Results Generated From:
Embase <1980 to 2012 Week 12>
Embase (updates since 2012-03-16)
<1>
Accession Number
2012149621
Authors
Minkowitz H.S. Onel E. Patronella C.K. Smoot J.D.
Institution
(Minkowitz) Department of Anesthesiology, Memorial Hermann Memorial City
Medical Center, 921 Gessner Road, Houston, TX 77024, United States
(Onel) Pacira Pharmaceuticals, Inc., Parsippany, NJ, United States
Title
A two-year observational study assessing the safety of DepoFoam
bupivacaine after augmentation mammaplasty.
Source
Aesthetic Surgery Journal. 32 (2) (pp 186-193), 2012. Date of Publication:
February 2012.
Publisher
SAGE Publications Inc. (2455 Teller Road, Thousand Oaks CA 91320, United
States)
Abstract
Background: Two-year safety outcomes in patients who received DepoFoam
bupivacaine during two prior breast augmentation studies were evaluated.
Objectives: The authors assess the clinical sequelae observed during
follow-up examination with respect to the integrity of the breast
implants. Methods: In Study 1, patients received bupivacaine HCl (75 mg)
in one breast pocket and DepoFoam bupivacaine (133 or 266 mg) in the
other. In Study 2, patients received either bupivacaine HCl (200 mg) or
DepoFoam bupivacaine (532 mg), divided equally into each breast pocket.
Investigators and patients remained blinded to the treatment administered.
Patients completed a questionnaire regarding breast pain, tenderness,
tingling, numbness, burning, changes in sensation, and any relevant life
events potentially affecting the implants. Patients were also assessed for
postoperative healing and implant integrity. Results: Ninety-four women
were evaluated. Most patients in all groups had no change in breast size
or shape and no changes in the skin or nipple. There were no reports of
palpable hard knots or swelling. There was one report of
irritation/implant leakage (in a patient who received bupivacaine HCl [75
mg] in the relevant breast). Most patients reported no breast pain,
tenderness, tingling, numbness, burning, other changes in sensation, chest
wall surgery or trauma, or life events affecting the implant. Conclusions:
At a two-year follow-up assessment, DepoFoam bupivacaine was not
associated with any complications that would compromise the integrity of
the breast implants. There was no indication of an association between
DepoFoam bupivacaine or bupivacaine HCl and changes in sensation or other
abnormal findings in these patients. 2012 The American Society for
Aesthetic Plastic Surgery, Inc.
<2>
Accession Number
2012127696
Authors
Lindqvist P. Holmgren A. Zhao Y. Henein M.Y.
Institution
(Lindqvist, Holmgren, Henein) Heart Centre, Umea University, S-90185 Umea,
Sweden
(Lindqvist, Zhao, Henein) Department of Public Health and Clinical
Medicine, Umea University, Sweden
(Holmgren) Department of Surgery and Peri-operative Sciences, Umea
University, Sweden
(Zhao) Ultrasound Department, Beijing AnZhen Hospital, Capital Medical
University, Beijing, China
Title
Effect of pericardial repair after aortic valve replacement on septal and
right ventricular function.
Source
International Journal of Cardiology. 155 (3) (pp 388-393), 2012. Date of
Publication: 22 Mar 2012.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: Aortic valve replacement (AVR) is associated with reversed
septal motion and right ventricular (RV) dysfunction but the cause remains
uncertain. The aim of this study was to investigate the role of
pericardial repair after AVR on septal and RV function. Methods: Thirty
patients (62 +/- 11 years, 18 males) with severe aortic stenosis were
studied before and after AVR surgery using echocardiography. Patients were
randomly allocated to pericardial repair vs. open pericardium. RV long
axis displacement and outflow tract fractional shortening (fs) were
measured. RV and right atrial (RA) tissue Doppler and strain rate (SR)
were measured as well as RA area. Systolic interventricular septal motion
towards and away from the RV was also determined. Stroke volume (SV) was
measured by conventional Doppler method. Pre-operative data were compared
with those from 30 normal gender and age matched controls. Results:
Post-operatively, global RV ejection function was preserved as shown by
SV. However, RV outflow tract fs and long axis displacement both fell (p <
0.01) but not SR. RA area remained unchanged but RA SR fell (p < 0.01). RV
displacement correlated with the extent of reversed septal motion (r =
0.60, p < 0.001) as well as RA SR (r = 0.54, p < 0.001). None of the RV or
septal measurements was affected by the pericardial repair procedure.
Conclusion: After AVR, septal motion is reversed and correlated directly
with RV long axis function. The latter is not affected by pericardial
repair but likely related to right atrial surgery injury. 2010 Elsevier
Ireland Ltd. All rights reserved.
<3>
Accession Number
2012147443
Authors
Momeni M. Liistro G. Baele P. Matta A. Kahn D. Van Dyck M. De Kock M. De
Kerchove L. Glineur D. Thiry D. Gregoire A. Jacquet L.-M. Laarbui F.
Watremez C.
Institution
(Momeni, Baele, Matta, Kahn, Van Dyck, De Kock, Watremez) Department of
Anesthesiology, Universit Catholique de Louvain, Cliniques Universitaires
Saint Luc, Avenue Hippocrate 10/1821, 1200 Brussels, Belgium
(Liistro) Department of Pneumology, Universit Catholique de Louvain,
Cliniques Universitaires Saint Luc, Brussels, Belgium
(De Kerchove, Glineur) Department of Cardiac Surgery, Universit Catholique
de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium
(Thiry, Gregoire) Department of Perfusion Services, Universit Catholique
de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium
(Jacquet, Laarbui) Department of Cardiac Intensive Care Unit, Universit
Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels,
Belgium
Title
An increase in endogenous erythropoietin concentrations has no
cardioprotective effects in patients undergoing coronary artery bypass
graft surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 26 (2) (pp 251-257),
2012. Date of Publication: April 2012.
Publisher
W.B. Saunders (Independence Square West, Philadelphia PA 19106-3399,
United States)
Abstract
Objective: Preliminary data showed an increase in endogenous
erythropoietin (EPO) concentrations after acute normovolemic hemodilution
(ANH) in patients undergoing coronary artery bypass graft (CABG) surgery.
Numerous studies have shown the organ protective properties of EPO. The
aim of this study was to investigate the cardioprotective effects of these
increased EPO concentrations that resulted from ANH during cardiac
surgery. Design: A prospective, randomized, blind study. Setting: A
university hospital. Participants: A total of 93 patients undergoing
isolated CABG surgery with or without cardiopulmonary bypass (CPB).
Interventions: Subjects with CPB were randomized into the control (C) or
ANH group. Those in the off-pump coronary artery bypass group underwent no
treatment. In the ANH group, a precalculated amount of blood was withdrawn
and replaced by colloids after the induction of anesthesia. Measurements
and Main Results: Hemodynamic parameters were recorded intra- and
postoperatively. Troponin concentrations were measured as a routine
parameter postoperatively. Upon intensive care unit arrival, the EPO
levels were higher in the ANH group than in the C group. There was no
significant difference between the troponin values of the C and the ANH
groups at 4 hours postoperatively. Conclusions: In patients undergoing
CABG surgery on CPB, an increase in endogenous EPO concentrations in the
physiologic range has no cardioprotective effects. 2012 Elsevier Inc.
<4>
Accession Number
2012147434
Authors
Greiff G. Stenseth R. Wahba A. Videm V. Lydersen S. Irgens W. Bjella L.
Pleym H.
Institution
(Greiff, Stenseth, Bjella, Pleym) Department of Cardiothoracic Anesthesia
and Intensive Care, St Olav University Hospital, Prinsesse Kristinas Gate
3, N-7006 Trondheim, Norway
(Wahba) Department of Cardiothoracic Surgery, St Olav University Hospital,
Trondheim, Norway
(Videm) Department of Immunology and Transfusion Medicine, St Olav
University Hospital, Trondheim, Norway
(Irgens) Department of Medical Biochemistry, St Olav University Hospital,
Trondheim, Norway
(Greiff, Stenseth, Wahba, Pleym) Department of Circulation and Medical
Imaging, Norwegian University of Science and Technology, Trondheim, Norway
(Videm) Department of Laboratory Medicine, Children's and Women's Health,
Norwegian University of Science and Technology, Trondheim, Norway
(Lydersen) Department of Neuroscience, Norwegian University of Science and
Technology, Trondheim, Norway
Title
Tranexamic acid reduces blood transfusions in elderly patients undergoing
combined aortic valve and coronary artery bypass graft surgery: A
randomized controlled trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 26 (2) (pp 232-238),
2012. Date of Publication: April 2012.
Publisher
W.B. Saunders (Independence Square West, Philadelphia PA 19106-3399,
United States)
Abstract
Objective: To evaluate the effects of tranexamic acid on postoperative
blood loss and transfusion requirements in elderly patients undergoing
combined aortic valve replacement and coronary artery bypass graft surgery
(CABG). Design: A prospective, randomized, double-blinded,
placebo-controlled, parallel-group trial. Setting: A university hospital
(single institution). Participants: Sixty-four patients 70 years or older
undergoing combined aortic valve replacement and CABG surgery were
included. One patient was withdrawn from the study after randomization by
the attending surgeon because of a change in the surgical procedure. The
remaining 63 patients were analyzed as intention to treat. Interventions:
The included patients were randomized to treatment with either tranexamic
acid, 10 mg/kg, as a bolus injection before surgery followed by 1 mg/kg/h
as an infusion during surgery, or a corresponding volume of 0.9% sodium
chloride. Measurements and Main Results: Postoperative blood loss was
recorded for 16 hours. The transfusion of blood products was recorded
during the entire hospital stay. The number of packed red cell
transfusions given to the patients was significantly lower in the
tranexamic acid group compared with the placebo group (median, 3.0
[interquartile range, 2-5] v 5.0 [3-7], p = 0.049). Conclusion: Tranexamic
acid reduced the number of packed red cell transfusions given to patients
70 years or older undergoing combined aortic valve replacement and CABG
surgery. 2012 Elsevier Inc.
<5>
Accession Number
2012134412
Authors
Pushparajah K. Miller O.I. Rawlins D. Barlow A. Nugent K. Simpson J.M.
Institution
(Pushparajah, Miller, Rawlins, Barlow, Nugent, Simpson) Department of
Congenital Heart Disease, Evelina Children's Hospital, Guy's and St
Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH,
United Kingdom
Title
Clinical application of a micro multiplane transoesophageal probe in
congenital cardiac disease.
Source
Cardiology in the Young. 22 (2) (pp 170-177), 2012. Date of Publication:
April 2012.
Publisher
Cambridge University Press (Shaftesbury Road, Cambridge CB2 2RU, United
Kingdom)
Abstract
Aim To assess the quality of imaging modalities of a new micro multiplane
transoesophageal echocardiogram probe.Method This is a prospective study
of micro transoesophageal echocardiogram S8-3t probe used at a single
institution between 15 December, 2009 and 15 March, 2010. The images were
compared with standard paediatric or adult probes where possible.
Assessors prospectively rated imaging quality - two dimensional, colour
flow imaging, pulse wave, and continuous wave Doppler - with a subjective
4-point scale (1 = poor to 4 = excellent).Results A total of 24 studies
were performed on 23 patients, with a median weight = 11.7 kilograms
(2.6-72 kilograms) and a median age of 3 years (0.16-60 years). Of the 23
patients, one neonate (2.8 kilograms) had transient bradycardia on probe
insertion. Imaging in patients less than 10 kilograms was of full
diagnostic value and new information was obtained in eight out of ten
patients. Pulse wave and continuous wave Doppler was consistently good
across all weight groups. There were high frame rates and good imaging
quality to a depth of 4-6 centimetres in all studies. A comparison with a
larger alternative probe was available for 12 studies (weight 11.9-72
kilograms). The median micro transoesophageal two-dimensional image
quality score was 3 (2-4) and 4 (3-4) with the comparative probe. For the
10- to 30-kilogram group, image quality with the micro transoesophageal
echocardiogram probe was judged as inferior to larger standard probes.
Adult sized patients had good imaging of near the field, allowing guidance
for percutaneous device closure of the atrial septum.Conclusion The micro
multiplane transoesophageal echocardiogram probe provides imaging of
diagnostic quality in neonates. In larger patients, it offers good imaging
of near field structures. In the intermediate-sized child (10-30
kilograms), standard paediatric probes provide better imaging. 2011
Cambridge University Press.
<6>
Accession Number
2012123903
Authors
Kataoka Y. Yasuda S. Miyamoto Y. Sase K. Kosuge M. Kimura K. Yoshimasa Y.
Miyazaki S.
Institution
(Kataoka) Department of Internal Medicine, National Cerebral and
Cardiovascular Center, Suita, Japan
(Yasuda) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Miyamoto) Department of Preventive Cardiology, National Cerebral and
Cardiovascular Center, Suita, Japan
(Sase) Department of Clinical Pharmacology, Juntendo University School of
Medicine, Tokyo, Japan
(Kosuge, Kimura) Division of Cardiology, Yokohama City University Medical
Center, Yokohama, Japan
(Yoshimasa) Department of Atherosclerosis and Diabetes, National Cerebral
and Cardiovascular Center, Suita, Japan
(Miyazaki) Division of Cardiology, Department of Internal Medicine, Kinki
University School of Medicine, Osakasayama, Japan
Title
Effects of voglibose and nateglinide on glycemic status and coronary
atherosclerosis in early-stage diabetic patients.
Source
Circulation Journal. 76 (3) (pp 712-720), 2012. Date of Publication: 2012.
Publisher
Japanese Circulation Society (14 Yoshida Kawaharacho, Sakyo-ku, Kyoto 606,
Japan)
Abstract
Background: Postprandial hyperglycemia and hyperinsulinemia have been
considered as important determinants for the development of
atherosclerosis. However, it remains to be elucidated whether correction
of the postprandial glycemic status prevents atherosclerotic changes.
Methods and Results: The DIANA (DIAbetes and diffuse coronary NArrowing)
study is a prospective randomized open-label multicenter trial. The 302
patients with coronary artery disease (CAD), impaired glucose
tolerance/diabetes mellitus (DM) pattern according to 75-g oral glucose
tolerance test and HbA<sub>1c</sub> <6.9% were randomly assigned to
life-style intervention (n=101), voglibose (0.9 mg/day, n=100) or
nateglinide treatment (180 mg/day, n=101). We compared 1-year coronary
atherosclerotic changes evaluated by quantitative coronary arteriography.
Although voglibose significantly increased the number of patients with
normal glucose tolerance at 1 year, there were no significant differences
in coronary atherosclerotic changes at 1 year. However, overall, less
atheroma progression was observed in patients in whom glycemic status was
improved at 1 year (%change in total lesion length: 3.5% vs. 26.2%,
P<0.01, %change in averaged lesion length: 0.7% vs. 18.6%, P=0.02).
Conclusions: Although coronary atherosclerotic changes were similar for
voglibose and nateglinide, an improvement in glycemic status at 1 year was
associated with less atheroma progression regardless of the treatment. Our
findings underscore the management of glycemic abnormality to prevent
coronary atherosclerotic changes in Japanese early-stage DM patients with
CAD.
<7>
Accession Number
2012141617
Authors
Kinney M.A.O. Mantilla C.B. Carns P.E. Passe M.A. Brown M.J. Michael
Hooten W. Curry T.B. Long T.R. Thomas Wass C. Wilson P.R. Weingarten T.N.
Huntoon M.A. Rho R.H. Mauck W.D. Pulido J.N. Allen M.S. Cassivi S.D.
Deschamps C. Nichols F.C. Robert Shen K. Wigle D.A. Hoehn S.L. Alexander
S.L. Hanson A.C. Schroeder D.R.
Institution
(Kinney, Mantilla, Carns, Michael Hooten, Curry, Long, Thomas Wass,
Wilson, Weingarten, Huntoon, Mauck, Pulido, Hoehn, Alexander) Department
of Anesthesiology, College of Medicine Mayo Clinic, Rochester, MN, United
States
(Mantilla) Department of Physiology, College of Medicine Mayo Clinic,
Rochester, MN, United States
(Passe) Anesthesia Clinical Research Unit, College of Medicine Mayo
Clinic, Rochester, MN, United States
(Brown) SMH Anesthesiology Division, College of Medicine Mayo Clinic,
Rochester, MN, United States
(Rho, Mauck) Division of Pain Management, College of Medicine Mayo Clinic,
Rochester, MN, United States
(Allen, Cassivi, Deschamps, Nichols, Robert Shen, Wigle) Department of
Surgery, College of Medicine Mayo Clinic, Rochester, MN, United States
(Hanson, Schroeder) Division of Biostatistics, Department of Health
Sciences Research, College of Medicine Mayo Clinic, Rochester, MN, United
States
Title
Preoperative Gabapentin for Acute Post-thoracotomy Analgesia: A
Randomized, Double-Blinded, Active Placebo-Controlled Study.
Source
Pain Practice. 12 (3) (pp 175-183), 2012. Date of Publication: March 2012.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
Background: The role of preoperative gabapentin in postoperative pain
management is not clear, particularly in patients receiving regional
blockade. Patients undergoing thoracotomy benefit from epidural analgesia
but still may experience significant postoperative pain. We examined the
effect of preoperative gabapentin in thoracotomy patients. Methods: Adults
undergoing elective thoracotomy were enrolled in this prospective,
randomized, double-blinded, placebo-controlled study, and randomly
assigned to receive 600mg gabapentin or active placebo (12.5mg
diphenhydramine) orally within 2hours preoperatively. Standardized
management included thoracic epidural infusion, intravenous
patient-controlled opioid analgesia, acetaminophen and ketorolac. Pain
scores, opioid use and side effects were recorded for 48hours. Pain was
also assessed at 3months. Results: One hundred twenty patients (63 placebo
and 57 gabapentin) were studied. Pain scores did not significantly differ
at any time point (P=0.53). Parenteral and oral opioid consumption was not
significantly different between groups on postoperative day 1 or 2 (P>0.05
in both cases). The frequency of side effects such as nausea and vomiting
or respiratory depression was not significantly different between groups,
but gabapentin was associated with decreased frequency of pruritus
requiring nalbuphine (14% gabapentin vs. 43% control group, P<0.001). The
frequency of patients experiencing pain at 3months post-thoracotomy was
also comparable between groups (70% gabapentin vs. 66% placebo group,
P=0.72). Conclusions: A single preoperative oral dose of gabapentin
(600mg) did not reduce pain scores or opioid consumption following
elective thoracotomy, and did not confer any analgesic benefit in the
setting of effective multimodal analgesia that included thoracic epidural
infusion. 2011 The Authors. Pain Practice 2011 World Institute of Pain.
<8>
Accession Number
2012143878
Authors
Isik I. Selimen D. Senay S. Alhan C.
Institution
(Isik, Selimen) Surgical Nursing Department, Health Sciences Faculty,
Marmara University, Istanbul, Turkey
(Senay, Alhan) Department of Cardiovascular Surgery, School of Medicine,
Acibadem University, Istanbul, Turkey
Title
Efficiency of antibacterial suture material in cardiac surgery: A
double-blind randomized prospective study.
Source
Heart Surgery Forum. 15 (1) (pp E40-E45), 2012. Date of Publication:
February 2012.
Publisher
Carden Jennings Publishing Co. Ltd (375 Greenbrier Drive, Suite #100,
Charlottesville VA 22901-1618, United States)
Abstract
Objective: Postoperative surgical site infections (SSI) still greatly
affect mortality and morbidity in cardiovascular surgery. SSI may be
related to the suture material. In this prospective, randomized,
controlled, and double-blinded study, the effect of antibacterial suture
material on SSI in cardiac surgical patients was investigated. Methods: We
randomly allocated 510 patients into 2 groups. Antibacterial suture
materials were used for wound closure in 170 patients (triclosan-coated
suture group), and routine suture materials were used in 340 patients
(noncoated suture group). All patients were evaluated for SSI on days 10,
20, and 30 following cardiac surgery. Results: Preoperative risk factors
and laboratory findings were comparable for the 2 groups. Sternal
infection occurred in 4 (2.4%) of the patients in the triclosan-coated
suture group and in 3.5% of the noncoated suture group (P > .05). Leg
wound infection occurred in 5 (3.5%) of the patients in the
triclosan-coated suture group and in 3.8% of the noncoated suture group (P
> .05). Only diabetes mellitus was an independent predictor of SSI.
Conclusion: Both noncoated and triclosan-coated suture materials are safe.
Larger studies may be needed to show the benefit and cost-effectiveness,
if any, of triclosan-coated materials over noncoated materials. 2012
Forum Multimedia Publishing, LLC.
<9>
Accession Number
2012145583
Authors
Sultan P. Hamilton M.A. Ackland G.L.
Institution
(Sultan) Department of Anesthesia, Stanford University Medical Center,
Stanford, CA 94305, United States
(Hamilton) Anaesthesia and Critical Care, St Georges Hospital NHS Trust,
London, United Kingdom
(Ackland) Centre for Anaesthesia, Critical Care and Pain Management,
University College London, London, United Kingdom
(Ackland) Department of Medicine, University College London, London,
United Kingdom
Title
Preoperative muscle weakness as defined by handgrip strength and
postoperative outcomes: A systematic review.
Source
BMC Anesthesiology. 12 , 2012. Article Number: 1. Date of Publication: 17
Jan 2012.
Publisher
BioMed Central Ltd. (Floor 6, 236 Gray's Inn Road, London WC1X 8HB, United
Kingdom)
Abstract
Background: Reduced muscle strength- commonly characterized by decreased
handgrip strength compared to population norms- is associated with
numerous untoward outcomes. Preoperative handgrip strength is a
potentially attractive real-time, non-invasive, cheap and easy-to-perform
"bedside" assessment tool. Using systematic review procedure, we
investigated whether preoperative handgrip strength was associated with
postoperative outcomes in adults undergoing surgery.Methods: PRISMA and
MOOSE consensus guidelines for reporting systematic reviews were followed.
MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Clinical
Trials (1980-2010) were systematically searched by two independent
reviewers. The selection criteria were limited to include studies of
preoperative handgrip strength in human adults undergoing non-emergency,
cardiac and non-cardiac surgery. Study procedural quality was analysed
using the Newcastle-Ottawa Quality Assessment score. The outcomes assessed
were postoperative morbidity, mortality and hospital stay.Results:
Nineteen clinical studies (17 prospective; 4 in urgent surgery) comprising
2194 patients were identified between1980-2010. Impaired handgrip strength
and postoperative morbidity were defined inconsistently between studies.
Only 2 studies explicitly ensured investigators collecting postoperative
outcomes data were blinded to preoperative handgrip strength test results.
The heterogeneity of study design used and the diversity of surgical
procedures precluded formal meta-analysis. Despite the moderate quality of
these observational studies, lower handgrip strength was associated with
increased morbidity (n = 10 studies), mortality (n = 2/5 studies) and
length of hospital stay (n = 3/7 studies).Conclusions: Impaired
preoperative handgrip strength may be associated with poorer postoperative
outcomes, but further work exploring its predictive power is warranted
using prospectively acquired, objectively defined measures of
postoperative morbidity. 2012 Sultan et al; licensee BioMed Central Ltd.
<10>
Accession Number
22099130
Authors
Shahzamani M. Ghanavati A. Froutagheh A.N. Foroughi M. Rahimian H.
Shahsanaei A. Hasantash S.A. Dabbagh A.
Institution
(Shahzamani, Ghanavati, Foroughi, Hasantash) Department of Cardiac
Surgery, Shahid Beheshti University of Medicine, Tehran, Iran, Islamic
Republic of
(Froutagheh) Research Development Department, Modarres Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Rahimian) Cardiac Surgery, Department of Cardiac Surgery, Modarres
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Shahsanaei) Research Deputy, Shahrekord University of Medical Sciences,
Shahrekord, Iran, Islamic Republic of
(Dabbagh) Anesthesiology Research Center and Anesthesiology Department,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Title
Carvedilol Compared With Metoprolol on Left Ventricular Ejection Fraction
After Coronary Artery Bypass Graft.
Source
Journal of Perianesthesia Nursing. 26 (6) (pp 384-387), 2011. Date of
Publication: December 2011.
Publisher
W.B. Saunders (Independence Square West, Philadelphia PA 19106-3399,
United States)
Abstract
A NUMBER OF elective coronary artery bypass graft (CABG) surgery patients
have impaired underlying left ventricular function (poor ejection
fraction). This study was performed to compare the effect of postoperative
oral carvedilol versus metoprolol on left ventricular ejection fraction
(LVEF) after CABG compared with metoprolol. In a double-blind clinical
trial, 60 patients with coronary artery disease, aged 35 to 65 years, who
had an ejection fraction of 15% to 35% were included. Either carvedilol or
metoprolol was administered the day after CABG. The patients were
evaluated by the same cardiologist 14 days before and 2 and 6 months after
elective CABG. The results demonstrated better improvements in LVEF in the
carvedilol group. No difference regarding postoperative arrhythmias or
mortality was detected. The results suggest that carvedilol may exert more
of an improved myocardial effect than metoprolol for the low ejection
fraction patients undergoing CABG in the early postoperative months. 2011
American Society of PeriAnesthesia Nurses.
<11>
[Use Link to view the full text]
Accession Number
2012133911
Authors
Bennett-Guerrero E. Phillips-Bute B. Waweru P.M. Gaca J.G. Spann J.C.
Milano C.A.
Institution
(Bennett-Guerrero) Perioperative Clinical Research, Duke Clinical Research
Institute, Duke University, Durham, NC 27710, United States
(Phillips-Bute, Waweru) Department of Anesthesiology, Duke University
Medical Center, Durham, NC, United States
(Gaca, Milano) Division of Cardiothoracic Surgery, Duke University Medical
Center, Durham, NC, United States
(Spann) Oklahoma Heart Institute, Hillcrest Medical Center, Tulsa, OK,
United States
Title
Pilot study of sternal plating for primary closure of the sternum in
cardiac surgical patients.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 6 (6) (pp 382-388), 2011. Date of Publication: November-December
2011.
Publisher
Lippincott Williams and Wilkins (250 Waterloo Road, London SE1 8RD, United
Kingdom)
Abstract
Objective: Postoperative sternal wound complications are a significant
problem in high-risk patients. In addition to closure with conventional
wires, several systems involving rigid fixation with metal plates are
currently available. The Rapid Sternal Closure System (Talon) is approved
for stabilization and fixation of the anterior chest wall. Anecdotal
evidence suggests that use of the Talon may result in improved
postoperative recovery. Methods: Fifty-one cardiac surgical patients at
higher risk for sternal wound complications were enrolled at two sites.
Subjects were randomized to insertion of Talons (n = 28) or wires only
(control, n = 23) for sternal closure. The primary endpoint was a
comparison between study groups of the percent of baseline incentive
spirometry volume through postoperative day 7. Secondary endpoints
included other measures of quality of recovery, sternal wound infection,
and nonunion. Results: The percentage of preoperative incentive spirometry
volume achieved was higher in the Talon arm (67% +/- 32%) versus control
(58% +/- 24%); however, this was not statistically significant (P = 0.41).
Use of the Talon was associated with decreased use of opiates (21.3 +/-
11.8 vs 25.4 +/- 21.6 mg, P = 0.44), increased ability to ambulate 1000 ft
on postoperative day 5 (25% vs 13%, P = 0.28), and decreased duration of
mechanical ventilation (median 0.5 vs 1.0 days, P = 0.24) and hospital
length of stay (4.5 +/- 3.2 vs 5.3 +/- 4.0 days, P = 0.40). One
superficial sternal wound infection was observed in each study arm. There
were no cases of nonunion. Conclusions: In this pilot study, the primary
endpoint was not statistically different between the treatment groups. Use
of the Talon was associated with trends toward benefit in endpoints
consistent with enhanced postoperative recovery, highlighting a need for
additional data from larger randomized trials. Copyright 2012 by the
International Society for Minimally Invasive Cardiothoracic Surgery.
<12>
Accession Number
70685995
Authors
Kuah D.
Institution
(Kuah) NSW Institute of Sport, Australia
Title
Platelet rich plasma-Current evidence and use in musculoskeletal medicine.
Source
Journal of Science and Medicine in Sport. Conference: 2011 Australian
Conference of Science and Medicine in Sport "Optimising Health and
Fitness-Participation, Prevention and Performance" Perth, WA Australia.
Conference Start: 20111019 Conference End: 20111022. Conference
Publication: (var.pagings). 14 (pp e66), 2011. Date of Publication:
December 2011.
Publisher
Elsevier
Abstract
The author will present a literature review on current evidence and use of
platelet rich plasma (PRP) in musculoskeletal (MSK) medicine. Reports of
PRP use was first made in 1987 by Ferrari et al. in open heart surgery.
Since then, there has been extensive use in a wide range of medical fields
including, orthopaedics, sports medicine, dentistry, ENT, neurosurgery,
cosmetic/aesthetic medicine, wound healing, cardiothoracic and
maxillofacial surgery. Much of the evidence on the use in musculoskeletal
(MSK) medicine has been in animal studies, anecdotal or case series. It is
only in recent years that randomized controlled trials in PRP use have
been published. Whilst much of the research and use of PRP in MSK medicine
has been in treating tendon pathologies (particularly chronic
tendinopathies), PRP is also used in bone, joint, muscle and ligament
injuries. This has included augmentation for acute orthopaedic procedures
such as joint replacement, internal fixation of fractures (particularly
for non unions), arthrodesis and tendon repairs. These uses and any
evidence will be presented by the author. It is generally accepted that
growth factors play a central role in tissue healing and regeneration. In
blood, platelets have a role in clotting, but also contain alpha granules
which contain various growth factors including TGF-beta, PDGF (platelet
derived growth factor), EGF (endothelial growth factor), VEGF (vascular
endothelial growth factor), FGF (fibroblast growth factor) and IGF
(insulin growth factor). It is understood that these growth factors
perform a variety of tasks including regulation of cellular migration and
proliferation, stimulation of cell replication, stimulation of
angiogenesis, and acceleration of mesenchymal stem cell replication and
osteoid production. The author was an invited presenter at a landmark
invitation only international seminar on use of growth factors in sports
medicine held in Qatar in February 2009 where the medical directors of
both IOC and WADA were present. At this seminar, a randomized controlled
trial on use of PRP in hamstring muscle tears was designed, targeted at
the national football competition, which were a captive audience.
Following this, WADA released its 2010 guidelines which included
recommendations specifically on PRP, allowing use in MSK conditions apart
fro into muscle. The 2011 WADA guidelines now allow the use of PRP for all
MSK areas.
No comments:
Post a Comment