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<1>
Accession Number
2010633388
Title
Efficacy and safety of more intensive lowering of LDL cholesterol: A
meta-analysis of data from 170 000 participants in 26 randomised trials.
Source
The Lancet. 376 (9753) (pp 1670-1681), 2010. Date of Publication: 13 Nov
2010.
Publisher
Elsevier Limited (32 Jamestown Road, London NW1 7BY, United Kingdom)
Abstract
Lowering of LDL cholesterol with standard statin regimens reduces the risk
of occlusive vascular events in a wide range of individuals. We aimed to
assess the safety and efficacy of more intensive lowering of LDL
cholesterol with statin therapy. We undertook meta-analyses of individual
participant data from randomised trials involving at least 1000
participants and at least 2 years' treatment duration of more versus less
intensive statin regimens (five trials; 39 612 individuals; median
follow-up 51 years) and of statin versus control (21 trials; 129 526
individuals; median follow-up 48 years). For each type of trial, we
calculated not only the average risk reduction, but also the average risk
reduction per 10 mmol/L LDL cholesterol reduction at 1 year after
randomisation. In the trials of more versus less intensive statin therapy,
the weighted mean further reduction in LDL cholesterol at 1 year was 051
mmol/L. Compared with less intensive regimens, more intensive regimens
produced a highly significant 15 (95 CI 11-18; p<00001) further reduction
in major vascular events, consisting of separately significant reductions
in coronary death or non-fatal myocardial infarction of 13 (95 CI 7-19;
p<00001), in coronary revascularisation of 19 (95 CI 15-24; p<00001), and
in ischaemic stroke of 16 (95 CI 5-26; p=0005). Per 10 mmol/L reduction in
LDL cholesterol, these further reductions in risk were similar to the
proportional reductions in the trials of statin versus control. When both
types of trial were combined, similar proportional reductions in major
vascular events per 10 mmol/L LDL cholesterol reduction were found in all
types of patient studied (rate ratio [RR] 078, 95 CI 076-080; p<00001),
including those with LDL cholesterol lower than 2 mmol/L on the less
intensive or control regimen. Across all 26 trials, all-cause mortality
was reduced by 10 per 10 mmol/L LDL reduction (RR 090, 95 CI 087-093;
p<00001), largely reflecting significant reductions in deaths due to
coronary heart disease (RR 080, 99 CI 074-087; p<00001) and other cardiac
causes (RR 089, 99 CI 081-098; p=0002), with no significant effect on
deaths due to stroke (RR 096, 95 CI 084-109; p=05) or other vascular
causes (RR 098, 99 CI 081-118; p=08). No significant effects were observed
on deaths due to cancer or other non-vascular causes (RR 097, 95 CI
092-103; p=03) or on cancer incidence (RR 100, 95 CI 096- 104; p=09), even
at low LDL cholesterol concentrations. Further reductions in LDL
cholesterol safely produce definite further reductions in the incidence of
heart attack, of revascularisation, and of ischaemic stroke, with each 10
mmol/L reduction reducing the annual rate of these major vascular events
by just over a fifth. There was no evidence of any threshold within the
cholesterol range studied, suggesting that reduction of LDL cholesterol by
2-3 mmol/L would reduce risk by about 40-50. UK Medical Research Council,
British Heart Foundation, European Community Biomed Programme, Australian
National Health and Medical Research Council, and National Heart
Foundation. 2010 Elsevier Ltd.
<2>
Accession Number
2010636379
Authors
Nienaber C.A. Kische S. Akin I. Rousseau H. Eggebrecht H. Fattori R.
Rehders T.C. Kundt G. Scheinert D. Czerny M. Kleinfeldt T. Zipfel B.
Labrousse L. Ince H.
Institution
(Nienaber, Kische, Akin, Rehders, Kundt, Kleinfeldt, Ince) Divisions of
Cardiology and Biomedical Statistics, University of Rostock, Rostock,
Germany
(Eggebrecht) University of Duisburg-Essen, Essen, Germany
(Scheinert) University Heart Center Leipzig, Leipzig, Germany
(Zipfel) German Heart Institute Berlin, Berlin, Germany
(Rousseau) Centre Hospitalire Universitaire, Hopital de Rangueil,
Toulouse, France
(Fattori) Universita St. Orsola Malpighi, Bologna, Italy
(Czerny) Department of Cardiothoracic Surgery, University of Vienna,
Vienna, Austria
(Labrousse) Bordeaux Heart University Hospital, Bordeaux, France
Title
Strategies for subacute/chronic type B aortic dissection: The
Investigation of Stent Grafts in Patients with Type B Aortic Dissection
(INSTEAD) trial 1-year outcome.
Source
Journal of Thoracic and Cardiovascular Surgery. 140 (6 SUPPL.) (pp
S101-S108), 2010. Date of Publication: December 2010.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Objective: Endovascular stent grafting represents a novel concept for type
B aortic dissection both in the acute and subacute/chronic setting, with
an unknown effect on outcomes. Methods: In a prospective trial 140
patients with stable type B dissection were randomly subjected to elective
stent-graft placement in addition to optimal medical therapy (n = 72) or
to optimal medical therapy (n = 68) with surveillance (arterial pressure
according to World Health Organization guidelines <=120/80 mm Hg). The
primary end point was 1-year all-cause mortality, whereas aorta-related
mortality, progression (with need for conversion or additional
endovascular or open surgical intervention), and aortic remodeling were
secondary end points. Results: There was no difference in all-cause
mortality: cumulative survival was 97.0% +/- 3.4% with optimal medical
therapy versus 91.3% +/- 2.1% with thoracic endovascular aortic repair (P
= .16). Moreover, aorta-related mortality was not different (P = .42), and
the risk for the combined end point of aorta-related death (rupture) and
progression (including conversion or additional endovascular or open
surgical intervention) was similar (P = .86). Three neurologic adverse
events occurred in the thoracic endovascular aortic repair group (1
paraplegia, 1 stroke, and 1 transient paraparesis) versus 1 episode of
paraparesis with medical treatment. Finally, aortic remodeling (with
true-lumen recovery and thoracic false-lumen thrombosis) occurred in 91.3%
with thoracic endovascular aortic repair versus 19.4% with medical
treatment (P < .001), which is suggestive of continued remodeling.
Conclusions: In survivors of uncomplicated type B aortic dissection,
elective stent-graft placement does not improve 1-year survival and
adverse events, despite favorable aortic remodeling. Copyright 2010 by
The American Association for Thoracic Surgery.
<3>
Accession Number
2010636400
Authors
Lansman S.L. Saunders P.C. Malekan R. Spielvogel D.
Institution
(Lansman, Saunders, Malekan, Spielvogel) Westchester Medical Center, New
York Medical College, Macy Pavilion 114W, Valhalla, NY, United States
Title
Acute aortic syndrome.
Source
Journal of Thoracic and Cardiovascular Surgery. 140 (6 SUPPL.) (pp
S92-S97), 2010. Date of Publication: December 2010.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
The term acute aortic syndrome refers to a heterogeneous group of
conditions that cause a common set of signs and symptoms, the foremost of
which is aortic pain. Various pathologic entities may give rise to this
syndrome, but the topic has come to focus on penetrating aortic ulcer and
intramural hematoma and their relation to aortic dissection. Penetrating
aortic ulcer is a focal atherosclerotic plaque that corrodes a variable
depth through the intima into the media. Intramural hematoma is a blood
collection within the aortic wall not freely communicating with the aortic
lumen, with restricted flow. It may represent a subcategory of aortic
dissection that manifests different behavior by virtue of limited flow in
the false lumen. This article reviews the current literature regarding
acute aortic syndrome, focusing on management options. Copyright 2010 by
The American Association for Thoracic Surgery.
<4>
Accession Number
2010622493
Authors
Nosotti M. Baisi A. Mendogni P. Palleschi A. Tosi D. Rosso L.
Institution
(Nosotti, Mendogni, Palleschi, Tosi, Rosso) Thoracic Surgery and Lung
Transplant Unit, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico,
University of Milan, Via Francesco Sforza, 35, 20122 Milan, Italy
(Baisi) Thoracic Surgery Unit, Ospedale San Paolo, University of Milan,
Milan, Italy
Title
Muscle sparing versus posterolateral thoracotomy for pulmonary lobectomy:
Randomised controlled trial.
Source
Interactive Cardiovascular and Thoracic Surgery. 11 (4) (pp 415-419),
2010. Date of Publication: October 2010.
Publisher
European Association for Cardio-Thoracis Surgery (3 Park Street, Windsor,
Berkshire SL4 1LU, United Kingdom)
Abstract
Muscle sparing thoracotomy (MST) has been proposed as an alternative to
posterolateral thoracotomy (PLT) for pulmonary lobectomy. This issue has
been addressed by few clinical reports. To explore that subject, a
prospective, controlled randomised, double-blind trial comparing MST
through the auscultatory triangle and PLT was planned. The study included
patients scheduled for pulmonary lobectomy for stage I or II
non-small-cell lung cancer and were followed for three years. The primary
endpoints were pain, analgesic consumption and post-thoracotomy pain
syndrome. The secondary endpoints included morbidity plus shoulder and
pulmonary functions. The trial randomised 100 patients into two groups.
Postoperative pain results were similar, although analgesic consumption
was higher in the PLT group (Ps0.001). The MST group had a shorter
hospital stay (Ps0.003). Three years post-thoracotomy syndrome was
unaffected by the type of incision. The women suffered more than men
during the early and late postoperative time. An inverse correlation
between incision length and pain was found. Immediate shoulder strength
was significantly better in the MST group (Ps0.004) but postoperative
pulmonary function and complications were comparable. The two incisions
results were very similar in the patient outcome, however, few aspects
indicated the MST as the more suitable incision for pulmonary lobectomy.
2010 Published by European Association for Cardio-Thoracic Surgery.
<5>
Accession Number
2010625414
Authors
He J. Li S. Shao W. Wang D. Chen M. Yin W. Wang W. Gu Y. Zhong B.
Institution
(He, Li, Shao, Wang, Chen, Yin, Wang, Zhong) Department of Cardiothoracic
Surgery, First Affiliated Hospital, Guangzhou Medical College, No. 151,
Yanjiang Rd, Guangzhou 510120, Guangdong Province, China
(He, Li, Shao, Wang, Chen, Yin, Wang, Zhong) Guangzhou Research Institute
of Respiratory Disease, China State Key Laboratory of Respiratory Disease,
Guangzhou, China
(Gu) Department of Pathology, First Affiliated Hospital, Guangzhou Medical
College, Guangzhou, China
Title
Activated carbon nanoparticles or methylene blue as tracer during
video-assisted thoracic surgery for lung cancer can help pathologist find
the detected lymph nodes.
Source
Journal of Surgical Oncology. 102 (6) (pp 676-682), 2010. Date of
Publication: 01 Nov 2010.
Publisher
Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)
Abstract
Background To assess whether using methylene blue (MB) or activated carbon
nanoparticles as tracer can increase the detected number of lymph nodes in
the systematic nodal dissected tissue during Video-Assisted Thoracic
Surgery (VATS) for non-small cell lung cancer. Methods Three groups of 20
patients each were obtained from randomization of 60 patients with NSCLC
requiring VATS with systematic nodal dissection (SND) from February 2007
and December 2008, there were 17, 16, and 17 patients in group A
(injection activated carbon nanoparticles), group B (injection MB), and
group C (controls), respectively. Results There was difference of the
total number of dissected lymph nodes per patient among three groups (P <
0.001). The total number of dissected LNs and mediastinal nodes per
patient in group A and group B was more than in group C (P < 0.001). There
were 20, 18, and 14 metastatic LNs dissected in 6, 6, and 7 patients of
group A, B, and C, respectively. There was difference of total number of
dissected metastatic LNs per patient among three groups (P = 0.002).
Conclusions MB can be as effective as activated carbon nanoparticles being
tracer to increase the detected number of LNs in the systematic nodal
dissected tissue during VATS for NSCLC. 2010 Wiley-Liss, Inc.
<6>
[Use Link to view the full text]
Accession Number
2010627363
Authors
Patel M.R. Jneid H. Derdeyn C.P. Klein L.W. Levine G.N. Lookstein R.A.
White C.J. Yeghiazarians Y. Rosenfield K.
Title
Arteriotomy closure devices for cardiovascular procedures: A scientific
statement from the american heart association.
Source
Circulation. 122 (18) (pp 1882-1893), 2010. Date of Publication: 02 Nov
2010.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street, Philadelphia PA
19106-3621, United States)
<7>
Accession Number
2010628756
Authors
Friberg O. Svedjeholm R. Soderquist B.
Institution
(Friberg) Department of Cardiothoracic Surgery and Anesthesiology, Orebro
University Hospital, Orebro, Sweden
(Svedjeholm) Department of Cardiothoracic Surgery, Linkoping University
Hospital, Linkoping, Sweden
(Soderquist) Department of Laboratory Medicine, Clinical Microbiology,
Orebro University Hospital, Sweden
Title
To the editor.
Source
JAMA - Journal of the American Medical Association. 304 (19) (pp
2123-2124), 2010. Date of Publication: 17 Nov 2010.
Publisher
American Medical Association (515 North State Street, Chicago IL 60654,
United States)
<8>
Accession Number
2010629202
Authors
Alfredsson J. Swahn E.
Institution
(Alfredsson, Swahn) Division of Cardiology, Department of Medical and
Health Sciences, University Hospital, Linkoping, Sweden
Title
Management of acute coronary syndromes from a gender perspective.
Source
Fundamental and Clinical Pharmacology. 24 (6) (pp 719-728), 2010. Date
of Publication: December 2010.
Publisher
Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United
Kingdom)
Abstract
Acute Coronary Syndromes are the most frequent manifestations of coronary
heart disease (CHD). Gender differences in treatment intensity, including
differences in level of care, have been reported. Also differences in
benefit from certain treatments, especially invasive treatment, have been
discussed. Finally, differences in outcome between men and women have been
proposed. Results have been inconsistent, partly depending on if and how
adjustment for differences in background characteristics has been made.
2010 The Authors Fundamental and Clinical Pharmacology 2010 Societe
Francaise de Pharmacologie et de Therapeutique.
<9>
Accession Number
2010634127
Authors
Gruenwald C.E. Manlhiot C. Chan A.K. Crawford-Lean L. Foreman C. Holtby
H.M. Van Arsdell G.S. Richards R. Moriarty H. McCrindle B.W.
Institution
(Gruenwald, Manlhiot, Crawford-Lean, Foreman, Holtby, Van Arsdell,
McCrindle) Department of Pediatrics, University of Toronto, Hospital for
Sick Children, Toronto, ON, Canada
(Chan) Department of Pediatrics, McMaster University, McMaster Children's
Hospital, Hamilton, ON, Canada
(Gruenwald, Richards, Moriarty) Faculty of Science, School of Community
Health, Charles Sturt University, Wagga Wagga, NSW, Australia
Title
Randomized, controlled trial of individualized heparin and protamine
management in infants undergoing cardiac surgery with cardiopulmonary
bypass.
Source
Journal of the American College of Cardiology. 56 (22) (pp 1794-1802),
2010. Date of Publication: 23 Nov 2010.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives We sought to determine whether infants (younger than 1 year
old) had similar clinical benefits with individualized anticoagulation
management as older children and adult undergoing cardiopulmonary bypass
(CPB). Background Individualized heparin and protamine management in older
children and adults undergoing CPB has been associated with improved
clinical outcomes. Methods Ninety infants younger than 1 year of age
undergoing CPB were enrolled in a randomized, controlled trial comparing
weight-based anticoagulation management using activated clotting time
(ACT) to individualized management with Hemostasis Management System Plus.
Manufacturer's guidelines were followed for the first 33 patients. A
modified protocol was used for the last 57 patients with adjustments for
coagulation system immaturity and hemodilution on CPB. Results The
hemostasis management system (HMS) device consistently underestimated
plasma anti-Xa levels, leading to an overestimated required heparin dose.
After a blinded interim analysis revealed poor outcomes in the
experimental HMS group using manufacturer guidelines, the safety committee
suspended the study pending protocol modifications. The use of the HMS
device following the modified protocol resulted in more stable anti-Xa
levels during CPB with improved post-operative outcomes including reduced
need for transfusions (71 ml/kg vs. 80 ml/kg; p = 0.003), ventilation time
(33 h vs. 49 h; p = 0.04), intensive care (88 h vs. 99 h; p = 0.003), and
hospital length of stay (192 h vs. 216 h; p < 0.001), compared with the
weight-based protocol. Conclusions This study supports the use of the HMS
device, with a modified protocol for infants younger than 1 year of age,
for anticoagulation management during CPB. Clinical guidelines for the use
of the HMS device should be modified for infants younger than 1 year of
age. 2010 American College of Cardiology Foundation.
<10>
Accession Number
2010622491
Authors
Modine T. Zannis C. Salleron J. Provot F. Gourlay T. Duhamel A. Koussa M.
Fayad G.
Institution
(Modine, Zannis, Koussa, Fayad) Hopital Cardiologique, Department of
Cardiovascular Surgery, Centre Hospitalier Regional et Universitaire de
Lille, 59037 Lille Cedex, France
(Salleron, Duhamel) Department of Biostatistics, Centre Hospitalier
Regional et Universitaire de Lille, Lille, France
(Provot) Department of Nephrology, Centre Hospitalier Regional et
Universitaire de Lille, Lille, France
(Gourlay) University of Strathclyde, Glasgow, United Kingdom
Title
A prospective randomized study to evaluate the renal impact of surgical
revascularization strategy in diabetic patients.
Source
Interactive Cardiovascular and Thoracic Surgery. 11 (4) (pp 406-410),
2010. Date of Publication: October 2010.
Publisher
European Association for Cardio-Thoracis Surgery (3 Park Street, Windsor,
Berkshire SL4 1LU, United Kingdom)
Abstract
Acute kidney injury (AKI) is a major postoperative complication following
cardiac surgery. Diabetes mellitus is a major cause of nephropathy and
end-stage renal failure. We aimed to evaluate the occurrence of adverse
renal outcomes, in diabetic patients, between on-pump (CPB) and off-pump
(OPCAB) coronary artery bypass graft (CABG). Seventy-one diabetic patients
(36 and 35 patients in the CPB and OPCAB groups, respectively) were
enrolled in a prospective randomized study. Renal tubular and glomerular
functions, were monitored preoperatively and over five consecutive days.
There was no significant difference between the groups in terms of age,
gender, New York Heart Association class, Canadian Cardiovascular Society
functional classification of angina grade and number of CABG. Intensive
care unit stay, duration of intubation, hospital stay and bleeding were
significantly higher in the CPB group. No significant differences in
plasmatic creatinine, urinary creatinine, creatinine clearance,
proteinuria or osmolality were detected. A significant rise in urinary
albumine excretion occurred in both groups peaking on the operative day;
for the on-pump CABG group (105 vs. 4857; Ps0.015) and for the OPCAB group
(116 vs. 3759; Ps0.04). Values were less important in the OPCAB group and
return to the baseline was faster than in the CPB group. OPCAB attenuates
sub-clinical AKI, in diabetic patients. 2010 Published by European
Association for Cardio-Thoracic Surgery.
<11>
[Use Link to view the full text]
Accession Number
2010624840
Authors
Prasad A. Banakal S. Muralidhar K.
Institution
(Prasad, Banakal, Muralidhar) Department of Anaesthesiology, Narayana
Hrudayalaya Institute of Medical Sciences, No 258/A, Bommasandra
Industrial Area, Anekal Taluk, Bangalore 560099, India
Title
N-Acetylcysteine does not prevent renal dysfunction after off-pump
coronary artery bypass surgery.
Source
European Journal of Anaesthesiology. 27 (11) (pp 973-977), 2010. Date of
Publication: November 2010.
Publisher
Lippincott Williams and Wilkins (250 Waterloo Road, London SE1 8RD, United
Kingdom)
Abstract
Background and objective Coronary artery bypass graft surgery in high-risk
patients may be associated with postoperative renal dysfunction.
N-Acetylcysteine is a powerful antioxidant and has been used to prevent
contrast-induced renal dysfunction. The efficacy of N-acetylcysteine in
preventing postoperative renal dysfunction following off-pump coronary
artery bypass graft surgery was studied. Methods A prospective,
randomized, controlled study was conducted in patients undergoing off-pump
coronary artery bypass graft. The study group (37 patients) received
N-acetylcysteine in the perioperative period, whereas the control group
(37 patients) did not. The data obtained were analysed using the
independent sample t-test (Student's t-test) and x<sup>2</sup>-test.
Results There was no significant difference in the incidence of renal
dysfunction between the two groups. Three patients (8.6%) in the
N-acetylcysteine group and four (11.4%) in the control group developed
renal dysfunction (P value was 1.00). Conclusion N-Acetylcysteine does not
have any beneficial effect on renal function in high-risk patients
undergoing offpump coronary artery bypass graft. Copyright European
Society of Anaesthesiology.
<12>
Accession Number
70304950
Authors
Sontag M.K. Sagel S.D. Wagener J. Accurso F.J.
Institution
(Sontag) Epidemiology, University of Colorado at Denver, Aurora, CO,
United States
(Sagel, Wagener, Accurso) Pediatrics, University of Colorado at Denver,
Aurora, CO, United States
Source
Pediatric Pulmonology. Conference: 24th Annual North American Cystic
Fibrosis Conference Baltimore, MD United States. Conference Start:
20101021 Conference End: 20101023. Conference Publication: (var.pagings).
45 (pp 396), 2010. Date of Publication: September 2010.
Publisher
Wiley-Liss Inc.
Abstract
Background: Colorado adopted newborn screening (NBS) for cystic fibrosis
in 1982, using an algorithm of two immunoreactive trypsinogen
determinations (IRT/IRT). We have previously reported a sensitivity of
94.6% (90.0-96.2%). Reports from other programs suggest sensitivity of
this approach with initial cutoffs >100 ng/ml may be as low as 80%. We
identified individuals in the Cystic Fibrosis Foundation (CFF) Registry
who may have been missed by the Colorado NBS in order to further refine
our sensitivity estimates. Methods: Names and current CF centers were
requested from the CFF on individuals born in Colorado between 1982 and
2007 that have CF but not seen by the Colorado Center. Local CF centers
were contacted and asked to confirm state of birth with families. The
additional missed cases were added to the number of missed cases
previously known. Infants with meconium ileus (n=67) were not included.
False negative rate and 95% confidence intervals are reported. Results:
Twenty infants were previously known missed cases followed in Colorado,
(median age of diagnosis 1 year: range 0.1-13.4 years), and 332
non-meconium ileus infants were identified by NBS (missed case rate 6.0%,
3.9-9.1%). Eight missed cases (40%) had genotypes associated with
pancreatic sufficiency. An additional 27 patients were identified from the
CFF query, however only 2 have been confirmed as missed cases on the
Colorado NBS. Of the remaining infants, 21 were confirmed as not missed on
NBS, and 4 individuals have not yet been located. The 2 confirmed missed
cases were diagnosed in other states: one diagnosed at 6 months due to
failure to thrive and electrolyte imbalance (Cl=120, F508del/ F508del) and
one diagnosed at 3 years of age (Cl=74, not genotyped). Three babies were
reported who have CF identified by Colorado NBS. One infant moved
following an elevated IRT, sweat test performed in infancy in another
state was negative, and the child was diagnosed at 14 years (Cl=111,
F508del/ F508del). One moved to another state after birth and diagnosis at
1.2 months was prompted by elevated IRT; another lived in a neighboring
state and diagnosis was prompted by elevated IRT at 1.4 months. Four
infants had been diagnosed by the Colorado NBS but not reported to the
CFF. Eight infants were a duplication of records (names
changed/misspelled). The birth state was misreported in four cases. One
case was concluded to be Munchausen's by proxy (CFTR mutations not
identified) and one child had a heart transplant, with no further mention
of CF (CFTR mutations not identified). The missed case rate using infants
with known state of birth is 22/337 (6.5%, 4.4-9.7%). Assuming all four
infants who have not been located were born in Colorado and missed on NBS,
the missed case rate is 26/341 (7.6% 5.6-10.9%). Conclusions: A systematic
review of national data reflecting potential missed cases from the
Colorado NBS program resulted in only two additional cases missed by NBS,
and one case missed by a negative sweat test in another state. These data
suggest the sensitivity of IRT/IRT in Colorado was 92.3% (89.1-94.7%).
This systematic approach should be considered in evaluating other CF NBS
protocols.
<13>
Accession Number
2010609719
Authors
Poyet R. Cuisset T. Frere C. Quilici J. Gaborit B. Moro P.-J. Camoin L.
Morange P.-E. Bonnet J.-L. Alessi M.-C.
Institution
(Poyet, Cuisset, Quilici, Moro, Bonnet) Departement de Cardiologie, CHU
Timone, Marseille, F-13385, France
(Cuisset, Frere, Gaborit, Morange, Alessi) Inserm, U626, Marseille,
F-13385, France
(Frere, Gaborit, Morange, Alessi) Laboratoire d'Hematologie, CHU Timone,
Marseille, F-13385, France
(Camoin) Laboratoire d'Hematologie, CHU Conception, Marseille, F-13385,
France
(Cuisset, Frere, Gaborit, Morange, Alessi) Faculte de Medecine, Marseille
F-13385, France
Title
Comparison of rosuvastatin and atorvastatin on clopidogrel response and
lipidic and inflammatory parameters after coronary stenting for acute
coronary syndrome: The prospective, randomized OSCAR study (optimal statin
therapy with clopidogrel after coronary revascularisation).
Source
Thrombosis Research. 126 (5) (pp e397-e399), 2010. Date of Publication:
2010.
Publisher
Elsevier Ltd (Langford Lane, Kidlington, Oxford OX5 1GB, United Kingdom)
<14>
Accession Number
2010620211
Authors
Macia I. Gossot D.
Institution
(Macia, Gossot) Department of Thoracic, Institut Mutualiste Montsouris, 42
Boulevard Jourdan, F-75014 Paris, France
Title
Maintaining a clear vision during long-lasting thoracoscopic procedures.
Source
Interactive Cardiovascular and Thoracic Surgery. 11 (5) (pp 522-524),
2010. Date of Publication: November 2010.
Publisher
European Association for Cardio-Thoracis Surgery (3 Park Street, Windsor,
Berkshire SL4 1LU, United Kingdom)
Abstract
Performing complex and long-lasting thoracoscopic procedures presupposes
that a perfectly clear vision is maintained. We have evaluated the use of
a lens cleaner system (EndoClear) which can be released inside the chest
cavity, thus avoiding the need for removing the scope. Forty-three
patients underwent a totally endoscopic major pulmonary resection. The
study group consisted of 13 patients whose surgery was performed using the
lens cleaner (group Lens Cleaner, LC). The control group (group C)
consisted of 30 patients operated without the assistance of EndoClear.
Both groups were similar in terms of age, gender, type and duration of
surgery. In group LC, the thoracoscope was cleaned using EndoClear a mean
of 8.6+/-2.5 times per operation and a mean of 1.3+/-1.3 times outside the
cavity (P<0.001). In group C, the thoracoscope had to be removed for
cleaning a mean 9.5+/-3.9 times significantly more often than in the group
LC (P<0.001). The EndoClear lens cleaning system is an efficient method
for cleaning the scope inside the chest cavity. 2010 Published by
European Association for Cardio-Thoracic Surgery.
<15>
Accession Number
2010623177
Authors
Schiariti M. Saladini A. Papalia F. Grillo P. Nesta C. Cuturello D.
Missiroli B. Puddu P.E.
Institution
(Schiariti, Saladini, Grillo, Nesta, Missiroli) S. Anna Hospital,
Catanzaro, Italy
(Schiariti, Papalia, Cuturello, Puddu) Department of the Heart and Great
Vessels A. Reale, University La Sapienza, Viale del Policlinico, 155, Rome
00161, Italy
Title
GPIIb/IIIa receptor antagonism using small molecules provides no additive
long-term protection after percutaneous coronary intervention as compared
to clopidogrel plus aspirin.
Source
Open Cardiovascular Medicine Journal. 4 (pp 151-156), 2010. Date of
Publication: 2010.
Publisher
Bentham Science Publishers B.V. (P.O. Box 294, Bussum 1400 AG,
Netherlands)
Abstract
Background: There is some controversy as to whether tirofiban or
eptifibatide, two small anti-aggregating drugs (AAD), may reduce the
incidence of composite ischemic events within one year in patients
undergoing percutaneous coronary intervention (PCI) in the real clinical
world. Methods: We compared consecutive patients on oral double AAD (with
clopidogrel and aspirin) who underwent PCI (n=207) and patients who were
on single AAD and received a second AAD, just prior to PCI, and either
high-dose tirofiban or double-bolus eptifibatide (double AAD plus small
molecules group, n=666). The primary end point (incidence of composite
ischemic events within one year) included death, acute myocardial
infarction, unstable angina, stent thrombosis or repeat PCI or coronary
bypass surgery (related to the target vessel PCI failure) and was modelled
by Cox's regression. Results: There were 89 composite ischemic events: 24
(11.6%) in double AAD alone and 65 (9.8%) in double AAD plus small
molecules groups (log-rank test: p=0.36). Incidences by type of ischemic
events were similar between the 2 groups. Based on 21 potential covariates
fitted simultaneously, adjusted hazard ratios (HR and 95% confidence
intervals) showed that age (HR 1.03, 1.01-1.06, p=0.01), diabetes (HR
1.68, 1.01-2.79, p=0.05) and intra aortic balloon pump (HR 5.12,
2.36-11.10, p=0.0001) were significant risk factors whereas thrombolysis
by tenecteplase (HR 0.35, 0.13-0.98, p=0.05) and having had hypertension
or anti-hypertensive treatment (HR 0.58, 0.36-0.93, p=0.03) were
significant protectors for events. Whether small molecules were present
provided a non significant additional benefit as compared to double AAD
alone (HR 0.83, 0.51-1.36, p=0.46). Pre-PCI CK-MB were not useful to
predict events (HR 1.01, 0.99-1.01, p=0.17). Conclusions: In clinical
world patients undergoing PCI (rescue plus primary <13%) while on double
AAD, based on clopidogrel plus aspirin, small molecules (tirofiban or
eptifibatide) provided no additive long-term protection against the
occurrence of composite ischemic events whereas thrombolysis by
tenecteplase did. Schiariti et al.
<16>
Accession Number
2010624744
Authors
Bystron M. Cervinka P. Spacek R. Kvasnak M. Jakabcin J. Cervinkova M. Kala
P. Widimsky P.
Institution
(Bystron, Cervinka, Spacek, Kvasnak, Jakabcin, Cervinkova) Krajska
Zdravotni A.s., Masaryk Hospital, Department of Cardiology, Socialni pece
3316/12A, 401 13 Usti nad Labem, Czech Republic
(Kala) Department of Cardiology, Faculty Hospital Brno Bohunice, Czech
Republic
(Widimsky) Cardiocenter, Third Faculty of Medicine, Charles University,
Prague, Czech Republic
Title
Randomized comparison of endothelial progenitor cells capture stent versus
cobalt-chromium stent for treatment of ST-elevation myocardial infarction.
Six-month clinical, angiographic, and IVUS follow-up.
Source
Catheterization and Cardiovascular Interventions. 76 (5) (pp 627-631),
2010. Date of Publication: 01 Nov 2010.
Publisher
Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)
Abstract
Purpose: The aim of this trial was to assess the feasibility and safety of
endothelial progenitor cells capture (EPC) stent in the treatment of acute
ST-elevation myocardial infarction (STEMI) when compared with
cobalt-chromium stents (CoCr). Methods: Between July 2006 and May 2008,
100 patients with single vessel disease undergoing primary PCI for STEMI
were randomly assigned to receive either EPC stent (N = 50) or CoCr stent
(N = 50). High-pressure stent implantation was carried out in both groups.
Dual antiplatelet treatment was administered for 30 days in both groups.
All patients underwent 6-month clinical, angiographic, and IVUS follow-up.
Results: The rate of major adverse cardiovascular events (MACEs) at 30
days was comparable in both groups. At 6-month follow-up, the rates of
MACEs and TLR in the EPC stent group when compared with CoCr stent were
24% vs.10%; P = 0.06 and 14% vs. 4%; P = 0.08, respectively. There were
three cases (6%) of stent thrombosis (ST) in the EPC stent group versus
none in CoCr group. Conclusion: The use of EPC capture stents in the
setting of STEMI is feasible and safe in terms of 30-days outcome.
However, at the 6-month follow-up, we found a trend of higher rates of
MACE and TLR in the EPC stent capture group compared to CoCr stents. The
study does not support the use of EPC capture stents with short duration
dual antiplatelet therapy in patients with STEMI. Future randomized
studies with large sample sizes would be necessary to demonstrate the
safety of such approach. Copyright 2010 Wiley-Liss, Inc.
<17>
[Use Link to view the full text]
Accession Number
2010609796
Authors
Aouad M.T. Kanazi G.E. Abdallah F.W. Moukaddem F.H. Turbay M.J. Obeid M.Y.
Siddik-Sayyid S.M.
Institution
(Aouad, Kanazi, Abdallah, Moukaddem, Turbay, Obeid, Siddik-Sayyid)
Department of Anesthesiology, American University of Beirut, P.O. Box
11-0236, Beirut, Lebanon
Title
Femoral vein cannulation performed by residents: A comparison between
ultrasound-guided and landmark technique in infants and children
undergoing cardiac surgery.
Source
Anesthesia and Analgesia. 111 (3) (pp 724-728), 2010. Date of
Publication: September 2010.
Publisher
Lippincott Williams and Wilkins (351 West Camden Street, Baltimore MD
21201-2436, United States)
Abstract
BACKGROUND: Percutaneous cannulation of the femoral vein, in the pediatric
age group, can be technically challenging, especially when performed by
residents in training. We examined whether the use of real-time ultrasound
guidance is superior to a landmark technique for femoral vein
catheterization in children undergoing heart surgery. METHODS: Patients
were prospectively randomized into 2 groups. In group LM, the femoral vein
was cannulated using the traditional method of palpation of arterial
pulse. In group US, cannulation was guided by real-time scanning with an
ultrasound probe. The time to complete cannulation (primary outcome),
success rate, number of needle passes, number of successful cannulations
on first needle pass, and incidence of complications were compared between
the 2 groups. RESULTS: Forty-eight pediatric patients were studied. The
time to complete cannulation was significantly shorter (155 [46-690] vs
370 [45-1620] seconds; P = 0.02) in group US versus group LM. The success
rate was similar in both groups (95.8%). The number of needle passes was
smaller (1 [1- 8] vs 3 [1-21]; P = 0.001) and the number of successful
cannulations on first needle pass higher (18 vs 6; P = 0.001) in group US
compared with group LM. The incidence of femoral artery puncture was
comparable between the 2 groups. CONCLUSIONS: Ultrasound-guided
cannulation of the femoral vein, in pediatric patients, when performed by
senior anesthesia residents, is superior to the landmark technique in
terms of speed and number of needle passes, with remarkable improvement in
first attempt success. (Anesth Analg 2010;111:724-8) Copyright 2010
International Anesthesia Research Society.
<18>
Accession Number
2010620725
Authors
Barnett H.J.M. Pelz D.M. Lownie S.P.
Institution
(Barnett) Robarts Research Institute, University of Western Ontario,
London, ON, Canada
(Pelz) Department of Medical Imaging, University of Western Ontario,
London, ON, Canada
(Lownie) Department of Clinical Neurological Sciences, University of
Western Ontario, London, ON, Canada
Title
Reflections by contrarians on the post-CREST evaluation of carotid
stenting for stroke prevention.
Source
International Journal of Stroke. 5 (6) (pp 455-456), 2010. Date of
Publication: December 2010.
Publisher
Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United
Kingdom)
Abstract
Carotid angioplasty and stenting has become a popular alternative to
carotid endarterectomy for the treatment of carotid stenosis in stroke.
Evidence from early randomized controlled trials comparing these
interventions revealed mixed results. The largest such trial, the Carotid
Revascularization Endarterectomy vs. Stenting Trial recently showed
equivalence of the procedures in a mixed cohort of both symptomatic and
asymptomatic patients. These results have been heralded in North America
as definitively demonstrating the safety and efficacy of carotid
angioplasty and stenting, making it an attractive alternative to carotid
endarterectomy. It is therefore probable that many more asymptomatic
patients will be subjected to Carotid angioplasty and stenting, perceived
by many to be less invasive than carotid endarterectomy. The authors argue
that the design of Carotid Revascularization Endarterectomy vs. Stenting
Trial was flawed by the mixture of two dissimilar patient groups, thus
violating the principle of ceteris paribus, essential for the validity of
a randomized controlled trials. The evidence for any invasive treatment of
asymptomatic carotid disease is weak, with recent data favouring purely
medical management. The authors believe that carotid angioplasty and
stenting in asymptomatic patients should cease until better evidence is
available. 2010 The Authors. International Journal of Stroke 2010 World
Stroke Organization.
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