and care-giving burdens, marital breakdown, and grief. A
substantial proportion of parents report unmet support needs; however,
there are no controlled trials of psychological or supportive care
interventions in this setting. Conclusions: To address this deficiency, we
have embarked upon a prospective study examining the predictors of
resilience or vulnerability in parents of infants with a major heart
abnormality, with particular focus on responses following prenatal versus
postnatal diagnosis. The perinatal period is a critical time to identify,
and offer appropriate intervention to, parents at risk of adverse
psychological outcomes, thus supporting the development of a secure
attachment pattern between infant and parent.

<12>
Accession Number
70235249
Authors
Jhang W.-K. Park J.-J. Yun T.-J. Kim Y.-H. Ko J.-K. Park I.-S. Seo D.-M.
Institution
(Jhang, Park, Yun, Kim, Ko, Park, Seo) University of Ulsan, Asan Medical
Center, South Korea
Source
Cardiology in the Young. Conference: 5th World Congress of Paediatric
Cardiology and Cardiac Surgery Cairns, QLD Australia. Conference Start:
20090621 Conference End: 20090626. Conference Publication: (var.pagings).
20 (pp 201), 2010. Date of Publication: April 2010.
Publisher
Cambridge University Press
Abstract
Objectives: Aortic insufficiency (AI) are major concern after the arterial
switch operation (ASO) but there are still many controversies about
incidence and risk factors for these. The aim of this study was to
evaluate the fate of neo aorta and the neo-aortic valve function. Methods:
Between April 1997 and July 2008, 239 patients had an ASO for TGA using
trap door technique in our institution. A retrospective review of 216
hospital survivors was performed. Results: Upon the time of discharge,
grade I AI was present in 19 (19/216,8.7%) patients and grade II AI in 3
(3/216,1.3%) patients. At a mean follow-up time of 70.5 +/- 53.5months,
there was grade I AI in 31 (31/216,14.3%) patients and grade II in
6(6/216, 2.7%) patients. The Z-value of neo-aortic valve, mid-sinus, and
sinotubular junction at the lastest follow-up echocardiography were
significantly larger in patients with grade II AI than others (p = 0.001).
Freedom from at least grade II AI was 95.0% at 10 years. Reoperation for
AR was done in only 1 patient with AI grade II because of LV dysfunction.
None of perioperative and operative variables was significantly associated
with the development of severe AI. Conclusions: The prevalence of AI had
an increasing tendency over time but significant AI and the need for
reoperation are rare. No definite risk factors for AI was revealed from
our data. However, more long term follow-up and meta analysis is needed to
compair with other surgical technique and discover risk factors.

<13>
Accession Number
70235314
Authors
Olguntrk R. Aktas I. Ergn M.A. Percin F. Tunaoglu S.F. Oguz D.A. Kula S.
Sanli C.
Institution
(Olguntrk, Tunaoglu, Oguz, Kula, Sanli) Gazi University, Faculty of
Medicine, Department of Pediatric Cardiology, Ankara, Turkey
(Aktas) Gazi University, Faculty of Medicine, Department of Pediatrics,
Ankara, Turkey
(Ergn, Percin) Gazi University, Faculty of Medicine, Department of
Genetic, Ankara, Turkey
Source
Cardiology in the Young. Conference: 5th World Congress of Paediatric
Cardiology and Cardiac Surgery Cairns, QLD Australia. Conference Start:
20090621 Conference End: 20090626. Conference Publication: (var.pagings).
20 (pp 222-223), 2010. Date of Publication: April 2010.
Publisher
Cambridge University Press
Abstract
Objective: There is evidence that most congenital cardiac anomalies are
associated with failures during heart development or process of
determination of left-right axis. CFC1 gene, which belongs to EGF-CFC gene
family, is a gene responsible for left-right axis. Also, mutation of CFC1
gene has been detected in individuals with complex cardiac disease without
heterotaxia. The purpose of this study is to determine the R78W
polymorphism frequency of CFC1 gene in congenital cyanotic cardiac
diseases and patients with dextrocardia and situs anomaly. Methods:
Hundred and seven patients with cyanotic congenital heart disease at the
age range of 0-16 years were included in the study. The diagnoses were
confirmed by clinical and laboratory (ECG, chest X-ray, echocardiography,
cardiac cathe-terisation) examinations. Age matched 100 normal children
were included as controls. R78W polymorphism of CFC1 gene was evaluated
using PCR with restriction analysis technique in both groups. Results:
R78W polymorphism frequency of CFC1 gene could not be shown in patient and
control groups. Conclusion: In this study, R78W polymorphism of CFC1 gene
was not detected in 207 events which include patient and control groups.
This result is parallel to the findings of the literature which indicates
that this polymorphism is rare in caucasians and usually detected in
African-Americans and Asians. As this mutation is rarely detected in
congenital cardiac defects, it may not be directly related to the etiology
of this disease group. Following investigations with larger groups and/or
meta-analysis of the previous studies will bring solutions to this issue.

<14>
Accession Number
2010414367
Authors
Fernandez-Balsells M.M. Murad M.H. Lane M. Lampropulos J.F. Albuquerque F.
Mullan R.J. Agrwal N. Elamin M.B. Gallegos-Orozco J.F. Wang A.T. Erwin
P.J. Bhasin S. Montori V.M.
Institution
(Fernandez-Balsells, Murad, Lane, Lampropulos, Albuquerque, Mullan,
Agrwal, Elamin, Gallegos-Orozco, Wang, Erwin, Montori) Knowledge and
Encounter Research Unit, Mayo Clinic, Rochester, MN 55905, United States
(Fernandez-Balsells) Endocrinology, Diabetes, and Nutrition Unit, Hospital
Universitari de Girona, Dr Josep Trueta, Institut Catala de la Salut,
17007 Girona, Spain
(Murad) Division of Preventive Medicine, Mayo Clinic, Rochester, MN 55905,
United States
(Agrwal, Gallegos-Orozco) Department of Internal Medicine, Mayo Clinic,
Scottsdale, AZ 85259, United States
(Bhasin) Section of Endocrinology, Diabetes, and Nutrition, Boston
University School of Medicine, Boston, MA 02118, United States
(Montori) Division of Endocrinology, Diabetes, Metabolism, and Nutrition,
Mayo Clinic, Rochester, MN 55905, United States
Title
Adverse effects of testosterone therapy in adult men: A systematic review
and meta-analysis.
Source
Journal of Clinical Endocrinology and Metabolism. 95 (6) (pp 2560-2575),
2010. Date of Publication: June 2010.
Publisher
Endocrine Society (8401 Connecticut Ave. Suite 900, Chevy Chase MD 20815,
United States)
Abstract
Context: The risks of testosterone therapy in men remain poorly
understood. Objective: The aim of this study was to conduct a systematic
review and meta-analyses of testosterone trials to evaluate the adverse
effects of testosterone treatment in men. Data Sources:Wesearched MEDLINE,
EMBASE, and Cochrane CENTRAL from 2003 through August 2008. Review of
reference lists and contact with experts further identified candidate
studies. Study Selection: Eligible studies were comparative, randomized,
and nonrandomized and reported the effects of testosterone on outcomes of
interest (death, cardiovascular events and risk factors, prostate
outcomes, and erythrocytosis). Reviewers, working independently and in
duplicate, determined study eligibility. Data Extraction: Reviewers
working independently and in duplicate determined the methodological
quality of studies and collected descriptive, quality, and outcome data.
Data Synthesis: The methodological quality of the 51 included studies
varied from low to medium, and follow-up duration ranged from 3 months to
3 yr. Testosterone treatment was associated with a significant increase in
hemoglobin [weightedmeandifference (WMD), 0.80 g/dl;95%confidence interval
(CI), 0.45 to 1.14] and hematocrit (WMD, 3.18%; 95% CI, 1.35 to 5.01), and
a decrease in high-density lipoprotein cholesterol (WMD, -0.49 mg/dl; 95%
CI, -0.85 to -0.13). There was no significant effect on mortality,
prostate, or cardiovascular outcomes. Conclusions: The adverse effects of
testosterone therapy include an increase in hemoglobin and hematocrit and
a small decrease in high-density lipoprotein cholesterol. These findings
are of unknown clinical significance. Current evidence about the safety of
testosterone treatment inmen in terms of patient-important outcomes is of
low quality and is hampered by the brief study follow-up. Copyright 2010
by The Endocrine Society.

<15>
Accession Number
2010416036
Authors
Abdelmalak B. Maheshwari A. Mascha E. Srivastava S. Marks T. Tang W.W.
Kurz A. Sessler D.I.
Institution
(Abdelmalak) Departments of General Anesthesiology and OUTCOMES RESEARCH,
Cleveland Clinic, Cleveland, OH, United States
(Maheshwari) Anesthesiology Institute, Cleveland Clinic, Cleveland, OH,
United States
(Mascha) Departments of Quantitative Health Sciences and OUTCOMES
RESEARCH, Cleveland Clinic, Cleveland, OH, United States
(Srivastava) Vascular Surgery, Cleveland Clinic, Cleveland, OH, United
States
(Marks) Department of General Anesthesiology, Cleveland Clinic, Cleveland,
OH, United States
(Tang) Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH,
United States
(Kurz, Sessler) Department of OUTCOMES RESEARCH, Cleveland Clinic,
Cleveland, OH, United States
(Sessler) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
Title
Design and Organization of the Dexamethasone, Light Anesthesia and Tight
Glucose Control (DeLiT) Trial: A factorial trial evaluating the effects of
corticosteroids, glucose control, and depth-of-anesthesia on perioperative
inflammation and morbidity from major non-cardiac surgery.
Source
BMC Anesthesiology. 10 , 2010. Article Number: 11. Date of
Publication: 30 Jun 2010.
Publisher
BioMed Central Ltd. (34 - 42 Cleveland Street, London W1T 4LB, United
Kingdom)
Abstract
Background: The perioperative period is characterized by an intense
inflammatory response. Perioperative inflammation promotes postoperative
morbidity and increases mortality. Blunting the inflammatory response to
surgical trauma might thus improve perioperative outcomes. We are studying
three interventions that potentially modulate perioperative inflammation:
corticosteroids, tight glucose control, and light
anesthesia.Methods/Design: The DeLiT Trial is a factorial randomized
single-center trial of dexamethasone vs placebo, intraoperative tight vs.
conventional glucose control, and light vs deep anesthesia in patients
undergoing major non-cardiac surgery. Anesthetic depth will be estimated
with Bispectral Index (BIS) monitoring (Aspect medical, Newton, MA). The
primary outcome is a composite of major postoperative morbidity including
myocardial infarction, stroke, sepsis, and 30-day mortality. C-reactive
protein, a measure of the inflammatory response, will be evaluated as a
secondary outcome. One-year all-cause mortality as well as post-operative
delirium will be additional secondary outcomes. We will enroll up to 970
patients which will provide 90% power to detect a 40% reduction in the
primary outcome, including interim analyses for efficacy and futility at
25%, 50% and 75% enrollment.Discussion: The DeLiT trial started in
February 2007. We expect to reach our second interim analysis point in
2010. This large randomized controlled trial will provide a reliable
assessment of the effects of corticosteroids, glucose control, and
depth-of-anesthesia on perioperative inflammation and morbidity from major
non-cardiac surgery. The factorial design will enable us to simultaneously
study the effects of the three interventions in the same population, both
individually and in different combinations. Such a design is an
economically efficient way to study the three interventions in one
clinical trial vs three.Trial registration: This trial is registered at
Clinicaltrials.gov #: NTC00433251. 2010 Abdelmalak et al; licensee BioMed
Central Ltd.

<16>
[Use Link to view the full text]
Accession Number
2010416674
Authors
Maeso S. Reza M. Mayol J.A. Blasco J.A. Guerra M. Andradas E. Plana M.N.
Institution
(Maeso, Reza, Blasco, Guerra, Andradas) Health Technology Assessment Unit,
Agencia Lain Entralgo, Gran Via 27, 7a planta, 28013 Madrid, Spain
(Mayol) General and Digestive Surgery Department, Hospital Clinico San
Carlos, Madrid, Spain
(Plana) Clinical Biostatistic Unit, Hospital Ramon y Cajal, Department of
Epidemiology and Public Health CIBER, Madrid, Spain
Title
Efficacy of the da vinci surgical system in abdominal surgery compared
with that of laparoscopy: A systematic review and meta-analysis.
Source
Annals of Surgery. 252 (2) (pp 254-262), 2010. Date of Publication:
August 2010.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street, Philadelphia PA
19106-3621, United States)
Abstract
Aim: The main aim of this review was to compare the safety and efficacy of
the Da Vinci Surgical System (DVSS) and conventional laparoscopic surgery
(CLS) in different types of abdominal intervention. Summary of background
data: DVSS is an emerging laparoscopic technology. The surgeon directs the
robotic arms of the system through a console by means of hand controls and
pedals, making use of a stereoscopic viewing system. DVSS is currently
being used in general, urological, gynecologic, and cardiothoracic
surgery. Methods: This systematic review analyses the best scientific
evidence available regarding the safety and efficacy of DVSS in abdominal
surgery. The results found were subjected to meta-analysis whenever
possible. Results: Thirty-one studies, 6 of them randomized control
trials, involving 2166 patients that compared DVSS and CLS were examined.
The procedures undertaken were fundoplication (9 studies, one also
examining cholecystectomy), Heller myotomy (3 studies), gastric bypass
(4), gastrectomy (2), bariatric surgery (1), cholecystectomy (4),
splenectomy (1), colorectal resection (7), and rectopexy (1). DVSS was
found to be associated with fewer Heller myotomy-related perforations, a
more rapid intestinal recovery time after gastrectomy-and therefore a
shorter hospital stay, a shorter hospital stay following cholecystectomy
(although the duration of surgery was longer), longer colorectal resection
surgery times, and a larger number of conversions to open surgery during
gastric bypass. Conclusions: The publications reviewed revealed DVSS to
offer certain advantages with respect to Heller myotomy, gastrectomy, and
cholecystectomy. However, these results should be interpreted with caution
until randomized clinical trials are performed and, with respect to
oncologic indications, studies include variables such as survival.
Copyright 2010 by Lippincott Williams & Wilkins.

<17>
[Use Link to view the full text]
Accession Number
2010408206
Authors
Xu D.S. Abruzzo T.A. Albuquerque F.C. Dabus G. Eskandari M.K. Guterman
L.R. Hage Z.A. Hurley M.C. Hanel R.A. Levy E.I. Nichols C.W. Ringer A.J.
Batjer H.H. Bendok B.R.
Institution
(Xu, Dabus, Hage, Hurley, Batjer, Bendok) Department of Neurological
Surgery and Radiology, Feinberg School of Medicine, Northwestern
University, Chicago, IL, United States
(Abruzzo) Departments of Neurology, Neurological Surgery, and Radiology,
University of Cincinnati College of Medicine, Cincinnati, OH, United
States
(Albuquerque, Nichols) Department of Neurological Surgery, Barrow
Neurological Institute, Phoenix, AZ, United States
(Eskandari) Department of Surgery, Feinberg School of Medicine,
Northwestern University, Chicago, IL, United States
(Guterman) Department of Neurological Surgery, Buffalo Neurosurgery Group,
West Seneca, NY, United States
(Hanel) Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL,
United States
(Levy) Departments of Neurological Surgery and Radiology, School of
Medicine and Biomedical Sciences, State University of New York at Buffalo,
Buffalo, NY, United States
(Ringer) Departments of Neurological Surgery and Radiology, Neuroscience
Institute, University of Cincinnati College of Medicine and Mayfield
Clinic, Cincinnati, OH, United States
Title
External carotid artery stenting to treat patients with symptomatic
ipsilateral internal carotid artery occlusion: A multicenter case series.
Source
Neurosurgery. 67 (2) (pp 314-321), 2010. Date of Publication: August
2010.
Publisher
Lippincott Williams and Wilkins (351 West Camden Street, Baltimore MD
21201-2436, United States)
Abstract
BACKGROUND: The external carotid artery (ECA) anastomoses in many distal
territories supplied by the internal carotid artery (ICA) and is an
important source of collateral circulation to the brain. Stenosis of the
ECA in ipsilateral ICA occlusion can produce ischemic sequelae. OBJECTIVE:
To examine the effectiveness of ECA stenting in treating symptomatic
ipsilateral ICA occlusion. METHODS: We retrospectively reviewed patient
databases from 5 academic medical centers to identify all individuals who
underwent ECA stenting after 1998. For all discovered cases,
coinvestigators used a common submission form to harvest relevant
demographic information, clinical data, procedural details, and follow-up
results for further analysis. RESULTS: Twelve patients (median age, 66
years; range, 45-79 years) were identified for our cohort. Vessel disease
involvement included severe ECA stenosis >= 70% in 11 patients and
ipsilateral ICA occlusion in all patients. Presenting symptoms included
signs of transient ischemic attack, stroke, and amaurosis fugax. ECA
stenting was associated with preservation of neurological status in 11
patients and resolution of symptoms in 5 patients at a median follow-up
time of 26 months (range, 1-87 months; mean, 29 months). Symptomatic
in-stent restenosis did not occur within any patient during the follow-up
course. CONCLUSION: We found ECA stenting in symptomatic ipsilateral ICA
disease to be a potentially effective strategy to preserve neurological
function and to relieve ischemic symptoms. Further investigation with
larger studies and longer follow-up periods is warranted to elucidate the
true indications of this management strategy. Copyright 2010 by the
Congress of Neurological Surgeons.

<18>
Accession Number
2010408612
Authors
Angeli F. Verdecchia P. Karthikeyan G. Mazzotta G. Gentile G. Reboldi G.
Institution
(Angeli, Mazzotta) Department of Cardiology, Clinical Research Unit
Preventive Cardiology, Hospital 'Santa Maria della Misericordia', Perugia,
Italy
(Verdecchia) Department of Medicine, Hospital of Assisi, Assisi, Italy
(Karthikeyan) Department of Cardiology, All India Institute of Medical
Sciences, New Delhi, India
(Gentile, Reboldi) Department of Internal Medicine, Medical School,
University of Perugia, 06126 Perugia, Italy
Title
beta-Blockers reduce mortality in patients undergoing high-risk
non-cardiac surgery.
Source
American Journal of Cardiovascular Drugs. 10 (4) (pp 247-259), 2010.
Date of Publication: 2010.
Publisher
Adis International Ltd (41 Centorian Drive, Private Bag 65901, Mairangi
Bay, Auckland 10 1311, New Zealand)
Abstract
Background: beta-Adrenergic receptor antagonists (beta-blockers) are
frequently used with the aim of reducing perioperative myocardial ischemia
and infarction. However, randomized clinical trials specifically designed
to evaluate the effects of b-blockers on mortality in patients undergoing
non-cardiac surgery have yielded conflicting results. Objective: This
study aimed to examine the effect of perioperative beta-blockers on total
and cardiovascular mortality in patients undergoing non-cardiac surgery.
Methods: We conducted a meta-analysis of randomized clinical trials that
examined the effects of beta-blockers versus placebo on cardiovascular and
all-cause mortality in patients undergoing non-cardiac surgery. We
extracted data from articles published before 30 November 2009 in
peer-reviewed journals indexed in MEDLINE, Cochrane Central Register of
Controlled Trials (CENTRAL), EMBASE and CINAHL. Data extraction was
carried out independently by two reviewers on the basis of an
intent-to-treat approach, and inconsistencies were discussed and resolved
in conference. The present meta-analysis was undertaken according to the
Quality of Reporting of Meta-analyses (QUORUM) statement. Results: A total
of 2148 records were screened, from which we identified 74 randomized
controlled trials for non-cardiac surgery. After excluding 49 studies that
did not report the clinical outcome of interest or were subanalyses or
presented duplicate data, the final search left 25 clinical trials.
Treatment with b-blockers had no significant effect on all-cause mortality
(odds ratio [OR] 1.15; 95% confidence interval [CI] 0.92, 1.43; p =
0.2717) or cardiovascular mortality (OR 1.13; 95%CI 0.85, 1.51; p =
0.5855). However, surgical risk category markedly differed across the
studies. According to JointAmerican College of Cardiology and American
Heart Association guidelines for perioperative assessment of patients
having non-cardiac surgery, five trials evaluated the effect of
beta-blockers in patients treated with emergency and vascular surgery
(high-risk category) whereas 15 and five trials evaluated the effect of
beta-blockers in intermediate low and intermediate high surgical risk
categories, respectively. Subgroup analyses showed that the surgical risk
category and dose titration of beta-blockers to target heart rate affected
the estimate of the effect of b-blockers for all-cause and cardiovascular
mortality. beta-Blockers reduced total mortality by 61% more in patients
who underwent high risk surgery than in those who underwent intermediate
high- or intermediate low-risk surgery. When cardiovascular mortality was
assessed, the benefit of b-blockers was 74% greater in trials that
titrated b-blockers to heart rate than in trials that did not, although
formal statistical significance was not achieved. Conclusions: These data
suggest that beta-blockers may be useful for reducing mortality in
patients who undergo high-risk non-cardiac surgery. 2010 Adis Data
Information BV.

<19>
Accession Number
2010410503
Authors
Olldashi F. Kerci M. Zhurda T. Ruci K. Banushi A. Traverso M.S. Jimenez J.
Balbi J. Dellera C. Svampa S. Quintana G. Pinero G. Teves J. Seppelt I.
Mountain D. Hunter J. Balogh Z. Zaman M. Druwe P. Rutsaert R. Mazairac G.
Pascal F. Yvette Z. Chancellin D. Okwen P. Djokam-Liapoe J. Jangwa E.
Mbuagbaw L. Fointama N. Pascal N. Baillie F. Jiang J.-Y. Gao G.-Y. Bao
Y.-H. Morales C. Sierra J. Naranjo S. Correa C. Gomez C. Herrera J.
Caicedo L. Rojas A. Pastas H. Miranda H. Constain A. Perdomo M. Munoz D.
Duarte A. Vasquez E. Ortiz C. Ayala B. Delgado H. Benavides G. Rosero L.
Mejia-Mantilla J. Varela A. Calle M. Castillo J. Garcia A. Ciro J. Villa
C. Panesso R. Florez L. Gallego A. Puentes-Manosalva F. Medina L. Marquez
K. Romero A.R. Hernandez R. Gualteros W. Urbina Z. Velandia J. Benitez F.
Trochez A. Villarreal A. Pabon P. Lopez H. Quintero L. Rubiano A. Tamayo
J. Pinera M. Navarro Z. Rondon D. Bujan B. Palacios L. Martinez D.
Hernandez Y. Fernandez Y. Casola E. Delgado R. Herrera C. Arbolaez M.
Dominguez M. Iraola M. Rojas O. Ensenat A. Pastrana I. De La Campa S.A.
Fortun T. Larrea M. Aragon L. Madrazo A. Svoboda P. Izurieta M. Daccach A.
Altamirano M. Ortega A. Cardenas B. Gonzalez L. Ochoa M. Ortega F.
Quichimbo F. Guinanzaca J. Zavala I. Segura S. Jerez J. Acosta D. Yanez F.
Camacho R. Khamis H. Shafei H. Kheidr A. Nasr H. Mosaad M. Rizk S. El
Sayed H. Moati T. Hokkam E. Amin M. Lowis H. Fawzy M. Bedir N. Aldars M.
Rodriguez V. Tobar J. Alvarenga J. Shalamberidze B. Demuria E.
Rtveliashvili N. Chutkerashvili G. Dotiashvili D. Gogichaishvili T.
Ingorokva G. Kazaishvili D. Melikidze B. Iashvili N. Tomadze G.
Chkhikvadze M. Khurtsidze L. Lomidze Z. Dzagania D. Kvachadze N. Gotsadze
G. Kaloiani V. Kajaia N. Dakubo J. Naaeder S. Sowah P. Yusuf A. Ishak A.
Selasi-Sefenu P. Sibiri B. Sarpong-Peprah S. Boro T. Bopaiah K. Shetty K.
Subbiah R. Mulla L. Doshi A. Dewan Y. Grewal S. Tripathy P. Mathew J.
Gupta B. Lal A. Choudhury M. Gupta S. Chug A. Pamidimukkala V. Jagannath
P. Maharaj M. Vommi R. Gudipati N. Chhang W.H. Patel P. Suthar N. Banker
D. Patel J. Dharap S. Kamble R. Patkar S. Lohiya S. Saraf R. Kumar D.
Parihar S. Mangual R. Kooper D. Mohapatra C. David S. Rajaleelan W. Pangi
A. Saraf V. Chikareddy S. Mankar S. Golhar A. Sakhare R. Wagh N. Hazarika
D. Chaudhuri P. Ketan P. Purohit G. Purohit Y. Pandya M. Gupta R. Kiran S.
Walia S. Goyal S. Attri A. Oberai A. Oberai M. Oberoi S. Tripathi G.K.
Peettakkandy V. Karuthillath P. Vadakammuriyil P. Pol J. Pol S. Saste M.
Raul S. Tiwari S. Nelly N. Chidambaram M. Kollengode V. Thampan S. Rajan
S. Raju S. Sharma R. Babu S.V. Sumathi C. Chatterjee P. Agarwal A. Magar
H. Magar M. Singh M. Gupta D. Haloi K. Sagdeo V. Giri P. Verma N. Jariwala
R. Goti A. Prabhu-Gaonkar A. Utagi S. Joshi M. Agrawal R. Sharma G. Saini
G. Tewari V. Yadav Y. Parihar V. Venkataramana N. Rao S. Reddy N. Chander
S.G. Hathila V. Das V. Agaja K. Purohit A. Lahari A. Bhagchandani R.
Vidyasagar B. Sachan P.K. Das T. Vyas S. Bhattacharjee S. Sancheti P.
Manoj T. Moideen M. Pansey K. Chandrasekaran V.P. Saikia K. Tata H. Vhora
S. Shah A. Rangad G. Rajasekaran S. Shankarlal S.T. Devadoss S. Saleem M.
Pillay H. Hazarika Z. Deshmukh P. Murugappan S.P. Jaiswal A. Vangani D.
Modha P. Chonzik C. Praveen M. Sethurayar V. Ipe S. Shetty N. Jain V. Shah
K. Dwikoryanto M. Golden N. Atmadjaya K. Wiargitha K. Sudiasa K.
Suwedagatha G. Bal'afif F. Budipramana V. Lemuel A. Chandra S. Ama F.
Sherafatkazemzadeh E. Moradi E. Sheikhi A. Ziaee A. Fanaei A.
Hajinasrollah E. Amini A. Mohammad B. Hadi N. Perone G. De Peri E. Volpi
A. Johnson J. Abe M. Mutiso V. Okanga B. Ojuka D. Abdullah B. Rahman H.
Noh Y. Jamaluddin S. Dawal H. Roslani A. Law C.-W. Devashanti P. Wahab Y.
Velaiutham S. Dato R. Loria J. Montes E. Gomez E. Cazales V. Bautista P.
Bautista R. Ahumada D. Hernandez E. Velasquez G. Ortega P. Lira G. Estrada
F. Martinez J. Olaomi O. Abubakar Y. Apollo K. Badejo O. Ihekire O.
Casasola J. Iribhogbe P. Oludiran O. Obeta E. Okojie C. Agbon E.U.
Komolafe E. Olaleye P. Uzochukwu T. Onakpoya U. Dongo A. Uhunmwagho O.
Eighemerio E. Morgan E. Thanni L. Afolabi A. Akinola T. Ademola A. Akute
O. Khalid L. Abubakar L. Aminu M. Ogirima M. Attansey A. Michael D. Aremu
O. Olugbenga O. Ukpong U. Salman Y. Obianyo N. Ani C. Ezeadawi R. Kehinde
O. Olaide A. Jogo A. Bitto T. Anyanwu S. Mbonu O. Oludara M. Somoye M.
Shehu B. Ismail N. Katchy A. Ndoma-Egba R. Grace-Inah N. Songden Z.
Abdulraheem A. Otu A. Nottidge T. Inyang D. Idiapho D. Giebel H. Hassan R.
Adisa A. Akinkuolie A. Okam K. Musa A. Falope I. Eze J. Caballero J.
Azabache W. Salirrosas O. Soto A. Torres E. Ramirez G. Perez M. Malca C.
Velez J. Yepez R. Yupanqui H. Lagos P. Rodriguez D. Flores J. Moya A.
Barrionuevo A. Gonzales-Portillo M. Nunez E. Eldawlatly A. Al Naami M.
Delvi B. Alyafi W. Djurovic B. Ng I. Yaghi A. Laincz A. Trenkler S. Valky
J. Modiba M. Legodi P. Rangaka T. Wallis L. Munoz A. Serrano A. Misis M.
Rubi M. De La Torre V. Ellawala R. Wijeratna S. Gunaratna L. Wijayanayaka
C. Nungu K. Haonga B. Mtapa G. Yutthakasemsunt S. Kittiwattanagul W.
Piyavechvirat P. Impool T. Thummaraj S. Salaeh R. Tangchitvittaya S.
Wattanakrai K. Soonthornthum C. Jiravongbunrod T. Meephant S. Subsompon P.
Pensuwan P. Chamnongwit W. Jerbi Z. Cherif A. Nash M. Harris T. Banerjee
J. Freij R. Kendall J. Moore S. Townend W. Cottingham R. Becker D. Lloyd
S. Burdett-Smith P. Mirza K. Webster A. Brady S. Grocutt A. Thurston J.
Lecky F. Goodacre S. Mulla Y. Sakala D. Chengo C.
Institution
(Olldashi, Kerci, Zhurda, Ruci) National Trauma Centre Hospital, Albania
(Banushi) Spitali Civil Durres, Albania
(Traverso, Jimenez) Hospital Angel Cruz Padilla, Argentina
(Balbi) Hospital Regional Rio Grande, Argentina
(Dellera) Hospital 4 de Junio Dr Ramon Carrillo, Argentina
(Svampa) Hospital Castro Rendon, Argentina
(Quintana) Hospital San Martin de La Plata, Argentina
(Pinero) Hospital Municipal de Agudos Dr Leonidas Lucero, Argentina
(Teves) Hospital Interzonal General de Agudos Dr Oscar Alende, Argentina
(Seppelt) Nepean Hospital, Australia
(Mountain) Sir Charles Gairdner Hospital, Australia
(Hunter, Balogh) Hospital, Australia
(Zaman) United Hospital Limited, Bangladesh
(Druwe, Rutsaert) Sint-Vincentius Hospital, Belgium
(Mazairac) Centre Hospitalier Regional de Namur, Bangladesh
(Pascal, Yvette, Chancellin) Tombel District Hospital, Cameroon
(Okwen) St Theresa's Catholic Medical Centre, Cameroon
(Djokam-Liapoe) Bamenda Provincial Hospital, Cameroon
(Jangwa) Bali District Hospital, Cameroon
(Mbuagbaw) Bafut District Hospital, Cameroon
(Fointama) Fundong District Hospital, Cameroon
(Pascal) St John of God Medical Centre, Cameroon
(Jiang, Gao, Bao) Hamilton General Hospital, Renji Hospital, China
(Morales, Sierra, Naranjo, Correa, Gomez) Hospital Universitario San
Vicente de Paul, Universidad de Antioquia, Colombia
(Herrera, Caicedo, Rojas, Pastas, Miranda) Hospital Universitario, San
Jose de Popayan, Colombia
(Constain, Perdomo, Munoz, Duarte, Vasquez) Hospital Pablo Tobon Uribe,
Colombia
(Ortiz, Ayala, Delgado, Benavides, Rosero) Hospital San Andres de Tumaco,
Colombia
(Mejia-Mantilla, Varela, Calle, Castillo, Garcia) Fundacion Clinica Valle
del Lili, Colombia
(Ciro, Villa, Panesso) Clinica las Americas, Colombia
(Florez, Gallego) Hospital General de Medellin, Colombia
(Puentes-Manosalva, Medina, Marquez) Hospital San Felix ESE, Colombia
(Romero, Hernandez, Martinez) Hospital Universitario del Caribe, Colombia
(Gualteros) Hospital Universitario San Jorge, Colombia
(Urbina, Velandia) Hospital San Rafael Tunja, Colombia
(Benitez, Trochez) Clinica La Estancia SA, Colombia
(Villarreal, Pabon) Fundacion Hospital San Jose de Buga, Colombia
(Delgado) Hospital Civil de Ipiales, Colombia
(Lopez) Hospital Universitario Departamental Narino, Colombia
(Quintero) Hospital Universitario del Valle, Colombia
(Rubiano) Hospital Universitario de Neiva, Colombia
(Tamayo) Hospital Manuel Uribe Angel, Colombia
(Pinera, Navarro, Rondon, Bujan) Hospital Clinico-Quirurgico Docente
Saturnino Lora, Cuba
(Palacios, Martinez, Hernandez, Fernandez) Hospital General Universitario
Carlos Manuel de Cespedes, Cuba
(Casola) Hospital Provincial Docente Manuel Ascunce Domenech, Cuba
(Delgado, Herrera, Arbolaez, Dominguez) Hospital Universitario Arnaldo
Milian Castro, Cuba
(Iraola, Rojas, Ensenat) Hospital Universitario Dr Gustavo Aldereguia
Lima, Cuba
(Pastrana, Rodriguez, De La Campa) Hospital Abel Santamaria Cuadrado, Cuba
(Fortun) Hospital Miguel Enriquez, Cuba
(Larrea) Hospital General Calixto Garcia, Cuba
(Aragon) Hospital Antonio Luaces Iraola, Cuba
(Madrazo) Hospital Provincial Docente VI Lenin, Cuba
(Svoboda) Research Institute for Special Surgery and Trauma, Czech
Republic
(Izurieta, Daccach, Altamirano, Ortega, Cardenas, Gonzalez) Hospital Luis
Vernaza, Ecuador
(Ochoa, Ortega, Quichimbo, Guinanzaca) Hospital Jose Carrasco Arteaga,
Ecuador
(Zavala, Segura) Hospital de Ninos Dr Roberto Gilbert Elizalde, Ecuador
(Jerez) Hospital Naval Guayaquil, Ecuador
(Acosta) Hospital Alcivar, Ecuador
(Yanez) Hospital Dr Rafael Rodriguez Zambrano, Ecuador
(Camacho) Clinica De Especialidades Medicas San Gregorio, Ecuador
(Khamis, Shafei, Kheidr, Nasr, Mosaad, Rizk) Mataria Teaching Hospital,
Egypt
(El Sayed, Moati, Hokkam) Suez Canal University, Egypt
(Amin, Lowis, Fawzy, Bedir, Aldars) Aswan Teaching Hospital, Egypt
(Rodriguez, Tobar, Alvarenga) Hospital Nacional Rosales, El Salvador
(Shalamberidze, Demuria, Rtveliashvili, Chutkerashvili, Dotiashvili)
Tbilisi State University Clinical Hospital 'I Javakhishvili', Georgia
(Gogichaishvili, Ingorokva, Kazaishvili, Melikidze, Iashvili) Tbilisi
First Hospital, University Clinic, Neurosurgery Center, Georgia
(Tomadze, Chkhikvadze, Khurtsidze, Lomidze, Dzagania, Kvachadze, Gotsadze,
Kaloiani) Tbilisi City Hospital, Tbilisi State Medical University ER
Department, Georgia
(Kajaia) Institute of Critical Care Medicine, Georgia
(Dakubo, Naaeder, Sowah) Korle Bu Teaching Hospital, Ghana
(Yusuf, Ishak) Nyinahin Government Hospital, Ghana
(Selasi-Sefenu) Sogakope District Hospital, Ghana
(Sibiri) Methodist Hospital, Ghana
(Sarpong-Peprah) WenchiEffia Nkwanta Regional Hospital, Ghana
(Boro) Saint Theresa's Hospital, Ghana
(Bopaiah, Shetty, Subbiah, Mulla, Doshi) Medical Trust Hospital Kochi,
India
(Dewan, Grewal, Tripathy, Mathew, Gupta) Christian Medical College
Ludhiana, India
(Lal, Choudhury) Aditya Neuroscience Centre, India
(Gupta, Gupta, Chug) Sri Sai Hospital, India
(Pamidimukkala, Jagannath, Maharaj, Vommi, Gudipati) Care Hospital, India
(Chhang) North Bengal Neuro Research Centre, India
(Patel, Suthar, Banker, Patel) Sheth VS General Hospital and NHL Municipal
College, India
(Dharap, Kamble, Patkar, Lohiya) LTM Medical College and General Hospital,
India
(Saraf, Kumar, Parihar, Gupta) Government Medical College and Associated
Hospitals Jammu, India
(Mangual, Kooper, Mohapatra) MKCG Medical College, India
(David, Rajaleelan) Christian Medical College Hospital Vellore, India
(Pangi, Saraf, Chikareddy) KLE Hospital and Medical Research Centre, India
(Mankar, Golhar, Sakhare, Wagh) NKP Salve Institute of Medical Sciences
and Lata Mangeshkar Hospital, India
(Lal, Hazarika) Sanjivani Diagnostics and Hospital, India
(Chaudhuri) Parkar Hospital, India
(Ketan) Jeevan Jyoti Hospital and Research Centre, India
(Purohit, Purohit, Pandya) Mansarovar Hospital, India
(Gupta, Kiran, Walia) Postgraduate Institute of Medical Science Rohtak,
India
(Goyal, Goyal, Goyal) Goyal Hospital Jalna, India
(Gupta, Attri, Sharma) Government Medical College Chandigarh, India
(Oberai, Oberai, Oberoi) Oberai Hospital, India
(Tripathi) Rajeev Gandhi Memorial Hospital and Research Centre, India
(Peettakkandy, Karuthillath, Vadakammuriyil) Calicut Medical College
Hospital, India
(Pol, Pol, Saste) Krishnamai Medical and Research Foundation's NIKOP
Hospital, India
(Raul, Tiwari, Nelly) St Stephen's Hospital, India
(Chidambaram) Government Rajaji Hospital, India
(Kollengode, Thampan) Medical College Trivandrum, India
(Rajan, Rajan) Sanjeevani Hospital, India
(Raju, Sharma) Kamineni Hospital, India
(Babu, Sumathi) Sri Sakthi Hospital, India
(Chatterjee, Agarwal) Bhattacharya Orthopaedic and Related Research
Centre, India
(Magar, Magar) Sushrut Hospital, India
(Singh, Gupta) All India Institute of Medical Sciences, India
(Lal, Haloi) GM Hospital (P) LTD, India
(Sagdeo, Giri) Government Medical College and Superspeciality Hospital
Nagpur, India
(Verma, Jariwala, Goti) Government Medical College New Civil Hospital,
India
(Prabhu-Gaonkar, Utagi) Chikitsa Hospital, India
(Joshi, Agrawal) Apollo Health City, India
(Sharma, Saini) Apex Neurotrauma and Superspeciality Hospital, India
(Tewari) Neuro Center Gola Ghat, India
(Yadav, Parihar) NSCB Medical College, India
(Venkataramana, Rao) BGS Global Hospital, India
(Reddy, Chander) Chettinad Hospital and Research Institute, India
(Hathila) Sir Sayajirao General Hospital and Medical College Baroda, India
(Das) Goyal Hospital and Research Centre Jodhpur, India
(Agaja) Krishna Surgical Hospital, Trauma Care Centre, India
(Purohit) Nizam's Institute of Medical Sciences, India
(Lahari) Niramay Hospital, India
(Bhagchandani) Apex Hospital Bhopal, India
(Vidyasagar) Dr Jeyasekharan Medical Trust, India
(Sachan) Himalayan Institute of Medical Sciences, India
(Das) Apollo Gleneagles Hospitals, India
(Vyas) Civil Hospital Gandhinagar, India
(Bhattacharjee) Sukhdev Raj Soin Hospital, India
(Sancheti) Sancheti Institute for Orthopaedics and Rehabilitation, India
(Manoj) St James Hospital, India
(Moideen) Al Shifa Hospital, India
(Pansey) Anant Institute of Medical Sciences, India
(Chandrasekaran) Vinayaka Mission Hospital, India
(Saikia) Gauhati Medical College and Hospital, India
(Tata) Krishna Hospital and Medical Research Centre, India
(Vhora) Ruby Hall Clinic, India
(Shah) Shreejee Hospital, India
(Rangad) Nazareth Hospital, India
(Rajasekaran) Ganga Hospital, India
(Shankarlal) Vadamalayan Hospitals, India
(Devadoss) Devadoss Multispeciality Hospital, India
(Saleem) KIOT Hospital, India
(Pillay) Baby Memorial Hospital, India
(Hazarika) Bethany Hospital, India
(Deshmukh) Suretech Hospital and Research Centre, India
(Murugappan) Surya Hospital, India
(Jaiswal) Apollo Clinic Varanasi, India
(Vangani) Fortis Escorts Hospital, India
(Modha) Gokul Hospital and Trauma Centre, India
(Chonzik) International Hospital Assam, India
(Praveen) Lifeline Multispeciality Hospital, India
(Sethurayar) Meenakshi Mission Hospital and Research Centre, India
(Ipe) MOSC Medical College Hospital, India
(Shetty) MS Ramaiah Memorial Hospital, India
(Shah) Saykhedkar Hospital and Research Centre, India
(Shah) Shanti Mukand Hospital, India
(Jain) Shri KM Memorial Jain Heart and General Hospital, India
(Shah) Usha Hospital, India
(Dwikoryanto) Soebandi Hospital Jember, Indonesia
(Golden, Atmadjaya, Wiargitha, Sudiasa, Suwedagatha) Sanglah General
Hospital, Indonesia
(Bal'afif) Saiful Anwar General Hospital, Indonesia
(Budipramana, Lemuel) Dr Soetomo General Hospital, Indonesia
(Chandra) Cipto Mangunkusumo Hospital, Indonesia
(Ama) Muhammadiyah Lamongan Hospital, Indonesia
(Sherafatkazemzadeh, Moradi, Sheikhi) Nemazi Hospital, Iran, Islamic
Republic of
(Ziaee, Fanaei) Erfan Hospital, Iran, Islamic Republic of
(Hajinasrollah) Loqman Medical Center, Iran, Islamic Republic of
(Amini) Imam Hosain Hospital, Iran, Islamic Republic of
(Mohammad, Hadi) Diwaniyah College of Medicine, Iraq
(Perone, De Peri) Spedali Civili di Brescia, Italy
(Volpi) Azienda Ospedaliera Di Parma, Italy
(Johnson) University Hospital of the West Indies, Jamaica
(Abe) Fukuoka University Hospital, Japan
(Mutiso, Okanga) Kenyatta National Hospital, Kenya
(Ojuka) Kapenguria District Hospital, Kenya
(Abdullah, Rahman, Noh) Hospital University Science Malaysia, Malaysia
(Jamaluddin, Dawal) Sungai Buloh Hospital, Malaysia
(Roslani, Law, Devashanti) University of Malaya Medical Centre, Malaysia
(Wahab, Velaiutham) Hospital Tengku Ampuan Rahimah, Malaysia
(Dato) Ampang Hospital, Malaysia
(Loria, Montes, Gomez, Cazales, Bautista) Hospital General Regional 25,
Mexico
(Bautista, Ahumada, Hernandez, Velasquez) Hospital Gustavo Rovirosa,
Mexico
(Ortega, Lira, Estrada) Hospital General de Uruapan Dr Pedro Daniel
Martinez, Mexico
(Martinez) Hospital General Ecatepec Las Americas, Mexico
(Martinez) Hospital General La Perla, Mexico
(Olaomi, Abubakar, Apollo, Badejo, Ihekire) Hospital General de Ecatepec
Dr Jose Maria Rodriguez, Mexico
(Casasola) National Hospital Abuja, Nigeria
(Iribhogbe, Oludiran, Obeta, Okojie, Agbon) University of Benin Teaching
Hospital, Nigeria
(Komolafe, Olaleye, Uzochukwu, Onakpoya) Obafemi Awolowo University
Teaching Hospitals, Nigeria
(Dongo, Uhunmwagho, Eighemerio, Morgan) Irrua Specialist Teaching
Hospital, Nigeria
(Thanni) Olabisi Onabanjo University Teaching Hospital, Nigeria
(Afolabi, Akinola, Ademola, Akute) University College Hospital Ibadan,
Nigeria
(Khalid, Abubakar, Aminu, Ogirima) Ahmadu Bello University Teaching
Hospital, Nigeria
(Attansey, Michael, Aremu) Baptist Medical Centre, Nigeria
(Olugbenga, Ukpong, Salman) University of Ilorin Teaching Hospital,
Nigeria
(Obianyo, Ani, Ezeadawi) Enugu State University Teaching Hospital, Nigeria
(Kehinde, Olaide) LAUTECH Teaching Hospital, Nigeria
(Jogo, Bitto) Federal Medical Centre Makurdi, Nigeria
(Anyanwu, Mbonu) Nnamdi Azikiwe University Teaching Hospital, Nigeria
(Oludara, Somoye) Lagos State University Teaching Hospital, Nigeria
(Shehu, Ismail) Usmanu Danfodiyo University Teaching Hospital, Nigeria
(Katchy) National Orthopaedic Hospital Enugu, Nigeria
(Ndoma-Egba, Grace-Inah) University of Calabar Teaching Hospital, Nigeria
(Songden, Abdulraheem) University of Abuja Teaching Hospital, Nigeria
(Otu, Nottidge) University of Uyo Teaching Hospital, Nigeria
(Inyang, Idiapho) Federal Medical Centre Yenagoa, Nigeria
(Giebel) Seventh Day Adventist Hospital, Nigeria
(Hassan) Federal Medical Centre Birnin-Kebbi, Nigeria
(Adisa) Abia State University Teaching Hospital, Nigeria
(Akinkuolie) Wesley Guild Hospital, Nigeria
(Okam) Federal Medical Centre Umuahia, Nigeria
(Musa) University of Maiduguri Teaching Hospital, Nigeria
(Falope) National Orthopaedic Hospital Igbobi, Nigeria
(Eze) University of Nigeria Teaching Hospital Enugu, Nigeria
(Caballero, Azabache, Salirrosas) Hospital Regional Docente de Trujillo,
Peru
(Soto, Torres, Ramirez, Perez) Hospital Nacional Hipolito Unanue, Peru
(Malca) Clinica Santa Ana, Peru
(Velez) Hospital La Caleta, Peru
(Yepez) Hospital Nacional Sergio E Bernales, Peru
(Yupanqui) Hospital de Apoyo de Sullana, Peru
(Lagos) Hospital IV Essalud Huancayo, Peru
(Rodriguez) Hospital Nacional Arzobispo Loayza, Peru
(Flores) Hospital Municipal Los Olivos, Peru
(Moya) Hospital Jose Cayetano Heredia, Peru
(Barrionuevo) Hospital Nacional Carlos Alberto Seguin Escobedo, Peru
(Gonzales-Portillo) Hospital Nacional Dos De Mayo, Peru
(Nunez) Hospital Nacional Cayetano Heredia, Peru
(Eldawlatly, Al Naami, Delvi) King Khalid University Hospital, Saudi
Arabia
(Alyafi) King Khalid National Guard Hospital, Saudi Arabia
(Djurovic) Klinicki Centar Srbije, Serbia
(Ng) National Neuroscience Institute, Singapore
(Yaghi) FNsP Ruzinov, Slovakia
(Laincz) NsP Poprad, Slovakia
(Trenkler) NsP JA Reiman Hospital, Slovakia
(Valky) Faculty Hospital F D Roosevelta, Slovakia
(Modiba, Legodi, Rangaka) Dr George Mukhari Hospital, South Africa
(Wallis) George Provincial Hospital, South Africa
(Munoz) Hospital Universitario Virgen del Rocio, Spain
(Serrano) Hospital Ramon y Cajal de Madrid, Spain
(Misis) Hospital Universitario Germans Trias i Pujol, Spain
(Rubi) Hospital Torrecardenas, Spain
(De La Torre) Hospital Universitario Virgen de la Victoria, Spain
(Ellawala, Wijeratna, Gunaratna, Wijayanayaka) National Hospital of Sri
Lanka, Sri Lanka
(Nungu, Haonga, Mtapa) Muhimbili Orthopaedic Institute, Tanzania
(Yutthakasemsunt, Kittiwattanagul, Piyavechvirat, Impool, Thummaraj) Khon
Kaen Regional Hospital, Thailand
(Salaeh) Pattani Hospital, Thailand
(Tangchitvittaya) Suratthani Hospital, Thailand
(Wattanakrai, Soonthornthum, Jiravongbunrod) Bhumibol Adulyadej Hospital,
Thailand
(Meephant) Lampang Hospital, Thailand
(Subsompon) Rayong Hospital, Thailand
(Pensuwan) Roi-Et Hospital, Thailand
(Chamnongwit) Phrae Hospital, Thailand
(Jerbi, Cherif) Hospital Habib Thameur, Tunisia
(Nash) University Hospital of North Staffordshire, United Kingdom
(Harris) Royal London Hospital, United Kingdom
(Banerjee) Leicester Royal Infirmary, United Kingdom
(Freij) Nottingham University Hospitals NHS Trust, United Kingdom
(Kendall) Frenchay Hospital, United Kingdom
(Moore) Countess of Chester Hospital, United Kingdom
(Townend) Hull Royal Infirmary, United Kingdom
(Cottingham) Royal Sussex County Hospital, United Kingdom
(Becker) Derby Hospitals NHS Trust, United Kingdom
(Lloyd) Bedford Hospital NHS Trust, United Kingdom
(Burdett-Smith) Royal Liverpool University Hospital, United Kingdom
(Mirza) Colchester General Hospital, United Kingdom
(Webster) Royal Lancaster Infirmary, United Kingdom
(Brady, Grocutt) Worthing Hospital, United Kingdom
(Thurston) Darent Valley Hospital, United Kingdom
(Lecky) Hope Hospital, United Kingdom
(Goodacre) Northern General Hospital, United Kingdom
(Mulla, Sakala) University Teaching Hospital, Lusaka, Zambia
(Chengo) Nchanga North General Hospital, Zambia
Title
Effects of tranexamic acid on death, vascular occlusive events, and blood
transfusion in trauma patients with significant haemorrhage (CRASH-2): A
randomised, placebo-controlled trial.
Source
The Lancet. 376 (9734) (pp 23-32), 2010. Date of Publication: 2010.
Publisher
Elsevier Limited (32 Jamestown Road, London NW1 7BY, United Kingdom)
Abstract
Background Tranexamic acid can reduce bleeding in patients undergoing
elective surgery. We assessed the effects of early administration of a
short course of tranexamic acid on death, vascular occlusive events, and
the receipt of blood transfusion in trauma patients. Methods This
randomised controlled trial was undertaken in 274 hospitals in 40
countries. 20 211 adult trauma patients with, or at risk of, significant
bleeding were randomly assigned within 8 h of injury to either tranexamic
acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h) or
matching placebo. Randomisation was balanced by centre, with an allocation
sequence based on a block size of eight, generated with a computer random
number generator. Both participants and study staff (site investigators
and trial coordinating centre staff ) were masked to treatment allocation.
The primary outcome was death in hospital within 4 weeks of injury, and
was described with the following categories: bleeding, vascular occlusion
(myocardial infarction, stroke and pulmonary embolism), multiorgan
failure, head injury, and other. All analyses were by intention to treat.
This study is registered as ISRCTN86750102, Clinicaltrials.gov
NCT00375258, and South African Clinical Trial Register DOH-27-0607-1919.
Findings 10 096 patients were allocated to tranexamic acid and 10 115 to
placebo, of whom 10 060 and 10 067, respectively, were analysed. All-cause
mortality was significantly reduced with tranexamic acid (1463 [145%]
tranexamic acid group vs 1613 [160%] placebo group; relative risk 091, 95%
CI 085-097; p=00035). The risk of death due to bleeding was significantly
reduced (489 [49%] vs 574 [57%]; relative risk 085, 95% CI 076-096;
p=00077). Interpretation Tranexamic acid safely reduced the risk of death
in bleeding trauma patients in this study. On the basis of these results,
tranexamic acid should be considered for use in bleeding trauma patients.
Funding UK NIHR Health Technology Assessment programme, Pfizer, BUPA
Foundation, and J P Moulton Charitable Foundation.

<20>
Accession Number
70231699
Authors
Tleyjeh I. Mensah G. Arif B.A. Erwin P. Chu V. Hoen B. Ezzati M. Baddour
L.
Institution
(Tleyjeh, Arif) King Fahd Medical City, Riyadh, Saudi Arabia
(Mensah) Global Research and Development-PepsiCo, Purchase, United States
(Erwin, Baddour) Mayo Clinic, Rochester, United States
(Chu) Duke Medical Center, Durham, United States
(Hoen) University Hospital of Besanson, Besanson, France
(Ezzati) Harvard School of Public Health, Boston, United States
Source
Circulation. Conference: World Congress of Cardiology Scientific Sessions
2010, WCC 2010 Beijing China. Conference Start: 20100616 Conference End:
20100619. Conference Publication: (var.pagings). 122 (2) (pp e39), 2010.
Date of Publication: 13 Jul 2010.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Infective Endocarditis (IE) is an important contributor to
mortality and morbidity worldwide. However, previous work in the Global
Burden of Diseases, Injuries, and Risk Factors (GBD) has not included
specific assessment of the burden of IE and its sequelae. We aim to
describe the methodology for a comprehensive assessment of IE burden
trends in 21 regions of the world for 1990 and 2005 as part of the current
GBD 2005 effort. Methods: A systematic review of published studies,
surveys, and other data sources is being conducted in order to assess the
global epidemiology of IE and related disabling sequelae. Cases of IE were
defined according to the Duke, modified Duke, Steckelberg, Von Reyn and
modified Von Reyn criteria. A comprehensive IE model included cure,
IE-related sequelae (stroke, valve incompetence, congestive heart failure,
and brain abscess), medical treatment, surgical treatment and prosthesis
related sequelae, and death. A simplified model was used for the
systematic review and it included cure, valve surgery, stroke, and death.
For incidence studies, key quality indicators include adequacy of
population sampling techniques and completeness of case ascertainment.
Electronic databases searched included MEDLINE, EMBASE, MEDLINE, LILACS,
KoreaMED, AMED, EXTRAMed, Scopus and Web of Science. Only population
studies were used to estimate IE incidence. To estimate IE sequelae,
incidence and mortality, data were used in the following order of
preference depending on availability for a given country: population-based
studies, followed by multicenter cohorts, and finally hospital based
series. Results: We identified 121 studies: 21 population-based, 21
multicenter studies and 79 hospital-based cohorts. Data originated from 40
countries and 2 international collaborations. Only eighteen
population-based studies reported on the incidence of IE/100,000 in 9
countries: Australia (3), France (2.2 and 3), Denmark (2.4 and 2.7), Italy
(3.6), Netherlands (1.5 and 9.6), Sweden (0.39 and 6.2), Tunisia (5.5), UK
(1.6 and 2.3), and USA (1.7, 3.8, 4.2, 4.95, and 11.6). Valve replacement
was performed on 30% (mean) and 29% (median) of IE cases. Stroke occurred
in 15% (mean) and 14% (median). Mortality occurred in 23% (mean) and 21%
(median) of cases. Bias secondary to incomplete data, non-representative
populations, and missing data for national or regional populations remain
important challenges. Specific strategies to address these limitations are
ongoing and include (1) translating non-English studies; (2) searching the
grey literature; and (3) contacting IE experts in world regions with
limited or no data. Conclusion: A comprehensive and systematic assessment
of the global burden and trends in IE mortality and disability using a
rigorous methodology is being conducted. IE is a relatively uncommon
disease but is associated with significant morbidity and mortality.
Completion of this effort will add substantively to the summary estimates
of cardiovascular mortality and disability.

<21>
Accession Number
70231765
Authors
Daming J. Qi G.
Institution
(Daming, Qi) Department of Cardiology, First Affiliated Hospital, China
Medical University, Shenyang, China
Source
Circulation. Conference: World Congress of Cardiology Scientific Sessions
2010, WCC 2010 Beijing China. Conference Start: 20100616 Conference End:
20100619. Conference Publication: (var.pagings). 122 (2) (pp e53), 2010.
Date of Publication: 13 Jul 2010.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: In drug eluting stent (DES) era, DES has further improved
the results of percutaneous coronary intervention (PCI) in term of
restenosis thus increasing the percentage of multivessel coronary artery
disease (MVD)patients treated with PCI. However, limited information
exists on the comparison of drug-eluting stents and CABG surgery in
east-asia population. The long-term outcome of drug-eluting stents
compared with that of CABG surgery is also unclear in real-world clinical
practice in east-asia. this meta-analysis summarizes avaible data from
obserational cohorts studied in oriental patients. the aim of this study
was to compare the safety (death, MI, and stroke) and efficacy
(target-vessel revascularization [TVR]) in multivessel disease patients
receiving drug-eluting stents and those undergoing CABG. Methods: We
performed a systematic literature search for observational coherts
comparing DES versus CABG in oriental patients with multivessel coronary
disease. The search wes performed in PubMed databases for english journals
published from Oct,2007 to Sep,2009. The mixed model method was used to
obtain the pooled hazard ratio (HR) for outcome of DES- PCI versus CABG.
Results: A total of five observational nonrandomized studies were
identified and analyzed including a totol of 6714 patients with
multivessel coronary disease who underwent DES (n=3204) and CABG (n=3410).
Mean follow-up time was 30 month. Pooled analysis showed that DES-PCI and
CABG were comparable in terms of all-cause death (HR=0.82;
95%CI=0.61-1.09; p=0.16) and acute myocardial infarction (HR = 1.18
95%CI=0.84-1.66; p=0.33). DES wes superior to CABG in cerebrovascular
accidents (HR=0.56; 95%CI=0.38-0.83; p=0.004). However, there was a
significantly higher risk of repeat revascularization in the DES-PCI group
(HR=8.98; 95%CI=6.38-12.63; p<0.00001). Overall major adverse cardiac and
cerebrovascular events rate (maccs) in the DES-PCI was higher compared to
the CABG group (HR=1.99; 95%CI = 1.71-2.33; p<0.00001). Conclusions: In
the real-world clinical practice, DES-PCI was similar to CABG on safty and
efficacy in treatment to oriental patients with multivessel coronary
artery disease. DES wes superior to CABG in cerebrovascular accidents.
Overall major adverse cardiac and cerebrovascular events rate continues to
be higher after DES-PCI due to an excess of redo revascularization
compared with CABG.

<22>
Accession Number
70233004
Authors
Zhang C. Sun A. Ge J. Zhang S. Wang K. Zou Y.
Institution
(Zhang, Sun, Ge, Zhang, Wang, Zou) Shanghai Institute of Cardiovascular
Diseases, Zhongshan Hospital, Shanghai, China
(Ge, Zou) Institute of Biomedical Science, Fudan University, Shanghai,
China
Source
Circulation. Conference: World Congress of Cardiology Scientific Sessions
2010, WCC 2010 Beijing China. Conference Start: 20100616 Conference End:
20100619. Conference Publication: (var.pagings). 122 (2) (pp e314),
2010. Date of Publication: 13 Jul 2010.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: To systematic review studies concerning the efficacy and
safety of autologous bone marrow-derived cells (BMCs) transfer in patients
with chronic ischemic heart disease. Methods: We searched MEDLINE, EMBASE,
and Cochrane database through September 2009. Eligible studies were
randomized controlled trials of autologous BMCs infusion in patients with
chronic ischemic heart disease. Results: 11 trials involving 490
participants were identified. Compared with controls, BMCs transfer
significantly improved left ventricular ejection fraction (LVEF) by 4.63%
(95% CI 2.42-6.84; P<0.0001). BMCs transfer was also associated with
significant reductions in left ventricular end-diastolic volume
(standardized mean difference -0.55, 95% CI -0.94 - 0.17, P=0.005) and
left ventricular end-systolic volume (standardized mean difference -0.45,
95% CI -0.73 - 0.17, P=0.002). For safety outcome, BMCs treatment was
associated with a trend toward significant effect on death (OR 0.42, 95%
CI 0.18-1.01, P=0.05). Subgroup analysis indicated that intramyocardial
cell injection was preferred due to its more significant improvement of
LVEF than intracoronary cell therapy. Meta-regression suggested the
existence of a negative association between baseline LVEF and LVEF change.
Conclusion: BMCs transplantation is safe and feasible in patient with
chronic ischemic heart disease. BMCs infusion is associated with a
significant improvement in LVEF, and an attenuation of left ventricular
remodeling.

<23>
Accession Number
2010372239
Authors
Shahnam A. Nasrollah O. Amin B.
Institution
(Shahnam, Nasrollah, Amin) Division of pediatric surgery, Imam Khomeini
Hospital, Ahvaz, Iran, Islamic Republic of
Title
Evaluation of two surgical methods (extrapleural & transpleural) in the
treatment of neonates with esophageal atresia.
Source
Internet Journal of Pediatrics and Neonatology. 12 (1) , 2010. Date of
Publication: 2010.
Publisher
Internet Scientific Publications LLC (23 Rippling Creek Drive, Sugar Land
TX 77479, United States)
Abstract
Objective: Esophagial atresia - Tracheoesophagial fistula, is a congenital
disease with unknown pathogenesis. Surgery is the treatment of choice and
extrapleural approach is the routine technique of surgery. While
transpleural approach is easier and faster with better availability. In
this study we compared outcome of these two techniques of surgery.Methods:
30 neonates with Esophagial atresia - Tracheoesophagial fistula type c,
were enrolled in this study 15 of whom underwent surgery by extrapleural
approach and 15 by transpleural approach. Then we compared 2 groups for
postoperative complications, duration of surgery and mortality
rate.Results: There were not significant statistic differences in these
two surgical techniques about leakage, wound infection and mortality rate.
However, there was a significant rate of pneumothorax in transpleural
approach (6 patients), while the average duration of operation was shorter
in transpleural approach.Conclusion: As, there is not significant
statistic differences between these two techniques of surgery about
mortality and morbidity as well as shorter duration of operation and
facility of surgery, it is recommended to utilize transpleural approach as
a proper technique of surgery. Internet Scientific Publications, LLC.,
1996 to 2010.