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<1>
Accession Number
2013738881
Authors
Lee J.M. Park S.-D. Lim S.Y. Doh J.-H. Cho J.M. Kim K.-S. Bae J.-W. Chung
W.-Y. Youn T.-J.
Institution
(Lee) Seoul National University Hospital, Seoul, South Korea
(Park) Inha University Hospital, Incheon, South Korea
(Lim) Korea University Ansan Hospital, Ansan, South Korea
(Doh) Inje University Ilsan Paik Hospital, Goyang, South Korea
(Cho) Kyung Hee University Hospital at Gangdong, Seoul, South Korea
(Kim) Jeju National University Hospital, Jeju, South Korea
(Bae) Chungbuk National University Hospital, Cheongju, South Korea
(Chung) Boramae Medical Center, Seoul, South Korea
(Youn) Division of Cardiology, Department of Internal Medicine, College of
Medicine, Seoul National University and Cardiovascular Center, Seoul
National University Bundang Hospital, 166 Gumi-ro, Bundang-gu,
Seongnam-si, Gyeonggi-do 463-707, South Korea
Title
Angiographic and clinical comparison of novel Orsiro Hybrid
sirolimus-eluting stents and Resolute Integrity zotarolimus-eluting stents
in all-comers with coronary artery disease (ORIENT trial): Study protocol
for a randomized controlled trial.
Source
Trials. 14 (1) , 2013. Article Number: 398. Date of Publication: 20 Nov
2013.
Publisher
BioMed Central Ltd. (Floor 6, 236 Gray's Inn Road, London WC1X 8HB, United
Kingdom)
Abstract
Background: The Orsiro Hybrid sirolimus-eluting stent is a newly developed
third-generation drug-eluting stent, featuring a unique dual-polymer mix.
An active bioabsorbable polymer delivers the anti-proliferative drug,
sirolimus, via controlled release, while a passive biocompatible polymeric
coating shields the metallic strut from surrounding tissue, preventing
interaction. To date, the Orsiro Hybrid sirolimus-eluting stent has
excelled in terms of late lumen loss at 9 months in a first-in-man
single-arm trial. However, the efficacy and safety data for Orsiro Hybrid
sirolimus-eluting stents in a broader population of all-comers are
limited. The present study offers an angiographic and clinical comparison
of the Orsiro Hybrid sirolimus-eluting stent and the Resolute Integrity
zotarolimus-eluting stent in the treatment of patients with coronary
artery disease.Methods/design: The ORIENT trial is a multicenter,
randomized, open-label, parallel-arm study designed to demonstrate the
non-inferiority of the Orsiro Hybrid sirolimus-eluting stent relative to
the Resolute Integrity zotarolimus-eluting stent. A total of 375 patients
with a spectrum of coronary artery disease will undergo prospective,
random assignment to a Orsiro Hybrid sirolimus-eluting stent or Resolute
Integrity zotarolimus-eluting stent (2:1 ratio), for a primary endpoint of
in-stent late lumen loss at 9 months by quantitative coronary angiography.
Secondary 12-month clinical endpoints are death, target lesion
revascularization, target vessel revascularization, myocardial infarction,
stent thrombosis and target lesion failure (a composite of cardiac death,
target lesion revascularization and target vessel-related myocardial
infarction).Discussion: The ORIENT trial is the first study to date
comparing the Orsiro Hybrid sirolimus-eluting stent with the Resolute
Integrity zotarolimus-eluting stent for efficacy and safety in a
population of all-comers with coronary artery disease.Trial registration:
Clinicaltrials.gov NCT01826552. 2013 Lee et al.; licensee BioMed Central
Ltd.

<2>
Accession Number
2013737196
Authors
Michael T.T. Alomar M. Papayannis A. Mogabgab O. Patel V.G. Rangan B.V.
Luna M. Hastings J.L. Grodin J. Abdullah S. Banerjee S. Brilakis E.S.
Institution
(Michael, Alomar, Papayannis, Mogabgab, Patel, Rangan, Luna, Hastings,
Grodin, Abdullah, Banerjee, Brilakis) VA North Texas Healthcare System,
University of Texas Southwestern Medical Center, 4500 South Lancaster
Road, Dallas, TX 75216, United States
Title
A randomized comparison of the transradial and transfemoral approaches for
coronary artery bypass graft angiography and intervention: The RADIAL-CABG
Trial (RADIAL versus femoral access for coronary artery bypass graft
angiography and intervention).
Source
JACC: Cardiovascular Interventions. 6 (11) (pp 1138-1144), 2013. Date of
Publication: November 2013.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Objectives This study sought to compare and contrast use and radiation
exposure using radial versus femoral access during cardiac catheterization
of patients who had previously undergone coronary artery bypass graft
(CABG) surgery. Background Limited information is available on the
relative merits of radial compared with femoral access for cardiac
catheterization in patients who had previously undergone CABG surgery.
Methods Consecutive patients (N = 128) having previously undergone CABG
surgery and referred for cardiac catheterization were randomized to radial
or femoral access. The primary study endpoint was contrast volume.
Secondary endpoints included fluoroscopy time, procedure time, patient and
operator radiation exposure, vascular complications, and major adverse
cardiac events. Analyses were by intention-to-treat. Results Compared with
femoral access, diagnostic coronary angiography via radial access was
associated with a higher mean contrast volume (142 +/- 39 ml vs. 171 +/-
72 ml, p < 0.01), longer procedure time (21.9 +/- 6.8 min vs. 34.2 +/-
14.7 min, p < 0.01), greater patient air kerma (kinetic energy released
per unit mass) radiation exposure (1.08 +/- 0.54 Gy vs. 1.29 +/- 0.67 Gy,
p = 0.06), and higher operator radiation dose (first operator: 1.3 +/- 1.0
mrem vs. 2.6 +/- 1.7 mrem, p < 0.01; second operator 0.8 +/- 1.1 mrem vs.
1.8 +/- 2.1 mrem, p = 0.01). Fewer patients underwent ad hoc percutaneous
coronary intervention (PCI) in the radial group (37.5% vs. 46.9%, p =
0.28) and radial PCI procedures were less complex. The incidences of the
primary and secondary endpoints was similar with femoral and radial access
among PCI patients. Access crossover was higher in the radial group (17.2%
vs. 0.0%, p < 0.01) and vascular access site complications were similar in
both groups (3.1%). Conclusions In patients who had previously undergone
CABG surgery, transradial diagnostic coronary angiography was associated
with greater contrast use, longer procedure time, and greater access
crossover and operator radiation exposure compared with transfemoral
angiography. (RADIAL Versus Femoral Access for Coronary Artery Bypass
Graft Angiography and Intervention [RADIAL-CABG] Trial; NCT01446263).
2013 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION PUBLISHED BY
ELSEVIER INC.

<3>
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Accession Number
2013745058
Authors
Schmidt P.C. Ruchelli G. Mackey S.C. Carroll I.R.
Institution
(Schmidt, Ruchelli, Mackey, Carroll) Department of Anesthesiology,
Perioperative, and Pain Medicine, Division of Pain Medicine, 1070
Arastradero Road Room 285, MC 5596, Palo Alto, CA 94304, United States
Title
Perioperative gabapentinoids choice of agent, dose, timing, and effects on
chronic postsurgical pain.
Source
Anesthesiology. 119 (5) (pp 1215-1221), 2013. Date of Publication:
November 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)

<4>
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Accession Number
2013736738
Authors
Jeong H.S. Cho J.Y. Kim E.J. Yu C.W. Ahn C.-M. Park J.H. Hong S.J. Lim
D.-S.
Institution
(Jeong, Cho, Kim, Ahn, Park, Hong, Lim) Department of Cardiology,
Cardiovascular Center, Korea University Anam Hospital, Seoul, South Korea
(Yu) Department of Cardiology, Sejong General Hospital, Sosabon-dong,
Bucheon 422-711, South Korea
Title
Comparison of clinical outcomes between first-generation and
second-generation drug-eluting stents in type 2 diabetic patients.
Source
Coronary Artery Disease. 24 (8) (pp 676-683), 2013. Date of Publication:
December 2013.
Publisher
Lippincott Williams and Wilkins (250 Waterloo Road, London SE1 8RD, United
Kingdom)
Abstract
BACKGROUND: Drug-eluting stent (DES) implantation has significantly
reduced the risk of restenosis and major adverse cardiac event (MACE)
rates compared with bare-metal stents in type 2 diabetic patients.
Differences in outcomes between the first-generation and second-generation
DESs in diabetic patients, however, have yet to be evaluated. AIM: We
compared MACEs after second-generation DES implantation compared with
those of first-generation stents in diabetic patients. METHODS AND
RESULTS: This single-center prospective cohort study compared
first-generation DES (n=654) and second-generation DES (n=339)
implantation in type 2 diabetic patients by propensity score matching. The
primary outcome was the occurrence of MACEs, defined as a composite of
all-cause death, nonfatal myocardial infarction, and target vessel
revascularization. The rate of MACEs was lower in the second-generation
DES group after 2 years of follow-up (3.3 vs. 10.0%, P<0.001).
Kaplan-Meier analysis showed higher MACE-free survival in diabetic
patients in the second-generation DES group (log-rank P<0.001). In a Cox
regression analysis, first-generation DES (hazard ratio=3.60, 95%
confidence interval, 2.03-6.37, P<0.001) was an independent predictor for
MACEs. CONCLUSION: In type 2 diabetic patients, second-generation DES
implantation resulted in lower MACEs compared with first-generation DESs,
primarily because of lower target lesion and vessel revascularization
rates. 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.

<5>
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Accession Number
2013745045
Authors
Juhl-Olsen P. Hermansen J.F. Frederiksen C.A. Rasmussen L.A. Jakobsen
C.-J. Sloth E.
Institution
(Juhl-Olsen, Hermansen, Frederiksen, Sloth) Department of Anaesthesiology
and Intensive Care, Aarhus University Hospital, 8200 Aarhus, Denmark
(Rasmussen, Jakobsen) Department of Anaesthesiology and Intensive Care,
Aarhus University Hospital, Denmark
Title
Positive end-expiratory pressure influences echocardiographic measures of
diastolic function a randomized, crossover study in cardiac surgery
patients.
Source
Anesthesiology. 119 (5) (pp 1078-1086), 2013. Date of Publication:
November 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background: Ultrasonography of the cardiovascular system is pivotal for
hemodynamic assessment. Diastolic function is evaluated with a combination
of tissue Doppler (e' and a') and pulsed Doppler (E and A) measures of
transmitral-and mitral valve annuli velocities. However, accurate
echocardiographic evaluation in the intensive care unit or perioperative
setting is contingent on relative resistance to positive pressure
ventilation and changes in preload. This study aimed to evaluate the
effects of positive end-expiratory pressure (PEEP) and positioning on
echocardiographic measures of diastolic function. Methods: The study was a
prospective, randomized, crossover study. Cardiac surgery patients with
ejection fraction greater than 45% and averaged e' of 9 or more were
included. Postoperatively, anesthetized patients were randomized into six
combinations of PEEP (0, 6, 12 cm H2O) and positions (horizontal,
Trendelenburg). At each combination, e' (primary endpoint), a', E, and A
were obtained with transesophageal echocardiography along with left
ventricular area. Image analysis was performed blinded to the protocol.
Results: Thirty patients completed the study. PEEP decreased lateral e'
from 6.6 +/- 3.6 to 5.3 +/- 3.0 cm/s (P < 0.001) in the horizontal
position and from 7.4 +/- 4.2 to 6.5 +/- 3.3 cm/s (P < 0.001) in
Trendelenburg. Similar results were found for septal e', a' bilaterally
and transmitral pulsed Doppler measures, and PEEP decreased left
ventricular area. E/A, E/e', and e'/a' remained unaffected by PEEP and
positioning. Conclusions: When evaluating diastolic function by
echocardiography, the levels of PEEP and its effect on ventricular area
have to be taken into account. In addition, this study dissuades the use
of E/e' for tracking changes in left ventricular filling pressures in
cardiac surgery patients. 2013, the American Society of
Anesthesiologists.

<6>
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Accession Number
2013745074
Authors
Lindholm E.E. Aune E. Noren C.B. Seljeflot I. Hayes T. Otterstad J.E.
Kirkeboen K.A.
Institution
(Lindholm, Noren) Department of Anesthesiology, Vestfold Hospital Trust,
P. O. Box 2168, 3103 Tonsberg, Norway
(Otterstad) Department of Cardiology, Vestfold Hospital Trust, Tonsberg,
Norway
(Aune) Center for Cardiological Innovation, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
(Seljeflot) Department of Cardiology, Center for Clinical Heart Research,
Oslo University Hospital, Ulleval, Norway
(Seljeflot) Faculty of Medicine, University of Oslo, Oslo, Norway
(Hayes) Scandinavian Venous Centre, Oslo, Norway
(Kirkeboen) Faculty of Medicine, University of Oslo, Ulleval, Norway
(Kirkeboen) Department of Anesthesiology, Oslo University Hospital,
Ulleval, Norway
Title
The anesthesia in abdominal aortic surgery (ABSENT) study: A prospective,
randomized, controlled trial comparing troponin T release with
fentanyl-sevoflurane and propofol-remifentanil anesthesia in major
vascular surgery.
Source
Anesthesiology. 119 (4) (pp 802-812), 2013. Date of Publication: October
2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background: On the basis of data indicating that volatile anesthetics
induce cardioprotection in cardiac surgery, current guidelines recommend
volatile anesthetics for maintenance of general anesthesia during
noncardiac surgery in hemodynamic stable patients at risk for
perioperative myocardial ischemia. The aim of the current study was to
compare increased troponin T (TnT) values in patients receiving
sevoflurane-based anesthesia or total intravenous anesthesia in elective
abdominal aortic surgery. Methods: A prospective, randomized, open,
parallel-group trial comparing sevoflurane-based anesthesia (group S) and
total intravenous anesthesia (group T) with regard to cardioprotection in
193 patients scheduled for elective abdominal aortic surgery. Increased
TnT level on the first postoperative day was the primary endpoint.
Secondary endpoints were postoperative complications, nonfatal coronary
events and mortality. Results: On the first postoperative day increased
TnT values (>13 ng/l) were found in 43 (44%) patients in group S versus 41
(43%) in group T (P = 0.999), with no significant differences in TnT
levels between the groups at any time point. Although underpowered, the
authors found no differences in postoperative complications, nonfatal
coronary events or mortality between the groups. Conclusions: In elective
abdominal aortic surgery sevoflurane- based anesthesia did not reduce
myocardial injury, evaluated by TnT release, compared with total
intravenous anesthesia. These data indicate that potential
cardioprotective effects of volatile anesthetics found in cardiac surgery
are less obvious in major vascular surgery. Copyright 2013, the American
Society of Anesthesiologists, Inc.

<7>
Accession Number
2013743396
Authors
Moerman A. Denys W. De Somer F. Wouters P.F. De Hert S.G.
Institution
(Moerman, Denys, Wouters, De Hert) Department of Anesthesiology and,
United States
(De Somer) Department of Cardiac Surgery, Ghent University Hospital, De
Pintelaan 185, Gent 9000, Belgium
Title
Influence of variations in systemic blood flow and pressure on cerebral
and systemic oxygen saturation in cardiopulmonary bypass patients.
Source
British Journal of Anaesthesia. 111 (4) (pp 619-626), 2013. Date of
Publication: October 2013.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Background. Although both pressure and flow are considered important
determinants of regional organ perfusion, the relative importance of each
is less established. The aim of the present study was to evaluate the
impact of variations in flow, pressure, or both on cerebral and whole-body
oxygen saturation. Methods. Thirty-four consenting patients undergoing
elective cardiac surgery on cardiopulmonary bypass were included. Using a
randomized cross-over design, four different haemodynamic states were
simulated: (i) 20% flow decrease, (ii) 20% flow decrease with
phenylephrine to restore baseline pressure, (iii) 20% pressure decrease
with sodium nitroprusside (SNP) under baseline flow, and (iv) increased
flow with baseline pressure. The effect of these changes was evaluated on
cerebral (Sc_O2) and systemic (Sv _O2) oxygen
saturation, and on systemic oxygen extraction ratio (OER). Data were
assessed by within- and between-group comparisons. Results. Decrease in
flow was associated with a decrease in ScO2 [from 63.5 (7.4) to 62.0 (8.5)
%, P<0.001]. When arterial pressure was restored with phenylephrine during
low flow, Sc_O2 further decreased from 61.0 (9.7) to 59.2 (10.2)
%, P<0.001. Increase in flow was associated with an increase in
Sc_O2 from 62.6 (7.7) to 63.6 (8.9) %, P=0.03, while decreases
in pressure with the use of SNP did not affect ScO2 . Sv_O2 was
significantly lower (P<0.001) and OER was significantly higher (P<0.001)
in the low flow arms. Conclusions. In the present elective cardiac surgery
population, Sc _O2 and Sv_O2 were significantly lower
with lower flow, regardless of systemic arterial pressure. Moreover,
phenylephrine administration was associated with a reduced cerebral and
systemic oxygen saturation. The Author [2013]. Published by Oxford
University Press on behalf of the British Journal of Anaesthesia.

<8>
Accession Number
2013733845
Authors
Nsair A. Liem D.A. Cadeiras M. Cheng R.K. Allareddy M. Kwon M. Shemin R.
Deng M.C.
Institution
(Nsair, Liem, Cadeiras, Cheng, Allareddy, Kwon, Shemin, Deng) University
of California, Ahmanson-UCLA Cardiomyopathy Center, 100 Medical Plaza,
Suite 630, Los Angeles, CA 90095, United States
Title
Molecular Basis of Recovering on Mechanical Circulatory Support.
Source
Heart Failure Clinics. 10 (1 SUPPL.) (pp S57-S62), 2014. Date of
Publication: January 2014.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Our insights into different system levels of mechanisms by left
ventricular assist device support are increasing and suggest a complex
regulatory system of overlapping biological processes. To develop novel
decision-making strategies and patient selection criteria, heart failure
and reverse cardiac remodeling should be conceptualized and explored by a
multifaceted research strategy of transcriptomics, metabolomics,
proteomics, molecular biology, and bioinformatics. Knowledge of the
molecular mechanisms of reverse cardiac remodeling is in its early stages,
and comprehensive reconstruction of the underlying networks is necessary.
2014 Elsevier Inc.

<9>
Accession Number
2013700148
Authors
Gu J. Liu X. Jiang W.-F. Li F. Zhao L. Zhou L. Wang Y.-L. Liu Y.-G. Zhang
X.-D. Wu S.-H. Xu K. Zhang D.-L. Gu J.-N.
Institution
(Gu, Liu, Jiang, Zhao, Zhou, Wang, Liu, Zhang, Wu, Xu, Zhang, Gu)
Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong
University School of Medicine, 241 West Huaihai Road, Shanghai 200030,
China
(Li) Department of Cardiac Surgery, Shanghai Chest Hospital, Shanghai
Jiaotong University School of Medicine, Shanghai, China
Title
Comparison of catheter ablation and surgical ablation in patients with
long-standing persistent atrial fibrillation and rheumatic heart disease:
A four-year follow-up study.
Source
International Journal of Cardiology. 168 (6) (pp 5372-5377), 2013. Date of
Publication: 15 Oct 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background In our previous prospective and randomized study, we have
demonstrated that the concomitant surgical ablation using saline-irrigated
cooled tip radiofrequency ablation (SICTRA) system is more effective than
subsequent circumferential pulmonary vein isolation (CPVI) combined with
substrate modification in treating patients with long-standing persistent
atrial fibrillation (LS-AF) and rheumatic heart disease (RHD) undergoing
cardiac surgery during middle-term follow-up. Whether this strategy also
decreases longer-term arrhythmia recurrence is unknown. This study
describes the 4-year efficacy of SICTRA for these patients. Furthermore,
we seek to compare the electrophysiological characteristics for recurrent
atrial tachyarrhythmia (ATa) at the session of catheter ablation between
two groups. Methods Long-term follow-up was performed in 95 patients who
underwent the catheter ablation strategy (n = 47, Group A) or SICTRA (n =
48, Group B) combined with valvular surgery for symptomatic LS-AF patients
with RHD. Results After one procedure, Group B had a significantly higher
freedom from ATa compared with Group A (29/48 vs 15/47, P = 0.005) after a
mean follow-up of 54 months (range 48 to 63 months). Catheter-based
mapping and ablation of recurrent ATa showed larger amounts of
macro-reentrant atrial tachycardias (ATs) in Group B and higher incidence
of pulmonary vein (PV) recovery in Group A. After multiple catheter
ablations for recurrent ATa, sinus rhythm (SR) could be maintained equally
between two groups. Conclusions Single procedure success seems to be
higher with SICTRA but repeated catheter ablation potentially results in
comparable outcomes in treating patients with LS-AF and RHD during
long-term follow-up. More macro-reentrant ATs and more PV recoveries are
identified to be responsible for ATa in SICTRA and catheter ablation
group, respectively. 2013 Elsevier Ireland Ltd 2013 Published by
Elsevier Ireland Ltd.

<10>
Accession Number
2013700143
Authors
Wan Y.-D. Sun T.-W. Kan Q.-C. Zhang X.-J. Guan F.-X. Zhang L. Zhang J.-Y.
Institution
(Wan, Sun, Zhang, Zhang, Zhang) Department of Integrated ICU, First
Affiliated Hospital, Zhengzhou University, Zhengzhou, China
(Kan) Department of Pharmacy, First Affiliated Hospital, Zhengzhou
University, Zhengzhou, China
(Guan) Academy of Medical Science, Henan Province, Zhengzhou, China
Title
Long-term outcomes of percutaneous coronary intervention with stenting and
coronary artery bypass graft surgery - A meta-analysis.
Source
International Journal of Cardiology. 168 (6) (pp e161-e164), 2013. Date of
Publication: 15 Oct 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)

<11>
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Accession Number
2013736492
Authors
Hibbert B. Simard T. Ramirez F.D. Pourdjabbar A. Raizman J.E. Maze R.
Wilson K.R. Hawken S. O'Brien E.R.
Institution
(Hibbert, Simard, Ramirez, Pourdjabbar, Raizman, Maze) Division of
Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
(Wilson) Department of Medicine, University of Ottawa, Ottawa, ON, Canada
(Hawken) Institute for Clinical Evaluative Sciences, University of Ottawa,
Ottawa, ON, Canada
(O'Brien) Division of Cardiology, Libin Cardiovascular Institute of
Alberta, University of Calgary, Ottawa, ON, Canada
Title
The effect of statins on circulating endothelial progenitor cells in
humans: A systematic review.
Source
Journal of Cardiovascular Pharmacology. 62 (5) (pp 491-496), 2013. Date of
Publication: November 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Numerous clinical trials have demonstrated early reductions in
cardiovascular events occurring independently of the lipid-lowering
effects of statins. These pleiotropic effects have been attributed to
antiinflammatory properties, to atherosclerotic plaque stabilization, and
more recently to mobilization of endothelial progenitor cells (EPCs). Our
aim was to evaluate the evidence supporting statin-induced EPC
mobilization in humans. We, therefore, performed a computerized literature
search and systematic review of randomized trials to determine the effect
of statin therapy and statin dosing on circulating EPC numbers. Our
literature search identified 10 studies including 479 patients which met
inclusion criteria with publication dates ranging from 2005 to 2011. Seven
studies compared statin to nonstatin regimens whereas 3 studied low versus
high-dose statin therapy. Reported increases in EPC number ranged from
25.8% to 223.5% with a median reported increase of 70.2% when compared to
nonstatin regimens with 7 of 10 studies reporting significant increases.
Considerable heterogeneity exists in regard to patient population, statin
regimens, and the definition of an EPC within the identified studies. In
conclusion, randomized studies in humans suggest that statin therapy
mobilizes EPCs into the circulation. Larger randomized studies using
uniform definitions are needed to definitively establish this effect.
2013 by Lippincott Williams & Wilkins.

<12>
Accession Number
2013731314
Authors
Strand E. Pedersen E.R. Svingen G.F.T. Schartum-Hansen H. Rebnord E.W.
Bjorndal B. Seifert R. Bohov P. Meyer K. Hiltunen J.K. Nordrehaug J.E.
Nilsen D.W.T. Berge R.K. Nygard O.
Institution
(Strand, Pedersen, Svingen, Bjorndal, Bohov, Nordrehaug, Nilsen, Berge,
Nygard) Department of Clinical Science, University of Bergen, 5021 Bergen,
Norway
(Schartum-Hansen, Rebnord, Seifert, Nordrehaug, Berge, Nygard) Department
of Heart Disease, Haukeland University Hospital, Bergen, Norway
(Meyer) Bevital AS, Bergen, Norway
(Hiltunen) Department of Biochemistry and Biocenter Oulu, University of
Oulu, Oulu, Finland
(Hiltunen, Berge, Nygard) MitoHealth Centre for Bioactive Food Components
and Prevention of Lifestyle Diseases, Bergen, Norway
(Nilsen) Division of Cardiology, Stavanger University Hospital, Stavanger,
Norway
Title
Dietary intake of n-3 long-chain polyunsaturated fatty acids and risk of
myocardial infarction in coronary artery disease patients with or without
diabetes mellitus: A prospective cohort study.
Source
BMC Medicine. 11 (1) , 2013. Article Number: 216. Date of Publication: 08
Oct 2013.
Publisher
BioMed Central Ltd. (Floor 6, 236 Gray's Inn Road, London WC1X 8HB, United
Kingdom)
Abstract
Background: A beneficial effect of a high n-3 long-chain polyunsaturated
fatty acid (LCPUFA) intake has been observed in heart failure patients,
who are frequently insulin resistant. We investigated the potential
influence of impaired glucose metabolism on the relation between dietary
intake of n-3 LCPUFAs and risk of acute myocardial infarction (AMI) in
patients with coronary artery disease.Methods: This prospective cohort
study was based on the Western Norway B-Vitamin Intervention Trial and
included 2,378 patients with coronary artery disease with available
baseline glycosylated hemoglobin (HbA1c) and dietary data. Patients were
sub-grouped as having no diabetes (HbA1c <5.7%), pre-diabetes (HbA1c
>=5.7%), or diabetes (previous diabetes, fasting baseline serum glucose
>=7.0, or non-fasting glucose >=11.1 mmol/L). AMI risk was evaluated by
Cox regression (age and sex adjusted), comparing the upper versus lower
tertile of daily dietary n-3 LCPUFA intake.Results: The participants (80%
males) had a mean age of 62 and follow-up of 4.8 years. A high n-3 LCPUFA
intake was associated with reduced risk of AMI (hazard ratio 0.38, 95%CI
0.18, 0.80) in diabetes patients (median HbA1c = 7.2%), whereas no
association was observed in pre-diabetes patients. In patients without
diabetes a high intake tended to be associated with an increased risk
(hazard ratio1.45, 95%CI 0.84, 2.53), which was significant for fatal AMI
(hazard ratio 4.79, 95%CI 1.05, 21.90) and associated with lower HbA1c
(mean +/- standard deviation 4.55 +/-0.68 versus 4.92 +/-0.60, P = 0.02).
No such differences in HbA1c were observed in those with pre-diabetes or
diabetes.Conclusions: A high intake of n-3 LCPUFAs was associated with a
reduced risk of AMI, independent of HbA1c, in diabetic patients, but with
an increased risk of fatal AMI and lower HbA1c among patients without
impaired glucose metabolism. Further studies should investigate whether
patients with diabetes may benefit from having a high intake of n-3
LCPUFAs and whether patients with normal glucose tolerance should be
careful with a very high intake of these fatty acids. Trial registration:
This trial is registered at clinicaltrials.gov as NCT00354081. 2013
Strand et al.; licensee BioMed Central Ltd.

<13>
Accession Number
2013702750
Authors
Beach L. Denehy L. Lee A.
Institution
(Beach) Physiotherapy Department, Royal Melbourne Hospital, Parkville, VIC
3050, Australia
(Denehy, Lee) Physiotherapy, Melbourne School of Health Sciences, The
University of Melbourne, Victoria 3010, Australia
(Lee) Alfred Health, Commercial Road, Melbourne, VIC 3004, Australia
(Lee) Institute for Breathing and Sleep, Austin Health, Studley Road,
Heidelberg, VIC 3084, Australia
Title
The efficacy of minitracheostomy for the management of sputum retention: A
systematic review.
Source
Physiotherapy (United Kingdom). 99 (4) (pp 271-277), 2013. Date of
Publication: December 2013.
Publisher
Elsevier Ltd (Langford Lane, Kidlington, Oxford OX5 1GB, United Kingdom)
Abstract
Background: Suction via a minitracheostomy is a safe procedure, but its
efficacy in facilitating sputum clearance in individuals with an acute
condition has not been systematically reviewed. Objectives: The aim of
this study was to identify and synthesise the efficacy of the insertion of
a minitracheostomy and tracheal suction via minitracheostomy for sputum
clearance in adults who have undergone surgery or have an acute condition
characterised by sputum retention. Data sources: A systematic literature
search using the electronic databases MEDLINE, CINAHL, EMBASE, Cochrane
Library and PEDro, with searches limited to English language journal
articles published between 1984 and September 2011. Data extraction and
data synthesis: All study designs were included. Two independent reviewers
used pre-defined inclusion and exclusion criteria to identify all eligible
articles. Results: Six studies in six patient groups met the inclusion
criteria, with two randomised controlled trials and four case series
included. These studies presented the results of 278 patients following
surgery and 13 with acute medical conditions. There were a range of
criteria that defined the efficacy of minitracheostomy for sputum
retention. Studies reporting the adjunctive role found a reduced incidence
of complications associated with sputum retention following thoracic
surgery. Other studies reported limited benefit in overall respiratory
status with minitracheostomy. Heterogeneity among the studies was evident,
with major limitations identified. Conclusions: Limited evidence suggests
that minitracheostomy may be a useful adjunct in optimising sputum
clearance in adults following thoracic surgery, but the effects in adults
with an acute condition and other types of surgery are inconclusive. 2013
Chartered Society of Physiotherapy.

<14>
Accession Number
2013733853
Authors
Roden D.F. Altman K.W.
Institution
(Roden, Altman) Department of Otolaryngology-Head and Neck Surgery, Mount
Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029,
United States
Title
Causes of dysphagia among different age groups: A systematic review of the
literature.
Source
Otolaryngologic Clinics of North America. 46 (6) (pp 965-987), 2013. Date
of Publication: December 2013.
Publisher
W.B. Saunders (Independence Square West, Philadelphia PA 19106-3399,
United States)
Abstract
Dysphagia is a common problem that has the potential to result in severe
complications such as malnutrition and aspiration pneumonia. Based on the
complexity of swallowing, there may be many different causes. This article
presents a systematic literature review to assess different comorbid
disease associations with dysphagia based on age. The causes of dysphagia
are different depending on age, affecting between 1.7% and 11.3% of the
general population. Dysphagia can be a symptom representing disorders
pertinent to any specialty of medicine. This review can be used to aid in
the diagnosis of patients presenting with the complaint of dysphagia.
2013 Elsevier Inc.

<15>
Accession Number
2013733464
Authors
Ginis K.A.M. Nigg C.R. Smith A.L.
Institution
(Ginis) Department of Kinesiology, McMaster University, 1280 Main Street
West, Ivor Wynne Centre E212, Hamilton, ON, L8S 4K1, Canada
(Nigg) Department of Public Health Sciences, John A. Burns School of
Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
(Smith) Department of Kinesiology, Michigan State University, East
Lansing, MI, United States
Title
Peer-delivered physical activity interventions: An overlooked opportunity
for physical activity promotion.
Source
Translational Behavioral Medicine. 3 (4) (pp 434-443), 2013. Date of
Publication: December 2013.
Publisher
Springer New York (233 Spring Street, New York NY 10013-1578, United
States)
Abstract
The purpose of this systematic review was to catalogue and synthesize
published studies that have examined the effects of peer-delivered
physical activity interventions on physical activity behavior. Ten
published studies were identified that met the inclusion criteria. The
following information was extracted from each study: study design and
duration; characteristics of the sample, peers, and interventions; and
physical activity outcomes. In all articles reporting within-groups
analyses, peer-delivered interventions led to increases in physical
activity behavior. When compared to alternatives, peer-delivered
interventions were just as effective as professionally delivered
interventions and more effective than control conditions for increasing
physical activity. Only three studies included measures of social
cognitive variables, yielding some evidence that peers may enhance
self-efficacy and self-determined forms of motivation. Based on these
findings, interventionists are encouraged to include peer mentors in their
intervention delivery models. Investigators are encouraged to pursue a
more comprehensive understanding of factors that can explain and maximize
the impact of peer-delivered activity interventions. 2013 Society of
Behavioral Medicine.

<16>
Accession Number
2013687228
Authors
Hansen K.W. Kaiser C. Hvelplund A. Soerensen R. Madsen J.K. Jensen J.S.
Pedersen S.H. Eberli F.R. Erne P. Alber H. Pfisterer M. Galatius S.
Institution
(Hansen, Hvelplund, Soerensen, Madsen, Jensen, Pedersen, Galatius)
Department of Cardiology, Copenhagen University Hospital Gentofte, Niels
Andersens Vej 65, Post 835, 2900 Hellerup, Denmark
(Alber) Department of Internal Medicine III (Cardiology), Innsbruck
Hospital, Innsbruck, Austria
(Eberli) Department of Cardiology, Triemli Hospital, Zurich, Switzerland
(Kaiser, Pfisterer) Department of Cardiology, University Hospital Basel,
Basel, Switzerland
(Erne) Division of Cardiology, Kantonsspital, Luzern, Switzerland
Title
Improved two-year outcomes after drug-eluting versus bare-metal stent
implantation in women and men with large coronary arteries: Importance of
vessel size.
Source
International Journal of Cardiology. 169 (1) (pp 29-34), 2013. Date of
Publication: 25 Oct 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Objectives To investigate the importance of vessel size on outcome
differences by comparing the effects of drug-eluting stents (DES) versus
bare-metal stents (BMS) in women and men with large coronary vessels.
Methods All 2314 BASKET-PROVE patients randomized to DES versus BMS were
followed for 2 years with a primary endpoint of major adverse cardiac
events (MACE: cardiac death, non-fatal myocardial infarction,
target-vessel revascularization). Cox proportional hazard models were used
to evaluate the relative risk for women and men, respectively. All
comparisons were adjusted for vessel size. Results Age, risk factors and
complexity of coronary artery disease differed between women and men. DES
reduced MACE rates at 2 years compared to BMS - in women: 4% vs. 15%, p <
0.0001 with a hazard ratio (HR) of 0.27 (0.15-0.51), and men: 6% vs. 10%,
p = 0.003 (HR = 0.60 (0.43-0.84)), respectively. The association persisted
in both women (HR = 0.25 (0.13-0.46)) and men (HR = 0.60 (0.42-0.84))
following multivariable adjustments. A significant gender-treatment
interaction was present (p = 0.02). The reduced risk of MACE following DES
vs. BMS implantation was present until 6 months in both women (HR = 0.15
(0.06-0.36)) and men (HR = 0.32 (0.17-0.59)) and remained significant
until 2 years in women (HR = 0.36 (0.15-0.87)), but not in men (HR = 0.87
(0.49-1.55)). Conclusions In women and men with similarly sized large
coronary arteries, DES reduced 2-year MACE rates compared to BMS, but the
significant gender-treatment interaction indicated a greater benefit of
DES in women. Thus, factors other than vessel size seem to determine this
gender difference. 2013 Elsevier Ireland Ltd.

<17>
Accession Number
2013734080
Authors
Caroleo S. Bisurgi G. Onorati F. Rubino A. Calandese F. De Munda C.
Renzulli A. Santangelo E. Verre M. Amantea B.
Institution
(Caroleo, Bisurgi, Calandese, De Munda, Santangelo, Amantea) Intensive
Care Unit, Catanzaro, Italy
(Onorati, Rubino, Renzulli) Cardiac Surgery Unit, University Hospital
Mater Domini, Magna Graecia University, Catanzaro, Italy
(Verre) Intensive Care Unit, Hospital Pugliese-Ciaccio, Catanzaro, Italy
Title
Intensive versus conventional insulinotherapy after elective and on-pump
myocardial revascularization: A prospective and randomized study.
Source
Clinica Terapeutica. 161 (SUPPL.2) (pp e33-e37), 2011. Date of
Publication: 2011.
Publisher
Societa Editrice Universo (Via G. B. Morgagni 1, Roma 00161, Italy)
Abstract
Objectives: Strict glycemic control is increasingly recognized as an
important goal in a broad spectrum of critically ill patients. We analyzed
the infl ammatory and clinical response of patients submitted to intensive
or conventional insulinotherapy in a specifi c clinical context. Materials
and Methods: We analyzed a prospective and randomized collected database
of an Intensive Care Unit (ICU) in a University Hospital. The database
comprised a total of 50 patients aged 30 to 80 (ASA II-III) who underwent
elective and on-pump myocardial revascularization from September 2006 to
June 2008. On ICU admission, patients were randomly assigned to Group 1
(intensive insulinotherapy) or Group 2 (conventional insulinotherapy).
Data collected included glucose and lactate blood levels, haemodynamic
parameters, cytokines (TNFalpha, IL-6, IL-8, IL-10), C-Reactive Protein,
white blood cells and platelets blood levels, body temperature, Sequential
Organ Failure Assessment (SOFA) score, Infection Probability Score (IPS)
and ICU length of stay (LOS). Within-between group analysis, one-way ANOVA
and unpaired t-test were used when appropriate. Results: Pre- and
perioperative variables were comparable between the two groups (p=NS for
all measurements). Glucose and lactate blood levels were lower in Group 1
(p<0.0001). Stroke Volume Index was higher in Group 1 (p<0.05). Moreover,
we observed statistically signifi -cant differences between groups in
terms of infl ammatory parameters and severity scores. No difference was
observed in ICU LOS. Conclusions: Intensive insulinotherapy after elective
on-pump myocardial revascularization signifi cantly modulates the infl
ammatory response. Different infl ammatory patterns could correlate with
different clinical response as suggested by SOFA and IP score analysis.

<18>
[Use Link to view the full text]
Accession Number
2013736390
Authors
Acedillo R.R. Shah M. Devereaux P.J. Li L. Iansavichus A.V. Walsh M. Garg
A.X.
Institution
(Acedillo, Shah, Li, Iansavichus, Garg) Division of Nephrology, Department
of Medicine, Western University, London, Canada
(Shah, Li, Garg) Department of Epidemiology and Biostatistics, Western
University, London, Canada
(Devereaux, Walsh) Department of Medicine, McMaster University, Hamilton,
Canada
(Devereaux, Walsh, Garg) Department of Clinical Epidemiology and
Biostatistics, McMaster University, Hamilton, Canada
Title
The risk of perioperative bleeding in patients with chronic kidney
disease: A systematic review and meta-analysis.
Source
Annals of Surgery. 258 (6) (pp 901-913), 2013. Date of Publication:
December 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
BACKGROUND:: Worldwide, millions of patients with chronic kidney disease
undergo surgery each year. Although chronic kidney disease increases the
risk of bleeding in nonoperative settings, the risk of perioperative
bleeding is less clear. We conducted a systematic review and meta-analysis
to summarize existing information and quantify the risk of perioperative
bleeding from chronic kidney disease. METHODS:: We screened 9376 citations
from multiple databases for cohort studies published between 1990 and
2011. Studies that met our inclusion criteria included patients undergoing
any major surgery, with a sample size of at least 100 patients with
chronic kidney disease (as defined by the primary study authors with an
elevated preoperative serum creatinine value or a low estimated glomerular
filtration rate). Their outcomes had to be compared with a reference group
of at least 100 patients without chronic kidney disease. Our primary
outcomes were (1) receipt of perioperative blood transfusions and (2) need
for reoperation for reasons of bleeding. RESULTS:: Twenty-three studies
met our criteria for review (20 cardiac surgery, 3 non-cardiac surgery).
Chronic kidney disease was associated with a greater risk of requiring
blood transfusion (7 studies in cardiac surgery, totaling 22,718 patients)
and weighted incidence in patients with normal kidney function was 53% and
in chronic kidney disease was 73%; pooled odds ratio, 2.7 (95% confidence
interval, 2.1-3.4). After adjustment for relevant factors, the association
remained statistically significant in 4 studies. Chronic kidney disease
was associated with more reoperation for reasons of bleeding (14 studies
in cardiac surgery, totaling 569,715 patients) and weighted incidence in
patients with normal kidney function was 2.4% and in chronic kidney
disease was 2.7%; pooled odds ratio, 1.6 (95% confidence interval,
1.3-1.8). However, after adjustment for relevant factors (as done in 5
studies), the association was no longer statistically significant.
CONCLUSIONS:: Chronic kidney disease is associated with perioperative
bleeding but not bleeding that required reoperation. Further studies
should stage chronic kidney disease with the modern system, better define
bleeding outcomes, and guide intervention to improve the safety of surgery
in this at-risk population. 2013 Lippincott Williams and Wilkins.

<19>
[Use Link to view the full text]
Accession Number
2013736393
Authors
Eliasen M. Gronkjaer M. Skov-Ettrup L.S. Mikkelsen S.S. Becker U. Tolstrup
J.S. Flensborg-Madsen T.
Institution
(Eliasen, Gronkjaer, Skov-Ettrup, Mikkelsen, Becker, Tolstrup) National
Institute of Public Health, University of Southern Denmark, Ester
Farimagsgade 5A, DK-1353, Copenhagen K, Denmark
(Becker) Department of Medical Gastroenterology, Hvidovre Hospital,
Copenhagen University Hospital, Copenhagen, Denmark
(Flensborg-Madsen) Unit of Medical Psychology, Department of Public
Health, University of Copenhagen, Denmark
Title
Preoperative alcohol consumption and postoperative complications: A
systematic review and meta-analysis.
Source
Annals of Surgery. 258 (6) (pp 930-942), 2013. Date of Publication:
December 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
OBJECTIVE:: To systematically review and summarize the evidence of the
association between preoperative alcohol consumption and postoperative
complications elaborated on complication type. BACKGROUND:: Conclusions in
studies on preoperative alcohol consumption and postoperative
complications have been inconsistent. METHODS:: A systematic review and
meta-analysis based on a search in MEDLINE, EMBASE, CINAHL, and PsycINFO
citations. Included were original studies of the association between
preoperative alcohol consumption and postoperative complications occurring
within 30 days of the operation. In total, 3676 studies were identified
and reviewed for eligibility, and data were extracted. Forest plots and
pooled relative risks (RRs), including 95% confidence intervals (CIs),
were estimated for several complication types. RESULTS:: Fifty-five
studies provided data for estimates. Preoperative alcohol consumption was
associated with an increased risk of various postoperative complications,
including general morbidity (RR = 1.56; 95% CI: 1.31-1.87), general
infections (RR = 1.73; 95% CI: 1.32-2.28), wound complications (RR = 1.23;
95% CI: 1.09-1.40), pulmonary complications (RR = 1.80; 95% CI:
1.30-2.49), prolonged stay at the hospital (RR = 1.24; 95% CI: 1.18-1.31),
and admission to intensive care unit (RR = 1.29; 95% CI: 1.03-1.61).
Clearly defined high alcohol consumption was associated with increased
risk of postoperative mortality (RR = 2.68; 95% CI: 1.50-4.78). Low to
moderate preoperative alcohol consumption and postoperative complications
did not seem to be associated; however, very few studies were included in
the analyses hereof. CONCLUSIONS:: Preoperative alcohol consumption was
associated with an increased risk of general postoperative morbidity,
general infections, wound complications, pulmonary complications,
prolonged stay at the hospital, and admission to intensive care unit.
2013 Lippincott Williams and Wilkins.

<20>
[Use Link to view the full text]
Accession Number
2013736386
Authors
Adie S. Harris I.A. Naylor J.M. Mittal R.
Institution
(Adie, Harris, Naylor, Mittal) SouthWest Sydney Clinical School,
University of New South Wales, Australia
(Adie, Harris, Naylor, Mittal) Orthopaedic Department, Liverpool Hospital,
Locked Bag 7103, Liverpool BC, NSW 1871, Australia
Title
CONSORT compliance in surgical randomized trials: Are we there yet? A
systematic review.
Source
Annals of Surgery. 258 (6) (pp 872-878), 2013. Date of Publication:
December 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
OBJECTIVE:: We performed a systematic review assessing the reporting
quality of trials of surgical interventions, and explored associated trial
level variables. BACKGROUND:: Randomized controlled trials (RCTs) provide
clinicians with the best evidence for the effects of interventions, but
may not be reported with necessary detail. METHODS:: In May 2009, 3
databases (MEDLINE, EMBASE, and CENTRAL) were searched for RCTs that
assessed a surgical intervention using a comprehensive electronic strategy
developed by the Cochrane Collaboration. The Consolidated Standards of
Reporting Trials (CONSORT) checklist was used as a measure of reporting
quality. An overall CONSORT score was calculated and expressed as a
proportion. This was supplemented with domains related to external
validity. We also collected data on characteristics hypothesized to
improve reporting quality, and exploratory regression was performed to
determine associations. RESULTS:: One hundred fifty recently published
RCTs were included. The most commonly represented surgical subspecialties
were general (29%), orthopedic (23%), and cardiothoracic (13%). Most (65%)
were published in subspecialty surgical journals. Overall reporting
quality was low, with only 55% of CONSORT items addressed. Less than half
of trials described adequate methods for sample size calculation (45%),
random sequence generation (43%), allocation concealment (45%), and
blinding (37%). The strongest associations with reporting quality were
adequate methods related to methodological domains, an author with an
epidemiology/statistics degree, and a longer report length. CONCLUSIONS::
There remains much room for improvement for the reporting of surgical
intervention trials. Authors and journal editors should apply existing
reporting guidelines, and guidelines specific to the reporting of surgical
interventions should be developed. 2013 Lippincott Williams and Wilkins.

<21>
Accession Number
2013732467
Authors
Lu J.G. Pensiero A. Aponte-Patel L. Velez De Villa B. Rusanov A. Cheng B.
Cabreriza S.E. Spotnitz H.M.
Institution
(Lu, Pensiero, Velez De Villa, Cabreriza, Spotnitz) Department of Surgery,
Columbia University Medical Center, Vanderbilt Clinic, 622 W 168th St, New
York, NY 10032, United States
(Aponte-Patel) Department of Pediatrics, Columbia University, New York,
NY, United States
(Rusanov) Department of Anesthesiology, Columbia University, New York, NY,
United States
(Cheng) Department of Biostatistics, Mailman School of Public Health, New
York, NY, United States
Title
Short-term reduction in intrinsic heart rate during biventricular pacing
after cardiac surgery: A substudy of a randomized clinical trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 146 (6) (pp 1494-1500),
2013. Date of Publication: December 2013.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Background The Biventricular Pacing After Cardiac Surgery trial
investigates hemodynamics of temporary pacing in selected patients at risk
of left ventricular dysfunction. This trial demonstrates improved
hemodynamics during optimized biventricular pacing compared with atrial
pacing at the same heart rate 1 and 2 hours after bypass and reduced
vasoactive-inotropic score over the first 4 hours after bypass. However,
this advantage of biventricular versus atrial pacing disappears 12 to 24
hours later. We hypothesized that changes in intrinsic heart rate can
explain variable effects of atrial pacing in this setting. Methods Heart
rate, mean arterial pressure, cardiac output, and medications depressing
heart rate were analyzed in patients randomized to continuous
biventricular pacing (n = 16) or standard of care (n = 18). Results During
30-second testing periods without pacing, intrinsic heart rate was lower
in the paced group 12 to 24 hours after bypass (76.5 +/- 17.5 vs 91.7 +/-
13.0 beats per minute; P =.040) but not 1 or 2 hours after bypass. Cardiac
output (4.4 +/- 1.2 vs 3.6 +/- 1.9 L/min; P =.054) and stroke volume (53
+/- 2 vs 42 +/- 2 mL; P =.051) increased overnight in the paced group.
Vasoactive medication doses were not different between groups, whereas
dexmedetomidine administration was prolonged over postoperative hours 12
to 24 in the paced group (793 +/- 528 vs 478 +/- 295 minutes; P =.013).
Conclusions These observations suggest that hemodynamic benefits of
biventricular pacing 12 to 24 hours after cardiopulmonary bypass lead to
withdrawal of sympathetic drive and decreased intrinsic heart rate.
Depression of intrinsic rate increases the apparent benefit of atrial
pacing in the chronically paced group but not in the control group.
Additional study is needed to define clinical benefits of these effects.
Copyright 2013 by The American Association for Thoracic Surgery.

<22>
Accession Number
2013728544
Authors
Yamashita K. Kondo T. Muramatsu T. Matsushita K. Nagahiro T. Maeda K.
Shintani S. Murohara T.
Institution
(Yamashita, Kondo, Muramatsu, Matsushita, Nagahiro, Maeda, Shintani,
Murohara) Department of Cardiology, Nagoya University, Graduate School of
Medicine, Nagoya, Japan
Title
Effects of valsartan versus amlodipine in diabetic hypertensive patients
with or without previous cardiovascular disease.
Source
American Journal of Cardiology. 112 (11) (pp 1750-1756), 2013. Date of
Publication: 01 Dec 2013.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Recently, we reported that angiotensin II receptor blocker (ARB),
valsartan, and calcium channel blocker (CCB), amlodipine, had similar
effects on the prevention of cardiovascular disease (CVD) events in
diabetic hypertensive patients. We assessed the difference of
cardiovascular protective effects between ARB and CCB in patients with and
without previous CVD, respectively. A total of 1,150 Japanese diabetic
hypertensive patients were randomized to either valsartan or amlodipine
treatment arms, which were additionally divided into 2 groups according to
the presence of previous CVD at baseline (without CVD, n = 818; with CVD,
n = 332). The primary composite outcomes were sudden cardiac death, acute
myocardial infarction, stroke, coronary revascularization, or
hospitalization for heart failure. The incidence of primary end point
events in patients with previous CVD was 3.5-times greater than that in
patients without previous CVD (64.1 vs 17.9/1,000 person-years). The ARB-
and the CCB-based treatment arms showed similar incidence of composite CVD
events in both patients without previous CVD (hazard ratio [HR] 1.35, 95%
confidence interval [CI] 0.76 to 2.40) and those with previous CVD (HR
0.79, 95% CI 0.48 to 1.31). The ARB-treatment arm showed less incidence of
stroke compared with the CCB-based treatment arm in patients with previous
CVD (HR 0.24, 95% CI 0.05 to 1.11, p = 0.068), whereas the 2 treatment
arms showed similar incidence of stroke in patients without previous CVD
(HR 1.52, 95% CI 0.59 to 3.91). In conclusion, the ARB- and the CCB-based
treatments exerted similar protective effects of CVD events regardless of
the presence of previous CVD. For stroke events, the ARB may have more
protective effects than the CCB in diabetic hypertensive patients with
previous CVD. 2013 Elsevier Inc. All.

<23>
Accession Number
2013726133
Authors
Surie S. Reesink H.J. Marcus J.T. Van Der Plas M.N. Kloek J.J.
Vonk-Noordegraaf A. Bresser P.
Institution
(Surie, Reesink, Bresser) Departments of Pulmonology, Academic Medical
Center, University of Amsterdam, Amsterdam, Netherlands
(Kloek) Department of Cardiothoracic Surgery, Academic Medical Center,
University of Amsterdam, Amsterdam, Netherlands
(Marcus) Department of Physics and Medical Technology, Free University
Medical Center, Amsterdam, Netherlands
(Vonk-Noordegraaf) Department of Pulmonology, Free University Medical
Center, Amsterdam, Netherlands
(Marcus, Van Der Plas, Bresser) Department of Respiratory Medicine, Our
Lady Hospital, PO Box 95500, 1090 HM Amsterdam, Netherlands
Title
Bosentan treatment is associated with improvement of right ventricular
function and remodeling in chronic thromboembolic pulmonary hypertension.
Source
Clinical Cardiology. 36 (11) (pp 698-703), 2013. Date of Publication:
November 2013.
Publisher
John Wiley and Sons Inc. (111 River Street, Hoboken NJ 07030-5774, United
States)
Abstract
Background Medical pretreatment before pulmonary endarterectomy (PEA) can
optimize right ventricular (RV) function and may improve postoperative
outcome in high-risk patients. Using cardiac magnetic resonance imaging
(cMRI), we determined whether the dual endothelin-1 antagonist bosentan
improves RV function and remodeling in patients with chronic
thromboembolic pulmonary hypertension (CTEPH) who waited for PEA.
Hypothesis We hypothesized that medical therapy prior to PEA will be
associated with improvements in RV remodeling and function. Methods In
this pilot study, 15 operable CTEPH patients were randomly assigned to
either bosentan (n = 8) or no bosentan (n = 7, control) for 16 weeks, next
to "best standard of care." Both before and after treatment, RV stroke
volume index (RVSVI), RV ejection fraction (RVEF), RV mass, RV isovolumic
relaxation time (rIVRT), leftward ventricular septal bowing (LVSB), and
left ventricular ejection fraction (LVEF) were determined using cMRI.
Results After 16 weeks, the change () from baseline (median [range]) in
the studied cMRI parameters differed significantly between the bosentan
group and the controls: RVSVI: 6 [-4-11] vs 1 [-6-3] mL/m ^-2;
RVEF: 8 [-10-15] vs -4 [-7-5]%; RV mass: -3 [-6 - 2] vs 2 [-1-3]
g/m^-2; rIVRT: -30 [-130-20] vs 10 [-30-30] msec; LVSB: 0.03
[-0.03-0.13] vs -0.03[-0.08-0.04] cm^-1; and LVEF: 8 [-5-17] vs
-2 [-14-2]% (all P < 0.05). The change from baseline in mean pulmonary
artery pressure (-11 [-17-11] vs 5 [-6-21] mm Hg, P < 0.05) and 6-minute
walk distance (20 [3-88] vs -4 [-40-40] m, P < 0.05) also differed
significantly. Conclusions In CTEPH, compared with control, treatment with
bosentan for 16 weeks was associated with a significant improvement in
cMRI parameters of RV function and remodelling. 2013 Wiley Periodicals,
Inc.

<24>
Accession Number
2013676915
Authors
Lupi A. Rognoni A. Secco G.G. Porto I. Nardi F. Lazzero M. Rossi L. Parisi
R. Fattori R. Genoni G. Rosso R. Stella P.R. Sheiban I. Bolognese L.
Liistro F. Bongo A.S. Agostoni P.
Institution
(Lupi, Rognoni, Lazzero, Rossi, Rosso, Bongo) Hospital Cardiology,
Maggiore della Carita Hospital, Novara, Italy
(Secco, Genoni) Department of Clinical and Experimental Medicine,
University of Eastern Piedmont, Maggiore della Carita Hospital, Novara,
Italy
(Secco, Parisi, Fattori) Division of Interventional Cardiology, Ospedali
Riuniti Marche Nord, Pesaro, Italy
(Porto, Bolognese, Liistro) Cardiology Department, San Donato Hospital,
Arezzo, Italy
(Nardi) Castelli Hospital, Cardiology Division, Verbania, Italy
(Stella, Agostoni) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(Sheiban) Interventional Cardiology, Division of Cardiology, University of
Turin, Turin, Italy
Title
Drug eluting balloon versus drug eluting stent in percutaneous coronary
interventions: Insights from a meta-analysis of 1462 patients.
Source
International Journal of Cardiology. 168 (5) (pp 4608-4616), 2013. Date of
Publication: 12 Oct 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background Drug eluting balloons (DEB) have been developed to overcome the
limitations of drug eluting stents (DES), but clinic results of various
DEB studies are still not consistent. Thus, we performed a meta-analysis
to compare outcomes of DEB and DES for the treatment of coronary artery
disease (CAD). Methods Medline/Web databases were searched for studies
comparing DEB and DES for obstructive CAD, reporting late lumen loss (LLL)
and rates for overall mortality, myocardial infarction (MI), stent
thrombosis (ST) and target lesion revascularization (TLR). Results 8
studies (1462 patients) were included in the meta-analysis. Compared with
DES, DEB treated patients showed non-significantly higher LLL (weighted
mean difference [WMD] 0.32, 95% confidence interval [CI] - 0.15 to 0.78, P
= 0.18) and non-significantly higher rate of binary restenosis (odds ratio
[OR] 1.40 [0.68-2.48], P = 0.36). Mortality (OR 1.13[0.54-2.37], P =
0.74), MI (OR 0.95, [0.50-1.80], P = 0.87), ST (OR 1.12, [0.34-4.19], P =
0.77) and TLR rates (OR 1.19[0.60-2.38], P = 0.61) were similar between
the 2 treatments. A pre-specified meta-regression analysis showed that LLL
WMD and TLR OR were inversely correlated to the prevalence of diabetes (P
< 0.0001) and directly correlated to reference coronary diameters (P <
0.001). Conclusions The present meta-analysis showed that compared to DES,
DEB use resulted in similar clinical efficacy and safety. Thus DEB could
be considered a reasonable alternative to DES for the treatment of CAD in
selected clinical settings (Clinicaltrials.gov identifier: NCT01760200).
2013 Elsevier Ireland Ltd.

<25>
Accession Number
2013732485
Authors
Jones B.O. Pepe S. Sheeran F.L. Donath S. Hardy P. Shekerdemian L. Penny
D.J. McKenzie I. Horton S. Brizard C.P. D'Udekem Y. Konstantinov I.E.
Cheung M.M.H.
Institution
(Jones, Cheung) Department of Cardiology, Royal Children's Hospital,
Flemington Rd, Parkville, VIC 3052, Australia
(Jones, Pepe, Sheeran, McKenzie, Horton, Brizard, D'Udekem, Konstantinov,
Cheung) Heart Research Group, Murdoch Children's Research Institute,
Parkville, VIC, Australia
(Jones, Pepe, Sheeran, McKenzie, Horton, Brizard, D'Udekem, Konstantinov,
Cheung) Department of Paediatrics, University of Melbourne, Melbourne,
VIC, Australia
(Donath) Clinical Epidemiology and Biostatistics Unit, Murdoch Children's
Research Institute, Parkville, VIC, Australia
(Hardy) National Perinatal and Epidemiology Unit, University of Oxford,
Oxford, United Kingdom
(Shekerdemian) Paediatric Critical Care, Texas Children's Hospital,
Houston, TX, United States
(Penny) Department of Cardiology, Texas Children's Hospital, Houston, TX,
United States
(McKenzie) Department of Anaesthesia, Royal Children's Hospital,
Melbourne, VIC, Australia
(Horton, Brizard, D'Udekem, Konstantinov) Cardiac Surgery Unit, Royal
Children's Hospital, Melbourne, VIC, Australia
Title
Remote ischemic preconditioning in cyanosed neonates undergoing
cardiopulmonary bypass: A randomized controlled trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 146 (6) (pp 1334-1340),
2013. Date of Publication: December 2013.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Objective: The myocardial protective effect of remote ischemic
preconditioning has been demonstrated in heterogeneous groups of patients
undergoing cardiac surgery. No studies have examined this technique in
neonates. The present study was performed to examine the remote ischemic
preconditioning efficacy in this high-risk patient group. Methods: A
preliminary, randomized, controlled trial was conducted to investigate
whether remote ischemic preconditioning in cyanosed neonates undergoing
cardiac surgery confers protection against cardiopulmonary bypass. Two
groups of neonates undergoing cardiac surgery were recruited for the
present study: patients with transposition of the great arteries
undergoing the arterial switch procedure and patients with hypoplastic
left heart syndrome undergoing the Norwood procedure. The subjects were
randomized to the remote ischemic preconditioning or sham control groups.
Remote ischemic preconditioning was induced by four 5-minute cycles of
lower limb ischemia and reperfusion using a blood pressure cuff. Troponin
I and the biomarkers for renal and cerebral injury were measured pre- and
postoperatively. Results: A total of 39 neonates were recruited - 20 with
transposition of the great arteries and 19 with hypoplastic left heart
syndrome. Of the 39 neonates, 20 were randomized to remote ischemic
preconditioning and 19 to the sham control group. The baseline
demographics appeared similar between the randomized groups. The
cardiopulmonary bypass and crossclamp times were not significantly
different between the 2 groups. The troponin I levels were not
significantly different at 6 hours after cardiopulmonary bypass nor were
the postoperative inotrope requirements. Markers of renal (neutrophil
gelatinase-associated lipocalin) and cerebral injury (S100b,
neuron-specific enolase) were not significantly different between the 2
groups. Conclusions: Our data suggest that remote ischemic preconditioning
in hypoxic neonates undergoing cardiopulmonary bypass surgery does not
provide myocardial, renal, or neuronal protection. Additional studies are
needed to examine the relationships among developmental age, hypoxia, and
the molecular mechanisms of ischemic preconditioning. Copyright 2013 by
The American Association for Thoracic Surgery.

<26>
Accession Number
2013730328
Authors
White M. Cantin B. Haddad H. Kobashigawa J.A. Ross H. Carrier M.
Pflugfelder P.W. Isaac D. Cecere R. Whittom L. Ali I.S. Wang S.-H. He Y.
Groulx A. Touyz R.M.
Institution
(White, Whittom) Department of Medicine, Montreal Heart Institute and
Universite de Montreal, 5000 Belanger St, Montreal, QC H1T 1C8, Canada
(Carrier) Department of Surgery, Montreal Heart Institute and Universite
de Montreal, Montreal, QC, Canada
(Cantin) Institut Universitaire de Cardiologie et de Pneumologie, Hopital
Laval, Ste-Foy, QC, Canada
(Haddad) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Kobashigawa) Heart Transplant Program, Cedars-Sinai Heart Institute, Los
Angeles, CA, United States
(Ross) Department of Cardiology, Toronto General Hospital, Toronto, ON,
Canada
(Pflugfelder) Research Centre, London Health Science Centre, London, ON,
Canada
(Isaac) Department of Medicine, Foothills Medical Centre, Calgary, AL,
Canada
(Cecere) Division of Cardiac Surgery, McGill University Health Centre,
Montreal, QC, Canada
(Ali) Department of Cardiothoracic Surgery, QEII Health Sciences Centre,
Halifax, NS, Canada
(Wang) Division of Cardiothoracic Surgery, University of Alberta,
Edmonton, AL, Canada
(He, Touyz) Ottawa Hospital Research Institute, University of Ottawa,
Ottawa, ON, Canada
(Groulx) Biostatistics, Pharmanet-i3, Burlington, ON, Canada
(Touyz) Institute of Cardiovascular and Medical Sciences, BHF Glasgow
Cardiovascular Research Centre, University of Glasgow, Glasgow, United
Kingdom
Title
Cardiac signaling molecules and plasma biomarkers after cardiac
transplantation: Impact of tacrolimus versus cyclosporine.
Source
Journal of Heart and Lung Transplantation. 32 (12) (pp 1222-1232), 2013.
Date of Publication: December 2013.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
We investigated cardiac proinflammatory, mitogenic, and apoptotic
signaling events, and plasma biomarkers of inflammation and oxidative
stress in de novo adult cardiac transplant (CTX) patients receiving
tacrolimus (TAC) or cyclosporine A (CsA). Methods One hundred CTX
recipients were randomized 1:1 to TAC/CsA in a prospective, randomized
open-label multicenter study. Biomarkers of inflammation, immunity,
oxidative stress, and cardiac signaling underlying growth and inflammation
(extracellular signal-related kinase 1/2, p38 mitogen-activated protein
kinase, mitogen-activated protein kinase kinases [MEK] 1/2 and 3/6,
c-Src), and apoptosis and survival (c-Jun NH₂-terminal kinases
[JNK], Bax/Bcl2, Akt) were assessed at 2, 4, 12, 26, and 52 weeks
post-CTX. Plasma from healthy controls (n = 30) and tissue from explanted
non-failing hearts (n = 6) were used as controls. Results Biomarkers of
inflammation/immunity (interleukin -6 and -18, soluble intercellular
adhesion molecule, E-selectin, monocyte chemoattractant protein-1,
osteopontin, fibrinogen, N-terminal prohormone brain natriuretic peptide,
high-sensitive C-reactive protein) and oxidative stress (thiobarbituric
acid reactive substances, nitrotyrosine) were increased, and antioxidant
capacity was (glutathione/glutathione disulfide) decreased in patients vs
healthy controls (p < 0.05). Phosphorylation of mitogen-activated protein
kinases and Akt was increased, and Bax/Bcl was decreased in transplanted
vs non-transplanted hearts. Except for plasma fibrinogen, which was lower
in TAC vs CsA, (p = 0.01), there were no significant differences in
parameters studied between TAC vs CsA immunoprophylaxis. Conclusions De
novo CTX recipients exhibit significant sub-clinical inflammation and
oxidative stress that persists 12 months after transplantation. Associated
with this is activation of myocardial growth and inflammatory signaling
and decreased apoptosis. Our findings suggest that CTX is an inflammatory
condition associated with oxidative stress and myocardial growth
regardless of CsA or TAC immunoprophylaxis and independently of rejection
status. 2013 International Society for Heart and Lung Transplantation.

<27>
Accession Number
2013729955
Authors
Parke R. McGuinness S. Dixon R. Jull A.
Institution
(Parke, McGuinness) Cardiothoracic and Vascular Intensive Care Unit,
Auckland City Hospital, Auckland, New Zealand
(Parke, Dixon, Jull) School of Nursing, University of Auckland, Auckland,
New Zealand
(Jull) National Institute of Health Innovation, University of Auckland,
Auckland, New Zealand
(Dixon) Centre for Child and Family Research, University of Auckland,
Auckland, New Zealand
Title
Open-label, phase II study of routine high-flow nasal oxygen therapy in
cardiac surgical patients.
Source
British Journal of Anaesthesia. 111 (6) (pp 925-931), 2013. Date of
Publication: December 2013.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Background. Respiratory complications after cardiac surgery increase
morbidity, mortality, and length of stay. Studies suggest that routine
delivery of positive airway pressure after extubation may be beneficial.
We sought to determine whether the routine administration of nasal
high-flow oxygen therapy (NHF) improves pulmonary function after cardiac
surgery. Methods. A pragmatic randomized controlled trial; participants
received either NHF (45 litre min ^-1) or usual care from
extubation to Day 2 after surgery. The primary outcome was number of
patients with Sp_O2 /FI_O2 ratio >=445 on Day 3 after
surgery. The secondary outcomes included atelectasis score on chest X-ray;
spirometry; intensive care and hospital length of stay; mortality on Day
28; oxygenation indices; escalation of respiratory support; and patient
comfort. Results.We randomized 340 patients over 14 months. The number of
patients with a Sp_O2/FI_O2 ratio of >=445 on Day 3
was78 (46.4%) in the NHF group vs 72 (42.4%) standard care [odds ratio
(OR) 1.18,95%confidenceinterval (CI) 0.77-1.81, P=0.45].
Pa_CO2was reducedatboth4hpostextubation and at 9 a.m. on Day 1
in the NHF group (5.3 vs 5.4 kPa, P=0.03 and 5.1 vs 5.3 kPa, P=0.03,
respectively). Escalation in respiratory support at any time in the study
occurred in 47 patients (27.8%) allocated to NHF compared with 77 (45%)
standard care (OR 0.47, 95% CI 0.29-0.7, P=0.001). Conclusions. Routine
use of NHF did not increase Sp _O2/FI_O2 ratio on Day
3 but did reduce the requirement for escalation of respiratory support.
The Author [2013]. Published by Oxford University Press on behalf of the
British Journal of Anaesthesia. All rights reserved.

<28>
Accession Number
2013729950
Authors
Landoni G. Greco T. Biondi-Zoccai G. Neto C.N. Febres D. Pintaudi M. Pasin
L. Cabrini L. Finco G. Zangrillo A.
Institution
(Landoni, Greco, Febres, Pintaudi, Pasin, Cabrini, Zangrillo) Anesthesia
and Intensive Care Department, San Raffaele Scientific Institute, Milan,
Italy
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Neto) Anaesthesia and Intensive Care Department, Federal University of
Sao Paulo, Sao Paulo, Brazil
(Neto) Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Finco) Department of Medical Sciences M. Aresu, University of Cagliari,
Italy
Title
Anaesthetic drugs and survival: A bayesian network meta-analysis of
randomized trials in cardiac surgery.
Source
British Journal of Anaesthesia. 111 (6) (pp 886-896), 2013. Date of
Publication: December 2013.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Background. Many studies have compared desflurane, isoflurane,
sevoflurane, total i.v. anaesthesia (TIVA), or all in cardiac surgery to
assess their effects on patient survival. Methods. We performed standard
pairwise and Bayesian network meta-analyses; the latter allows indirect
assessments if any of the anaesthetic agents were not compared in
head-tohead trials. Pertinent studies were identified using BioMedCentral,
MEDLINE/PubMed, Embase, and the Cochrane Library (last updated in June
2012). Results. We identified 38 randomized trials with survival data
published between 1991 and 2012, with most studies (63%) done in coronary
artery bypass grafting (CABG) patients with standard cardiopulmonary
bypass. Standard meta-analysis showed that the use of a volatile agent was
associated with a reduction in mortality when compared with TIVA at the
longest follow-up available [25/1994 (1.3%) in the volatile group vs
43/1648 (2.6%) in the TIVA arm, odds ratio (OR)=0.51, 95% confidence
interval (CI) 0.33-0.81, P-value for effect=0.004, number needed to treat
74, I ²=0%] with results confirmed in trials with low risk of
bias, in large trials, and when including only CABG studies. Bayesian
network metaanalysis showed that sevoflurane (OR=0.31, 95% credible
interval 0.14-0.64) and desflurane (OR=0.43, 95% credible interval
0.21-0.82) were individually associated with a reduction in mortality when
compared with TIVA. Conclusions. Anaesthesia with volatile agents appears
to reduce mortality after cardiac surgery when compared with TIVA,
especially when sevoflurane or desflurane is used. A large, multicentre
trial is warranted to confirm that long-term survival is significantly
affected by the choice of anaesthetic. The Author [2013]. Published by
Oxford University Press on behalf of the British Journal of Anaesthesia.
All rights reserved.

<29>
Accession Number
2013729942
Authors
Grassin-Delyle S. Tremey B. Abe E. Fischler M. Alvarez J.C. Devillier P.
Urien S.
Institution
(Grassin-Delyle, Devillier) Laboratoire de Pharmacologie, UPRES EA220, 11
rue Guillaume Lenoir, 92150 Suresnes, France
(Tremey, Fischler) Service d'Anesthesie, Hopital Foch, 11 rue Guillaume
Lenoir, 92150 Suresnes, France
(Grassin-Delyle, Abe, Alvarez) Laboratoire de Pharmacologie-Toxicologie,
Hopital Raymond Poincare, AP-HP, Garches, France
(Fischler, Alvarez, Devillier) UFR Sciences de la Sante, Universite
Versailles Saint Quentin en Yvelines, Montigny le Bretonneux, France
(Urien) URC Paris Centre, CIC-0901 Inserm Necker-Cochin, AP-HP, Paris,
France
(Urien) EA-3620, Universite Paris Descartes, Sorbonne Paris Cite, Paris,
France
Title
Population pharmacokinetics of tranexamic acid in adults undergoing
cardiac surgery with cardiopulmonary bypass.
Source
British Journal of Anaesthesia. 111 (6) (pp 916-924), 2013. Date of
Publication: December 2013.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Background. Interest in antifibrinolytic tranexamic acid (TA) has grown
since the widespread removal of aprotinin, but its dosing during cardiac
surgery is still debated. The objectives of this study were to investigate
the population pharmacokinetics (PK) of TA given with either low- or
high-dose continuous infusion schemes in adult cardiac surgery patients
during cardiopulmonary bypass (CPB). Methods. Patients were randomized to
receive either low-dose (10 mg kg^-1 followed by an infusion of
1 mg kg ^-1 h^-1 throughout the operation, and 1 mg
kg^-1 into the CPB) or high-dose (30 mg kg^-1, then 16
mg kg^-1 h^-1, and 2 mg kg^-1 into the CPB)
TA. Serum TA concentrations were measured in 61 patients and the data were
modelled using Monolix. Results. TA concentrations were 28-55
mugml^-1 in the low-dose group and 114-209 mug ml^-1
in the high-dose group throughout surgery. TA PK was best described by a
twocompartment open model. The main covariate effect was bodyweight,
whereas the CPB did not influence the PK. Assuming a bodyweight of 70 kg,
the population estimates were 4.8 litre h ^-1 for clearance, 6.6
litre for the volume of the central compartment, 32.2 litre h^-1
for the diffusional clearance, and the peripheral volume of distribution
was 10.8 litre. Conclusions. The PK of TA was satisfactorily described by
an open two-compartmental model, which was used to propose a dosing scheme
suitable for obtaining and maintaining the desired plasma concentration in
a stable and narrow range in cardiac surgery patients. The Author [2013].
Published by Oxford University Press on behalf of the British Journal of
Anaesthesia. All rights reserved.

<30>
Accession Number
71241557
Authors
Jadhav M. Bobhate P. Garekar S. Radhakrisshnan B. Ranganathan Mohanty S.R.
Kulkarni S. Rao S.G.
Institution
(Jadhav, Bobhate, Garekar, Radhakrisshnan, Ranganathan, Mohanty, Kulkarni,
Rao) Children's Heart Center, Kokilaben Dhirubhai Ambani Hospital, Andheri
(West), Mumbai, Maharashtra, India
Title
Levosimendan versus milrinone after corrective open-heart surgery in
children.
Source
Annals of Pediatric Cardiology. Conference: 14th Annual Conference of the
Pediatric Cardiac Society of India Chennai India. Conference Start:
20121004 Conference End: 20121007. Conference Publication: (var.pagings).
5 (1) (pp 104-105), 2012. Date of Publication: January-June 2012.
Publisher
Medknow Publications and Media Pvt. Ltd
Abstract
Introduction: Levosimendan has been shown to improve cardiac function and
hemodynamics in adults. After open-heart surgery in neonates and infants,
the low cardiac output syndrome (LCOS) commonly complicates the
postoperative course and is associated with poor outcome. The aim of our
study is to evaluate whether levosimendan is superior to milrinone after
open heart surgery in children. Methods: It is a retrospective study. All
children (up to 18 years) operated at our center, from June 2011, and
received levosimendan were selected. They were compared with patients
receiving milrinone in the postoperative period. Results: A total of 14
patients were selected. The levosimendan group age range was two days to
17 years and in the milrinone group it was three days to 10 years. The
weight in the milrinone group was between 2.8 and 30.8 kg and in the
levosimendan group it was 2.2 to 44 kg. The mean duration of inotropic
requirement was 3.14 days (75.3 hours) for the levosimendan group and it
was 2.8 days (67.2 hours) for the milrinone group. The mean duration of
Intensive Care Unit (ICU) stay was 4.4 days (105.6 hours) for the
milrinone group versus 4.7 days (112.8 hours) for the levosimendan group.
The ionotropic step up was not required for the milrinone group, while the
levosimendan group required it in 21% of the cases. Conclusion: The mean
duration of ionotropic support and ICU stay were marginally more in the
levosimendan group. The step up of ionotropic support was required in the
Levosimendan group. Levosimendan was not superior to milrinone in the
children, after cardiac surgery. A large randomized controlled trial is
required to evaluate the role of levosimendan in children, post cardiac
surgery.

<31>
Accession Number
71239158
Authors
Hwang E.-G. Min S.-K. Kim Y.-I.
Institution
(Hwang, Min, Kim) Inje University, Seoul Paik Hospital, Seoul, South Korea
Title
Surgery of primary spontaneous pneumothorax via single incision.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: 2013 Annual Scientific Meeting of the International
Society for Minimally Invasive Cardiothoracic Surgery, ISMICS 2013 Prague
Czech Republic. Conference Start: 20130612 Conference End: 20130615.
Conference Publication: (var.pagings). 8 (2) (pp 160-161), 2013. Date of
Publication: March-April 2013.
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Thoracoscopic operation is common in primary spontaneous
pneumothorax. Recently, single incision approach is widely used. This
study is aimed to evaluate the effectiveness of operation via single
incision in primary spontaneous pneumothorax compare with conventional
thoracoscopic operation. Methods: We reviewed medical records of primary
spontaneous pneumothorax operated by thoracoscopic approach from January
2011 to November 2012 retrospectively. Groups were divided into two groups
according to approach as one camera port and another port on anterior
chest wall (2-ports ) and single incision via 7th ICS- MXL (SITS).
Operative method was common in two groups as wedge resection and
reinforcement of stapled line with polyglycolic acid sheet and fibrin
glue. Various parameters were compared with two groups including age, sex,
operative time, numbers of staples, complications (wound infection,
postop. CTD > 5 days, respiratory complication), postop. CTD days, postop.
recurrence, and need of additional opioid. Statistical analysis was done
by chi ²-test, and statistical significance was p-value < 0.05.
Results: Thirty-two (32) cases were collected; 2-ports group were 16
cases, SITS were 16 cases. Men were 29, women were 3. Age mean was 24.75
yrs (15-66) (p=0.108). Operative time was mean 59.37 minutes (p=0.176);
mean number of staples were 5.50 in 2-ports and 3.87 in SITS (p=0.163).
Complications occurred in 12 cases, 6 cases (all postop. CTD> 5 days) in
2-ports and 6 cases (wound infection 2, postop. CTD > 5 days 3,
respiratory cx. 1) in SITS (p=0.261). Mean postop. CTD were 4.69 in
2-ports and 3.38 in SITS (p=0.69). Postop. recurrence occurred in 4 cases
(13.3%), 3 cases in 2-ports group (18.7%) and a case in SITS group (6.2%)
(p=.600). Additional opioid needed in 19 cases, 11 cases needed in 2-ports
group (69%) and 8 cases in SITS group (50%) (p=0.473) Conclusions: There
were no significant differences between 2-ports approach and
single-incision approach. So, we could suggest that single-incision
approach can be a substitute to conventional approach. Surgical technique
and postoperative pain management should be refined to reduce
postoperative pain. More cases and randomized controlled study are
essential to evaluate the efficacy of single-incision approach.