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<1>
Accession Number
2012081088
Authors
Sabzi F. Moradi G.R. Dadkhah H. Poormotaabed A. Dabiri S.
Institution
(Sabzi, Poormotaabed, Dabiri) Department of Cardiac Surgery, Emam Ali
Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran,
Islamic Republic of
(Moradi) Department of Cardiac Anesthesiology, Emam Ali Hospital,
Kermanshah University of Medical Sciences, Kermanshah, Iran, Islamic
Republic of
(Dadkhah) Department of Cardiac Surgery, Heshmat Hospital, Guilan
University of Medical Sciences, Rasht, Iran, Islamic Republic of
Title
Low dose aprotinin increases mortality and morbidity in coronary artery
bypass surgery.
Source
Journal of Research in Medical Sciences. 17 (1) (pp 74-82), 2012. Date
of Publication: 2012.
Publisher
Isfahan University of Medical Sciences (Hezar Jerib Avenue, P.O. Box
81745-319, Isfahan, Iran, Islamic Republic of)
Abstract
BACKGROUND: The low dose aprotinin consistently reduces blood and
transfusion requirement in adults during cardiac surgical procedures but
its effectiveness in some ethnical groups were debated and controversy
about its effect on mortality and morbidity precludes its routine use.
This study was designated to determine whether a low dose of aprotinin
causes more mortality and morbidity when used after coronary artery bypass
grafting (CABG) surgery. METHODS: In a clinical trial study, 380 patients
in placebo and 273 patients in aprotinin group were enrolled. A test dose
before skin incision and 2 million kallikrein inactivation units (KIU)
during initiation of cardiopulmonary bypass (CPB) were given to patients.
Differences in quantity of blood transfusion, morbidity and mortality were
analyzed. Multivariable analysis was performed to determine risk factors
for mortality. RESULTS: Decreased blood product transfusions and increased
rate of morbidity were found in the aprotinin group. Independent
predictors for increased number of transfusion were aspirin continued
before operation and small body mass index (BMI) but there was a
significant difference in mortality and morbidity between two groups.
CONCLUSIONS: In patients undergoing CABG procedure, low dose aprotinin is
effective in attenuating post bypass coagulopathy and decreasing blood
product use, but it increases morbidity.

<2>
Accession Number
2012055829
Authors
Hanada K. Higuma T. Nishizaki F. Sukekawa T. Yokota T. Yamada M. Saito S.
Kushibiki M. Oikawa K. Abe N. Tomita H. Osanai T. Okumura K.
Institution
(Hanada, Higuma, Nishizaki, Sukekawa, Yokota, Yamada, Saito, Kushibiki,
Oikawa, Abe, Tomita, Osanai, Okumura) Department of Cardiology, Hirosaki
University Graduate School of Medicine, Hirosaki, Japan
Title
Randomized study on the efficacy and safety of landiolol, an
ultra-short-acting beta1-adrenergic blocker, in patients with acute
myocardial infarction undergoing primary percutaneous coronary
intervention.
Source
Circulation Journal. 76 (2) (pp 439-445), 2012. Date of Publication:
2012.
Publisher
Japanese Circulation Society (14 Yoshida Kawaharacho, Sakyo-ku, Kyoto 606,
Japan)
Abstract
Background: It is still controversial whether intravenous administration
of beta-blocker in the very acute phase of acute myocardial infarction
(AMI) is beneficial. Landiolol is an ultra-short-acting beta-blocker that
has less effect on blood pressure, but little is known about its efficacy
and safety for patients with AMI undergoing primary percutaneous coronary
intervention (PCI). Methods and Results: A consecutive 96 patients with
AMI not manifesting cardiogenic shock were prospectively randomized to
landiolol (n=47) or a control group (n=49). Continuous administration of
landiolol (3 mug kg-1 min-1 for 24 h) was done just after PCI in the
landiolol group, but not in the control group. Heart rate decreased by
9.4+/-1.7 beats/min after initiation of landiolol (P<0.01), but was
unchanged in the control group. Left ventricular ejection fraction
assessed 6 months later was greater than that at 2 weeks in the landiolol
group (52.0+/-1.5 vs. 49.1+/-1.5%, P=0.01), but remained unchanged in the
control group. Left ventricular end-diastolic volume index assessed 6
months later was increased compared with that at 2 weeks in the control
group (78.0+/-2.7 vs. 72.5+/-2.8 ml/m2, P=0.02), whereas it was unchanged
in the landiolol group. Conclusions: Early intravenous administration of
landiolol in patients with AMI undergoing PCI is safe and has the
potential to improve cardiac function and inhibit cardiac remodeling in
the chronic phase.

<3>
Accession Number
2012084681
Authors
Kamaledeen A. Young C. Attia R.Q.
Institution
(Kamaledeen, Young, Attia) Department of Cardiothoracic Surgery, St.
Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, United Kingdom
Title
What are the differences in outcomes between right-sided active infective
endocarditis with and without left-sided infection?.
Source
Interactive Cardiovascular and Thoracic Surgery. 14 (2) (pp 205-208),
2012. Date of Publication: February 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was: in patients with isolated
right-sided infective endocarditis (RSE) is the outcome of surgical
management the same as in patients with or without left-sided involvement?
Altogether, 419 papers were found using the reported search, six of which
represented the best evidence to answer the clinical question. Two studies
point towards better outcomes with isolated RSE. In one paper, mortality
was significantly lower in isolated RSE patients (P = 0.0093) for the
duration of the follow-up time (median 488 patient-years). Two studies
reported early mortality (<30 days) for RSE patients at 3.6 and 3.8%,
respectively. Combined right-and left-sided endocarditis (RLSE) patients
were found to have a poorer pre-operative clinical presentation than
isolated RSE patients with a greater requirement for inotropic support
(P<0.006) and the likelihood of an emergency operation (P <0.001). They
had a poorer intraoperative course with a higher incidence of cardiac
abscess formation (P <0.001). One study suggested that there is no
significant difference in in-hospital and long-term mortality between
intravenous drug abuse (IVDA) patients and non-IVDA patients. Leftheart
involvement in the IVDA group was 61.5%. This was in-line with the
published literature, demonstrating a rise in RLSE in IVDA compared with
non-IVDA patients. Three articles looking at isolated left-sided
endocarditis (LSE) gave mortality rates in the surgical group to be 27.1,
27.8 and 38%, respectively. In one study, the LSE mortality was not
different for native vs. prosthetic valve infection (OR 0.65, 95% CI
0.23-1.87). After propensity matching and adjusting for hazards, the
complication rate in the LSE group was higher and this translated to a
higher mortality rate. We conclude from the literature that outcomes are
more favourable with lower early and late mortality for isolated RSE
patients over pure LSE or combined RLSE. The Author 2011.

<4>
Accession Number
2012084680
Authors
Tsakok T. Tsakok M. Damji C. Watson R.
Institution
(Tsakok) Academic Foundation Programme, Guy's and St Thomas' NHS
Foundation Trust, Great Maze Pond, London, United Kingdom
(Tsakok, Watson) Green Templeton College, University of Oxford, Oxford,
United Kingdom
(Damji) Foundation Programme, Hillingdon Hospitals NHS Foundation Trust,
London, United Kingdom
Title
Washout after lobectomy: Is water more effective than normal saline in
preventing local recurrence?.
Source
Interactive Cardiovascular and Thoracic Surgery. 14 (2) (pp 200-204),
2012. Date of Publication: February 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was: 'is water washout more
effective than normal saline washout after lobectomy in preventing local
recurrence?' Altogether more than 48 papers were found using the reported
search, of which nine represented the best evidence to answer the clinical
question. The authors, journal, date, country of publication, patient
group studied, study type, relevant outcomes and results of these papers
are tabulated. Tumour cell 'spillage' after cancer resection is linked to
a worse prognosis, so washout to minimize contamination is an established
surgical technique. While the mechanical effects of lavage are well
validated, the differential cytocidal effects of water versus saline as
irrigation fluids are not. There are currently no studies addressing this
issue in the thoracic surgery setting, after lung cancer lobectomy.
However, the majority of relevant papers describe the use of basic in
vitro methods and animal models to produce data that can conceivably be
extrapolated to the clinical question in hand. The number of studies is
small, and some have technical limitations. While two of the
better-designed experiments suggest that water exerts a superior cytocidal
effect on tumour cells, data from other studies are somewhat unimpressive,
with two studies reporting that water washout controls tumour growth to a
lesser extent than saline. This, together with the complete paucity of
clinical trials on the subject, leads us to conclude that water is
unlikely to represent a superior irrigation fluid in lung cancer patients
after lobectomy. The Author 2011.

<5>
Accession Number
2012084679
Authors
Mathews T.J. Churchhouse A.M.D. Housden T. Dunning J.
Institution
(Mathews, Churchhouse, Housden) Department of Thoracic Surgery, Royal
Infirmary of Edinburgh, Edinburgh, United Kingdom
(Dunning) Department of Cardiothoracic Surgery, James Cook University
Hospital, Middlesbrough, United Kingdom
Title
Does adding ketamine to morphine patient-controlled analgesia safely
improve post-thoracotomy pain?.
Source
Interactive Cardiovascular and Thoracic Surgery. 14 (2) (pp 194-199),
2012. Date of Publication: February 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was 'is the addition of
ketamine to morphine patient-controlled analgesia (PCA) following thoracic
surgery superior to morphine alone'. Altogether 201 papers were found
using the reported search, of which nine represented the best evidence to
answer the clinical question. The authors, journal, date and country of
publication, patient group studied, study type, relevant outcomes and
results of these papers are tabulated. This consisted of one systematic
review of PCA morphine with ketamine (PCA-MK) trials, one meta-analysis of
PCA-MK trials, four randomized controlled trials of PCA-MK, one
meta-analysis of trials using a variety of peri-operative ketamine regimes
and two cohort studies of PCA-MK. Main outcomes measured included pain
score rated on visual analogue scale, morphine consumption and incidence
of psychotomimetic side effects/hallucination. Two papers reported the
measurements of respiratory function. This evidence shows that adding
ketamine to morphine PCA is safe, with a reported incidence of
hallucination requiring intervention of 2.9%, and a meta-analysis finding
an incidence of all central nervous system side effects of 18% compared
with 15% with morphine alone, P = 0.31, RR 1.27 with 95% CI (0.8-2.01).
All randomized controlled trials of its use following thoracic surgery
found no hallucination or psychological side effect. All five studies in
thoracic surgery (n = 243) found reduced morphine requirements with
PCA-MK. Pain scores were significantly lower in PCA-MK patients in
thoracic surgery papers, with one paper additionally reporting increased
patient satisfaction. However, no significant improvement was found in a
meta-analysis of five papers studying PCA-MK in a variety of surgical
settings. Both papers reporting respiratory outcomes found improved oxygen
saturations and PaCO ₂ levels in PCA-MK patients following
thoracic surgery. We conclude that adding low-dose ketamine to morphine
PCA is safe and post-thoracotomy may provide better pain control than PCA
with morphine alone (PCA-MO), with reduced morphine consumption and
possible improvement in respiratory function. These studies thus support
the routine use of PCA-MK instead of PCA-MO to improve post-thoracotomy
pain control. The Author 2011.

<6>
Accession Number
2012084678
Authors
Urso S. Sadaba J.R. Pettinari M.
Institution
(Urso) Department of Cardiac Surgery, Fundacion Jimenez Diaz, Madrid,
Spain
(Sadaba) Department of Cardiac Surgery, Hospital de Navarra, Pamplona,
Spain
(Pettinari) Department of Cardiac Surgery, Gasthuisberg University
Hospital, Leuven, Belgium
Title
Impact of off-pump to on-pump conversion rate on post-operative results in
patients undergoing off-pump coronary artery bypass.
Source
Interactive Cardiovascular and Thoracic Surgery. 14 (2) (pp 188-193),
2012. Date of Publication: February 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was: In patients undergoing
off-pump coronary artery bypass (OPCAB) surgery, does the off-pump to
on-pump conversion rate have an impact on post-operative results?
Altogether more than 420 papers were found using the reported search, of
which 14 randomized controlled trials (RCTs) represented the best evidence
to answer the clinical question. The authors, journal, date and country of
publication, patient group studied, study type, relevant outcomes and
results of these papers are tabulated and ordered according to the sample
size. In the 14 RCTs reviewed, the off-pump to on-pump conversion rate
incidence ranged from 0 to 13.3%. The most frequent causes of conversion
were haemodynamic instability and intramyocardial-coronary target. A low
conversion rate (<2%) was reported by five studies. Three of them did not
show any difference in terms of mortality between the OPCAB and on-pump
groups, one showed better survival of the OPCAB group at 5 years, and one
reported better early survival of the OPCAB group. Three of these trials
describe a high OPCAB experience and reported that patients undergoing
OPCAB had a shorter post-operative stay and lower morbidity compared with
patients undergoing on-pump coronary artery bypass grafting. Five RCTs
showed a high conversion rate (>9%), and among them, one reported lower
morbidity of the OPCAB patients, three were not able to show any benefit
in terms of morbidity of the OPCAB, and one reported worse survival and
patency graft rate of the OPCAB group. Four RCTs reported conversion rates
ranging from 3.7 to 7.0%, describing a wide spectrum of results. We
conclude that RCTs with a high off-pump to on-pump conversion rate were
often associated with a lower experience in OPCAB of the surgeons
participating in the trials. These studies were also mostly unable to show
any benefit in terms of mortality or morbidity of OPCAB over the on-pump
strategy. On the contrary, a low conversion rate is mostly reported by
RCTs with a high structured experience in OPCAB. These trials were mostly
able to show a benefit, in terms of morbidity and survival, of the OPCAB
over the on-pump strategy. The Author 2011.

<7>
Accession Number
2012084673
Authors
Bertolaccini L. Terzi A. Rizzardi G. Gorla A. Viti A. Palmisano S. Coletta
G.
Institution
(Bertolaccini, Terzi, Rizzardi, Gorla, Viti) Thoracic Surgery Unit, S.
Croce e Carle City Hospital, Via Michele Coppino 26, 12100 Cuneo, Italy
(Palmisano, Coletta) Anesthesiology Unit, S. Croce e Carle City Hospital,
Cuneo, Italy
Title
Risk is not our business: Safety of thoracic surgery in patients using
antiplatelet therapy.
Source
Interactive Cardiovascular and Thoracic Surgery. 14 (2) (pp 162-166),
2012. Date of Publication: February 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
American Heart Association recommendations have changed preoperative
management of patients with antiplatelet therapy (APT). We assessed safety
and outcomes of surgery in patients who were receiving APT. A prospective
study of patients operated on while receiving APT was matched with those
with no APT (ratio 1:4), using the propensity score method. Logistic
regression analysis was used to identify covariates among imbalanced
baseline patient variables. Both chi² test and Fisher's test
were used to calculate the probability value for the comparison of
dichotomous variables. Between January 2008 and December 2010, 38 patients
who received APT at the time of surgery were matched with 141 patients who
had not received APT. APT indications were a history of myocardial
infarction, coronary artery by-pass graft and/or valve replacement (19),
coronary artery stent (11) and severe peripheral vascular disease (8).
None of the patients required re-operation for bleeding. Two patients
received blood transfusions. The amount of chest tube drainage was not
statistically significantly different. There were no statistically
significant differences between the outcomes for the operative time,
length of hospital stay, estimated blood loss or morbidity. The results
show that thoracic surgical procedures can safely be performed in patients
receiving APT at the time of surgery, with no increased risk of bleeding
or morbidity and no differences in the operative time and the length of
hospital stay. The Author 2011.

<8>
Accession Number
2012096689
Authors
Soltanzadeh M. Ebad A. Pipelzadeh M.R. Tabatabaei S.K. Dehghani
Firouzabadi M. Vasigh A. Soltanzadeh M.A. Heidari A. Ramazani A. Haybar H.
Institution
(Soltanzadeh, Ebad, Pipelzadeh, Tabatabaei, Dehghani Firouzabadi, Vasigh)
Department of Anesthesiology of Imam Khomeini Hospital, Ahwaz Jundishapur
University of Medical sciences, Ahwaz, Iran, Islamic Republic of
(Soltanzadeh) Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Heidari, Ramazani) Department of Cardiac surgery, Imam Khomeini Hospital,
Ahwaz Jundishapur University of Medical sciences, Ahwaz, Iran, Islamic
Republic of
(Haybar) Department of Cardiology, Imam Khomeini Hospital, Ahwaz
Jundishapur University of Medical sciences, Ahwaz, Iran, Islamic Republic
of
Title
Gabapentin may relieve post-coronary artery bypass graft pain: A double
blind randomized clinical trial.
Source
Iranian Cardiovascular Research Journal. 5 (3) (pp 79-82), 2012. Date of
Publication: 20120915.
Publisher
Iranian Cardiovascular Research Journal (Zand Ave., Shiraz, Iran, Islamic
Republic of)
Abstract
Background: One of the most common complaints after coronary artery bypass
graft (CABG) is postoperative pain. Gabapentin is an anticonvulsant and
antineuralgic agent. Objective: To evaluate the analgesic effect of
preemptive gabapentin on post-operative pain and morphine consumption
after cardiac surgery. Methods: A double-blind randomized clinical trial
was conducted on 60 male candidates for CABG. The patients were divided
into two groups-the gabapentin (n=30) and the control group (n=30). The
test group received 800 mg gabapentin orally two hours before the surgery
followed by 400 mg of the drug two hours post-extubation. The control
group received placebo instead. Then severity of pain was recorded
according to an 11-point visual analog pain scale. The amount of morphine
consumed, its side effects and hemodynamic changes were also recorded
during and at 2, 6, 12, 18 and 24 hours after extubation. Results: The
mean+/-SD cumulative morphine consumption at the first 24 hours after
extubation in gabapentin group was 0.9+/-1.5 mg while it was 1.5+/-4 mg
for the control group. Therefore, gabapentin group consumed 38% less than
the control group (P=0.01). The pain scores during rest and coughing at 2,
6, and 12 hours after extubation were also significantly lower in the
gabapentin group compared with the control group (P=0.02). The mean+/-SD
mechanical ventilation time was 5.4+/-1.7 hours for gabapentin group and
1.6+/-4.4 hours for the control group (P=0.035). The other variables
including hemodynamic changes (HR, SBP and DBP), and incidence of nausea,
vomiting and respiratory depression showed no significant difference
between the studied groups within 24 hours after extubation. Conclusion:
Oral pre-medication with gabapentin before CABG significantly reduces
post-operative pain and morphine consumption in adult cardiac surgery.
2012 Academic Journals.

<9>
Accession Number
2012088975
Authors
Iritakenishi T. Hayashi Y. Yamanaka H. Kamibayashi T. Ueda K. Mashimo T.
Institution
(Iritakenishi, Hayashi, Yamanaka, Kamibayashi, Ueda, Mashimo) Department
of Anesthesiology, Osaka University Medical School, 2-2, Yamada-oka,
Suita, Osaka 565-0871, Japan
Title
Milrinone, a phosphodiesterase III inhibitor, prevents reduction of
jugular bulb saturation during rewarming from hypothermic cardiopulmonary
bypass.
Source
Perfusion. 27 (1) (pp 13-17), 2012. Date of Publication: January 2012.
Publisher
SAGE Publications Ltd (55 City Road, London EC1Y 1SP, United Kingdom)
Abstract
Introduction: Inadequate cerebral oxygen balance during cardiopulmonary
bypass may cause neuropsychological dysfunction. Milrinone, a
phosphodiesterase III inhibitor, augments cerebral blood flow by direct
vasodilatation. We conducted a prospective, randomized study in patients
undergoing cardiac surgery with cardiopulmonary bypass to clarify the
clinical efficacy of milrinone in the imbalance of cerebral oxygen supply
and demand during the rewarming period of cardiopulmonary bypass. Methods:
This is a prospective, randomized and placebo-controlled study. After
anesthesia, a 5.5 F fiberoptic oximeter catheter was inserted into the
right jugular bulb retrogradely for monitoring the jugular venous
oxyhemoglobin saturation (SjO₂). Patients were randomly
assigned to two groups, one receiving a continuous infusion of milrinone,
0.5 mug/kg/min during hypothermic cardiopulmonary bypass, and the other
receiving saline as control. Results: Milrinone significantly prevented
the reduction of the jugular venous oxyhemoglobin saturation at 10 minutes
from the start of rewarming compared with the control group, but did not
do so from 10 to 20 minutes after rewarming. Conclusion: Milrinone
suppresses the reduction of SjO₂ and improves the balance of
cerebral oxygen supply and demand during the early rewarming period of
hypothermic cardiopulmonary bypass. 2011 The Author(s).

<10>
Accession Number
2012085896
Authors
Lador A. Nasir H. Mansur N. Sharoni E. Biderman P. Leibovici L. Paul M.
Institution
(Lador, Leibovici) Medicine E, Rabin Medical Center, Beilinson Hospital,
Petah-Tikva, Israel
(Nasir, Mansur) Pharmacology Services, Rabin Medical Center, Beilinson
Hospital, Petah-Tikva, Israel
(Sharoni, Biderman) Department of Cardiothoracic Surgery, Rabin Medical
Center, Beilinson Hospital, Petah-Tikva, Israel
(Sharoni, Biderman, Leibovici, Paul) Sackler Faculty of Medicine, Tel-Aviv
University, Ramat-Aviv, Israel
(Paul) Unit of Infectious Diseases, Rabin Medical Center, Beilinson
Hospital, Petah-Tikva, Israel
Title
Antibiotic prophylaxis in cardiac surgery: Systematic review and
meta-analysis.
Source
Journal of Antimicrobial Chemotherapy. 67 (3) (pp 541-550), 2012.
Article Number: dkr470. Date of Publication: March 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Background: Antibiotic prophylaxis is recommended in cardiac surgery.
Current debate concerns the type of antibiotic(s), dosing and the duration
of prophylaxis. Methods: Systematic review of randomized controlled trials
comparing one antibiotic regimen versus another in cardiac surgery. We
searched The Cochrane Library, PubMed, LILACS, conference proceedings and
bibliographies. Two reviewers independently extracted the data. The
primary outcome was deep sternal wound infections (DSWIs). Meta-analysis
was performed using the Mantel-Haenszel fixed-effect method. Risk ratios
(RRs) with 95% confidence intervals (95% CIs) are reported. Results:
Fifty-nine trials were included. There were no significant differences in
DSWI or all other categories of surgical site infections (SSIs) for
antibiotic prophylaxis with beta-lactams comprising a Gram-negative
spectrum of coverage versus prophylaxis targeting Gram-positive bacteria,
but the former led to a significantly lower rate of post-operative
pneumonia (RR 0.68, 95% CI 0.51-0.90) and all-cause mortality (RR 0.66,
95% CI 0.47-0.92). In trials comparing different antibiotic regimens for
different durations, prophylaxis duration of <=24 h post-operation led to
higher rates of DSWI (RR 1.83, 95% CI 1.25-2.66), any sternal SSI,
surgical interventions for SSI and endocarditis compared with longer
duration prophylaxis. There was no advantage of regimens lasting >48 h
post-operation. In the comparison of glycopeptides versus beta-lactams, an
advantage of glycopeptides was observed when comparators were given for
similar duration and for beta-lactams when given for a longer duration
than the glycopeptides. There was no significant advantage of high
antibiotic dosing. Conclusions: Evidence supports second- or
third-generation cephalosporins for cardiac surgery prophylaxis and points
at a possible advantage of prophylaxis prolongation up to 48 h
post-operatively. The Author 2011. Published by Oxford University Press
on behalf of the British Society for Antimicrobial Chemotherapy. All
rights reserved.

<11>
Accession Number
21881356
Authors
Nakamura H. Ando K. Shinmyo T. Morita K. Kurimoto N.
Institution
(Nakamura, Ando, Shinmyo, Morita) Departments of Chest surgery, St.
Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
(Kurimoto) Departments of Medical Statistics, St. Marianna University
School of Medicine, Kawasaki, Kanagawa, Japan
Title
Female gender is an independent prognostic factor in non-small-cell lung
cancer: A meta-analysis.
Source
Annals of Thoracic and Cardiovascular Surgery. 17 (5) (pp 469-480), 2011.
Date of Publication: October 25, 2011.
Publisher
Japanese Association for Coronary Artery Surgery (2-1 Nibancho,
Chiyoda-ku, Tokyo 102-0084, Japan)
Abstract
Purpose: It is not clear whether women with non-small-cell lung cancer
(NSCLC) live significantly longer than men. Thus, we conducted a
meta-analysis of published studies to quantitatively compare NSCLC
survival data between genders. Materials and Methods: A MEDLINE Web search
for computer-archived bibliographic data regarding overall survival
differences between genders was performed. DerSimonian-Laird random
effects analysis was used to estimate the pooled hazard ratio (HR).
Results: We selected 39 articles as appropriate data sources, involving 86
800 patients including 32 701 women and 54 099 men. Combined HRs for women
vs. men in studies using univariate and multivariate analyses respectively
were 0.79 (p <0.0001) and 0.78 (p <0.0001). Pooled HRs for 3 study
subgroups having (1) fewer than 30% stage I cases, (2) fewer than 50%
adenocarcinoma cases, and (3) statistical adjustment for smoking status
all indicated the survival advantage of women. Conclusion: This
meta-analysis of published data concerning NSCLC patients indicated
significantly better survival for women. 2011 The Editorial Committee of
Annals of Thoracic and Cardiovascular Surgery. All rights reserved.

<12>
Accession Number
21881371
Authors
Pehlivan E. Turna A. Gurses A. Gurses H.N.
Institution
(Pehlivan, Gurses) Chest Diseases and Thoracic Surgery, Yedikule Teaching
Hospital, Istanbul, Turkey
(Turna) Department of Thoracic Surgery, Cerrahpasa Medical Faculty,
Istanbul University, Istanbul, Turkey
(Gurses) Department of Physical Therapy and Rehabilitation, School of
Health, Istanbul Bilim University, Istanbul, Turkey
Title
The effects of preoperative short-term intense physical therapy in lung
cancer patients: A randomized controlled trial.
Source
Annals of Thoracic and Cardiovascular Surgery. 17 (5) (pp 461-468), 2011.
Date of Publication: October 25, 2011.
Publisher
Japanese Association for Coronary Artery Surgery (2-1 Nibancho,
Chiyoda-ku, Tokyo 102-0084, Japan)
Abstract
Background: We planned to investigate the effect of preoperative short
period intensive physical therapy on lung functions, gas-exchange, and
capacity of diffusion, and ventilation-perfusion distribution of patients
with non-small cell lung cancer. Methods: Sixty patients with lung cancer,
who were deemed operable, were randomly allocated into two groups.
Intensive physical therapy was performed in patients in the study group
before operation. Both groups received routine physical therapy after
operation. Results: There was no difference in pulmonary function tests
between the two groups. Intensive physical therapy statistically
significantly increased peripheral blood oxygen saturation. At least one
complication was noted in 5 patients (16.7%) in the control group, and 2
(6.7%), in the study group. However, there was no statistically
significant difference (p = 0,4). The hospital stay has been found to be
statistically significantly shortened by intensive physical therapy (p
<0.001). Ventilation-perfusion distribution was found to be significantly
effected by intensive physical therapy. The change was prominent in the
the contralateral lung (p <0.001). Conclusions: Intensive physical therapy
appeared to increase oxygen saturation, reduce hospital stay, and change
the ventilation/perfusion distribution. It had a significant, positive
effect on the exercise capacity of patients. 2011 The Editorial Committee
of Annals of Thoracic and Cardiovascular Surgery. All rights reserved.

<13>
Accession Number
2012083380
Authors
Baretti R. Debus B. Lin B. Weng Y.-G. Pasic M. Hubler M. Grauhan O.
Knosalla C. Dandel M. Kemper D. Hiemann N. Lehmkuhl H.B. Hetzer R.
Institution
(Baretti, Debus, Lin, Weng, Pasic, Hubler, Grauhan, Knosalla, Dandel,
Kemper, Hiemann, Lehmkuhl, Hetzer) Deutsches Herzzentrum, Berlin, Germany
Title
Arrhythmia post heart transplantation.
Source
Applied Cardiopulmonary Pathophysiology. 15 (4) (pp 256-271), 2011. Date
of Publication: 2011.
Publisher
Pabst Science Publishers (Eichengrund 28, Lengerich D-49525, Croatia)
Abstract
A variety of arrhythmias can occur after heart transplantation (HTx).
Hearts selected to be donated for HTx should be in good condition and
generally beat in sinus rhythm (SR). Absence or loss of SR after HTx can
be due to any reason and can lead to serious hemodynamic problems.
Ischemia reperfusion injury, unbalanced serum electrolytes and re-warming
of cold my-ocardial tissue are known to initiate arrhythmia during the
period of reperfusion after implantation of the heart graft. An important
cause of arrhythmias after HTx is the possible rejection reaction, which
often prompts supraventricular arrhythmias. Subsequent to the initial
course after HTx operation transplant vasculopathy can cause arrhythmias
of all kinds. The post-HTx effects of some antiarrhythmic substances such
as amiodarone administered preoperatively are at present under discussion
as possibly being associated with an increased risk for mortality. A
survey of patients' data from the Deutsches Herzzentrum Berlin (DHZB)
showed that continuous SR is accompanied by favorable course after HTx.
Absence of SR or its loss predicts organ failure. Significant risk factors
for cardiac graft failure were found to be associated with the
preoperative condition of recipients and donors as well as with the
operative procedures and the respective postoperative courses. Of these
risk factors three were prominently associated with cardiac graft failure:
absence or loss of SR initially after HTx operation, donor age over 30
years and previous thoracic operation of the recipient. Antiarrhythmic
medication regulates cardiac rhythm. We examined the hypothesis whether
preoperatively administered an-tiarrhythmic medication influences post-HTx
cardiac rhythm and function due to loading of the recipient's body with an
antiarrhythmic substance. The examination of the DHZB data showed that
medication for antiarrhythmic purposes in patients waiting for HTx is
without influence on the occurrence or continuation of sinus rhythm or on
the incidence of arrhythmia after HTx. No preoperatively administered
antiarrhythmic substance was associated with postoperative arrhythmia or
with cardiac graft failure.

<14>
Accession Number
2012078791
Authors
Ludman A.J. Hausenloy D.J. Babu G. Hasleton J. Venugopal V.
Boston-Griffiths E. Yap J. Lawrence D. Hayward M. Kolvekar S. Bognolo G.
Rees P. Yellon D.M.
Institution
(Ludman, Hausenloy, Babu, Hasleton, Venugopal, Boston-Griffiths, Rees,
Yellon) Hatter Cardiovascular Institute, University College London
Hospital, 67 Chenies Mews, London WC1E 6HX, United Kingdom
(Yap, Lawrence, Hayward, Kolvekar, Bognolo) Heart Hospital, University
College London Hospital, London, United Kingdom
Title
Failure to recapture cardioprotection with high-dose atorvastatin in
coronary artery bypass surgery: A randomised controlled trial.
Source
Basic Research in Cardiology. 106 (6) (pp 1387-1395), 2011. Date of
Publication: November 2011.
Publisher
D. Steinkopff-Verlag (P.O. Box 100462, Darmstadt D-64204, Germany)
Abstract
The acute administration of atorvastatin has been reported to reduce
myocardial infarct size in animal studies. However, this cardioprotective
effect is lost with the chronic administration of atorvastatin, although
it can be recaptured by administering an acute high-dose of atorvastatin.
We hypothesised that pre-treatment with highdose atorvastatin, on a
background of chronic standard 'statin' therapy, would reduce myocardial
injury in patients undergoing elective coronary artery bypass graft (CABG)
surgery. One hundred and one consenting patients undergoing elective CABG
surgery at a single tertiary cardiac centre were recruited into two
randomised controlled, single-blinded clinical studies. Study 1:45
patients were randomised to receive either 160 mg of atorvastatin 2 h
preoperatively and 24 h following surgery or their standard statin
therapy. Study 2:56 patients were randomised to receive either 160 mg of
atorvastatin 12 h preoperatively and 24 h following surgery or their
standard statin therapy. Blood samples for troponin T and creatine kinase
were taken prior to surgery and then at 6, 12, 24, 48 and 72 h
post-surgery. Cardiac enzyme levels at each time point and the total
area-under curve (AUC) were calculated. The group characteristics and
surgical methods were well matched. High-dose atorvastatin was not
associated with any significant side effects. There was no significant
difference in serum troponin T or creatine kinase in either study at each
time point or over 72 h. Study 1: AUC, troponin T: atorvastatin 29.6 +/-
34.8 mug/L versus control 25.0 +/- 22.0 mug/L:P > 0.05. Creatine kinase:
atorvastatin 33,544 +/- 20,063 IU/L versus control 30,620 +/- 10,776
IU/L:P > 0.05. Study 2: AUC, troponin T: atorvastatin 21.8 +/- 14.3 mug/L
versus control 20.9 +/- 8.7 mug/L:P > 0.05. Creatine kinase: atorvastatin
36,262 +/- 28,821 IU/L versus control 33,448 +/- 14,984:P > 0.05. There
were no differences in postoperative outcomes. We report that the
administration of high-dose atorvastatin to low risk patients undergoing
elective CABG surgery, who are already on standard dose 'statin' therapy
is safe, but does not further reduce perioperative myocardial injury.
Springer-Verlag 2011.

<15>
Accession Number
70664904
Authors
Marinac-Dabic D. Matheny M. West S. Steinbuch M. Sedrakyan A.
Institution
(Marinac-Dabic) Food and Drug Administration, Silver Spring, MD, United
States
(Matheny) Vanderbilt University, Nashville, TN, United States
(West) RTI International, Research Triangle Park, NC, United States
(Steinbuch) Johnson and Johnson, Princeton, NJ, United States
(Sedrakyan) Cornell University, New York, NY, United States
Title
Applying rigorous methods to advance the evidence for safety and
effectiveness of implantable medical devices.
Source
Pharmacoepidemiology and Drug Safety. Conference: 27th International
Conference on Pharmacoepidemiology and Therapeutic Risk Management
Chicago, IL United States. Conference Start: 20110814 Conference End:
20110817. Conference Publication: (var.pagings). 20 (pp S17-S18), 2011.
Date of Publication: August 2011.
Publisher
John Wiley and Sons Ltd
Abstract
Background: In 2010 FDA launched Medical Device Epidemiology Network
(MDEpiNet) Initiative to advance epidemiologic methods development in the
area of medical device technology so that at any point of device lifecycle
both regulatory and public health decisions can be made based on the best
available scientific evidence. Objectives: In this context, the authors
will present conceptual framework and case studies from various medical
device settings to illustrate rigorous methods that can be used to advance
accumulation and appraisal of evidence for implantable medical devices.
Description: We will use orthopedic, cardiovascular, and general surgery
examples to illustrate various robust methods to study implantable
devices. Dr. Sedrakyan will present conceptual framework for premarket and
postmarket evaluation of implantable medical devices. Dr. Marinac-Dabic
will illustrate innovative analytical methods of simultaneous application
of meta-analysis, cross design synthesis and network meta-analysis of
orthopedic implant data from mandated post-approval studies, US and
international orthopedic registries, administrative billing data and
published literature. Dr. Matheny will showcase the uses of propensity-
score matching methods and risk adjusted statistical process control
techniques to perform device surveillance in retrospective cohorts using a
large national interventional cardiology database. Dr. Steinbuch will
present a bariatric case study that applied data analytic techniques to
explore a set of pre-surgical factors/characteristics in multiple
observational data sources, with an overall goal of determining the type
of bariatric surgery procedure (e.g. laparoscopic bypass, laparoscopic
band) on an individual patient level that will lead to the most optimal
outcome (e.g. weight loss, reduced co-morbidities). Dr West will discuss
the challenges and opportunities when using systematic reviews to study
general surgical implants with the focus on lap-band implant surgery. In
summary, the presentations will examine a variety of data sources and
methodologies that can be used to study and refine benfit/risk profile of
approved implantable medical devices and illustrate utility of informatics
and automated tools to enhance capacity of medical device surveillance.