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<1>
Accession Number
2010123132
Title
Timing of renal replacement therapy initiation for acute kidney injury in
critically ill patients: a systematic review of randomized clinical trials
with meta-analysis and trial sequential analysis.
Source
Critical Care. 25 (1) (no pagination), 2021. Article Number: 15. Date of
Publication: December 2021.
Author
Li X.; Liu C.; Mao Z.; Li Q.; Zhou F.
Institution
(Li, Mao, Li, Zhou) Department of Critical Care Medicine, the First
Medical Centre, Chinese People's Liberation Army General Hospital, 28
Fu-Xing Road, Beijing 100853, China
(Li, Liu) Medical School of Chinese PLA, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is a common serious complication in
critically ill patients. AKI occurs in up to 50% patients in intensive
care unit (ICU), with poor clinical prognosis. Renal replacement therapy
(RRT) has been widely used in critically ill patients with AKI. However,
in patients without urgent indications such as acute pulmonary edema,
severe acidosis, and severe hyperkalemia, the optimal timing of RRT
initiation is still under debate. We conducted this systematic review of
randomized clinical trials (RCTs) with meta-analysis and trial sequential
analysis (TSA) to compare the effects of early RRT initiation versus
delayed RRT initiation. Method(s): We searched databases (PubMed,
EMBASE and Cochrane Library) from inception through to July 20, 2020, to
identify eligible RCTs. The primary outcome was 28-day mortality. Two
authors extracted the data independently. When the I2 values <
25%, we used fixed-effect mode. Otherwise, the random effects model was
used as appropriate. TSA was performed to control the risk of random
errors and assess whether the results in our meta-analysis were
conclusive. Result(s): Eleven studies involving 5086 patients were
identified. Two studies included patients with sepsis, one study included
patients with shock after cardiac surgery, and eight others included mixed
populations. The criteria for the initiation of RRT, the definition of
AKI, and RRT modalities existed great variations among the studies. The
median time of RRT initiation across studies ranged from 2 to 7.6 h in the
early RRT group and 21 to 57 h in the delayed RRT group. The pooled
results showed that early initiation of RRT could not decrease 28-day
all-cause mortality compared with delayed RRT (RR 1.01; 95% CI 0.94-1.09;
P = 0.77; I2 = 0%). TSA result showed that the required
information size was 2949. The cumulative Z curve crossed the futility
boundary and reached the required information size. In addition, early
initiation of RRT could lead to unnecessary RRT exposure in some patients
and was associated with a higher incidence of hypotension (RR 1.42; 95% CI
1.23-1.63; P < 0.00001; I2 = 8%) and RRT-associated infection
events (RR 1.34; 95% CI 1.01-1.78; P = 0.04; I2 = 0%).
 Conclusion(s): This meta-analysis suggested that early initiation of
RRT was not associated with survival benefit in critically ill patients
with AKI. In addition, early initiation of RRT could lead to unnecessary
RRT exposure in some patients, resulting in a waste of health resources
and a higher incidence of RRT-associated adverse events. Maybe, only
critically ill patients with a clear and hard indication, such as severe
acidosis, pulmonary edema, and hyperkalemia, could benefit from early
initiation of RRT. Copyright © 2021, The Author(s).

<2>
Accession Number
370203527
Title
Transcatheter pulmonary valve implantation: Systematic literature review.
Source
Revista Brasileira de Cardiologia Invasiva. 21 (2) (pp 176-187), 2013.
Date of Publication: 2013.
Author
Botrel T.E.A.; Clark O.A.C.; Queiroga M.C.; Filho R.I.R.; Pilla C.B.;
Arrieta R.S.; Cristovao S.; Silva C.C.; Esteves C.A.; Oliveira E.C.;
Simoes L.C.; Chamie F.; Neves J.; Max R.; Pedra C.A.C.
Institution
(Botrel) Pesquisador da Evidencias - Credibilidade Cientifica, Campinas,
SP, Brazil
(Clark) Credibilidade Cientifica, Campinas, SP, Brazil
(Queiroga) Hospital da Unimed Joao Pessoa, Joao Pessoa, PB, Brazil
(Filho) Instituto de Cardiologia, Fundacao Universitaria de Cardiologia,
Porto Alegre, RS, Brazil
(Pilla) Servico de Cardiologia Pediatrica e Cardiologia Intervencionista,
Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil
(Arrieta) Servico de Hemodinamica e Cardiologia Intervencionista,
Instituto do Coracao do Hospital das Clinica, Universidade de Sao Paulo,
Sao Paulo, SP, Brazil
(Cristovao) Hospital Beneficencia Portuguesa de Sao Paulo, Sao Paulo, SP,
Brazil
(Silva) Escola Paulista de Medicina, Universidade Federal de Sao Paulo,
Sao Paulo, SP, Brazil
(Esteves) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP, Brazil
(Oliveira) Departamento de Cardiopatias Congenitas, Hospital de Clinicas,
Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
(Simoes) Instituto Nacional de Cardiologia, Hospital Laranjeiras, Rio de
Janeiro, RJ, Brazil
(Chamie) Hospital Federal dos Servidores do Estado, RJ, Brazil
(Neves) Instituto de Medicina Integral Prof. Fernando Figueira, Recife,
PE, Brazil
(Max) Departamento de Cardiologia Pediatrica Intervencionista, Hospital
Biocor, Belo Horizonte, MG, Brazil
(Pedra) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Surgical repair of some complex congenital heart diseases involves
reconstruction of the right ventricular outflow tract using homografts,
bioprostheses, bovine jugular grafts or other valved conduits between the
right ventricle and the main pulmonary artery. Although these surgical
procedures may be performed with low mortality rates, the life span of
these implanted valves or conduits is usually short (< 10 years) due to
either degeneration and/or calcification. Variable degrees of pulmonary
stenosis, often associated with pulmonary insufficiency, are consequences
of conduit degeneration. In 2000, Bonhoeffer et al. were the first to
report the transcatheter pulmonary valve implantation (TPVI) of a
bioprosthetic pulmonary valve later named Melody valve (Medtronic,
Minneapolis, USA). The technique was initially developed to limit the need
for multiple surgical procedures, and, ultimately, to work as a surrogate
of a new surgical valve replacement. Subsequent clinical studies in Europe
and the United States confirmed the safety and efficacy of this technique
in a larger number of patients. Since the National Sanitary Surveillance
Agency (Agencia Nacional de Vigilancia Sanitaria - Anvisa) granted
approval for clinical use of the Melody transcatheter pulmonary biological
valve in February 2103, we deemed that a judicious assessment of this new
technology was timely and necessary before the widespread use in our
country. The objective of this study was to perform a systematic
literature review on the use of TPVI in patients with dysfunctional
homografts, valved conduits and bioprostheses implanted surgically in the
right ventricular outflow tract.

<3>
Accession Number
2007577501
Title
The benefit of fibrosa layer stripping technique during minimally invasive
aortic valve replacement for calcified aortic valve stenosis-A randomized
controlled trial.
Source
Journal of Cardiac Surgery. 36 (2) (pp 466-474), 2021. Date of
Publication: February 2021.
Author
Zhou Y.; Zhang L.; Hua K.; Zhang J.; Yang X.
Institution
(Zhou, Zhang, Hua, Zhang, Yang) Department of Cardiac Surgery, Beijing
Anzhen Hospital, Capital Medical University, Beijing, China
Publisher
Blackwell Publishing Inc.
Abstract
Background: Fibrosa layer stripping (FLS) technique is a new approach to
remove the calcified aortic valve. In this study, we aimed to assess the
effectiveness of the FLS technique by comparing it with the conventional
technique in minimally invasive aortic valve replacement (MIAVR).
 Method(s): A prospective, single-center, randomized controlled trial
was conducted at Beijing Anzhen Hospital. Seventy patients diagnosed with
severe calcific aortic stenosis were randomly assigned to undergo FLS (n =
35) or conventional (n = 35) technique to debride calcified aortic valve.
Preoperative profile, procedural parameters, and postoperative outcomes
were analyzed. Result(s): No significant difference was observed in
the preoperative profile between the two groups. Compared with the
conventional technique, the FLS technique had a significantly higher
indexed effective orifice area and lower mean gradient. Moreover, the FLS
technique was associated with significantly reduced aortic cross-clamp
time (41 [38-44] vs. 56 [51-60] min, p <.001), cardiopulmonary bypass
(CPB) time (63 [56-69] vs. 81 [75-84] min, p <.001), and operative time
(148 [141-156] vs. 173 [169-180] min, p <.001). Lastly, the length of
intensive care unit stay (1.2 +/- 0.4 vs. 1.5 +/- 0.8 days, p =.041) and
hospital stay (5.3 +/- 0.6 vs. 6.0 +/- 1.4 days, p =.020) was
significantly reduced in the FLS group compared with those in the
conventional group. Conclusion(s): FLS technique is effective in
removing calcified tissue during MIAVR and is associated with shorter
cross-clamp time and CPB time, and better hemodynamic performance than the
conventional technique. Copyright © 2020 Wiley Periodicals LLC

<4>
Accession Number
2010766215
Title
The effectiveness of Sufi music for mental health outcomes. A systematic
review and meta-analysis of 21 randomised trials.
Source
Complementary Therapies in Medicine. 57 (no pagination), 2021. Article
Number: 102664. Date of Publication: March 2021.
Author
Gurbuz-Dogan R.N.; Ali A.; Candy B.; King M.
Institution
(Gurbuz-Dogan, Ali, Candy, King) Division of Psychiatry, University
College London, London, United Kingdom
Publisher
Churchill Livingstone
Abstract
Background: There is some evidence that Sufi music therapy might improve
physical and mental well-being; however, no systematic review or
meta-analysis has pooled and critiqued the evidence. The aim of this
systematic review was to evaluate the effects of Sufi music therapy on
mental health outcomes. Method(s): We searched Medline, PsycINFO, the
Web of Science, Science Direct, PsycARTICLES, Cochrane Library, SCOPUS,
CINAHL Plus, AMED, and ULAKBIM databases, and the reference lists of the
studies found. Papers published in academic peer-reviewed journals were
included, as well as from other sources such as chapters in edited books,
the grey literature, or conference presentations. Articles published up to
March 2020 in Turkish and English were included. Our primary outcome of
interest was anxiety and secondary outcomes of interest were other mental
health outcomes such as depression. To assess the methodological quality
of the articles, the Cochrane Risk of Bias Tool was used. The quality of
evidence was assessed using the GRADEpro GDT system. Result(s): This
search yielded 21 clinical trials that were eligible for inclusion. A
meta-analysis, using a random effects model, of 18 randomised controlled
trials involving 1454 participants showed that Sufi music therapy with
makams, compared with treatment as usual (TAU) or a no-music control
group, reduced symptoms of anxiety in the short term in patients
undergoing an operation or treatments such as chemotherapy or
haemodialysis (standardised mean difference SMD= -1.15, 95 % CI, -1.64 to
-0.65; very low-quality evidence). The evidence of Sufi music with makam's
effect on anxiety is rated as very low. Qualitative synthesis of secondary
outcomes revealed significant effects for depression, positive symptoms in
schizophrenia, stress, which however were based on fewer studies. Trials
were of moderate methodological quality, and there was significant
heterogeneity across the studies. Conclusion(s): Sufi music may
reduce anxiety of patients undergoing medical procedures like
haemodialysis, coronary artery surgery, angiography, colonoscopy, bone
marrow aspiration and biopsy procedures. Evidence from single studies
suggests effects on depression and stress as well. However, due to
methodological limitations of the studies, further, higher quality studies
are required in other cultures. Copyright © 2021

<5>
Accession Number
2010453712
Title
Calcium-Induced Autonomic Denervation in Patients With Post-Operative
Atrial Fibrillation.
Source
Journal of the American College of Cardiology. 77 (1) (pp 57-67), 2021.
Date of Publication: 05 Jan 2021.
Author
Wang H.; Zhang Y.; Xin F.; Jiang H.; Tao D.; Jin Y.; He Y.; Wang Q.; Po
S.S.
Institution
(Wang, Zhang, Xin, Jiang, Tao, Jin, He, Wang) Department of Cardiovascular
Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning,
China
(Po) Section of Cardiovascular Diseases and Heart Rhythm Institute,
University of Oklahoma Health Sciences Center, Oklahoma City, OK, United
States
Publisher
Elsevier Inc.
Abstract
Background: Post-operative atrial fibrillation (POAF) is associated with
worse long-term cardiovascular outcomes. Objective(s): This study
hypothesized that injecting calcium chloride (CaCl<inf>2</inf>) into the
major atrial ganglionated plexi (GPs) during isolated coronary artery
bypass grafting (CABG) can reduce the incidence of POAF by calcium-induced
autonomic neurotoxicity. Method(s): This proof-of-concept study
randomized 200 patients undergoing isolated, off-pump CABG to
CaCl<inf>2</inf> (n = 100) or sodium chloride (sham, n = 100) injection.
Two milliliters of CaCl<inf>2</inf> (5%) or sodium chloride (0.9%) was
injected into the 4 major atrial GPs during CABG. All patients received
7-day continuous telemetry and Holter monitoring. The primary outcome was
incidence of POAF (>=30 s) in 7 days. Secondary outcomes included length
of hospitalization, POAF burden, average ventricular rate during AF,
plasma level of inflammatory markers, and actionable antiarrhythmic
therapy to treat POAF. Result(s): The POAF incidence was reduced from
36% to 15% (hazard ratio: 0.366; 95% confidence interval: 0.211 to 0.635;
p = 0.001). Length of hospitalization did not differ between the 2 groups.
POAF burden (first 7 post-operative days), the use of amiodarone or
esmolol, and the incidence of atrial couplets and nonsustained atrial
tachyarrhythmias were significantly reduced in the CaCl<inf>2</inf> group.
Heart rate variability data showed a decrease in both high-frequency and
low-frequency power in the CaCl<inf>2</inf> group with a preserved
low-frequency/high-frequency ratio, suggesting that the
sympathetic/parasympathetic balance was not perturbed by CaCl<inf>2</inf>
injection. Conclusion(s): Injection of CaCl<inf>2</inf> into the 4
major atrial GPs reduced the POAF hazard by 63%. Inhibition of GP function
by Ca-mediated neurotoxicity may underlie the therapeutic effect. (Calcium
Autonomic Denervation Prevents Postoperative Atrial Fibrillation;
ChiCTR1800019276) Copyright © 2021 American College of Cardiology
Foundation

<6>
Accession Number
2010427775
Title
Selection of the best of 2020 in interventional cardiology.
Source
REC: CardioClinics. 56 (Supplement 1) (pp 48-53), 2021. Date of
Publication: 03 Jan 2021.
Author
Ojeda S.; Romaguera R.; Cruz-Gonzalez I.; Moreno R.
Institution
(Ojeda) Servicio de Cardiologia, Hospital Universitario Reina Sofia;
Instituto Maimonides de Investigacion Biomedica (IMIBIC), Universidad de
Cordoba, Cordoba, Spain
(Romaguera) Servicio de Cardiologia, Hospital de Bellvitge, Institut
d'Investigacio de Bellvitge (IDIBELL), Universitat de Barcelona,
L'Hospitalet de Llobregat, Barcelona, Spain
(Cruz-Gonzalez) Departamento de Cardiologia, Hospital Clinico de
Salamanca, Instituto de Investigacion Biomedica de Salamanca (IBSAL),
Universidad de Salamanca, Salamanca, Spain
(Cruz-Gonzalez, Moreno) Centro de Investigacion en Red de Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
(Moreno) Servicio de Cardiologia, Hospital Universitario La Paz; Instituto
de Investigacion del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
Publisher
Elsevier Espana S.L.
Abstract
This article reviews the most relevant studies in the field of
interventional cardiology in 2020. In the area of coronary intervention,
relevant information with respect to the percutaneous coronary
intervention (PCI) vs coronary artery bypass grafting for the left main
treatment has been published, as well as, the best approach in dealing
with complex bifurcation lesions. There have also been significant studies
regarding antiplatelet strategies in patients with acute coronary syndrome
undergoing PCI, which will potentially change our clinical practice.
Regarding stable angina, data point out that an initial conservative
treatment can be an appropriate strategy. Finally, coronary physiology
continues to generate a great interest in different clinical and
anatomical contexts. The advances in the field of intervention for
structural heart disease have continued to increase exponentially in the
last year. The first randomized trial assessing the optimal antithrombotic
treatment after transcatheter aortic valve implantation has been published
and that will have clinical implications. It also highlightes the
development and implantation of the first mitral and tricuspid
percutaneous prosthesis, as well as, the evidence in favour of left atrial
appendage closure in high-risk patients. Finally, this year has been
marked by the COVID-19 pandemic which has had an impact on the clinical
and research activities. Copyright © 2020 Sociedad Espanola de
Cardiologia

<7>
Accession Number
2010123141
Title
Effect of sevoflurane on the inflammatory response during cardiopulmonary
bypass in cardiac surgery: the study protocol for a randomized controlled
trial.
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 25. Date of
Publication: December 2021.
Author
Cardoso T.A.A.M.; Kunst G.; Neto C.N.; de Ribamar Costa Junior J.; Silva
C.G.S.; Bastos G.M.; Borges J.B.; Hirata M.H.
Institution
(Cardoso, Neto, Silva) Department of Surgery and Anesthesia, Dante
Pazzanese Institute of Cardiology, Captain Pinto Ferreira Street, 62, ap
92, Jardim Paulista, Sao Paulo 01423-020, Brazil
(Kunst) Department of Anaesthetics, Intensive Care Medicine and Pain
Therapy, King's College Hospital NHS Foundation Trust, Denmark Hill,
London, United Kingdom
(de Ribamar Costa Junior) Department of Interventional Cardiology, Dante
Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Bastos, Borges) Molecular Cardiology Research Laboratory, Dante Pazzanese
Institute of Cardiology, Sao Paulo, Brazil
(Hirata) Department of Clinical and Toxicological Analysis, School of
Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
Publisher
BioMed Central Ltd
Abstract
Background: Recent experimental evidence shows that sevoflurane can reduce
the inflammatory response during cardiac surgery with cardiopulmonary
bypass. However, this observation so far has not been assessed in an
adequately powered randomized controlled trial. Method(s): We plan to
include one hundred patients undergoing elective coronary artery bypass
graft with cardiopulmonary bypass who will be randomized to receive either
volatile anesthetics during cardiopulmonary bypass or total intravenous
anesthesia. The primary endpoint of the study is to assess the
inflammatory response during cardiopulmonary bypass by measuring
PMN-elastase serum levels. Secondary endpoints include serum levels of
other pro-inflammatory markers (IL-1beta, IL-6, IL-8, TNFalpha),
anti-inflammatory cytokines (TGFbeta and IL-10), and microRNA expression
in peripheral blood to achieve possible epigenetic mechanisms in this
process. In addition clinical endpoints such as presence of major
complications in the postoperative period and length of hospital and
intensive care unit stay will be assessed. Discussion(s): The trial
may determine whether adding volatile anesthetic during cardiopulmonary
bypass will attenuate the inflammatory response. Trial registration:
ClinicalTrials.gov NCT02672345. Registered on February 2016 and updated on
June 2020. Copyright © 2021, The Author(s).

<8>
Accession Number
2007396266
Title
Effects of platelet-rich plasma on the healing of sternal wounds: A
meta-analysis.
Source
Wound Repair and Regeneration. 29 (1) (pp 153-167), 2021. Date of
Publication: January/February 2021.
Author
Yao D.; Feng G.; Zhao F.; Hao D.
Institution
(Yao, Feng, Zhao, Hao) No. 3 Department of Burns and Plastic Surgery and
Wound Healing Center, The Fourth Medical Center of Chinese PLA General
Hospital, Beijing, China
Publisher
Blackwell Publishing Inc.
Abstract
Sternal wound infection (SWI) is a devastating complication after cardiac
surgery. Platelet-rich plasma (PRP) may have a positive impact on sternal
wound healing. A systematic review with meta-analyses was performed to
evaluate the clinical effectiveness of topical application of autologous
PRP for preventing SWI and promoting sternal wound healing compared to
placebo or standard treatment without PRP. Relevant studies published in
English or Chinese were retrieved from the Cochrane Central Register of
Controlled Trials (The Cochrane Library), PubMed, Ovid EMBASE, Web of
Science, Springer Link, and the WHO International Clinical Trials Registry
Platform (ICTRP) using the search terms "platelet-rich plasma" and
"sternal wound" or "thoracic incision." References identified through the
electronic search were screened, the data were extracted, and the
methodological quality of the included studies was assessed. The
meta-analysis was performed for the following outcomes: incidence of SWI,
incidence of deep sternal wound infection (DSWI), postoperative blood loss
(PBL), and other risk factors. In the systematic review, totally 10
comparable studies were identified, involving 7879 patients. The
meta-analysis for the subgroup of retrospective cohort studies (RSCs)
showed that the incidence of SWI and DSWI in patients treated with PRP was
significantly lower than that in patients without PRP treatment. However,
for the subgroup of randomized controlled trials (RCTs), there was no
significant difference in the incidence of SWI or DSWI after intervention
between the PRP and control groups. There was no significant difference in
PBL in both RCTs and RSCs subgroups. Neither adverse reactions nor in-situ
recurrences were reported. According to the results, PRP could be
considered as a candidate treatment to prevent SWI and DSWI. However, the
quality of the evidence is too weak, and high-quality RCTs are needed to
assess its efficacy on preventing SWI and DSWI. Copyright © 2020
The Wound Healing Society

<9>
Accession Number
633988896
Title
Randomized Trial of Aspirin Versus Warfarin After Transcatheter Aortic
Valve Replacement in Low-Risk Patients.
Source
Circulation. Cardiovascular interventions. 14 (1) (pp e009983), 2021. Date
of Publication: 01 Jan 2021.
Author
Rogers T.; Shults C.; Torguson R.; Shea C.; Parikh P.; Bilfinger T.; Cocke
T.; Brizzio M.E.; Levitt R.; Hahn C.; Hanna N.; Comas G.; Mahoney P.;
Newton J.; Buchbinder M.; Moreno R.; Zhang C.; Craig P.; Asch F.M.;
Weissman G.; Garcia-Garcia H.M.; Ben-Dor I.; Satler L.F.; Waksman R.
Institution
(Rogers, Torguson, Shea, Zhang, Craig, Ben-Dor, Satler, Waksman) Section
of Interventional Cardiology (T.R., R.T., P.C., I.B.-D., MedStar
Washington Hospital Center, WA, Ghana
(Rogers) Cardiovascular Branch, Division of Intramural Research, National
Heart, Lung, Blood Institute, National Institutes of Health, Bethesda,
United States
(Shults) Department of Cardiac Surgery (C. Shults), MedStar Health
Research Institute (F.M.A.), MedStar Washington Hospital Center, WA, Ghana
(Parikh) Department of Cardiology (P.P.), Stony Brook University Hospital,
NY
(Bilfinger) Department of Cardiothoracic Surgery (T.B.), Stony Brook
University Hospital, NY
(Cocke) Department of Cardiology (T.C.), Valley Hospital, Ridgewood,
United States
(Brizzio) Department of Cardiothoracic Surgery (M.E.B.), Valley Hospital,
Ridgewood, United States
(Levitt) Henrico Cardiology Associates (R.L.), HCA Virginia Health System
(Hahn) Cardiothoracic Surgical Associates - Richmond (C.H.), HCA Virginia
Health System
(Hanna) Department of Cardiology (N.H.), St. John Health System, Tulsa,
United States
(Comas) Department of Cardiothoracic Surgery (G.C.), St. John Health
System, Tulsa, United States
(Mahoney) Department of Cardiology (P.M.), Sentara Norfolk General
Hospital, VA
(Newton) Department of Cardiothoracic Surgery (J.N.), Sentara Norfolk
General Hospital, VA
(Buchbinder) Department of Cardiology (M.B.), Foundation for
Cardiovascular Medicine, San Diego, CA
(Moreno) Department of Cardiothoracic Surgery (R.M.), Foundation for
Cardiovascular Medicine, San Diego, CA
(Weissman, Garcia-Garcia) Department of Cardiology (G.W., MedStar
Washington Hospital Center, WA, Ghana
Publisher
NLM (Medline)
Abstract
BACKGROUND: The optimal antithrombotic regimen after transcatheter aortic
valve replacement remains unclear. METHOD(S): In this randomized
open-label study, low-risk patients undergoing transfemoral transcatheter
aortic valve replacement at 7 centers in the United States were randomized
1:1 to low-dose aspirin or warfarin plus low-dose aspirin for 30 days.
Patients who could not be randomized were enrolled in a separate registry.
Computed tomography or transesophageal echocardiography was performed at
30 days. The primary effectiveness end point was a composite of the
following at 30 days: hypoattenuated leaflet thickening, at least
moderately reduced leaflet motion, hemodynamic dysfunction (mean aortic
valve gradient >=20 mmHg, effective orifice area <=1.0 cm2, dimensionless
valve index <0.35, or moderate or severe aortic regurgitation), stroke, or
transient ischemic attack. RESULT(S): Between July 2018 and October
2019, 94 patients were randomly assigned, 50 to aspirin and 44 to warfarin
plus aspirin, and 30 were enrolled into the registry. In the
intention-to-treat analysis of the randomized cohort, the composite
primary effectiveness end point was met in 26.5% for aspirin versus 7.0%
for warfarin plus aspirin (P=0.014; odds ratio, 4.8 [95% CI, 1.3-18.3]).
The rate of hypoattenuated leaflet thickening was 16.3% for aspirin versus
4.7% for warfarin plus aspirin (P=0.07; odds ratio, 4.0 [95% CI,
0.8-20.0]). There was no excess bleeding at 30 days with anticoagulation.
In the as-treated analysis of pooled randomized and registry cohorts, the
rate of hypoattenuated leaflet thickening was 16.7% for aspirin versus
3.1% for warfarin plus aspirin (P=0.011; odds ratio, 6.3 [95% CI,
1.3-30.6]). CONCLUSION(S): In low-risk transcatheter aortic valve
replacement patients, anticoagulation with warfarin may prevent
transcatheter heart valve dysfunction in the short term without excess
bleeding. Registration: URL: https://www.clinicaltrials.gov. Unique
identifier: NCT03557242.

<10>
Accession Number
633190561
Title
Prevalence of ICU Delirium in Postoperative Pediatric Cardiac Surgery
Patients.
Source
Pediatric critical care medicine : a journal of the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies. 22 (1) (pp 68-78), 2021. Date of Publication: 01 Jan 2021.
Author
Staveski S.L.; Pickler R.H.; Khoury P.R.; Ollberding N.J.; Donnellan A.L.;
Mauney J.A.; Lincoln P.A.; Baird J.D.; Gilliland F.L.; Merritt A.D.;
Presnell L.B.; Lanese A.R.; Lisanti A.J.; Large B.J.; Fineman L.D.; Gibson
K.H.; Mohler L.A.; Callow L.; Barnes S.S.; Whalen R.L.; Grant M.J.C.;
Sheppard C.; Kline-Tilford A.M.; Steadman P.W.; Shafland H.C.; Corlett
K.M.; Kelly S.P.; Ortman L.A.; Peyton C.E.; Hagstrom S.K.; Shields A.M.;
Nye T.; Alvarez T.C.E.; Justice L.B.; Kidwell S.T.; Redington A.N.; Curley
M.A.Q.
Institution
(Staveski, Curley) University of California San Francisco, School of
Nursing, San Francisco, CA
(Pickler, Curley) The Ohio State University College of Nursing, Columbus,
OH
(Khoury, Donnellan, Justice, Kidwell, Curley) Cincinnati Children's
Hospital Medical Center, Heart Institute, Cincinnati, OH
(Ollberding, Curley) Division of Biostatistics and Epidemiology,
Cincinnati Children's Hospital Medical Center, Cincinnati, OH
(Mauney, Curley) Department of Pediatrics, Critical Care Baylor College of
Medicine, TX, Houston
(Lincoln, Curley) Cardiac Intensive Care Unit, Department of Nursing,
Boston Children's Hospital, MA, Boston
(Baird, Curley) Institute for Nursing and Interprofessional Research,
Children's Hospital Los Angeles, Los Angeles, CA
(Gilliland, Curley) Cardiovascular Intensive Care Unit, Department of
Nursing, John Hopkins All Children's Hospital, FL, St. Petersburg, United
States
(Merritt, Curley) Cardiac Intensive Care Unit, Department of Nursing,
Children's National Health Systems, DC, WA
(Presnell, Curley) Cardiovascular Intensive Care Unit, Department of
Nursing, Lucile Packard Children's Hospital, Palo Alto, CA
(Lanese, Curley) Department of Child Health Evaluative Sciences, Hospital
for Sick Children, ON, Toronto, Canada
(Lisanti, Curley) Cardiac Nursing, Department of Nursing, Children's
Hospital of Philadelphia, Philadelphia, United States
(Large, Curley) Division of Cardiovascular Intensive Care, Phoenix
Children's Hospital, AZ, Phoenix, United States
(Fineman, Curley) Pediatric Intensive Care Unit, Department of Nursing,
UCSF Benioff Children's Hospital, San Francisco, CA
(Gibson, Curley) Cardiac Intensive Care Unit, Department of Nursing,
Children's Healthcare of Atlanta, Atlanta, United States
(Mohler, Curley) Cardiovascular Intensive Care Unit, Department of
Nursing, Children's Hospital of Orange County, Orange, CA
(Callow, Curley) Pediatric Cardiac Surgery, Department of Nursing,
Congenital Heart Center, Mott Children's Hospital, MI, Ann Arbor, United
States
(Barnes, Curley) Department of Anesthesiology and Critical Care Medicine,
John Hopkins Hospital, MD, Baltimore, United States
(Whalen, Curley) Cardiac Care Center, Heart Program, Nicklaus Children's
Hospital, FL, Miami, United States
(Grant, Curley) Pediatric Critical Care Services, Primary Children's
Hospital, UT, Salt Lake City, United States
(Sheppard, Curley) Pediatric Pulmonary Hypertension, Stollery Children's
Hospital, AB, Edmonton, Canada
(Kline-Tilford, Curley) Cardiovascular Surgery, Children's Hospital of
Michigan, MI, Detroit, United States
(Steadman, Curley) Cardiac Care Unit, Ann & Robert H. Lurie Children's
Hospital of Chicago, Chicago, Mexico
(Shafland, Curley) Cardiovascular Intensive Care Unit, Department of
Nursing, Children's Minnesota, MN, Minneapolis, United States
(Corlett, Curley) Cardiac Intensive Care Unit, Department of Nursing,
Seattle Children's Hospital, Seattle, WA
(Kelly, Curley) Pediatric Critical Care, Department of Nursing,
Doernbecher Children's Hospital, OR, Portland, Jamaica
(Ortman, Curley) Division of Critical Care, Department of Pediatrics,
Omaha Children's Hospital and Medical Center, Omaha, NE
(Peyton, Curley) Department of Nursing, Children's Hospital Heart
Institute, Children's Hospital Colorado, CO, Aurora, United States
(Hagstrom, Curley) Pediatric Critical Care, Department of Nursing,
University of Minnesota Masonic Children's Hospital, MN, Minneapolis,
United States
(Shields, Curley) Cardiac Intensive Care, Department of Nursing, UPMC
Children's Hospital of Pittsburgh, Pittsburgh, United States
(Nye, Curley) Department of Nursing, Advocate Children's Hospital, Oak
Lawn, United States
(Alvarez, Curley) Research in Patient Services, Department of Nursing,
Cincinnati Children's Hospital Medical Center, Cincinnati, OH
(Redington, Curley) Cardiology Clinic, Cincinnati Children's Hospital
Medical Center, Cincinnati, OH
(Curley) Family and Community Health, Department of Nursing, University of
Pennsylvania School of Nursing, Philadelphia, United States
(Curley) Anesthesia and Critical Care Medicine, Perelman School of
Medicine, University of Pennsylvania, Philadelphia, United States
(Curley) Research Institute, Children's Hospital of Philadelphia,
Philadelphia, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The objective of this study was to determine the prevalence of
ICU delirium in children less than 18 years old that underwent cardiac
surgery within the last 30 days. The secondary aim of the study was to
identify risk factors associated with ICU delirium in postoperative
pediatric cardiac surgical patients. DESIGN: A 1-day, multicenter
point-prevalence study of delirium in pediatric postoperative cardiac
surgery patients. SETTING: Twenty-seven pediatric cardiac and general
critical care units caring for postoperative pediatric cardiac surgery
patients in North America. PATIENTS: All children less than 18 years old
hospitalized in the cardiac critical care units at 06:00 on a randomly
selected, study day. INTERVENTIONS: Eligible children were screened for
delirium using the Cornell Assessment of Pediatric Delirium by the study
team in collaboration with the bedside nurse. MEASUREMENT AND MAIN
RESULTS: Overall, 181 patients were enrolled and 40% (n = 73) screened
positive for delirium. There were no statistically significant differences
in patient demographic information, severity of defect or surgical
procedure, past medical history, or postoperative day between patients
screening positive or negative for delirium. Our bivariate analysis found
those patients screening positive had a longer duration of mechanical
ventilation (12.8 vs 5.1 d; p = 0.02); required more vasoactive support
(55% vs 26%; p = 0.0009); and had a higher number of invasive catheters (4
vs 3 catheters; p = 0.001). Delirium-positive patients received more total
opioid exposure (1.80 vs 0.36 mg/kg/d of morphine equivalents; p < 0.001),
did not have an ambulation or physical therapy schedule (p = 0.02), had
not been out of bed in the previous 24 hours (p < 0.0002), and parents
were not at the bedside at time of data collection (p = 0.008). In the
mixed-effects logistic regression analysis of modifiable risk factors, the
following variables were associated with a positive delirium screen: 1)
pain score, per point increase (odds ratio, 1.3; 1.06-1.60); 2) total
opioid exposure, per mg/kg/d increase (odds ratio, 1.35; 1.06-1.73); 3)
SBS less than 0 (odds ratio, 4.01; 1.21-13.27); 4) pain medication or
sedative administered in the previous 4 hours (odds ratio, 3.49;
1.32-9.28); 5) no progressive physical therapy or ambulation schedule in
their medical record (odds ratio, 4.40; 1.41-13.68); and 6) parents not at
bedside at time of data collection (odds ratio, 2.31; 1.01-5.31).
 CONCLUSION(S): We found delirium to be a common problem after cardiac
surgery with several important modifiable risk factors. Copyright
© 2020 by the Society of Critical Care Medicine and the World
Federation of Pediatric Intensive and Critical Care Societies.

<11>
Accession Number
633182329
Title
Closure of Iatrogenic Atrial Septal Defect After Transcatheter Mitral
Valve Repair: The Randomized MITHRAS Trial.
Source
Circulation. 143 (3) (pp 292-294), 2021. Date of Publication: 19 Jan 2021.
Author
Lurz P.; Unterhuber M.; Rommel K.-P.; Kresoja K.-P.; Kister T.; Besler C.;
Fengler K.; Sandri M.; Daehnert I.; Thiele H.; von Roeder M.; Blazek S.
Institution
(Lurz, Unterhuber, Rommel, Kresoja, Kister, Besler, Fengler, Sandri,
Thiele, von Roeder, Blazek) Department of Internal Medicine/Cardiology
(P.L., M.U., K.-P.K., T.K., C.B., M.S., H.T., Heart Center Leipzig at
Leipzig University, Germany
(Lurz, Thiele) Leipzig Heart Institute, Germany (P.L.
(Daehnert) Department of Pediatric Cardiology (I.D.), Heart Center Leipzig
at Leipzig University, Germany
Publisher
NLM (Medline)

<12>
Accession Number
634061522
Title
Comparison of Reusable Models in Pericardiocentesis Simulation Training.
Source
Annals of the Academy of Medicine, Singapore. 49 (12) (pp 971-977), 2020.
Date of Publication: 01 Dec 2020.
Author
Lin Z.; Soh C.H.W.; Chua M.T.; Lin J.; Ho C.J.Y.; Lee J.Y.H.; Shen F.Y.T.;
Yau Y.W.; Kuan W.S.
Institution
(Lin) Emergency Medicine Department, National University Hospital,
National University Health System, Singapore
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Pericardiocentesis is a potentially life-saving procedure.
We compared two low-cost models-an agar-based model and a novel model,
Centesys-in terms of ultrasound image quality and realism, effectiveness
of the model, and learners' confidence and satisfaction after training.
 METHOD(S): In this pilot randomised 2x2 crossover trial stratified by
physician seniority, participants were assigned to undergo
pericardiocentesis training either with the agar-based or Centesys model
first, followed by the other model. Participants were asked to rate their
confidence in performing ultrasound-guided pericardiocentesis, clarity and
realism of cardiac structures on ultrasound imaging, and satisfaction on a
7-point Likert scale before and after training with each model.
 RESULT(S): Twenty participants with median postgraduate year of 4
(interquartile range [IQR] 3.75-6) years were recruited. Pre-training,
participants rated themselves a median score of 2.5 (IQR 2-4) for level of
confidence in performing pericardiocentesis, which improved to 5 (IQR 4-6)
post-training with Centesys (P=0.007). Centesys was recognised to be more
realistic in simulating cardiac anatomy on ultrasound (median 5 [IQR 4-5]
versus 3.5 [IQR 3-4], P=0.002) than the agar-based model. There was
greater satisfaction with Centesys (median 5 [IQR 5-6] versus 4 [IQR
3.75-4], P<0.001). All 20 participants achieved successful insertion of a
pericardial drain into the simulated pericardial sac with Centesys.
 CONCLUSION(S): Centesys achieved greater learner satisfaction as
compared to the agar-based model, and was an effective tool for teaching
ultrasound-guided pericardiocentesis and drain insertion.

<13>
Accession Number
2010588402
Title
Right sided infective endocarditis: About 13 cases, review of literature.
Source
Archives of Cardiovascular Diseases Supplements. Conference: Les 31emes
Journees Europeennes de la Societe Francaise de Cardiologie. 13 (1) (pp
82), 2021. Date of Publication: January 2021.
Author
Ouechtati ben Attia W.; Allouche E.; Elarbi M.; Bejar M.; Alayech F.; Ben
Ahmed H.; Bezdah L.
Institution
(Ouechtati ben Attia, Allouche, Elarbi, Bejar, Alayech, Ben Ahmed, Bezdah)
Cardiologie, hopital Charles Nicolle Tunis, Tunis, Tunisia
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: The right sided infective endocarditis is a rare disease, it
represents 5- 10% of the total number of Infective endocarditis events,
mainly occurring in patients with congenital heart disease, patients
carrying intravascular catheters or intracardiac devices, and it's
frequently seen in injection drug users. The care of these patients is a
medical and surgical challenge. Method(s): We report 13 cases of
right sided infective endocarditis. Result(s): Our patients were
seven female, six men with an age ranging between 23 and 68 years. They
all had a predisposing factor: pacemaker, venous catheter, recent cardiac
surgery and drug abuse. Blood cultures were positive in 10 cases, with the
identification of Staphylococcus aureus in 7 patients. Cardiac ultrasound
was the key examination to display vegetations and quantify tricuspid
regurgitation. Treatment was given according to international
recommendations, and was based primarily on a bi-bactericidal antibiotic
therapy adapted to the isolated germ; surgical treatment was proposed in
three cases with favorable evolution in two patients. There was a two case
of death resulting from septic shock. One in the following of cardiac
surgery and the other occurred early and did not respond to medical
treatment. The outcome was favorable for the other cases.
 Conclusion(s): Although rare, tricuspid endocarditis is not
exceptional and occurs in a context that favors. The operative indication
is rarely hemodynamic, but rather infectious to eradicate an antibiotic
resistant focus. Overall prognosis of remains better than the left
side. Copyright © 2020

<14>
Accession Number
2010742236
Title
Utilities and placement skills of the incision protective sleeve in
video-assisted thoracoscopic surgery (VATS).
Source
Journal of Thoracic Disease. 12 (12) (pp 7272-7280), 2020. Date of
Publication: December 2020.
Author
Su Z.; Wu C.; Bian H.; Zhou Z.; Jiang T.; Zhao X.; Liu F.; Zhang Y.; Lin
K.; Gao Q.
Institution
(Su, Bian, Zhou, Jiang, Zhao, Liu, Zhang, Lin, Gao) Department of Thoracic
Surgery, Chifeng University Affiliated Hospital, Chifeng, China
(Wu) Department of Obstetrics and Gynecology, Chifeng University
Affiliated Hospital, Chifeng, China
Publisher
AME Publishing Company
Abstract
Background: The incision protective sleeve can protect incisions and help
to establish an operating port and thus has been widely applied in
thoracic surgeries. However, its other utilities are often neglected. This
article explores the additional functions and placement techniques of
incision protective sleeves in video-assisted transthoracic surgery
(VATS). Method(s): Operators with different surgical experience were
divided into three groups: resident group, attending surgeon group, and
professor group. Each group independently chose one of the four surgical
maneuvers, and the incision protective sleeve was placed during the
operation. Up to 200 operations were randomly selected in each group, and
the patients' gender, age, incision site, incision length, the operator's
experience, and the time and technique of incision protective sleeve
placement were recorded. CT was performed to measure the thickness of
chest wall and the width of intercostal spaces. Data were analyzed using
SPSS 21.0 software package. Multivariate linear regression analysis was
performed was performed for the time required for incision protective
sleeve placement. Result(s): The operator's experience was inversely
related to the time required for incision protective sleeve placement,
width of intercostal spaces was negatively correlated with operative time,
chest wall thickness and incision length were positively correlated with
operative time. Among the maneuvers, incision protective sleeve placement
skills were significant different. Conclusion(s): The placement of
the incision protective sleeve for VATS is affected by multiple factors,
which are not only related to the patient's condition, chest wall
thickness and intercostal space, but also closely related to the
operator's experience and the manipulation adopted. Copyright ©
Journal of Thoracic Disease. All rights reserved.

<15>
Accession Number
634050241
Title
From pathogenesis to treatment, a systemic review of cardiac lipoma.
Source
Journal of cardiothoracic surgery. 16 (1) (pp 1), 2021. Date of
Publication: 06 Jan 2021.
Author
Shu S.; Wang J.; Zheng C.
Institution
(Shu, Wang) Department of Radiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Techonolgy, Hubei Province,
No.1277 Jiefang Avenue, Wuhan 430022, China
(Shu, Wang) Hubei Province Key Laboratory of Molecular Imaging, Wuhan,
China
(Zheng) Department of Radiology, Union Hospital, Tongji Medical College,
Huazhong University of Science and Techonolgy, Hubei Province, No.1277
Jiefang Avenue, Wuhan 430022, China
(Zheng) Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Publisher
NLM (Medline)
Abstract
Cardiac lipoma is an uncommon primary cardiac tumor. With the advancement
of diagnostic methods and treatment techniques, more cases of cardiac
lipomas have been reported and suggest that the entity previously widely
thought to display classic features may also show atypical findings. A
systemic review of the rare cardiac tumor was done by searching the
literature of cardiac lipoma. We endeavor to summarize the clinical
features of the rare disease from pathogenesis to treatment. Literature of
cardiac lipoma was retrospectively searched through PubMed and 255 cases
of cardiac lipoma were included into this analysis. Cardiac lipomas can
occur anywhere within the heart, 53.1% were located within the cardiac
chambers, 32.5% in the pericardium, 10,7% within the myocardium and 3.7%
involved multiple structures. More than half of the reported cardiac
lipomas (66%) may be clinically symptomatic, presenting with symptoms
ranging from chest discomfort to syncope depending on their size and
location as well as extent of myocardial involvement. Noninvasive cardiac
imaging has replaced the role of autopsy and cardiothoracic surgery in
detection and diagnosis of cardiac lipomas. Most symptomatic patients
(83.7%) were treated by resection of cardiac lipomas and 68.3% of
asymptomatic patients also underwentprophylactic resection. Overgrowth and
myocardial infiltration of lipomas may result in unsuccessful resection.
Recurrence of cardiac lipomas was rare but reported in a few cases. The
early detection and accurate diagnosis of cardiac lipoma is of great
significance in clinical management, to avoid an unfavourable outcome due
to overgrowth.

<16>
Accession Number
634054216
Title
Early Aspirin Discontinuation After Coronary Stenting: A Systematic Review
and Meta-Analysis.
Source
Journal of the American Heart Association. 10 (2) (pp e018304), 2021. Date
of Publication: 19 Jan 2021.
Author
Wiebe J.; Ndrepepa G.; Kufner S.; Lahmann A.L.; Xhepa E.; Kuna C.; Voll
F.; Gosetti R.; Laugwitz K.-L.; Joner M.; Kastrati A.; Cassese S.
Institution
(Wiebe, Ndrepepa, Kufner, Lahmann, Xhepa, Kuna, Voll, Joner, Kastrati,
Cassese) Klinik fur Herz- und Kreislauferkrankungen Deutsches Herzzentrum
MunchenTechnische Universitat Munchen Munich Germany
(Gosetti, Laugwitz) 1. Medizinische Klinik Klinikum rechts der
IsarTechnische Universitat Munchen Munich Germany
(Laugwitz, Joner, Kastrati) DZHK (German Centre for Cardiovascular
Research), partner site Munich Heart Alliance Munich Germany
Publisher
NLM (Medline)
Abstract
Background The clinical impact of early aspirin discontinuation compared
with dual antiplatelet therapy (DAPT) in patients undergoing percutaneous
coronary intervention with stenting remains poorly studied. We
investigated the clinical outcomes of patients assigned to either early
aspirin discontinuation or DAPT after percutaneous coronary intervention
with stenting. Methods and Results We performed a meta-analysis of
aggregate data from randomized clinical trials enrolling participants
receiving a percutaneous coronary intervention with stenting and assigned
to either early aspirin discontinuation or DAPT. Scientific databases were
searched from inception through March 30, 2020. Trial-level hazard ratios
(HRs) and 95% CIs were pooled using a random effects model with inverse
variance weighting. The primary outcome was all-cause death. Secondary
outcomes were myocardial infarction, stent thrombosis, stroke, and major
bleeding. Overall, 36 206 participants were allocated to either early
aspirin discontinuation (experimental therapy, n=18 088) or DAPT (control
therapy, n=18 118) in 7 trials. Median follow-up was 12 months. All-cause
death occurred in 2.5% of patients assigned to experimental and 2.9% of
patients assigned control therapy (hazard ratio [HR], 0.91, 95% CI,
0.75-1.11; P=0.37). Overall, patients treated with experimental versus
control therapy showed no significant difference in terms of myocardial
infarction (HR, 1.02 [0.85-1.22], P=0.81), stent thrombosis (HR, 1.02
[0.87-1.20], P=0.83), or stroke (HR, 1.01 [0.68-1.49], P=0.96). However,
the risk for major bleeding (HR, 0.58 [0.43-0.77], P<0.01) was
significantly reduced by experimental as compared with control therapy.
Conclusions In patients treated with percutaneous coronary intervention
and stenting, assigned to a strategy of early aspirin discontinuation
versus DAPT, the risk of death and ischemic events is not significantly
different but the risk of bleeding is lower.

<17>
Accession Number
2010691139
Title
Remote Ischemic Preconditioning in Non-cardiac Surgery: A Systematic
Review and Meta-analysis.
Source
Journal of Surgical Research. 261 (pp 261-273), 2021. Date of Publication:
May 2021.
Author
Lamidi S.; Baker D.M.; Wilson M.J.; Lee M.J.
Institution
(Lamidi) The Medical School, University of Sheffield, Sheffield, United
Kingdom
(Baker, Lee) Academic Directorate of General Surgery, Sheffield Teaching
Hospitals NHS FT, Sheffield, United Kingdom
(Wilson) School of Health and Related Research, University of Sheffield,
Sheffield, United Kingdom
(Lee) Department of Oncology and Metabolism, The Medical School,
University of Sheffield, Sheffield, United Kingdom
Publisher
Academic Press Inc.
Abstract
Background: Remote ischemic preconditioning (RIPC) may mitigate
physiological stress related to surgery. There is no clear consensus on
conduct of RIPC studies, or whether it is effective. The aim of this study
was to (i) assess delivery of RIPC, (ii) identify reported outcomes, (iii)
measure effect on key clinical outcomes. Method(s): This review was
registered on PROSPERO (CRD:42020180725). EMBASE and Medline databases
were searched, and results screened by two reviewers. Full-texts were
assessed for eligibility by two reviewers. Data extracted were methods of
RIPC and outcomes reported. Meta-analysis of key clinical events was
performed using a Mantel-Haenszel random effects model. The TIDieR
framework was used to assess intervention reporting, and Cochrane risk of
bias tool was used for all studies included. Result(s): Searches
identified 25 studies; 25 were included in the narrative analysis and 18
in the meta-analysis. RIPC was frequently performed by occluding arm
circulation (15/25), at 200 mmHg (9/25), with three cycles of 5 min
ischemia and 5 min of reperfusion (16/25). No study fulfilled all 12
TIDieR items (mean score 7.68). Meta-analysis showed no benefit of RIPC on
MI (OR 0.71 95% CI 0.48-1.04, I2 = 0%), mortality (OR 0.56, 95% CI
0.31-1.01, I2 = 0%), or acute kidney injury (OR 0.72 95% CI 0.48-1.08).
 Conclusion(s): RIPC could be standardized as 200 mmHg pressure in 3 x
5 min on and off cycles. The signal of benefit should be explored in a
larger well-designed randomized trial. Copyright © 2020 Elsevier
Inc.

<18>
Accession Number
634037897
Title
Postneoadjuvant surveillance and surgery as needed compared with
postneoadjuvant surgery on principle in multimodal treatment for
oesophageal cancer: A scoping review protocol.
Source
BMJ Open. 11 (1) (no pagination), 2021. Article Number: e044190. Date of
Publication: 28 Jan 2021.
Author
Schmucker C.; Nagavci B.; Hipp J.; Schmoor C.; Meerpohl J.; Hoeppner J.
Institution
(Schmucker, Nagavci, Meerpohl) Institute for Evidence in Medicine (for
Cochrane Germany Foundation), Medical Center - University of Freiburg,
Faculty of Medicine, University of Freiburg, Freiburg, Baden-Wurttemberg,
Germany
(Hipp, Hoeppner) Center for Surgery, Department of General and Visceral
Surgery, Medical Center, University of Freiburg, Faculty of Medicine,
University of Freiburg, Freiburg, Baden-Wurttemberg, Germany
(Schmoor) Clinical Trials Unit, Medical Center - University of Freiburg,
Faculty of Medicine, University of Freiburg, Freiburg im Breisgau,
Baden-Wurttemberg, Germany
(Meerpohl) Cochrane Germany, Cochrane Germany Foundation, Freiburg,
Germany
(Hoeppner) Department of Surgery, University Medical Center
Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
Publisher
BMJ Publishing Group
Abstract
Introduction In current medical practice of curative treatment for
non-metastatic oesophageal cancer, surgery on principle is carried out by
oesophagectomy after neoadjuvant treatment. However, oesophagectomy is
often associated with postoperative morbidity and mortality. Taking into
account that modern neoadjuvant therapy is effective and many of patients
show no vital tumour cells in the operative specimens, we aim to perform a
scoping review as part of the development phase for a prospectively
planned multicentre randomised controlled trial investigating 'surgery as
needed vs surgery on principle in patients with postneoadjuvant complete
response of oesophageal cancer' (Prospective trial registration number
DRKS00022801). This scoping approach will allow us to finally define
and/or adapt the research question including the design and methodology of
the randomised controlled trial taking into account the findings for
example, research gaps and/or pitfalls in the currently available study
pool addressing this or very similar questions. Methods and analysis To
identify relevant research, we will conduct searches in the electronic
databases Medline, Web of Science Core Collection, Cochrane Library and
Science Direct. We will also check references of relevant studies and
perform a cited reference research (forward citation tracking). Titles and
abstracts of the records identified by the searches will be screened and
full texts of all potentially relevant articles will be obtained. We will
consider randomised trials and non-randomised controlled studies. Data
extraction tables will be set up, including study and patients'
characteristics, aim of study and reported outcomes. We will summarise the
data using tables and figures (eg, bubble plots) to present the research
landscape and to describe potential clusters and/or gaps to support the
planning of a randomised trial in this patient population. Ethics and
dissemination Ethical approval is not required for this scoping review.
Study findings will be shared by publication in a peer-reviewed journal
and by presentation to key stakeholders on scientific meetings.
 Copyright © Author(s) (or their employer(s)) 2021. Re-use
permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<19>
Accession Number
2010317931
Title
High-dose vitamin D versus placebo to prevent complications in COVID-19
patients: A structured summary of a study protocol for a randomised
controlled trial (CARED-TRIAL).
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 111. Date of
Publication: December 2021.
Author
Mariani J.; Tajer C.; Antonietti L.; Inserra F.; Ferder L.; Manucha W.
Institution
(Mariani, Tajer, Antonietti) Hospital de Alta Complejidad en Red El Cruce
- Nestor Kirchner, Florencio Varela, Buenos Aires, Argentina
(Mariani, Tajer, Antonietti) Universidad Nacional Arturo Jauretche,
Florencio Varela, Buenos Aires, Argentina
(Inserra, Ferder) Maimonides University, Ciudad Autonoma de Buenos Aires,
Argentina
(Manucha) Consejo Nacional de Investigaciones Cientificas y Tecnicas,
Universidad Nacional de Cuyo, Instituto de Medicina y Biologia
Experimental de Cuyo (IMBECU), Mendoza, Argentina
Publisher
BioMed Central Ltd
Abstract
Objectives: To evaluate whether a single high dose of oral cholecalciferol
improves the respiratory outcomes as compared with placebo among adults
COVID-19 patients at moderate risk of clinical complications. Trial
design: The CARED trial is an investigator-initiated, multicentre,
randomized, parallel, two-arm, sequential, double-blind and
placebo-controlled clinical trial. It was planned as a pragmatic trial
since the inclusion criteria are broad and the study procedures are as
simple as possible, in order to be implemented in the routine clinical
practice in general wards in the pandemic setting and a middle-income
country context. The sequential design involves two stages. The first
stage will assess the effects of vitamin D supplementation on blood
oxygenation (physiological effects). The second stage will assess the
effects on clinical outcomes. Participant(s): Participants of either
gender admitted to general adult wards in 21 hospital sites located in
four provinces of Argentina are invited to participate in the study if
they meet the following inclusion criteria and none of the exclusion
criteria: Inclusion criteriaSARS-CoV-2 confirmed infection by
RT-PCR;Hospital admission at least 24 hours before;Expected
hospitalization in the same site >=24 hours;Oxygen saturation >=90%
(measured by pulse oximetry) breathing ambient air;Age >=45 years or at
least one of the following conditions: Hypertension; Diabetes; At least
moderate COPD or asthma; Cardiovascular disease (history of myocardial
infarction, percutaneous transluminal coronary angioplasty, coronary
artery bypass grafting or valve replacement surgery); Body mass index
>=30;Willingness to sign informed consent (online supplementary material 1
and 2). Exclusion criteria:Age <18 years;Women in childbearing age;>= 72
hs since current admission;Requirement for a high dose of oxygen (>5
litres/minute) or mechanical ventilation (non-invasive or
invasive);History of chronic kidney disease requiring haemodialysis or
chronic liver failure;Inability for oral intake.Chronic supplementation
with pharmacological vitamin D;Current treatment with
anticonvulsants;History of: Sarcoidosis; Malabsorption syndrome; Known
hypercalcemia or serum calcium >10.5 mg/dL;Life expectancy <6 months;Known
allergy to study medication;Any condition at discretion of investigator
impeding to understand the study and give informed consent. Intervention
and comparator: The intervention consists in a single oral dose of 500.000
IU of commercially available cholecalciferol soft gel capsules (5 capsules
of 100.000 IU) or matching placebo Main outcomes: The primary outcome for
the first stage is the change in the respiratory Sepsis-related Organ
Failure Assessment (SOFAr) score between pre-treatment value and the worst
value recorded during the first 7 seven days of hospitalization, the death
or discharge, whichever occurs first. The SOFAr score measured as the
ratio between the pulse oximetry saturation (SpO<inf>2</inf>) and
FiO<inf>2</inf> (27, 28) is used instead of the arterial partial pressure
of oxygen (PaO<inf>2</inf>). SOFAr score is a 4-points scale, with higher
values indicating deeper respiratory derangement as follows: 1
PaO<inf>2</inf> <400; 2 PaO<inf>2</inf> <300; 3 PaO<inf>2</inf> <200; 4
PaO<inf>2</inf> <100. The primary outcome for the second stage is the
combined occurrence of requirement >=40% of FiO<inf>2</inf>, invasive or
non-invasive ventilation, up to 30 days or hospital discharge.
Randomisation: A computer-generated random sequence and the treatment
assignment is performed through the web-based randomization module
available in the electronic data capture system (Castor). A randomization
ratio 1:1, stratified and with permuted blocks was used. Stratification
variables were diabetes (yes/no), age (<=60/>60 years) and the site.
Blinding (masking): Double-blind was achieved by using placebo soft gel
capsules with the same organoleptic properties as the active medication.
Central management of the medication is carried out by a pharmacist in
charge of packaging the study drug in unblinded fashion, who have no
contact with on-site investigators. Medication is packaged in opaque white
bottles, each containing five soft gel capsules of the active drug or
matching placebo, corresponding to complete individual treatment.
Treatment codes are kept under the pharmacist responsibility, and all
researchers are unaware of them. Numbers to be randomised (sample size):
The first stage is planned to include 200 patients (100 per group), the
second stage is planned to include 1064 additional patients. The total
sample size is 1264 patients. Trial Status: Currently the protocol version
is the number 1.4 (from October 13th, 2020). The recruitment is
ongoing since August 11th, 2020, and the first subject was enrolled on
August 14th. Since then, 21 sites located in four provinces of Argentina
were initiated, and 167 patients were recruited by January
11th, 2021. We anticipate to finish the recruitment for the
first stage in mid-February, 2021, and in August, 2021 for the second
stage. Trial registration: The study protocol is registered in
ClinicalTrials.gov (identifier number NCT04411446) on June 2, 2020. Full
protocol: The full protocol is attached as an additional file, accessible
from the Trials website (Additional file 1). In the interest in expediting
dissemination of this material, the familiar formatting has been
eliminated; this Letter serves as a summary of the key elements of the
full protocol. The study protocol has been reported in accordance with the
Standard Protocol Items: Recommendations for Clinical Interventional
Trials (SPIRIT) guidelines (Additional file 2). Copyright © 2021,
The Author(s).

<20>
Accession Number
2010851713
Title
Progression of Tricuspid Regurgitation After Surgery for Ischemic Mitral
Regurgitation.
Source
Journal of the American College of Cardiology. 77 (6) (pp 713-724), 2021.
Date of Publication: 16 Feb 2021.
Author
Bertrand P.B.; Overbey J.R.; Zeng X.; Levine R.A.; Ailawadi G.; Acker
M.A.; Smith P.K.; Thourani V.H.; Bagiella E.; Miller M.A.; Gupta L.; Mack
M.J.; Gillinov A.M.; Giustino G.; Moskowitz A.J.; Gelijns A.C.; Bowdish
M.E.; O'Gara P.T.; Gammie J.S.; Hung J.; Taddei-Peters W.C.; Buxton D.;
Caulder R.; Geller N.L.; Gordon D.; Jeffries N.O.; Lee A.; Moy C.S.;
Gombos I.K.; Ralph J.; Weisel R.D.; Gardner T.J.; Rose E.A.; Parides M.K.;
Ascheim D.D.; Moquete E.; Chang H.; Chase M.; Foo J.; Chen Y.; Goldfarb
S.; Kirkwood K.; Dobrev E.; Levitan R.; O'Sullivan K.; Overbey J.; Santos
M.; Williams D.; Weglinski M.; Williams P.; Wood C.; Ye X.; Nielsen S.L.;
Wiggers H.; Malgaard H.; Mack M.; Adame T.; Settele N.; Adams J.; Ryan W.;
Smith R.L.; Grayburn P.; Chen F.Y.; Nohria A.; Cohn L.; Shekar P.; Aranki
S.; Couper G.; Davidson M.; Bolman R.M.; Burgess A.; Conboy D.; Lawrence
R.; Noiseux N.; Stevens L.-M.; Prieto I.; Basile F.; Dionne J.; Fecteau
J.; Blackstone E.H.; Lackner P.; Berroteran L.; Dolney D.; Fleming S.;
Palumbo R.; Whitman C.; Sankovic K.; Sweeney D.K.; Geither C.; Doud K.;
Pattakos G.; Clarke P.A.; Argenziano M.; Williams M.; Goldsmith L.; Smith
C.R.; Naka Y.; Stewart A.; Schwartz A.; Bell D.; Van Patten D.; Sreekanth
S.; Alexander J.H.; Milano C.A.; Glower D.D.; Mathew J.P.; Harrison J.K.;
Welsh S.; Berry M.F.; Parsa C.J.; Tong B.C.; Williams J.B.; Ferguson T.B.;
Kypson A.P.; Rodriguez E.; Harris M.; Akers B.; O'Neal A.; Puskas J.D.;
Guyton R.; Baer J.; Baio K.; Neill A.A.; Voisine P.; Senechal M.; Dagenais
F.; O'Connor K.; Dussault G.; Ballivian T.; Keilani S.; Speir A.M.; Magee
P.; Ad N.; Keyte S.; Dang M.; Slaughter M.; Headlee M.; Moody H.; Solankhi
N.; Birks E.; Groh M.A.; Shell L.E.; Shepard S.A.; Trichon B.H.; Nanney
T.; Hampton L.C.; Mangusan R.; Michler R.E.; D'Alessandro D.A.; DeRose
J.J.; Goldstein D.J.; Bello R.; Jakobleff W.; Garcia M.; Taub C.; Spevak
D.; Swayze R.; Sookraj N.; Perrault L.P.; Basmadjian A.-J.; Bouchard D.;
Carrier M.; Cartier R.; Pellerin M.; Tanguay J.F.; El-Hamamsy I.; Denault
A.; Demers P.; Jonathan Lacharite S.R.; Horvath K.A.; Corcoran P.C.;
Siegenthaler M.P.; Murphy M.; Iraola M.; Greenberg A.; Sai-Sudhakar C.;
Hasan A.; McDavid A.; Kinn B.; Page P.; Sirois C.; Latter D.; Leong-Poi
H.; Bonneau D.; Errett L.; Peterson M.D.; Verma S.; Feder-Elituv R.; Cohen
G.; Joyner C.; Fremes S.E.; Moussa F.; Christakis G.; Karkhanis R.; Yau
T.; Farkouh M.; Woo A.; Cusimano R.J.; David T.; Feindel C.; Garrard L.;
Fredericks S.; Mociornita A.; Mullen J.C.; Choy J.; Meyer S.; Kuurstra E.;
Young C.A.; Beach D.; Villanueva R.; Atluri P.; Woo Y.J.; Mayer M.L.;
Bowdish M.; Starnes V.A.; Shavalle D.; Matthews R.; Javadifar S.; Romar
L.; Kron I.L.; Johnston K.; Dent J.M.; Kern J.; Keim J.; Burks S.; Gahring
K.; Bull D.A.; Desvigne-Nickens P.; Dixon D.O.; Haigney M.; Holubkov R.;
Jacobs A.; Miller F.; Murkin J.M.; Spertus J.; Wechsler A.S.; Sellke F.;
McDonald C.L.; Byington R.; Dickert N.; Ikonomidis J.S.; Williams D.O.;
Yancy C.W.; Fang J.C.; Giannetti N.; Richenbacher W.; Rao V.; Furie K.L.;
Miller R.; Pinney S.; Roberts W.C.; Walsh M.N.; Kilcullen N.; Hung D.;
Keteyian S.J.; Brawner C.A.; Aldred H.; Browndyke J.; Toulgoat-Dubois Y.
Institution
(Bertrand, Zeng, Levine, Hung) Division of Cardiology, Massachusetts
General Hospital, Boston, MA, United States
(Overbey, Bagiella, Gupta, Giustino, Moskowitz, Gelijns) Department of
Population Health Science and Policy, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Ailawadi) Section of Adult Cardiac Surgery, University of Virginia,
Charlottesville, VA, United States
(Acker) Division of Cardiovascular Surgery, Department of Surgery,
University of Pennsylvania School of Medicine, Philadelphia, PA, United
States
(Smith) Department of Surgery, Duke University Medical Center, Durham, NC,
United States
(Thourani) Cardiothoracic Surgery, Piedmont Heart Institute, Atlanta, GA,
United States
(Miller) Division of Cardiovascular Sciences, National Heart, Lung, and
Blood Institute, National Institutes of Health, Bethesda, MD, United
States
(Mack) Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott &
White Health, Plano, TX, United States
(Gillinov) Department of Thoracic & Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Bowdish) Department of Surgery, Keck School of Medicine, University of
Southern California, Los Angeles, CA, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
MA, United States
(Gammie) Division of Cardiac Surgery, University of Maryland School of
Medicine, Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
Background: Whether to repair nonsevere tricuspid regurgitation (TR)
during surgery for ischemic mitral valve regurgitation (IMR) remains
uncertain. Objective(s): The goal of this study was to investigate
the incidence, predictors, and clinical significance of TR progression and
presence of >=moderate TR after IMR surgery. Method(s): Patients (n =
492) with untreated nonsevere TR within 2 prospectively randomized IMR
trials were included. Key outcomes were TR progression (either progression
by >=2 grades, surgery for TR, or severe TR at 2 years) and presence of
>=moderate TR at 2 years. Result(s): Patients' mean age was 66 +/- 10
years (67% male), and TR distribution was 60% <=trace, 31% mild, and 9%
moderate. Among 2-year survivors, TR progression occurred in 20 (6%) of
325 patients. Baseline tricuspid annular diameter (TAD) was not predictive
of TR progression. At 2 years, 37 (11%) of 323 patients had >=moderate TR.
Baseline TR grade, indexed TAD, and surgical ablation for atrial
fibrillation were independent predictors of >=moderate TR. However, TAD
alone had poor discrimination (area under the curve, <=0.65). Presence of
>=moderate TR at 2 years was higher in patients with MR recurrence (20%
vs. 9%; p = 0.02) and a permanent pacemaker/defibrillator (19% vs. 9%; p =
0.01). Clinical event rates (composite of >=1 New York Heart Association
functional class increase, heart failure hospitalization, mitral valve
surgery, and stroke) were higher in patients with TR progression (55% vs.
23%; p = 0.003) and >=moderate TR at 2 years (38% vs. 22%; p = 0.04).
 Conclusion(s): After IMR surgery, progression of unrepaired nonsevere
TR is uncommon. Baseline TAD is not predictive of TR progression and is
poorly discriminative of >=moderate TR at 2 years. TR progression and
presence of >=moderate TR are associated with clinical events. (Comparing
the Effectiveness of a Mitral Valve Repair Procedure in Combination With
Coronary Artery Bypass Grafting [CABG] Versus CABG Alone in People With
Moderate Ischemic Mitral Regurgitation, NCT00806988; Comparing the
Effectiveness of Repairing Versus Replacing the Heart's Mitral Valve in
People With Severe Chronic Ischemic Mitral Regurgitation,
NCT00807040) Copyright © 2021 American College of Cardiology
Foundation

<21>
Accession Number
2010726954
Title
Complete revascularization reduces cardiovascular death in patients with
ST-segment elevation myocardial infarction and multivessel disease:
Systematic review and meta-analysis of randomized clinical trials.
Source
European Heart Journal. 41 (42) (pp 4103-4110), 2020. Date of Publication:
07 Nov 2020.
Author
Pavasini R.; Biscaglia S.; Barbato E.; Tebaldi M.; Dudek D.; Escaned J.;
Casella G.; Santarelli A.; Guiducci V.; Gutierrez-Ibanes E.; Di Pasquale
G.; Politi L.; Saglietto A.; D'Ascenzo F.; Campo G.
Institution
(Pavasini, Biscaglia, Tebaldi, Campo) Cardiovascular Institute, Azienda
Ospedaliero Universitaria di Ferrara, Via Aldo Moro 8, Ferrara 44124,
Italy
(Barbato) Division of Cardiology, Department of Advanced Biomedical
Sciences, Federico II University, Via Pansini, Naples 80131, Italy
(Dudek) Institute of Cardiology, Jagiellonian University Medical College,
ul. Sw Anny 12, Krakow 31-008, Poland
(Dudek, Campo) Maria Cecilia Hospital, GVM Care and Research, Via Corriera
1, Cotignola 48033, Italy
(Escaned) Hospital Clinico San Carlos IDISCC, Complutense University of
Madrid, Calle del Prof Martin Lagos s/n, Madrid 28040, Spain
(Casella, Di Pasquale) U.O.C. Cardiologia, Ospedale Maggiore, Largo
Nigrisoli 2, Bologna 40133, Italy
(Santarelli) Cardiovascular Department, Infermi Hospital, Viale Luigi
Settembrini 2, Rimini 47923, Italy
(Guiducci) Interventional Cardiology Unit, S. Maria Nuova Hospital, Viale
Risorgimento 80, Reggio Emilia 42123, Italy
(Gutierrez-Ibanes) Servicio de Cardiologia, Hospital General Universitario
Gregorio Maranon, CIBERCV, Calle del Dr Esquerdo 46, Madrid 28007, Spain
(Gutierrez-Ibanes) Universidad Carlos III, Calle Madrid 126, Madrid 28903,
Spain
(Politi) Cardiologia Interventistica, ASST Rhodense, Corso Europa 250, Rho
20024, Italy
(Saglietto, D'Ascenzo) Division of Cardiology, A.O.U. Citta della Salute e
della Scienza, University of Turin, Corso Bramante 88/90, Turin 10126,
Italy
Publisher
Oxford University Press
Abstract
Aims The aim of this work was to investigate the prognostic impact of
revascularization of non-culprit lesions in patients with ST-segment
elevation myocardial infarction (STEMI) and multivessel disease by
performing a meta-analysis of available randomized clinical trials (RCTs).
Methods Data from six RCTs comparing complete vs. culprit-only
revascularization in STEMI patients with multivessel dis- and results ease
were analysed with random effect generic inverse variance method
meta-analysis. The endpoints were expressed as hazard ratio (HR) with 95%
confidence interval (CI). The primary outcome was cardiovascular death.
Main secondary outcomes of interest were all-cause death, myocardial
infarction (MI), and repeated coronary revascularization. Overall, 6528
patients were included (3139 complete group, 3389 culprit-only group).
After a follow-up ranging between 1 and 3 years (median 2 years),
cardiovascular death was significantly reduced in the group receiving
complete revascularization (HR 0.62, 95% CI 0.39-0.97, I2 =
29%). The number needed to treat to prevent one cardiovascular death was
70 (95% CI 36-150). The secondary endpoints MI and revascularization were
also significantly reduced (HR 0.68, 95% CI 0.55-0.84, I2 = 0%
and HR 0.29, 95% CI 0.22-0.38, I2 = 36%, respectively). Needed
to treats were 45 (95% CI 37-55) for MI and 8 (95% CI 5-13) for
revascularization. All-cause death (HR 0.81, 95% CI 0.56-1.16,
I2 = 27%) was not affected by the revascularization strategy.
Conclusion In a selected study population of STEMI patients with
multivessel disease, a complete revascularization strategy is associated
with a reduction in cardiovascular death. This reduction is concomitant
with that of MI and the need of repeated revascularization. Copyright
© 2020 Oxford University Press. All rights reserved.

<22>
Accession Number
2010864505
Title
N-acetylcysteine for preventing of acute kidney injury in chronic kidney
disease patients undergoing cardiac surgery: A metaanalysis.
Source
Heart Surgery Forum. 21 (6) (pp E513-E521), 2018. Date of Publication: 06
Nov 2018.
Author
He G.; Li Q.; Li W.; Wang L.; Yang J.; Zeng F.
Institution
(He, Li, Wang, Zeng) Department of Respiratory Medicine, The First College
of Clinical Medical Sciences, Yichang Central People's Hospital, China
Three Gorges University, Yichang, Hubei province, China
(Li, Yang) Department of Cardiology, The First College of Clinical Medical
Sciences, Institute of Cardiovascular Diseases, China Three Gorges
University, Yichang, Hubei province, China
(He, Li, Li, Wang, Yang, Zeng) Institute of Evidence-Based and
Translational Medicine, China Three Gorges University, Yichang, Hubei
province, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Objective: The aim of this study was to determine whether N-acetylcysteine
(NAC) has an effect on acute kidney injury (AKI) in chronic kidney disease
patients undergoing cardiac surgery. Method(s): We reviewed
literature through PubMed, Medline through PubMed and OVID, The Cochrane
Library, Wan Fang Database, China Biology Medicine Database, Chinese
Periodical Database, China Knowledge Resource Integrated Database, and
Chinese Clinical Trial Registry (1980 to July 10, 2018). Two investigators
independently collected the data and assessed the quality of each study.
RevMan 5.3 was used for the present metaanalysis. Result(s): A total
of 5 RCTs (N = 678 participants) were included in the primary analysis.
Pooled analysis showed that intravenous infusion of NAC significantly
reduced the incidence of AKI (RR = 0.77, 95% = 0.63 to 0.94, P < .01) and
that NAC could decrease the adverse cardiac events (RR = 0.83, 95% = 0.70
to 0.97, P < .05), but that it may increase the length of stay in the ICU
(mean difference [MD] = 2.1, 95% CI = 1.61 to 2.60, P < .01). There were
no statistically significant differences between the 2 groups in the
requirement for renal replacement therapy(RRT) (RR = 1.33, 95% = 0.63 to
2.81, P = .45) and all-cause mortality (RR = 0.51, 95% = 0.25 to 1.06, P =
.07). Conclusion(s): Our study shows that intravenous infusion of NAC
could prevent postoperative AKI in preexisting-renal-failure patients
undergoing cardiac surgery. Copyright © 2018 Forum Multimedia
Publishing, LLC.

<23>
Accession Number
2010217295
Title
Transapical off-pump mitral valve repair with NeoChord implantation: A
systematic review.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Ahmed A.; Abdel-Aziz T.A.; AlAsaad M.M.R.; Majthoob M.
Institution
(Ahmed) Department of Cardiothoracic Surgery, Faculty of Medicine, Ain
Shams University, Cairo, Egypt
(Abdel-Aziz, AlAsaad, Majthoob) Department of Cardiothoracic Surgery,
Dubai Hospital, Dubai, United Arab Emirates
Publisher
Blackwell Publishing Inc.
Abstract
Introduction: Mitral valve repair (MVr) is the gold standard for the
treatment of degenerative mitral valve regurgitation (MR). The recently
introduced NeoChord DS1000 has gained increasing recognition as a
feasible, potentially safe, and effective procedure with minor
complications and promising outcomes. This study aims to conduct a
systematic review of the published literature that discusses the technical
feasibility and outcome of transapical off-pump MVr with NeoChord DS1000
device implantation in the treatment of degenerative MR. Method(s):
This review was performed according to the PRISMA statement. Databases
searched in this review included Pubmed, Web of Science, Scopus, and
Cochrane databases for systematic reviews. All English articles on humans
reporting isolated MVr using NeoChord DS1000 device were included provided
that basic preoperative data, operative specifications, and postoperative
mortality and morbidity were reported. Result(s): This review
included six studies comprised 249 patients who had NeoChord mitral
procedure. Almost all patients included had severe MR (243/249, 97.6%).
Operative success was achieved in 241 out of the 249 patients (96.8%). No
intraoperative mortality was reported. Intraoperative arrhythmia was
reported in six patients (2.4%) and significant bleeding was reported in
eight patients (3.2%). Conclusion(s): Awaiting more evidence,
NeoChord mitral procedure appears to be a promising procedure that can be
considered in selected cases. Copyright © 2021 Wiley Periodicals
LLC

<24>
Accession Number
2010217281
Title
Sternal closure with single compared with double or figure-of-8 wires in
obese patients post cardiac surgery.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Shafi A.M.A.; Abuelgasim E.; Abuelgasim B.; Iddawela S.; Harky A.
Institution
(Shafi) Department of Cardiothoracic Surgery, St Bartholomew's Hospital,
Barts Heart Centre, London, United Kingdom
(Abuelgasim, Abuelgasim) Faculty of Medicine, Imperial College London,
London, United Kingdom
(Iddawela) Department of Respiratory Medicine, University Hospitals
Birmingham, Birmingham, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Health and Life
Sciences, University of Liverpool, Liverpool, United Kingdom
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: Sternal instability and wound infections are major causes of
morbidity following cardiac surgery, which is further amplified in high
risk patients that include diabetics and patients with high body mass
index (BMI). We compare the different outcomes of different sternal wire
closure techniques following median sternotomy for cardiac surgery in
obese patients. Method(s): A comprehensive electronic literature
search was undertaken according to PRISMA guidelines from inception to
July 2020 to identify all published data comparing single wire sternal
closure to either double wire or figure-of-8 techniques following median
sternotomy for cardiac surgery in obese patients, defined as a BMI >= 30.
 Result(s): Eight studies met the final inclusion criteria; single
wire versus double wire sternal closure (n = 2) and single wire versus
figure-of-8 wire closure (n = 6). Higher rate of sternal instability was
noted in single wire versus double wire closure (22/150 [14.7%] patients
vs. 6/150 [4%] patients, p = 0.003, odd ratio [OR] 0.25 [95% confidence
interval [CI] 0.10-0.63]). Similarly, sternal instability was higher in
single wire vs figure-of-8 wire closure technique (33/2422 [1.3%] vs.
11/8035 [0.1%], p = 0.04 OR 0.30 [95% CI, 0.09-0.96]), respectively.
 Conclusion(s): There is benefit in the use of either double or
figure-of-8 sternal wire closure techniques over single wire closure in
terms of sternal instability. However, as the studies were limited, larger
scale comparative studies are required to provide a solid evidence base
for choosing the optimal sternal closure technique in this high risk group
of patients. Copyright © 2021 Wiley Periodicals LLC

<25>
Accession Number
634053935
Title
Myocardial Ischemia in the Management of Chronic Coronary Artery Disease:
Past and Present.
Source
Circulation. Cardiovascular imaging. (pp CIRCIMAGING120011615), 2021. Date
of Publication: 18 Jan 2021.
Author
Gibbons R.J.
Institution
(Gibbons) Department of Cardiovascular Medicine, Mayo Clinic, MN,
Rochester
Publisher
NLM (Medline)
Abstract
For many years, stress-induced myocardial ischemia has been considered
important in the management of chronic coronary artery disease. Early
evidence focused on the exercise ECG and the Duke treadmill score. In the
1970s, randomized clinical trials, which compared coronary artery bypass
surgery to medical therapy, enrolled patients who were very different from
contemporary practice and had inconsistent results. Surgery appeared to be
of greatest benefit in high-risk patients defined by anatomy (such as left
main disease) or stress-induced ischemia. However, randomized clinical
trials of revascularization versus contemporary medical therapy over the
past 20 years have been surprisingly negative. Nuclear cardiology
substudies from these trials reported inconsistent results. Two
observational studies from a single-center provided the best evidence for
the use of stress-induced ischemia to identify patients who were most
likely to benefit from revascularization. The recently completed ISCHEMIA
trial (International Study of Comparative Health Effectiveness With
Medical and Invasive Approaches) was designed to test the hypothesis that
revascularization would improve outcomes in patients with moderate-severe
ischemia on stress testing. Unfortunately, 14.2% of the randomized
patients had either mild or no ischemia on core lab review. Nearly
one-quarter of the patients were randomized on the basis of an exercise
ECG without imaging. The negative results of the trial reflect the
long-term population decline in coronary artery disease and abnormal
stress tests, as well as improvements in patient outcome due to optimal
medical therapy. Topics requiring further research are presented. The
implications of the trial for the use of both stress imaging and coronary
computed tomography angiography in clinical practice are examined.

<26>
Accession Number
2010596248
Title
Single Versus Dual Antiplatelet Therapy Following TAVR: A Systematic
Review and Meta-Analysis of Randomized Controlled Trials.
Source
JACC: Cardiovascular Interventions. 14 (2) (pp 234-236), 2021. Date of
Publication: 25 Jan 2021.
Author
Guedeney P.; Sorrentino S.; Mesnier J.; De Rosa S.; Indolfi C.; Zeitouni
M.; Kerneis M.; Silvain J.; Montalescot G.; Collet J.-P.
Publisher
Elsevier Inc.

<27>
Accession Number
2010583834
Title
Suture- or Plug-Based Large-Bore Arteriotomy Closure: A Pilot Randomized
Controlled Trial.
Source
JACC: Cardiovascular Interventions. 14 (2) (pp 149-157), 2021. Date of
Publication: 25 Jan 2021.
Author
van Wiechen M.P.; Tchetche D.; Ooms J.F.; Hokken T.W.; Kroon H.; Ziviello
F.; Ghattas A.; Siddiqui S.; Laperche C.; Spitzer E.; Daemen J.; de
Jaegere P.P.; Dumonteil N.; Van Mieghem N.M.
Institution
(van Wiechen, Ooms, Hokken, Kroon, Ziviello, Spitzer, Daemen, de Jaegere,
Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Tchetche, Ghattas, Siddiqui, Laperche, Dumonteil) Department of
Cardiology, Clinique Pasteur, Toulouse, France
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to test the superiority in terms of efficacy
and safety of a dedicated plug-based vascular closure device (VCD) during
transcatheter aortic valve replacement (TAVR) over a suture-based VCD.
 Background(s): Vascular complications after TAVR are relevant and
often associated with VCD failure. Method(s): The MASH (MANTA vs.
Suture-based vascular closure after transcatHeter aortic valve
replacement) trial is an international, 2-center pilot randomized
controlled trial comparing the MANTA VCD (Teleflex, Wayne, Pennsylvania)
versus 2 ProGlides (Abbott Vascular, Abbott Park, Illinois). The primary
composite endpoint consisted of access site-related major or minor
vascular complications at 30-days' follow-up. Secondary endpoints included
clinically relevant access site bleeding, time to hemostasis, and modified
VCD failure (defined as failure to achieve hemostasis within 5 min or
requiring additional endovascular maneuvers such as endovascular stenting,
surgical techniques, or additional closure devices). Adverse events were
adjudicated by an independent clinical events committee according to the
VARC-2 definitions. Result(s): A total of 210 TAVR patients were
included between October 2018 and January 2020. Median age was 81 years,
54% were male, and the median STS score was 2.7%. There was no significant
difference in the primary endpoint of access site-related vascular
complications between MANTA and ProGlide (10% vs. 4%; p = 0.16).
Clinically significant access site bleedings were similar with both
closure techniques (9% vs. 6%; p = 0.57). Modified VCD failure occurred
less frequently in MANTA versus ProGlide (20% vs. 40%; p < 0.01).
Suture-based closure required more often additional closure devices,
whereas MANTA numerically needed more covered stents and surgical
bailouts. Conclusion(s): Plug-based large-bore arteriotomy closure
was not superior to suture-based closure. Plug-based closure required
fewer, but a different kind of bailout maneuvers. Copyright ©
2021 American College of Cardiology Foundation

<28>
Accession Number
2006776756
Title
Effect of Combining Furosemide With Standard Hydration Therapy on
Contrast-Induced Acute Kidney Injury Following Coronary Angiography or
Intervention in a High-Risk Population.
Source
Angiology. 72 (2) (pp 138-144), 2021. Date of Publication: February 2021.
Author
Hu M.; Yan G.; Tang H.; Wang L.; Zhang Q.; Gong J.; Tang C.
Institution
(Hu, Tang, Tang) School of Medicine, Southeast University, Nanjing,
Jiangsu, China
(Hu, Wang, Zhang, Gong) Jinling Hospital Department Cardiology, Nanjing
University, School of Medicine, Nanjing, Jiangsu, China
(Yan, Tang) Department of Cardiology, Zhongda Hospital, School of
Medicine, Southeast University, Nanjing, Jiangsu, China
Publisher
SAGE Publications Inc.
Abstract
This study aimed to investigate whether combining furosemide with standard
hydration therapy results in increased preventive effects on
contrast-induced acute kidney injury (CI-AKI) following coronary
angiography (CA) or percutaneous coronary intervention (PCI). Patients (n
= 230) were enrolled in the study and were randomized to the furosemide
group or the control group. Patients in the furosemide group received 0.2
to 0.5 mg/kg of furosemide as a continuous intravenous infusion for 24
hours postoperatively and the same standard hydration regimen received by
the control group. Blood samples were obtained 24 hours before and 48
hours after the procedure and urine volume was recorded postprocedure.
Patients were followed up for an average of 6 months after the procedure.
The incidence of CI-AKI in the furosemide group was significantly lower
than that in the control group (8.7% vs 18.3%, P =.034). Multivariate
logistic regression showed that age-glomerular filtration rate-ejection
fraction score and V/estimated glomerular filtration rate ratio were
independent risk factors for CI-AKI. During the average 6-month follow-up,
incidence of major adverse cardiovascular events (MACEs) in the furosemide
group was also significantly lower. Furosemide combined with standard
hydration therapy may reduce the incidence of CI-AKI and MACEs following
CA or PCI. Copyright © The Author(s) 2020.

<29>
Accession Number
2004163815
Title
The no-touch saphenous vein is an excellent alternative conduit to the
radial artery 8 years after coronary artery bypass grafting: A randomized
trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 161 (2) (pp 624-630),
2021. Date of Publication: February 2021.
Author
Dreifaldt M.; Mannion J.D.; Geijer H.; Liden M.; Bodin L.; Souza D.
Institution
(Dreifaldt, Souza) Faculty of Medicine and Health, Department of
Cardiothoracic and Vascular Surgery and University Health Care Research
Center, Orebro University, Orebro, Sweden
(Mannion) Department of Surgery, Bayhealth Medical Center, Dover, Del,
United States
(Geijer, Liden) Faculty of Medicine and Health, Department of Radiology,
Orebro University, Orebro, Sweden
(Bodin) Unit of Intervention and Implementation Research, Institute of
Environmental Medicine, Karolinska Institute, Stockholm, Sweden
Publisher
Mosby Inc.
Abstract
Background: In 2004, a prospective randomized trial demonstrated that
after 3 years, saphenous veins (SVs) harvested with a no touch (NT)
technique had a greater patency than radial grafts for coronary bypass
surgery. Here we report the 8-year follow-up data of this trial.
 Method(s): The trial included 108 patients undergoing coronary artery
bypass grafting (CABG). Each patient was assigned to receive 1 NT SV and 1
radial artery (RA) graft to either the left or right coronary territory to
complement the left internal thoracic artery (LITA). Sequential grafting
was common, so overall graft patency as well as the patency of each
anastomosis were assessed. Result(s): Angiography was performed in 84
patients (78%) at mean of 97 months postoperatively. Graft patency were
high and similar for both NT and RA: 86% for NT versus 79% for RA (P
=.22). The patency of coronary anastomoses was significantly higher with
the NT SV grafts (91% vs 81%; P =.046). The NT grafts also had excellent
patency in coronary arteries with <90% stenosis (93% patency) and in
coronary arteries of small diameter (87% patency) or with mild
calcification (88% patency). Patency for the LITA was 92%.
 Conclusion(s): NT SV grafts have excellent patency similar to that of
RA grafts after 8 years. In addition, NT SV grafts can be used in
situations that are not ideal for RA grafts. Copyright © 2019 The
American Association for Thoracic Surgery

<30>
Accession Number
2003779168
Title
Incidence and impact of silent brain lesions after coronary artery bypass
grafting.
Source
Journal of Thoracic and Cardiovascular Surgery. 161 (2) (pp 636-644),
2021. Date of Publication: February 2021.
Author
Tachibana H.; Hiraoka A.; Saito K.; Naito Y.; Chikazawa G.; Tamura K.;
Totsugawa T.; Yoshitaka H.; Sakaguchi T.
Institution
(Tachibana, Hiraoka, Chikazawa, Tamura, Totsugawa, Yoshitaka, Sakaguchi)
Department of Cardiovascular Surgery, The Sakakibara Heart Institute of
Okayama, Okayama, Japan
(Saito, Naito) Department of Rehabilitation, The Sakakibara Heart
Institute of Okayama, Okayama, Japan
Publisher
Mosby Inc.
Abstract
Objective: Silent brain lesions are known to occur after coronary artery
bypass grafting (CABG). The aim of this study was to seek the incidence
rate, the influence of procedures, and their impact on the postoperative
course. Method(s): From July 2016 to April 2018, 104 consecutive
patients undergoing elective and isolated first-time CABG (65 off-pump and
39 on-pump) were enrolled. New brain lesions were evaluated by brain
magnetic resonance imaging both before and after CABG. Postoperative
outcomes, including cognitive function, were compared between patients
with and without brain lesions. Result(s): The overall incidence of
new brain lesions was 20.1% (21/104). Excluding one symptomatic stroke
case, silent brain lesions were revealed in the remaining patients. The
percentage of on-pump CABG (61.9% [13/21] vs 31.3% [26/83], P =.019) and
aortic clamp (52.4% [11/21] vs 24.1% [20/83], P =.014) were significantly
greater in patients with brain lesions. Brain lesions were observed in
12.3% and 15.8% of patients in the off-pump and anaortic CABG. The Katz
Index of Independence in Activities of Daily Living was significantly
lower in patients with brain lesions (from 5.8 +/- 0.9 to 5.4 +/- 1.2 vs
from 5.9 +/- 0.5 to 5.9 +/- 0.6, P =.013). In patients with new lesions,
postoperative cognitive dysfunction (POCD) was observed only in multiple
lesions, and the maximum size was significantly greater in patients with
POCD. Conclusion(s): Magnetic resonance imaging of the brain
frequently detected postoperative silent brain lesions after CABG in
off-pump and aorta non-touch groups. Multiple and larger new brain lesions
were associated with the development of POCD. Copyright © 2019
The American Association for Thoracic Surgery

<31>
Accession Number
2005753246
Title
Open kidney cancer surgery and perioperative cardiac arrhythmias.
Source
Central European Journal of Urology. 73 (4) (pp 1-8), 2020. Date of
Publication: 2020.
Author
Dobronska K.; Jureczko L.; Kowalczyk R.; Dobronski P.; Trzebicki J.
Institution
(Dobronska, Jureczko, Kowalczyk, Trzebicki) First Department of
Anesthesiology and Intensive Care, Medical University of Warsaw, Warsaw,
Poland
(Dobronski) Department of Urology, Medical University of Warsaw, Warsaw,
Poland
Publisher
Polish Urological Association
Abstract
Introduction Although cardiac arrhythmias during anesthesia are often
observed, the literature focuses mainly on cardio-thoracic surgery. We
aimed to evaluate the incidence of arrhythmias appearing in the
perioperative period in patients undergoing urological surgery and
furthermore to define whether combining general with epidural anesthesia
prevents them. Material and methods The study included 50 adults, without
a prior cardiac or arrhythmia history, undergoing an open kidney cancer
surgery, who were randomly allocated to receive either general or combined
epidural/general anesthesia. A Holter monitor was applied the evening
before the surgery, tracing continuously for a period of 24 hours
(7PM-7PM). ClinicalTrials.gov NCT02988219 Results There was no statistical
difference in the arrhythmia occurrence between the randomization groups.
Among 65.21% the following arrhythmias were observed: 27 - bradycardia, 4
- sinus pause, 6 - ventricular extrasystoles (>1000/24 hours), 3 -
supraventricular extrasystoles (>200/24 hours). The patients with
arrhythmia were older and often with hypertension (p <0.01). A longer
surgery duration predisposed to arrhythmia appearance (122.5 vs. 99
minutes), (p <0.01). The temperature measured at the beginning and at the
end of the surgery was significantly lower among the participants with
arrhythmia (p = 0.02, p = 0.01). The gender, body mass index (BMI),
laboratory tests and the intake of intravenous fluids did not influence
the occurrence of arrhythmia. Conclusions Perioperative cardiac
arrhythmias (usually sinus arrhythmias) are common during an open kidney
surgery and occur regardless of the anesthetic technique and usually do
not require any treatment. Age, hypertension, long operation time or low
body temperature predispose the patient to perioperative cardiac
arrhythmias during surgery. Copyright © 2020, Polish Urological
Association. All rights reserved.

<32>
Accession Number
634032801
Title
Death and Myocardial Infarction Following Initial Revascularization Versus
Optimal Medical Therapy in Chronic Coronary Syndromes With Myocardial
Ischemia: A Systematic Review and Meta-Analysis of Contemporary Randomized
Controlled Trials.
Source
Journal of the American Heart Association. 10 (2) (pp e019114), 2021. Date
of Publication: 19 Jan 2021.
Author
Soares A.; Boden W.E.; Hueb W.; Brooks M.M.; Vlachos H.E.A.; O'Fee K.;
Hardi A.; Brown D.L.
Institution
(Soares, O'Fee, Brown) Department of Medicine Washington University School
of Medicine St. Louis MO
(Soares, O'Fee, Hardi, Brown) Washington University School of Medicine St.
Louis MO
(Boden) Veterans Affairs New England Healthcare System Boston MA
(Hueb) Heart Institute of the University of Sao Paolo Sao Paolo Brazil
(Brooks, Vlachos) Department of Epidemiology University of Pittsburgh PA
(Brown) Cardiovascular Medicine Washington University School of Medicine
St. Louis MO
Publisher
NLM (Medline)
Abstract
Background In chronic coronary syndromes, myocardial ischemia is
associated with a greater risk of death and nonfatal myocardial infarction
(MI). We sought to compare the effect of initial revascularization with
percutaneous coronary intervention (PCI) or coronary artery bypass
grafting (CABG) plus optimal medical therapy (OMT) with OMT alone in
patients with chronic coronary syndrome and myocardial ischemia on
long-term death and nonfatal MI. Methods and Results Ovid Medline, Embase,
Scopus, and Cochrane Library databases were searched for randomized
controlled trials of PCI or CABG plus OMT versus OMT alone for patients
with chronic coronary syndromes. Studies were screened and data were
extracted independently by 2 authors. Random-effects models were used to
generate pooled treatment effects. The search yielded 7 randomized
controlled trials that randomized 10 797 patients. Median follow-up was 5
years. Death occurred in 640 of the 5413 patients (11.8%) randomized to
revascularization and in 647 of the 5384 patients (12%) randomized to OMT
(odds ratio [OR], 0.97; 95% CI, 0.86-1.09; P=0.60). Nonfatal MI was
reported in 554 of 5413 patients (10.2%) in the revascularization arms
compared with 627 of 5384 patients (11.6%) in the OMT arms (OR, 0.75; 95%
CI, 0.57-0.99; P=0.04). In subgroup analysis, nonfatal MI was
significantly reduced by CABG (OR, 0.35; 95% CI, 0.21-0.59; P<0.001) but
was not reduced by PCI (OR, 0.92; 95% CI, 0.75-1.13; P=0.43)
(P-interaction <0.001). Conclusions In patients with chronic coronary
syndromes and myocardial ischemia, initial revascularization with PCI or
CABG plus OMT did not reduce long-term mortality compared with OMT alone.
CABG plus OMT reduced nonfatal MI compared with OMT alone, whereas PCI did
not.

<33>
Accession Number
634016513
Title
Effect of dexmedetomidine on perioperative hemodynamics and organ
protection in children with congenital heart disease: A randomized
controlled trial.
Source
Medicine. 100 (1) (pp e23998), 2021. Date of Publication: 08 Jan 2021.
Author
Ming S.; Du X.; Huang H.; Fan Y.; Liang Q.; Xie Y.
Institution
(Ming, Xie, Du, Huang) Department of Anesthesiology, Second Affiliated
Hospital of Guangxi Medical University
(Fan) Department of Cardiothoracic surgery, Ruikang Hospital Affiliated to
Guangxi University of Chinese Medicine, Nanning, China
(Liang) Department of Anesthesiology, Ruikang Hospital Affiliated to
Guangxi University of Chinese Medicine
(Xie) Department of Anesthesiology, First Affiliated Hospital of Guangxi
Medical University, Nanning, Guangxi, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: This study aimed to investigate the effects of dexmedetomidine
(Dex) on hemodynamics and organ protection in congenital heart disease
(CHD) children who underwent open-heart surgery under cryogenic
cardiopulmonary bypass. METHOD(S): Ninety children were randomly
allocated to group C (0.9% saline 0.2 mug/kg/hour), group D1 (Dex 0.2
mug/kg/hour), and group D2 (Dex 0.4 mug/kg/hour) (n = 30 per group). All
participants received fentanyl, propofol and 1% sevoflurane for anesthesia
induction. Hemodynamic data were measured from T0 (before the induction)
to T7 (30 minutes after extubation). The difference of arterial internal
jugular vein bulbar oxygen difference and cerebral oxygen extraction ratio
were calculated according to Fick formula. Enzyme-linked immunosorbent
assay was performed to detect the serum myocardial, brain and kidney
injury markers. The incidence of acute kidney injury (AKI) was calculated
by serum creatinine level. Tracheal extubation time, postoperative pain
score and emergence agitation score were also recorded. RESULT(S):
Compared with group C, group D1, and D2 exhibited reduction in hemodynamic
parameters, myocardial and brain injury indicators, and tracheal
extubation time. There were no significant differences in blood urea
nitrogen and neutrophil gelatinase-associated lipocalin or incidence of
AKI among the 3 groups. Besides, the incidence of tachycardia, nausea,
vomiting and moderate agitation, and the FLACC scale in group D1 and D2
were lower than those in group C. Moreover, Dex 0.4 g/kg/hour could
further reduce the dosage of fentanyl and dopamine compared with Dex 0.2
g/kg/hour. CONCLUSION(S): Dex anesthesia can effectively maintain
hemodynamic stability and diminish organ injuries in CHD
children. Copyright © 2021 the Author(s). Published by Wolters
Kluwer Health, Inc.

<34>
Accession Number
2005145452
Title
Transcatheter aortic valve replacement in patients with a history of
cancer: Periprocedural and long-term outcomes.
Source
Catheterization and Cardiovascular Interventions. 97 (1) (pp 157-164),
2021. Date of Publication: 01 Jan 2021.
Author
Murphy A.C.; Koshy A.N.; Cameron W.; Horrigan M.; Kearney L.; Yeo B.;
Farouque O.; Yudi M.B.
Institution
(Murphy, Koshy, Cameron, Horrigan, Kearney, Farouque, Yudi) Department of
Cardiology, Austin Health, Melbourne, VIC, Australia
(Murphy, Koshy, Kearney, Farouque, Yudi) Department of Medicine, The
University of Melbourne, Melbourne, VIC, Australia
(Yeo) Department of Oncology, The Olivia Newton-John Cancer and Wellness
Centre, Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: A history of cancer is incorporated into the surgical risk
assessment of patients undergoing surgical aortic valve replacement
through the Society for Thoracic Surgeons score. However, the prognostic
significance of cancer in patients treated with transcatheter aortic valve
replacement (TAVR) is unclear. As the cancer survivorship population
increases, it is imperative to establish the efficacy and safety of TAVR
in patients with severe symptomatic aortic stenosis (AS) and a history of
malignancy. Objective(s): The primary goal of this study was to
assess the periprocedural outcomes and long-term mortality in patients
with a history of cancer undergoing TAVR. Method(s): A systematic
review of PubMed, MEDLINE, and EMBASE was conducted to identify studies
reporting outcomes in patients with a history of malignancy undergoing
TAVR. A meta-analysis was performed using a random-effects model with a
primary outcome of all-cause mortality and cardiac mortality at the
longest follow-up. On secondary analyses, procedural safety was assessed.
 Result(s): A total of 13 observational studies with 10,916 patients
were identified in the systematic review. Seven studies including 6,323
patients were included in the quantitative analysis. Short-term mortality
(relative risk [RR] 0.61, 95%CI 0.36-1.01; p =.06) and long-term all-cause
mortality (RR 1.24, 95%CI 0.95-1.63; p =.11) were not significantly
different when comparing patients with and without a history of cancer. No
significant difference in the rate of periprocedural complications
including stroke, bleeding, acute kidney injury, and pacemaker
implantation was noted. Conclusion(s): In patients with severe AS
undergoing TAVR, a history of cancer was not associated with adverse short
or long-term survival. Based on these findings, TAVR should be considered
in all patients with severe symptomatic AS, irrespective of their history
of malignancy. Copyright © 2020 Wiley Periodicals LLC.

<35>
Accession Number
2010792280
Title
A feasibility study for CODE-MI: High-sensitivity cardiac
troponin-Optimizing the diagnosis of acute myocardial infarction/injury in
women.
Source
American Heart Journal. 234 (pp 60-70), 2021. Date of Publication: April
2021.
Author
Zhao Y.; Sivaswamy A.; Lee M.K.; Izadnegahdar M.; Chu A.; Ferreira-Legere
L.E.; Humphries K.H.; Udell J.A.
Institution
(Zhao) Population Data BC, Vancouver, Canada
(Sivaswamy, Chu, Ferreira-Legere, Udell) ICES, Toronto, Canada
(Lee, Humphries) Centre for Improved Cardiovascular Health at Centre for
Health Evaluation and Outcome Sciences, Vancouver, Canada
(Izadnegahdar, Humphries) Division of Cardiology, University of British
Columbia, Vancouver, Canada
(Chu, Udell) University of Toronto, Toronto, Canada
(Udell) Cardiovascular Division, Department of Medicine, Women's College
Hospital and Peter Munk Cardiac Centre, Toronto General Hospital, Toronto,
Canada
Publisher
Mosby Inc.
Abstract
Background: CODE-MI is a pan-Canadian, multicentre, stepped-wedge, cluster
randomized trial that evaluates the impact of using the female-specific
99th percentile threshold for high-sensitivity cardiac troponin (hs-cTn)
on the diagnosis, treatment and outcomes of women presenting to the
emergency department (ED) with symptoms suggestive for myocardial
ischemia. A feasibility study was conducted to estimate the number of
eligible patients, the rate of the study's primary outcome under control
conditions, and the statistical power to detect a clinically important
difference in the primary outcome. Method(s): Using linked
administrative data from 11 hospitals in Ontario, Canada, from October
2014 to September 2017, the following estimates were obtained: number of
women presenting to the ED with symptoms suggestive of myocardial ischemia
and a 24-hour peak hs-cTn value within the female-specific and overall
thresholds (ie, primary cohort); the rate of the 1-year composite outcome
of all-cause mortality, re-admission for nonfatal myocardial infarction,
incident heart failure, or emergent/urgent coronary revascularization.
Study power was evaluated via simulations. Result(s): Overall,
2,073,849 ED visits were assessed. Among women, chest pain (with or
without cardiac features) and shortness of breath were the most common
complaints associated with a diagnosis of acute coronary syndrome. An
estimated 7.7% of women with these complaints are eligible for inclusion
in the primary cohort. The rate of the 1-year outcome in the primary
cohort varied significantly across hospitals with a median rate of 12.2%
(95%CI: 7.9%-17.7%). With 30 hospitals, randomized at 5-month intervals in
5 steps, approximately 19,600 women are expected to be included in
CODE-MI, resulting in >82% power to detect a 20% decrease in the odds of
the primary outcome at a 0.05 significance level. Conclusion(s): This
feasibility study greatly enhanced the design of CODE-MI, allowed accurate
evaluation of the study power, and demonstrated the strength of using
linked administrative health data to guide the design of pragmatic
clinical trials. Copyright © 2021 Elsevier Inc.

<36>
Accession Number
2010133649
Title
Effects of intraoperative goal-directed fluid therapy and restrictive
fluid therapy combined with enhanced recovery after surgery protocol on
complications after thoracoscopic lobectomy in high-risk patients: study
protocol for a prospective randomized controlled trial.
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 36. Date of
Publication: December 2021.
Author
Guan Z.; Gao Y.; Qiao Q.; Wang Q.; Liu J.
Institution
(Guan, Gao, Qiao, Wang) Department of Anesthesiology, the First Affiliated
Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
(Liu) Department of Neurology, the Second Affiliated Hospital of Xi'an
Jiaotong University, Xi'an, Shaanxi, China
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is a common complication after
thoracoscopic lobectomy in high-risk patients due to insufficient
intraoperative infusion. Goal-directed fluid therapy (GDFT) is an
individualized fluid infusion strategy; the fluid infusion strategy is
adjusted according to the patient's fluid response. GDFT during operation
can reduce the incidence of AKI after major surgery. Enhanced recovery
after surgery (ERAS) protocol optimizes perioperative interventions to
decrease the postoperative complications after surgery. In ERAS protocol
of lobectomy, intraoperative restrictive fluid therapy is recommended. In
this study, we will compare the effects of intraoperative GDFT with
restrictive fluid therapy combined with an ERAS protocol on the incidence
of AKI after thoracoscopic lobectomy in high-risk patients.
Methods/design: This is a prospective single-center single-blind
randomized controlled trial. Two hundred seventy-six patients scheduled
for thoracoscopic lobectomy are randomly allocated to receive either GDFT
or restrictive fluid therapy combined with an ERAS protocol at a 1:1
ratio. The primary outcome is the incidence of AKI after operation. The
secondary outcomes include (1) the incidence of renal replacement therapy,
(2) the length of intensive care unit stay after operation, (3) the length
of hospital stay after operation, and (4) the incidence of other
complications including infection, acute lung injury, pneumonia,
arrhythmia, heart failure, myocardial injury after noncardiac surgery, and
cardiac infarction. Discussion(s): This is the first study to compare
intraoperative GDFT with restrictive fluid therapy combined with an ERAS
protocol on the incidence of AKI after thoracoscopic lobectomy in
high-risk patients. The hypothesis is that the restrictive fluid therapy
is noninferior to GDFT in reducing the incidence of AKI, but restrictive
fluid therapy is simpler to apply than GDFT. Trial registration:
ClinicalTrials.govNCT04302467. Registered on 26 February
2020 Copyright © 2021, The Author(s).

<37>
Accession Number
2010128408
Title
Non-surgical treatment of tetanus infection associated with breast cancer
skin ulcer: a case report and literature review.
Source
BMC Infectious Diseases. 21 (1) (no pagination), 2021. Article Number: 37.
Date of Publication: December 2021.
Author
Nomura K.; Sakawaki E.; Sakawaki S.; Yamaoka A.; Aisaka W.; Okamoto H.;
Takeyama Y.; Uemura S.; Narimatsu E.
Institution
(Nomura, Aisaka, Uemura, Narimatsu) Department of Emergency Medicine,
Sapporo Medical University, Minami 1-jo, Nishi 16-chome, 291, Chuo-ku,
Sapporo-shi, Hokkaido 060-8543, Japan
(Sakawaki, Sakawaki, Takeyama) Department of Emergency Medicine, Hakodate
Municipal Hospital, 1-chome 10-1, Minato-cho, Hakodate-shi, Hokkaido
041-8680, Japan
(Yamaoka) Department of Neurosurgery, Sunagawa City Medical Center,
3-chome1-1 Nishi 4-jo Kita, Sunagawa-shi, Hokkaido 073-0196, Japan
(Okamoto) Department of Emergency Medicine, Teine Keijinkai Hospital,
12-chome 1-40, Maeda 1-jo, Teine-ku, Sapporo-shi, Hokkaido 006-0811, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Previous studies have reported poor prognosis in cases of
tetanus that develops after bacteria enters via breast cancer-related skin
ulcers that are not treated with surgical debridement. Herein, we review
the literature concerning this presentation and report the first case of
complete remission from tetanus without surgical debridement of the skin
ulcer. Case presentation: An Asian woman aged over 60 years had a history
of skin ulcer caused by breast cancer. She was diagnosed with tetanus due
to trismus and opisthotonus. Based on the suspicion that the skin ulcer
was the portal of entry for tetanus bacteria, we considered several
debridement and thoracic surgical options for tetanus treatment. However,
debridement was not performed as the surgery was considered high risk and
the patient did not consent to it. The patient received treatment with
anti-tetanus globulin and metronidazole; sound insulation and shielding
were also performed in a dark room. Subsequently, the patient's symptoms
improved, and sound insulation and deep sedation management were completed
on 19th day of hospitalization. With no symptom recurrence, the patient
was discharged on Day 54. To date, over 3 years after treatment, no
evidence of tetanus recurrence has been observed. The case was
characterized by a lack of autonomic hyperactivity. The tetanus severity
was likely representative of the low amount of toxin that the patient was
exposed to. Conclusion(s): This case involved moderate severity
tetanus originating from a chronic skin ulcer related to breast cancer.
The patient survived without undergoing extensive debridement. No evidence
of tetanus relapse was observed during the follow-up period, likely due to
vaccination that might have restored the patient's active immunity.
Debridement is not always necessary for tetanus complicated by breast
cancer skin ulcers. Furthermore, appropriate toxoid vaccination is
critical for preventing the onset and recurrence of tetanus in these
patients. Copyright © 2021, The Author(s).

<38>
[Use Link to view the full text]
Accession Number
2007589081
Title
The anti-adhesive effect of anti-VEGF agents in experimental models: A
systematic review.
Source
Wound Repair and Regeneration. 29 (1) (pp 168-182), 2021. Date of
Publication: January/February 2021.
Author
Giannis D.; Geropoulos G.; Ziogas I.A.; Gitlin J.; Oropallo A.
Institution
(Giannis) Institute of Health Innovations and Outcomes Research, The
Feinstein Institutes for Medical Research, Manhasset, NY, United States
(Giannis, Geropoulos, Ziogas) Surgery Working Group, Society of Junior
Doctors, Athens, Greece
(Geropoulos) Thoracic Surgery Department, University College London
Hospitals, NHS Foundation Trust, London, United Kingdom
(Ziogas) Aristotle University of Thessaloniki School of Medicine,
Thessaloniki, Greece
(Gitlin) The Donald and Barbara Zucker School of Medicine at
Hofstra/Northwell, Northwell Health, Hempstead, NY, United States
(Oropallo) Department of Vascular Surgery, The Donald and Barbara Zucker
School of Medicine at Hofstra/Northwell, Northwell Health, New Hyde Park,
NY, United States
Publisher
Blackwell Publishing Inc.
Abstract
Adhesions constitute a major problem in abdominal-pelvic and thoracic
surgery with significant impact in the postoperative quality of life and
healthcare services utilization. Adhesiogenesis is the result of increased
fibrin formation, impaired fibrinolysis, angiogenesis, and fibrosis.
Despite the recent advancements, the ideal anti-adhesive agent remains to
be determined. To this end, we performed a comprehensive literature search
in PubMed, EMBASE, and Scopus databases to identify studies investigating
the antiadhesive role of anti-VEGF agents in peritoneal, pleural, and
pericardial experimental adhesion models. Fifteen studies were eligible
for inclusion with a total population of 602 animals (334 rats, 180
rabbits, and 88 mice). The majority of included studies (11/15) used
bevacizumab, while three studies used other anti-VEGF antibodies and one
study used an anti-VEGFR-antibody. A rat model was used in nine studies,
while rabbit (n = 3) or mouse (n = 3) models were used less frequently.
Eleven studies used peritoneal models, three studies used pleural models,
and one study used a pericardial model. The scales (n = 12) and interval
(Range: 1-42 days) used for the evaluation of adhesions varied between the
studies. All studies demonstrated a significant decrease in adhesion
scores between the anti-VEGF and control groups up to 42 days
postprocedure. VEGF blockade resulted in decreased fibrosis in four out of
five studies that used peritoneal models, while the effect on pleural
models depended on the pleurodesis agent and was significant between 7 and
28 days. The effect of anti-VEGF agents on anastomosis integrity depends
on the dose and the model that is used (inconclusive results).Current data
support the anti-adhesive role of Anti-VEGF agents in all three serosal
surfaces up to 6 weeks postprocedure. Further studies are needed to
confirm the anti-adhesive role of anti-VEGF agents in pleural and
pericardial adhesion experimental models and investigate any effect on
anastomosis integrity in peritoneal models. Copyright © 2020 by
the Wound Healing Society

<39>
Accession Number
2007444114
Title
Ultrasound-Guided Pecto-Intercostal Fascial Block for Postoperative Pain
Management in Cardiac Surgery: A Prospective, Randomized,
Placebo-Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (3) (pp 896-903),
2021. Date of Publication: March 2021.
Author
Khera T.; Murugappan K.R.; Leibowitz A.; Bareli N.; Shankar P.; Gilleland
S.; Wilson K.; Oren-Grinberg A.; Novack V.; Venkatachalam S.; Rangasamy
V.; Subramaniam B.
Institution
(Khera, Murugappan, Leibowitz, Shankar, Gilleland, Wilson, Oren-Grinberg,
Novack, Venkatachalam, Rangasamy, Subramaniam) Center for Anesthesia and
Research Excellence, Department of Anesthesia Critical Care and Pain
Medicine, Beth Israel Deaconess Medical Center, Boston, MA
(Murugappan, Leibowitz, Oren-Grinberg, Subramaniam) Harvard Medical
School, Boston, MA, United States
(Bareli) Clinical Research Center, Soroka University Medical Center,
Beer-Sheva, Israel
Publisher
W.B. Saunders
Abstract
Objective: To explore the effect of pecto-intercostal fascial plane block
(PIFB) on postoperative opioid requirements, pain scores, lengths of
intensive care unit and hospital stays and incidence of postoperative
delirium in cardiac surgical patients. Design(s): Single- center,
prospective, randomized (1:1), quadruple- blinded, placebo-controlled
trial. Setting(s): Single center, tertiary- care center.
 Participant(s): The study comprised 80 adult cardiac surgical
patients (age >18 y) requiring median sternotomy. Intervention(s):
Patients were randomly assigned to receive ultrasound-guided PIFB, with
either 0.25% bupivacaine or placebo, on postoperative days 0 and 1.
 Measurements and Main Results: Of the 80 patients randomized, the
mean age was 65.78 +/- 8.73 in the bupivacaine group and 65.70 +/- 9.86 in
the placebo group (p = 0.573). Patients receiving PIFB with 0.25%
bupivacaine showed a statistically significant reduction in visual analog
scale scores (4.8 +/- 2.7 v 5.1 +/- 2.6; p < 0.001), but the 48-hour
cumulative opioid requirement computed as morphine milligram equivalents
was similar (40.8 +/- 22.4 mg v 49.1 +/- 26.9 mg; p = 0.14). There was no
difference in the incidence of postoperative delirium between the groups
evaluated using the 3-minute diagnostic Confusion Assessment Method (3/40
[7.5%] v 5/40 [12.5%] placebo; p = 0.45). Conclusion(s): Patients who
received PIFB with bupivacaine showed a decline in cumulative opioid
consumption postoperatively, but this difference between the groups was
not statistically significant. Low incidence of complications and
improvement in visual analog scale pain scores suggested that the PIFB can
be performed safely in this population and warrants additional studies
with a larger sample size. Copyright © 2020 Elsevier Inc.

<40>
Accession Number
2010858279
Title
Multilevel Hemilaminotomy Windows for the Surgical Management of Spinal
Epidural Lipomatosis Causing Syringomyelia: Technical Note and Literature
Review.
Source
World Neurosurgery. 148 (pp 4-12), 2021. Date of Publication: April 2021.
Author
Martinez Santos J.L.; Saway B.; Damon A.C.; Varma A.
Institution
(Martinez Santos, Saway, Varma) Department of Neurological Surgery,
Medical University of South Carolina, Charleston, SC, United States
(Martinez Santos, Damon) Department of Neurological Surgery, Mayo Clinic
Florida, Jacksonville, FL, United States
Publisher
Elsevier Inc.
Abstract
Background: Spinal epidural lipomatosis (SEL) is the excessive
accumulation of extradural adipose tissue. Severe cases could result in
myelopathy, and very rarely, in syringomyelia formation. Surgery has been
associated with high morbidity and mortality, and no proven long-term
benefits. The objective was to provide a technical description of an
efficient and cost-effective procedure for multilevel thoracic
decompression without requiring spinal instrumentation. Method(s): A
technique of multilevel hemilaminotomy windows is described in a patient
with severe thoracic SEL causing syringomyelia. A 3-dimensional spine
model was created to illustrate the technique and working angles. We
performed a literature review by searching PubMed, Ovid Embase, and Scopus
electronic databases with the predetermined inclusion criteria of cases
with spinal lipomatosis and a fluid cavity within the spinal cord.
 Result(s): The patient's deficit and syringomyelia resolved
postoperatively. A review of the literature revealed only 3 cases of
syringomyelia secondary to SEL. Syringomyelia expansion occurred in all
cases leading to progressive neurologic decline, and surgery with removal
of the excessive adipose tissue resolved the syringomyelia and improved
the neurologic functioning in all cases. Conclusion(s): This
technique of multilevel alternating hemilaminotomy "windows" allows for
safe and effective decompression and resection of the excessive adipose
tissue with reduced operative time and without requiring spine
instrumentation. The technique maintains the integrity of the posterior
column, thus reducing the risk of postdecompression deformity. Careful
bipolar electrocoagulation of internal vertebral veins and meticulous
hemostasis is key for minimizing the intraoperative blood loss and
avoiding postoperative hematoma formation. Copyright © 2021
Elsevier Inc.

<41>
Accession Number
2005908976
Title
Incidence, risk factors, and outcomes of coronary obstruction following
valve-in-valve transcatheter aortic valve replacement: A systematic review
and meta-analysis.
Source
International Heart Journal. 62 (1) (pp 104-111), 2021. Date of
Publication: 2021.
Author
Gao Z.; Wang Y.; Qian D.; Jin J.
Institution
(Gao, Wang, Qian, Jin) Institute of Cardiovascular Diseases of PLA,
Chongqing, China
(Gao, Wang, Qian, Jin) Department of Cardiology, Xinqiao Hospital, Army
Medical University (Third Military Medical University), Chongqing, China
Publisher
International Heart Journal Association
Abstract
There is scant information about the incidence, risk factors, and outcomes
of coronary obstruction (CO) following valve-in-valve transcatheter aortic
valve replacement (VIV-TAVR). A meta-analysis of the published studies
from January 2000 to April 2020 was conducted, and the endpoint was CO. A
total of 2858 patients were enrolled in this study. The mean age was 77.7
+/- 9.8, and 39.9% of them were female. The Society of Thoracic Surgeons
(STS) score, European System for Cardiac Operative Risk Evaluation
(EuroSCORE), and Logistic EuroSCORE were 8.9 +/- 7.8, 16.0 +/- 10.9, and
26.3 +/- 16.3, respectively. The overall incidence of CO was 2.58%. CO
incidence between patients with prior stented and stentless valves were
significantly different (1.67% versus 7.17%), with an odds ratio (OR) of
0.25 and a 95% confidence interval (CI) of 0.14-0.44 (P < 0.00001). The
first-generation valves were significantly associated with higher CO
incidence compared with the second-generation valves (7.09% versus 2.03%;
OR, 2.44; 95%CI, 1.06-5.62; P = 0.04), while no statistical difference was
found between self-expandable valves and balloon-expandable valves (2.45%
versus 2.60%; OR, 0.99; 95%CI, 0.55-1.79; P = 0.98). Virtual transcatheter
to coronary ostia (VTC) distance (3.3 +/- 2.1 mm, n = 29 versus 5.8 +/-
2.4 mm, n = 169; mean difference, -2.70; 95%CI, -3.46 to -1.95; P <
0.00001) and the sinus of Valsalva (SOV) diameter (27.5 +/- 3.8 mm, n = 23
versus 32.3 +/- 4.0 mm, n = 101; mean difference, -3.80; 95%CI, -6.55 to
-1.05; P = 0.007) were enormously shorter in patients with CO. The
24-hour, in-hospital, and 30-day mortality of patients with CO were 10.5%,
30.8%, and 37.1%, respectively. In conclusion, device selections, VTC
distances, and SOV diameters may be important factors in assessing the CO
risk in VIV-TAVR. (Int Heart J 2021; 62: 104-111). Copyright ©
2021, International Heart Journal Association. All rights reserved.

<42>
Accession Number
633970976
Title
Effectiveness, cost-effectiveness and safety of gabapentin versus placebo
as an adjunct to multimodal pain regimens in surgical patients: Protocol
of a placebo controlled randomised controlled trial with blinding (GAP
study).
Source
BMJ Open. 10 (11) (no pagination), 2020. Article Number: e041176. Date of
Publication: 20 Nov 2020.
Author
Baos S.; Rogers C.A.; Abbadi R.; Alzetani A.; Casali G.; Chauhan N.;
Collett L.; Culliford L.; De Jesus S.E.; Edwards M.; Goddard N.; Lamb J.;
McKeon H.; Molyneux M.; Stokes E.A.; Wordsworth S.; Gibbison B.; Pufulete
M.
Institution
(Baos, Rogers, Collett, Culliford, De Jesus, Lamb, McKeon, Pufulete)
Bristol Trials Centre, Clinical Trials and Evaluation Unit, Bristol
Medical School, University of Bristol, Bristol, United Kingdom
(Abbadi, Casali) Department of Surgery, University Hospitals Bristol and
Weston Nhs Foundation Trust, Bristol, United Kingdom
(Alzetani) Department of Surgery, University Hospital Southampton Nhs
Foundation Trust, Southampton, United Kingdom
(Chauhan, Molyneux, Gibbison) Department of Anaesthesia, University
Hospitals Bristol and Weston Nhs Foundation Trust, Bristol, United Kingdom
(Edwards, Goddard) Department of Anaesthesia, University Hospital
Southampton Nhs FoundationTrust, Southampton, United Kingdom
(Edwards) Acute Critical and Perioperative Care Research Group, Nihr
Biomedical Research Centre, University Hospital Southampton Nhs Foundation
Trust, University of Southampton, Southampton, United Kingdom
(Stokes, Wordsworth) Health Economics Research Centre, University of
Oxford, Oxford, United Kingdom
(Gibbison) Bristol Medical School, University of Bristol, Bristol, United
Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Gabapentin is an antiepileptic drug currently licensed to
treat epilepsy and neuropathic pain but has been used off-label to treat
acute postoperative pain. The GAP study will compare the effectiveness,
cost-effectiveness and safety of gabapentin as an adjunct to standard
multimodal analgesia versus placebo for the management of pain after major
surgery. Methods and analysis The GAP study is a multicentre,
double-blind, randomised controlled trial in patients aged 18 years and
over, undergoing different types of major surgery (cardiac, thoracic or
abdominal). Patients will be randomised in a 1:1 ratio to receive either
gabapentin (600 mg just before surgery and 600 mg/day for 2 days after
surgery) or placebo in addition to usual pain management for each type of
surgery. Patients will be followed up daily until hospital discharge and
then at 4 weeks and 4 months after surgery. The primary outcome is length
of hospital stay following surgery. Secondary outcomes include pain, total
opioid use, adverse health events, health related quality of life and
costs. Ethics and dissemination This study has been approved by the
Research Ethics Committee. Findings will be shared with participating
hospitals and disseminated to the academic community through peer-reviewed
publications and presentation at national and international meetings.
Patients will be informed of the results through patient organisations and
participant newsletters. Copyright © Author(s) (or their
employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

<43>
Accession Number
2010850369
Title
Tidal volume during 1-lung ventilation: A systematic review and
meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2021.
Date of Publication: 2021.
Author
Peel J.K.; Funk D.J.; Slinger P.; Srinathan S.; Kidane B.
Institution
(Peel, Slinger) Department of Anesthesia, University of Toronto, Toronto,
ON, Canada
(Funk) Departments of Anesthesia and Medicine, University of Manitoba,
Winnipeg, MB, Canada
(Srinathan, Kidane) Section of Thoracic Surgery, Department of Surgery,
University of Manitoba, Winnipeg, MB, Canada
(Kidane) Department of Community Health Sciences, University of Manitoba,
Winnipeg, MB, Canada
(Kidane) Research Institute in Oncology and Hematology, Winnipeg, MB,
Canada
Publisher
Mosby Inc.
Abstract
Background: The selection of tidal volumes for 1-lung ventilation remains
unclear, because there exists a trade-off between oxygenation and risk of
lung injury. We conducted a systematic review and meta-analysis to
determine how oxygenation, compliance, and clinical outcomes are affected
by tidal volume during 1-lung ventilation. Method(s): A systematic
search of MEDLINE and EMBASE was performed. A systematic review and
random-effects meta-analysis was conducted. Pooled mean difference
estimated arterial oxygen tension, compliance, and length of stay; pooled
odds ratio was calculated for composite postoperative pulmonary
complications. Risk of bias was determined using the Cochrane risk of bias
and Newcastle-Ottawa tools. Result(s): Eighteen studies were
identified, comprising 3693 total patients. Low tidal volumes (5.6
[+/-0.9] mL/kg) were not associated with significant differences in
partial pressure of oxygen (-15.64 [-88.53-57.26] mm Hg; P =.67), arterial
oxygen tension to fractional intake of oxygen ratio (14.71 [-7.83-37.24];
P =.20), or compliance (2.03 [-5.22-9.27] mL/cmH2O; P =.58) versus
conventional tidal volume ventilation (8.1 [+/-3.1] mL/kg). Low versus
conventional tidal volume ventilation had no significant impact on
hospital length of stay (-0.42 [-1.60-0.77] days; P =.49). Low tidal
volumes are associated with significantly decreased odds of pulmonary
complications (pooled odds ratio, 0.40 [0.29-0.57]; P <.0001).
 Conclusion(s): Low tidal volumes during 1-lung ventilation do not
worsen oxygenation or compliance. A low tidal volume ventilation strategy
during 1-lung ventilation was associated with a significant reduction in
postoperative pulmonary complications. Copyright © 2020 The
American Association for Thoracic Surgery

<44>
Accession Number
2010836924
Title
Effect of Acute Immunosuppression on Left Ventricular Recovery and
Mortality in Fulminant Viral Myocarditis: A Case Series and Review of
Literature.
Source
CJC Open. (no pagination), 2021. Date of Publication: 2021.
Author
Turgeon P.Y.; Massot M.; Beaupre F.; Belzile D.; Beaudoin J.; Bernier M.;
Bourgault C.; Germain V.; Laliberte C.; Morin J.; Gervais P.; Trahan S.;
Charbonneau E.; Dagenais F.; Senechal M.
Institution
(Turgeon, Massot, Beaupre, Belzile, Beaudoin, Bernier, Bourgault, Germain,
Laliberte, Morin, Senechal) Department of Cardiology, Institut
Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Canada
(Gervais) Department of Infectious Disease, Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec, Canada
(Trahan) Department of Pathology, Institut Universitaire de Cardiologie et
de Pneumologie de Quebec, Quebec, Canada
(Charbonneau, Dagenais) Department of Cardiac Surgery, Institut
Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Background: Fulminant viral myocarditis (FVM) is a rare cause of
cardiogenic shock associated with high morbidity and mortality rates. An
inappropriately activated immune system results in severe myocardial
inflammation. Acute immunosuppressive therapy for FVM therefore gained in
popularity and was described in numerous retrospective studies.
 Method(s): We conducted an extensive review of the literature and
compared it with our single-centre retrospective review of all cases of
FVM from 2009-2019 to evaluate the possible effect of acute
immunosuppression with intravenous immunoglobulins and/or high dose
corticosteroids in patients with FVM. Result(s): We report on 17
patients with a mean age of 46 +/- 15 years with a mean left ventricular
ejection fraction (LVEF) of 15 +/- 9% at admission. Fourteen (82%) of our
patients had acute LVEF recovery to >= 45% after a mean time from
immunosuppression of 74 +/- 49 hours (3.1 days). Extracorporeal membrane
oxygenation (ECMO) was required in 35% (6/17) of our patients for an
average support of 126 +/- 37 hours. Overall mortality was 12% (2/17). No
patient needed a long-term left ventricular assist device or heart
transplant. All surviving patients achieved complete long-term LVEF
recovery. Conclusion(s): Our cohort of 17 severely ill patients
received acute immunosuppressive therapy and showed a rapid LVEF recovery,
short duration of ECMO support, and low mortality rate. Our suggested
scheme of investigation and treatment is presented. These results bring
more cases of successfully treated FVM with immunosuppression and ECMO to
the literature, which might stimulate further prospective trials or a
registry. Copyright © 2020 Canadian Cardiovascular Society

<45>
Accession Number
2010284492
Title
Vasoplegia in patients following ventricular assist device explant and
heart transplantation.
Source
Perfusion (United Kingdom). (no pagination), 2021. Date of Publication:
2021.
Author
Emmanuel S.; Pearman M.; Jansz P.; Hayward C.S.
Institution
(Emmanuel, Pearman, Jansz, Hayward) St Vincent's Hospital, Sydney, NSW,
Australia
(Emmanuel, Jansz, Hayward) School of Medicine, University of New South
Wales, Sydney, NSW, Australia
(Emmanuel, Pearman, Jansz) School of Medicine, University of Notre Dame,
Sydney, NSW, Australia
(Emmanuel, Jansz, Hayward) The Victor Chang Cardiac Research Institute,
Sydney, NSW, Australia
Publisher
SAGE Publications Ltd
Abstract
Background: Vasoplegia has been shown to be associated with increased
morbidity and mortality in patients undergoing cardiac surgery. It has
been previously stated that low pulsatile states as seen with current left
ventricular assist devices (LVADs) may contribute to vasoplegia post
LVAD-explant and heart transplant. We sought to examine the literature
regarding vasoplegia in the post-operative setting for patients undergoing
LVAD explant and heart transplant. Method(s): A literature review was
conducted to firstly define vasoplegia in the setting of LVAD patients,
and secondly to better understand the relationship between vasoplegia and
LVAD explantation in the postoperative heart transplant patient cohort. A
keyword search of 'vasoplegia' OR 'vasoplegic' AND 'transplant' was used.
Search engines used were PubMed, Cochrane Library, ClinicalTrials.gov,
Ovid, Scopus and grey literature. Result(s): 17 studies met the
selection criteria for review. Three key themes emerged from the
literature. Firstly, there is limited consensus regarding the definition
of vasoplegia. Secondly, patients with LVADs experienced higher rates of
vasoplegia following heart transplant than their counterparts and thirdly,
increased cardiopulmonary bypass time was associated with a higher rate of
vasoplegia. Conclusion(s): Vasoplegia is not clearly defined in the
literature as it pertains to the LVAD patient cohort. Patients bridged
with LVADs appear to have higher rates of vasoplegia, however the
aetiology of this is unclear and may be associated with continuous flow
physiology or prolonged cardiopulmonary bypass time. A universal
definition will aid in risk stratification, early recognition and
management. Copyright © The Author(s) 2021.

<46>
Accession Number
2010284454
Title
Left or bilateral internal mammary artery employment in coronary artery
bypass grafting: midterm results.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2021. Date of
Publication: 2021.
Author
Fomenko M.S.; Schneider Y.A.; Tsoi V.G.; Pavlov A.A.; Shilenko P.A.
Institution
(Fomenko, Schneider, Tsoi, Pavlov, Shilenko) Federal State Budgetary
Institution, Federal Centers of High Medical Technologies, Health
Ministry, Kaliningrad, Russian Federation
Publisher
SAGE Publications Inc.
Abstract
Background: The gold standard for coronary artery bypass grafting to the
left anterior descending artery is use of the left internal mammary
artery. Better long-term survival has been reported using bilateral
internal mammary arteries compared to left internal mammary artery only,
but many surgeons are reluctant to employ bilateral internal mammary
arteries in coronary artery bypass grafting. This study aimed to evaluate
the effectiveness and safety of bilateral internal mammary artery use.
 Method(s): From 2014 to 2017, 1703 patients underwent coronary artery
bypass grafting in our institute. Of these, 772 met the inclusion criteria
and were randomly assigned to receive bilateral (n = 387) or left (n =
385) internal mammary artery grafts. The mean age was 67.1 +/- 6.0 years
(range 48-85 years) and 474 (61.4%) were male. The mean number of diseased
vessels was 3.1 +/- 0.9, and mean EuroSCORE II was 3.4% +/- 1.1%.
 Result(s): Hospital mortality was 1.2% in the left internal mammary
artery group vs. 1.8% in the bilateral internal mammary artery group (p =
0.55). There was no difference in procedure-related complications between
groups. Mean follow-up was 65.9 months. Survival in the bilateral internal
mammary artery group at 1, 3, and 5 years was 98.7%, 98.7%, and 94.8% vs.
98.1%, 98.1%, and 90.9%, respectively, in the left internal mammary artery
group (p = 0.63). Conclusion(s): Application of bilateral internal
mammary arteries in coronary artery bypass grafting is safe and effective,
with comparable midterm results to those with the left internal mammary
artery only. Copyright © The Author(s) 2021.

<47>
Accession Number
2010284327
Title
The International Society for Minimally Invasive Cardiothoracic Surgery
Expert Consensus Statement on Transcatheter and Surgical Aortic Valve
Replacement in Low- and Intermediate-Risk Patients: A Meta-Analysis of
Randomized and Propensity-Matched Studies.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2021. Date of Publication: 2021.
Author
Thourani V.H.; Edelman J.J.; Holmes S.D.; Nguyen T.C.; Carroll J.; Mack
M.J.; Kapadia S.; Tang G.H.L.; Kodali S.; Kaneko T.; Meduri C.U.; Forcillo
J.; Ferdinand F.D.; Fontana G.; Suwalski P.; Kiaii B.; Balkhy H.; Kempfert
J.; Cheung A.; Borger M.A.; Reardon M.; Leon M.B.; Popma J.J.; Ad N.
Institution
(Thourani) Department of Cardiovascular Surgery, Marcus Heart and Vascular
Center, Piedmont Heart and Vascular Institute, Atlanta, GA, United States
(Edelman) Department of Cardiac Surgery, Fiona Stanley Hospital,
University of Western Australia, Perth, Australia
(Holmes, Ad) Division of Cardiac Surgery, University of Maryland School of
Medicine, Baltimore, MD, United States
(Nguyen) Division of Adult Cardiothoracic Surgery, University of
California, San Francisco, CA, United States
(Carroll) Division of Cardiology, University of Colorado, Denver, CO,
United States
(Mack) Department of Cardiology, Baylor Health Care System, Heart Hospital
Baylor Plano, Dallas, TX, United States
(Kapadia) Department of Cardiology, Cleveland Clinic Foundation,
Cleveland, OH, United States
(Tang) Department of Cardiovascular Surgery, Mount Sinai Health System,
New York, NY, United States
(Kodali, Leon) Division of Cardiology, Columbia University Medical Center,
New York, NY, United States
(Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Boston, MA, United States
(Meduri) Division of Cardiology, Marcus Heart and Vascular Center,
Piedmont Heart Institute, Atlanta, GA, United States
(Forcillo) Department of Cardiac Surgery, Centre Hospitalier de
l'Universite de Montreal (CHUM), Montreal, Canada
(Ferdinand) Department of Cardiothoracic Surgery, University of
Pittsburgh, School of Medicine $, UPMC Hamot Heart and Vascular Institute,
University of Pittsburgh Medical Center, PA, United States
(Fontana) Cardiovascular Institute, Los Robles Hospital and Medical
Center, Thousand Oaks, CA, United States
(Suwalski) Department of Cardiac Surgery, Central Clinical Hospital of the
Ministry of Interior and Administration, Centre of Postgraduate Medical
Education, Warsaw, Poland
(Kiaii) Cardiothoracic Surgery, UC Davis Medical Center, Sacramento, CA,
United States
(Balkhy) Section of Cardiac Surgery, University of Chicago Medicine, IL,
United States
(Kempfert) Department of Cardiac Surgery, German Heart Institute, Berlin,
Germany
(Cheung) Department of Cardiac Surgery, The University of British
Columbia, St. Paul's Hospital, Vancouver, Canada
(Borger) Department of Cardiac Surgery, Leipzig Heart Centre, Germany
(Reardon) Department of Cardiac Surgery, Methodist DeBakey Heart &
Vascular Center, Houston, TX, United States
(Popma) Department of Interventional Cardiology, Beth Israel Deaconess
Medical Center, Boston, MA, United States
(Ad) Cardiovascular Surgery, Adventist White Oak Medical Center, Silver
Spring, MD, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: There is an increasing amount of evidence supporting use of
transcatheter aortic valve replacement (TAVR) for treatment of aortic
stenosis in patients at low or intermediate risk for surgical aortic valve
replacement (SAVR). TAVR is now approved for use in all patient cohorts.
Despite this, there remains debate about the relative efficacy of TAVR
compared with SAVR in lower-risk cohorts and various subgroups of
patients. We performed a systematic review and meta-analysis of randomized
controlled trials (RCTs) and propensity-matched trials to guide a
consensus among expert cardiologists and surgeons. Method(s): Studies
comparing TAVR and SAVR in low- and intermediate-risk patients were
identified by a thorough search of the major databases. Mortality, stroke,
and other perioperative outcomes were assessed at 30 days and 1 year.
 Result(s): Early mortality was lower in TAVR compared to SAVR in
RCTs, but not propensity-matched studies in low-risk cohorts (0.66% vs
1.5%; odds ratio [OR] = 0.44, 95% confidence interval [CI] 0.20 to 0.98,
I2 = 0%). No difference in mortality between TAVR and SAVR was
identified in intermediate-risk patients at early or later time points.
Incidence of perioperative stroke in 3 low-risk RCTs was significantly
lower in TAVR (0.4%) than SAVR (1.4%; OR = 0.33, 95% CI 0.13 to 0.81,
I2 = 0%). There was no difference in stroke for
intermediate-risk patients between TAVR and SAVR. The expert panel of
cardiologists and cardiac surgeons provided recommendations for TAVR and
SAVR in various clinical scenarios. Conclusion(s): In RCTs comparing
TAVR and SAVR in low-risk patients, early mortality and stroke were lower
in TAVR, but did not differ at 1 year. There was no difference in
mortality and stroke in intermediate-risk patients. The Multidisciplinary
Heart Team must consider individual patient characteristics and
preferences when recommending TAVR or SAVR. The decision must consider the
long-term management of each patient's aortic valve disease. Copyright
© The Author(s) 2021.

<48>
Accession Number
2010182627
Title
A systematic review and meta-analysis of delayed coronary artery access
for coronary angiography with or without percutaneous coronary
intervention (PCI) in patients who underwent transcatheter aortic valve
replacement (TAVR).
Source
Cardiovascular Intervention and Therapeutics. (no pagination), 2021. Date
of Publication: 2021.
Author
Diaz M.A.; Patton M.; Valdes P.; Vieira J.L.; Rmeileh A.; Macedo F.Y.
Institution
(Diaz, Patton, Valdes, Rmeileh, Macedo) Division of Cardiology, Department
of Internal Medicine, Palmetto General Hospital, 2001 W 68th St, Hialeah,
FL 33016, United States
(Vieira) Heart and Vascular Center, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
Springer Japan
Abstract
Coronary artery disease (CAD) and severe aortic valve stenosis frequently
coexist. Given the progressive nature of CAD, silent or non-significant
CAD may become symptomatic or functionally relevant years after TAVR.
However, there is a paucity of data documenting the feasibility of either
coronary angiography and/or PCI after TAVR. We systematically searched
Medline, Pubmed, Embase, Cochrane database, Google Scholar, Science
Direct, Web of Science, and conference abstracts from conception to March
2020 using OvidSP in TAVR patients undergoing coronary angiography with or
without PCI at least 6 months after TAVR. Patients and procedural
characteristics were summarized. The primary outcome of interest was
successful coronary angiography for either the left main coronary artery
(LMCA) or right coronary artery (RCA) with or without PCI. Pooled
estimates were calculated using a random-effects meta-analysis. The study
protocol was registered in PROSPERO. Eleven reports for a total of 696
coronary angiograms and 287 PCI were included in the analysis. Patients
were slightly predominantly male, older and had a mean left ventricular
ejection fraction of more than 50% with an intermediate STS. The summary
estimate rates of successful LMCA and RCA angiography with a Medtronic
self-expandable valve (SEV) were 84% (95% CI 73-90%, I2 = 79, p
= 0.015) and 69% (95% CI 37-89%, I2 = 86, p = 0.23),
respectively, while with the Edwards Lifesciences balloon expandable valve
(BEV), the summary estimate rates for successful LMCA and RCA angiography
were 94% (95% CI 72-99%, I2 = 66, p = 0.003) and 95% (95% CI
48-99%, I2 = 83, p = 0.05), respectively. The summary estimate
rate of successful PCI post TAVR with either a Medtronic SEV or Edwards
Lifesciences BEV was 93% (95% CI 86-96%, I2 = 33, p = 0.0001).
The overall achievement of a successful coronary angiography with or
without PCI in post-TAVR patients is high, with a lower success rate for
RCA angiography in patients with the Medtronic SEV Mortality and bleeding
did not differ in our analysis. Copyright © 2021, Japanese
Association of Cardiovascular Intervention and Therapeutics.

<49>
Accession Number
2007541471
Title
Surgical Strategy for Intravenous Cardiac Leiomyomatosis.
Source
Heart Lung and Circulation. 30 (2) (pp 240-246), 2021. Date of
Publication: February 2021.
Author
Deng Y.; Dong S.; Song B.
Institution
(Deng, Dong, Song) Department of Cardiovascular Surgery, The First
Hospital of Lanzhou University, Gansu Province, China
Publisher
Elsevier Ltd
Abstract
Intravenous-cardiac leiomyomatosis (IVCL) is a rare, histologically benign
but biologically aggressive tumour. Accurate diagnosis and appropriate
treatment choices are important for prognosis. The best surgical approach
remains unclear owing to limited evidence. This study aimed to assess
surgical strategies for treating IVCL and to propose individualised
surgical strategies. We searched PubMed, Web of Science, and the Cochrane
Library to identify case reports and case series published in English over
the last 10 years. Two (2) reviewers independently screened the literature
according to the inclusion and exclusion criteria, and subsequently
extracted data. One hundred and ten (110) cases were included. According
to our analysis, IV cardiac leiomyomatosis is most common in the fifth
decade, and the mean age at detection is 45.71+/-7.67 years. Most patients
had undergone previous hysterectomy/myomectomy, or had a co-existing
uterine leiomyoma when admitted. The most common clinical presentations
were dyspnoea, palpitation, pelvic mass, and leg oedema. More patients
benefited more from one-stage surgery. Seventy-eight per cent (78%) of
cases experienced a surgical approach of thoracic and abdominal incisions.
Extractions of IVCL were varied. Eighty-seven (87) patients experienced
cardiopulmonary bypass and deep hypothermic circulatory arrest was
performed on 64.4% of them. Total hysterectomy and bilateral oophorectomy,
together with pelvic leiomyoma excision, were done in 76.0% of patients.
Overall, surgical strategies for IVCL are varied; the optimal strategy
required consideration of multiple factors. Complete resection is
recommended for both single- and two-stage operations. Once complete
resection is achieved, recurrence is rare. Copyright © 2020
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<50>
Accession Number
2007179215
Title
Prevalence and Cost of Managing Paediatric Cardiac Disease in Queensland.
Source
Heart Lung and Circulation. 30 (2) (pp 254-260), 2021. Date of
Publication: February 2021.
Author
Strange G.A.; Veerappan S.; Alphonso N.; Refeld S.; Simon S.; Justo R.
Institution
(Strange) School of Medicine, University of Notre Dame, Freemantle, WA,
Australia
(Strange) Department of Cardiology, Royal Prince Alfred Hospital, Sydney,
NSW, Australia
(Veerappan, Alphonso, Refeld, Justo) Queensland Children's Hospital,
Brisbane, Qld, Australia
(Veerappan, Alphonso, Justo) School of Medicine, University of Queensland,
Brisbane, Qld, Australia
(Simon) Hatter Institute for Cardiovascular Research in Africa, University
of Cape Town, Cape Town, South Africa
(Simon) Torrens University Australia, Adelaide, SA, Australia
Publisher
Elsevier Ltd
Abstract
Background: There is a paucity of contemporary information regarding the
prevalence and related health care expenditure of the most common cardiac
conditions in Australian children, including congenital heart disease
(CHD). Method(s): The 10 most common cardiac conditions managed by
Queensland Paediatric Cardiac Service during 2014-2015 were identified
from an electronic database: ventricular septal defect (VSD), pulmonary
stenosis, aortic stenosis, tetralogy of Fallot, atrioventricular septal
defect, transposition, Ebstein's anomaly, long QT syndrome, dilated
cardiomyopathy, and rheumatic carditis. Demographic data, clinic
attendance, investigational procedures, and therapeutic interventions were
extracted from the electronic health records to derive indicative
population estimates and direct health care expenditure relating to CHD.
 Result(s): A total of 2,519 patients diagnosed with the 10 target
conditions were being actively managed, including 456 (18.1%) new-born and
787 prevalent cases (2.5/1,000 population) aged <5 years. A total of
12,180 (4.8/case) investigations were performed (6,169 echocardiographic
and 279 cardiac catheterisation procedures) costing $2.25 million/annum. A
further 5,326 clinic visits (2.1/case, 22% regional) were conducted at a
cost of $550,000/annum. A combined total of 804 catheter-based
interventions and surgical procedures were performed in 300 cases (11.9%)
at a cost of $13.6 million/annum. VSD (38.6% of cases) was the single
greatest contributor ($5.1 million/annum) to total combined direct health
care costs of $13.6 million/annum for the 2,519 patients.
 Conclusion(s): These pilot data indicate a significant patient
population and health care burden imposed by CHD in Queensland. Future
initiatives to better quantify this burden, from an individual to health
system perspective, are urgently needed. Copyright © 2020
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<51>
Accession Number
2008354680
Title
Anticoagulation After Isolated Mitral Valve Repair: A Systematic Review
and Meta-Analysis of Clinical Outcomes.
Source
Heart Lung and Circulation. 30 (2) (pp 247-253), 2021. Date of
Publication: February 2021.
Author
Papadimas E.; Tan Y.K.; Choong A.M.T.L.; Kofidis T.; Teoh K.L.K.
Institution
(Papadimas, Choong, Kofidis, Teoh) Department of Cardiac Thoracic &
Vascular Surgery, National University Heart Centre, Singapore
(Tan, Kofidis) Yong Loo Lin School of Medicine, Singapore
(Choong, Kofidis) Cardiovascular Research Institute, National University
of Singapore, Singapore
(Choong, Kofidis) Department of Surgery, Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
Publisher
Elsevier Ltd
Abstract
Recommendations from international guidelines on optimal
thromboprophylaxis after mitral repair are controversial and based on
underpowered observational studies. This study aimed to evaluate the
prophylactic use of warfarin after isolated mitral valve repair (MVr). A
PubMed, EMBASE and Scopus search for studies in English on postoperative
thromboprophylaxis for isolated MVr published to February 2020 was
performed. The analysis excluded all studies with combined operations,
mitral valve replacement and preoperative or postoperative atrial
fibrillation. Clinical endpoints that were studied were thromboembolic
events, bleeding complications and mortality. Random effects meta-analyses
of the effect of postoperative warfarin use as compared with no warfarin
use across all clinical endpoints was conducted. Warfarin use did not
confer benefit in terms of thromboembolic prophylaxis after isolated MVr
in patients without atrial fibrillation (OR, 0.97; 95% CI, 0.72-1.31). At
the same time, it did not increase the risk of bleeding complications (OR,
1.10; 95% CI, 0.53-2.30) or affect overall survival during the follow-up
period of the included studies (OR, 1.06; 95% CI, 0.28-4.05). To conclude,
warfarin use is not necessary for patients after isolated MVr who remain
in sinus rhythm. Recommendations from international guidelines may need to
be revisited for this group of patients. Copyright © 2020
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<52>
[Use Link to view the full text]
Accession Number
2010671704
Title
Perioperative Spinal Cord Ischemia After Cardiac Surgery Not Involving the
Aorta: A Review of the Literature.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Wanat-Hawthorne A.; Akorede R.; Floyd T.
Institution
(Wanat-Hawthorne, Akorede, Floyd) Department of Anesthesiology and Pain
Management, UT Southwestern, Dallas, TX, United States
Publisher
W.B. Saunders
Abstract
Spinal cord ischemia (SCI) associated with aortic surgery is
well-described; however, SCI after cardiac surgery not involving the aorta
is an unusual and underappreciated phenomenon. The authors reviewed the
literature and found 54 case reports of perioperative spinal cord ischemia
in nonaortic surgery. The severity of its implications is evidenced by the
fact that 14 patients died, 22 had no recovery, and seven had only partial
recovery. Various types of cardiac surgery have reported this complication
including coronary artery bypass grafting (CABG), off-pump CABG, valve
surgeries, combination valve and CABG surgeries, and transcatheter aortic
valve procedures. Patient comorbidities, such as high blood pressure,
hypercholesterolemia, diabetes, and peripheral vascular disease, also may
play a role in the development of this adverse outcome. The authors review
the literature to define further possible mechanisms, surgical techniques,
and patient factors that could contribute to the risk of perioperative SCI
after cardiac surgery. Copyright © 2020 Elsevier Inc.

<53>
Accession Number
634025734
Title
TEG 6s versus rotem sigma-a comparison of two viscoelastic haemostatic
assays (VHA) in the management of major haemorrhage.
Source
Vox Sanguinis. Conference: 30th Regional Congress of the ISBT. Thailand.
114 (SUPPL 2) (pp 121), 2019. Date of Publication: 2019.
Author
Roberts S.; Duffy R.; Volling-Geoghegan D.
Institution
(Roberts, Duffy, Volling-Geoghegan) Department of Anaesthesia, Princess
Alexandra Hospital, Brisbane, Australia
Publisher
Blackwell Publishing Ltd
Abstract
Background: Princess Alexandra Hospital is a 688 bed, tertiary adult
hospital in Princess Alexandra Hospital is a 688 bed, tertiary adult
hospital in Brisbane specializing in trauma, liver and renal
transplantation. The emergency department and Intensive Care Unit use
Rotem Sigma VHA analysis in assessment of bleeding. The Anaesthetic
Department and 26 Theatre Operating Complex use the TEG 6s Cartridge
system. Aim(s): This pilot study compared equivalent VHA parameters
using TEG 6s and Rotem Sigma in patients with major bleeding undergoing
non-cardiac and nontransplant surgery. Method(s): In early 2018 VHA
device validation was undertaken on 15 patients. 30 bleeding patients were
randomly recruited by anaesthetic staff from May to December 2018.
Citrated viscoelastic haemostatic assays were run on the same citrated
blood samples. Data for time to test, time to transfuse, product
transfusion, parameters for equivalent assays ie CFF - Fibtem, CRT -
Extem, CK - Intem and anaesthetic team feedback was collected. R
Coefficient for VHA parameters was derived as per R Core Team (2018). R: A
language and environment for statistical computing. R Foundation for
Statistical Computing, Vienna, Austria. URL https://www.R-project. org/.
 Result(s): Results showed a strong correlation for CFF and Fibtem A10
all results, CFF - Fibtem A10 with normal values and Maximum Amplitude and
Clot Formation Time in CRT - Extem and CK - Intem. There was weaker
correlation between abnormal CFF - Fibtem A10 results, as well as R time
and Clotting Time in the CRT - Extem and CK - Intem assays across all
values. Summary/Conclusions: Despite consistency, the different CFF-Fibtem
results when abnormal triggered different fibrinogen dosing as per our TEG
6s and Rotem algorithms. Further investigation with a larger, bleeding,
patient cohort is recommended for data acquisition and investigation of
potential savings in both product usage and cost.

<54>
Accession Number
2010845660
Title
Impact of Elevated Glycosylated Haemoglobin on Outcomes following CABG in
Patients with Diabetes Mellitus.
Source
Pakistan Journal of Medical and Health Sciences. 14 (4) (pp 1167-1169),
2020. Date of Publication: October 2020.
Author
Ali F.; Khilji S.A.; Tahir S.
Institution
(Ali) Consultant Cardiologist
(Khilji) Associate Professor of Cardiac Surgery
(Tahir) Resident, Faisalabad Institute of Cardiology, Faisalabad, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Objective: To determine the impact of HbA1c on clinical outcome after
coronary artery bypass graft surgery in patients with diabetes mellitus.
 Study Design: Randomized control trial. Place and Duration of study:
Department of Cardiac Surgery, Faisalabad Institute of cardiology,
Faisalabad from 1st June 2019 to 30th June 2020.
Methodology: Five hundred patients who underwent isolated coronary artery
bypass graft surgery were included and stratified into two groups
according to HbA1c levels. Control group have patients with HbA1c levels
less than 7% while Study group have patients with HbA1c levels greater
than 7%. Postoperative atrial fibrillation (AF), myocardial infarction
(MI), hospital stay, time on ventilator, stroke, wound infection,
in-hospital and 30 day mortality were recorded and compared.
 Result(s): There are statistically significant results in terms of
hospital stay, time on ventilator and wound infection (p-value 0.001).
 Conclusion(s): HbA1c is good predictor of in hospital morbidity, so
it is necessary to have strict glycaemic control to prevent postoperative
complications. Copyright © 2020 Lahore Medical And Dental
College. All rights reserved.

<55>
Accession Number
634030079
Title
Lipoprotein(a), LDL-cholesterol, and hypertension: predictors of the need
for aortic valve replacement in familial hypercholesterolaemia.
Source
European heart journal. (no pagination), 2021. Date of Publication: 12 Jan
2021.
Author
Perez de Isla L.; Watts G.F.; Alonso R.; Diaz-Diaz J.L.; Muniz-Grijalvo
O.; Zambon D.; Fuentes F.; de Andres R.; Padro T.; Lopez-Miranda J.; Mata
P.
Institution
(Perez de Isla) Cardiology Department, Hospital Clinico San Carlos,
IDISSC, Facultad de Medicina, Universidad Complutense ,C/Profesor Martin
Lagos s/n, Madrid 28040, Spain
(Perez de Isla, Alonso, Mata) Fundacion Hipercolesterolemia Familiar,
Madrid, Spain
(Watts) School of Medicine, Faculty of Health and Medical Sciences,
University of Western Australia, Perth, WA, Australia
(Watts) Lipid Disorders Clinic, Cardiometabolic Services, Department of
Cardiology, Royal Perth Hospital, Perth, WA, Australia
(Alonso) Center for Advanced Metabolic Medicine and Nutrition, Santiago de
Chile, Chile
(Diaz-Diaz) Department of Internal Medicine, Hospital Abente y Lago, A
Coruna, Spain
(Muniz-Grijalvo) Department of Internal Medicine, Hospital Virgen del
Rocio, Sevilla, Spain
(Zambon) Department of Endocrinology, Hospital Clinic, Barcelona, Spain
(Fuentes, Lopez-Miranda) Lipids and Atherosclerosis Unit, CIBERObn,
IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba,
Spain
(de Andres) Department of Internal Medicine, Fundacion Jimenez Diaz,
Madrid, Spain
(Padro) Programa-ICCC Cardiovascular, Institut de Recerca del Hospital
Santa Creu i Sant Pau, IIB Santa Pau, Barcelona, Spain
Publisher
NLM (Medline)
Abstract
AIMS: Familial hypercholesterolaemia (FH) and elevated lipoprotein(a)
[Lp(a)] are inherited disorders associated with premature atherosclerotic
cardiovascular disease (ASCVD). Aortic valve stenosis (AVS) is the most
prevalent valvular heart disease and low-density lipoprotein cholesterol
(LDL-C) and Lp(a) may be involved in its pathobiology. We investigated the
frequency and predictors of severe AVS requiring aortic valve replacement
(AVR) in molecularly defined patients with FH. METHODS AND RESULTS:
SAFEHEART is a long-term prospective cohort study of a population with FH
and non-affected relatives (NAR). We analysed the frequency and predictors
of the need for AVR due to AVS in this cohort. Five thousand and
twenty-two subjects were enrolled (3712 with FH; 1310 NAR). Fifty patients
with FH (1.48%) and 3 NAR (0.27%) required AVR [odds ratio 5.71; 95%
confidence interval (CI): 1.78-18.4; P=0.003] after a mean follow-up of
7.48 (3.75) years. The incidence of AVR was significantly higher in
patients with FH (log-rank 5.93; P=0.015). Cox regression analysis
demonstrated an association between FH and AVR (hazard ratio: 3.89; 95%
CI: 1.20-12.63; P=0.024), with older age, previous ASCVD, hypertension,
increased LDL-CLp(a)-years, and elevated Lp(a) being independently
predictive of an event. CONCLUSION(S): The need for AVR due to AVS is
significantly increased in FH patients, particularly in those who are
older and have previous ASCVD, hypertension, increased LDL-CLp(a)-years
and elevated Lp(a). Reduction in LDL-C and Lp(a) together with control of
hypertension could retard the progression of AVS in FH, but this needs
testing in clinical trials.ClinicalTrials.gov number
NCT02693548. Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. © The Author(s) 2021. For
permissions, please email: journals.permissions@oup.com.

<56>
Accession Number
610196600
Title
Cardiovascular and other outcomes postintervention with insulin glargine
and omega-3 fatty acids (ORIGINALE).
Source
Diabetes Care. 39 (5) (pp 709-716), 2016. Date of Publication: 01 May
2016.
Author
Gerstein H.C.; Bosch J.; Dagenais G.R.; Jung H.; Maggioni A.P.; Pogue J.;
Probstfield J.; Ramachandran A.; Riddle M.C.; Ryden L.E.; Yusuf S.;
Richardson L.; Diaz R.; Johnston P.; Vige R.; Birkeland K.; Budaj A.;
Cardona E.; Chazova I.; Commerford P.; Danilova L.; Davies M.; Fernando
R.; Fodor G.; Gilbert R.; Gomis R.; Hanefeld M.; Hildebrandt P.;
Kacerovsky-Bielesz G.; Keltai M.; Kim J.H.; Krum H.; Lanas F.; Lewis B.S.;
Lonn E.; Lopez-Jaramillo P.; Marin-Neto J.; Marre M.; McKelvie R.; McQueen
M.; Mendoza I.; Morillo C.; Pan C.; Pirags V.; Profozic V.; Ratner R.;
Rosenstock J.; Spinas G.A.; Sreenan S.; Stoel I.; Syvanne M.; Yale J.F.;
Avezum A.; Bahit M.C.; Bogaty P.; Bordeleau L.; Chacomicronn C.; Corson
M.; Harper W.L.; Halon D.; Magloire P.; Mann J.; Pavlova V.; Punthakee Z.;
Silva J.; Tsang B.; Yakubovich N.; Abdallah A.; Ahmad S.; Chandra J.;
Chandra R.; Cukierman-Yaffee T.; Dyal L.; Joldersma L.; MacRae L.; MacRae
S.; Malik S.; Mead A.; Pasha F.; Pazmino-Canizares J.; Pohl K.; Sakalas
A.; Tyrwhitt J.; Ahuad Guerrero R.; Alebuena A.; Alvarez N.; Alzogaray M.;
Amuchastegui M.; Andres M.; Angos M.; Baglivo H.; Barbieri M.; Bassi F.;
Bello F.; Bono J.; Bustamante Labarta M.; Bustos B.; Caccavo A.; Calveira
M.; Camino A.; Cantero M.; Capozzi M.; Cardone M.; Cartasegna L.;
Cassetari A.; Castellanos R.; Chavez Caballero R.; Cipullo M.; Contreras
A.; Coria J.; Corinaldesi F.; Costa G.; Crespo C.; Cruz M.; Cuello J.;
Cuneo C.; Del Corro I.; Diez R.; Dituro C.; Dominguez A.; Facta A.;
Faingold C.; Farah M.; Fares Taie A.; Fernandez A.; Ferrari A.; Ferrari
N.; Garcia Monteverde C.; Garrido M.; Giachello C.; Gonzalez M.; Gutierrez
N.; Guzman L.; Guzman P.; Hasbani E.; Henquin R.; Hershon A.; Hirschon
Alvarez Prado A.; Hominal M.; Hrabar A.; Imposti H.; La Grutta M.;
Lanchiotti P.; Lobo Marquez L.; Lopez Santi R.; Lowenstein J.; Lugo M.;
Luqueci M.; Mainini S.; Majul C.; Manzano R.; Manzur S.; Marcucci G.;
Marino M.; Massari F.; Mendez N.; Molina M.; Montana O.; Mulazzi M.;
Nardone L.; Odetto I.; Orlandini A.; Oviedo A.; Paez O.; Parnas A.; Patron
F.R.; Pedernera C.; Pelagagge M.; Plastino M.; Polari P.; Pomposiello J.;
Porta A.; Prado A.; Quiroz M.; Ramirez A.; Rodriguez M.; Ronderos R.; Sago
L.; Sanchez A.; Sanchez R.; Sandrin A.; Schygiel P.; Sernia V.; Sinay I.;
Smith Casabella T.; Sosa Liprandi A.; Sosa Liprandi M.; Soso L.; Sposetti
G.; Stisman D.; Streitenberger P.; Suarez G.; Tonin H.; Ulla M.; Valdez
J.; Vico M.; Villamil A.; Villarino A.; Viscaya Castro A.; Visco V.; Vogel
D.; Waisman F.; Zaidman C.; Amerena J.; Applebe A.; Aylward P.; Binnekamp
M.; Bruce I.; Burdeniuk C.; Burnet R.; Colman P.; Colquhoun D.; Davis S.;
De Looze F.; De Pasquale C.; D'Emden M.; Eaton H.; Farshid A.; Foulanos
S.; Galanos J.; Gordon G.; Guhu M.; Ho J.; Jeffery I.; Jerums G.; Kwan M.;
Lefkovits J.; Luu S.; MacIsaac R.; Marjason J.; Mohabbati V.; Nankervis
A.; O'Neal D.; Perera N.; Poynten A.; Rahman A.; Razak S.; Roberts T.;
Sebastian M.; Simpson R.; Soldatos G.; Sullivan D.; Teede H.; Tiong F.;
Topliss D.; Torpy D.; Waddell-Smith K.; Waites J.; Wenman J.; Whelan A.;
Williams L.; Yeap B.; Yeow W.; Yong G.; Aczel S.; Azimy N.; Bertha P.;
Blocher J.; Bohnel C.; Brath H.; Breuss J.; De Campo A.; Drexel H.;
Ettmuller Y.; Feder A.; Feinboeck C.; Gulz E.; Hofmann M.; Hoppichler F.;
Jahnel H.; Jankovic V.; Kann T.; Kathrein T.; Kotter T.; Kratz E.;
Kreuzwieser E.; Loreck C.; Ludvik B.; Marte T.; Mellitzer K.; Nistler S.;
Placher-Sorko G.; Prager R.; Rein P.; Riedl M.; Saly C.; Schernthaner G.;
Schichka E.; Seidlhofer C.; Sonnenfeld M.; Stefan H.; Steiner K.; Thomas
B.; Toplak H.; Urstoger K.; Vetter B.; Vonbank A.; Waldschutz W.; Wallner
F.; Winkler F.; Goncharik D.; Lazareva I.; Lichorad N.; Mrochek A.;
Murashko N.; Radyuk D.; Ramanovski A.; Sudzhaeva S.; Sujayeva V.;
Yarashevich N.; Campbell G.; Marshall S.; West A.; Abreu F.; Alves M.;
Ayoub-Aidar J.; Barros M.; Barros-Silveira J.; Blacher M.; Costa E.; Costa
F.; Daltro C.; Delana J.; Eliaschewitz F.; Facanha C.; Feitosa G.;
Figueiredo J.; Forti A.; Franco D.; Franken M.; Freire F.; Garcia V.;
Gouvea-Neto A.; Grofallo S.; Kanedlai N.; Kerr-Saraiva J.; Ladeira R.;
Leaes P.; Lemos M.; Lima F.; Lima Filho M.; Macedo L.; Manenti E.; Monte
O.; Mossman A.; Mothe F.; Mouco O.; Moyses Golbert M.; Nasser Hissa L.;
Nasser-Hissa M.; Nicolau J.; Nigro Maia L.; Ninno T.; Nunes C.; Oliveira
C.; Oliveira O.; Passos da silva R.; Pericles-Esteves J.; Rabelo L.;
Rabelo-Alves Junior A.; Rassi S.; Rech R.; Roldan F.; Salles J.; Sampaio
C.; Seabra A.; Sealissi N.; Seixas A.; Sena R.; Shehadeh I.; Teixeira M.;
Turin H.; Vicente Serrano C.; Vidigal M.; Vilela M.; Wajchenberg B.;
Abbott C.; Abu-Bakare A.; Ardilouze J.; Auersperg E.; Bailey A.; Bailey
G.; Baillargeon J.; Beaurivage C.; Belair J.; Belanger A.; Bellabarba D.;
Berlingieri J.; Bernier F.; Bhargava R.; Bhesania T.; Booth W.; Bose S.;
Boulianne M.; Bourgeois S.; Breton D.; Brossoit R.; Buithieu J.; Campeau
J.; Carlson B.; Carpentier A.; Cavalcanti R.; Cha J.; Chagnon P.; Chan Y.;
Chessex C.; Chiasson J.; Chouinard S.; Clayton D.; Conway J.; Crepeau J.;
Cudmore D.; D'Ignazio G.; Doig G.; Dominguez M.; Dube F.; Dumas R.; Dupuis
R.; Dyrda I.; Eddy D.; Eiley D.; Fox H.; Fratesi S.; Gallant S.; Garceau
C.; Garfield N.; Germain C.; Glazer S.; Gosselin G.; Gould D.; Grills G.;
Halle J.; Hardin P.; Harper W.; Heath J.; Heath V.; Hivert M.; Ho K.;
Houde G.; Hramiak I.; Hutchinson A.; Huynh T.; Ilie-Haynes R.; Imran S.;
Islam A.; Iwanochko M.; Jones C.; Joyce C.; Kirouac I.; Kumar R.; Lamothe
M.; Langlois M.; Lauzon C.; Lavoie M.; Leader R.; Lecours S.; Lepage S.;
Lochnan H.; Ma P.; McLean A.; Mecci S.; Mehta P.; Mercier M.; Miller D.;
Morisset A.; Nawaz S.; Nisker W.; Nyomba G.; O'Keefe D.; Palardy J.;
Parekh P.; Paul T.; Perron P.; Pesant M.; Phillips R.; Pruneau G.; Quintin
I.; Raby K.; Richard C.; Rosenfeld G.; Saulnier D.; Shaban J.; Shah A.;
Shu D.; Sigal R.; Silverman M.; Singh J.; Sivucha W.; Skamene A.;
Sliwowicz D.; Smith R.; St Hilaire R.; Steinson D.; Sussex B.; Tan K.;
Tannous R.; Telner A.; Theroux P.; Tsoukas C.; Tsoukas G.; van Buuren J.;
VanRossum N.; Vexler R.; Vizel S.; Warnica W.; Weingert M.; Wilson R.;
Wong W.; Woo V.; Yale J.; Acevedo M.; Alwyn C.; Baier E.; Baier S.;
Galloso R.; Lahsen R.; Lorenas G.; Montecinos A.; Montecinos M.; Pineda
P.; Pollak F.; Sapunar J.; Serrano V.; Stockins B.; Varleta P.; Yovanovich
J.; Zambra F.; Ba J.; Bao Y.; Bi Y.; Bu S.; Chen B.; Chen H.; Chen J.;
Chen L.; Chen M.; Chen Y.; Cui J.; Dong M.; Feng P.; Feng Z.; Gao C.; Gao
F.; Gao X.; Gao Z.; Gong Y.; Guang L.; Guo X.; Han F.; Han X.; Hou X.; Hu
R.; Ji L.; Jia J.; Jia W.; Jiao X.; Jin X.; Kuang J.; Li M.; Li Q.; Li X.;
Li Y.; Ling Y.; Liu F.; Liu Z.; Lu B.; Lu J.; Lu Z.; Lv X.; Ning G.; Peng
Y.; Ren Y.; Shao Y.; Shi Y.; Shu X.; Sun H.; Sun L.; Sun X.; Tang K.; Tian
H.; Wang C.; Wang F.; Wang L.; Wang Q.; Wang W.; Wang X.; Wang Y.; Wen J.;
Wu C.; Wu H.; Wu J.; Wu M.; Xing X.; Xue Y.; Yan L.; Yan S.; Yang H.; Yang
N.; Yang W.; Yang Z.; Yao J.; Yao L.; Yu D.; Yu H.; Yu M.; Yu X.; Yuan L.;
Yuan M.; Yuan S.; Yuan W.; Yuan Y.; Yuan Z.; Zeng T.; Zhang J.; Zhang R.;
Zhang X.; Zhao L.; Zheng B.; Zheng J.; Zhou W.; Zhu N.; Zhu Y.; Zou D.;
Zou J.; Accini J.L.; Bohorquez R.; Botero R.; Cure C.; Figueredo M.;
Hernandez E.; Kattah W.; Llamas A.; Orozco L.; Pava L.; Perez M.; Pineda
M.; Quintero A.; Quiros R.; Urina M.; Velez S.; Altabas V.; Baotic I.;
Berkovic M.; Goldoni V.; Kerum T.; Mirosevic G.; Tarle D.; Vidovic I.;
Zjacic-Rotkvic V.; Abbas R.; Andersen H.; Auscher S.; Baumbach L.;
Brockstedt H.; Christensen P.; Christiansen M.; Clemmensen K.; Egstrup K.;
Gislason G.; Haar D.; Hansen K.; Heden Andersen P.; Helleberg K.;
Hermansen K.; Holmer J.; Jeppesen J.; Klausen I.; Koustrup-Sonder T.;
Krarup T.; Lerche S.; Lervang H.; Linde B.; Lund P.; Lund S.; Madsbed S.;
Molvig J.; Orskov C.; Ostergaaard O.; Perrild H.; Pietraszek A.; Ralfkjaer
N.; Roenne H.; Rokkedal Nielsen J.; Seibaek M.; Soendergaard H.; Sorensen
L.; Sundahl Mortensen L.; Torp-Pedersen C.; Tuxen C.; Urhammer S.;
Vadstrup E.; Ambos A.; Janson A.; Rudenko P.; Viitas L.; Aranko S.; Badeau
M.; Eriksson J.; Haapamaki H.; Kajander O.; Kuusisto A.; Luukkonen S.;
Makela J.; Nieminen S.; Niskanen L.; Ripatti J.; Ruotsalainen S.; Saltevo
J.; Savela K.; Strand J.; Valle T.; Virkamaki A.; Aboud E.; Alavoine L.;
Bekherraz A.; Bohme P.; Bourezane H.; Catargi B.; Charpentier G.; Clergeot
A.; Courreges J.; Delmas T.; Duengler F.; Feknous C.; Gendre D.; Guerci
B.; Hadjadj S.; Kerlan V.; Laguerre N.; Le Potier J.; Lombardo F.;
Malville E.; Marechaud R.; Mattei C.; Moreira J.; Penfornis A.; Petit C.;
Pinel J.; Piquel X.; Raccah D.; Reznik Y.; Rod A.; Roudaut N.; Rousseau
E.; Schillo F.; Schmitt B.; Sonnet E.; Torremocha F.; Travert F.; Vanhoute
C.; Vimeux M.; Abdollahnia R.; Adamidou A.; Arslan S.; Bach-Kliegel B.;
Bartusch B.; Bauer N.; Bieler T.; Blankenfeld H.; Boeckmann U.; Busch K.;
Butzer R.; Chenchanna-Merzhaeuser M.; Denger R.; Deutsch C.; Diessel S.;
Donati-Hirsch I.; Dornisch M.; Enghofer K.; Fleig T.; Forst T.; Frommherz
M.; Goeller K.; Habbig J.; Hadziselimovic S.; Hamann A.; Hampel T.; Heger
S.; Helmes C.; Hoffman C.; Hohberg C.; Humpert P.; Kamke A.; Kamke W.;
Kindermann P.; Klein C.; Klein D.; Koehler A.; Kuehn A.; Langer K.; Limmer
S.; Loew A.; Maimer A.; Marck C.; Meier G.; Methner-Friederich M.; Metzler
W.; Meyer K.; Miftari N.; Milde J.; Minnich J.; Molkewehrum M.; Morcos M.;
Mueller-Hoff C.; Nguyen M.; Nishwitz M.; Oldenburg J.; Ott P.; Pauli K.;
Pauly B.; Pfeiffer A.; Pfuetzner A.; Pischa U.; Radke R.; Reismann P.;
Riemer M.; Rochlitz H.; Rudofsky G.; Ruhla S.; Sammler A.; Schaper F.;
Schiemenz K.; Scholz G.; Schumm-Draeger P.; Segiet T.; Segner A.; Seissler
J.; Spahn S.; Stier U.; Tonon G.; von Amelunxen S.; von Schacky C.;
Wilhelm B.; Wilhelm K.; Witt K.; Wuechner-Hofmann S.; Baranyai M.; Birkus
Z.; Foldesi I.; Gaal Z.; Harcsa E.; Hati K.; Hohmann Z.; Istenes I.;
Jozsef I.; Juhasz E.; Kempler P.; Keresztes B.; Keresztes K.; Kis-Gombos
P.; Kovacs I.; Kozma T.; Laszlo Z.; Noori E.; Nyirati G.; Papp Z.; Patkay
J.; Poor F.; Pusztai P.; Putz Z.; Rigo E.; Sereg M.; Simon K.; Somogyi A.;
Sumegi J.; Szabo A.; Szabo J.; Szigeti S.; Szilveszter D.; Tarko M.; Varga
C.; Varga Szabo L.; Voros P.; Arathi; Badgandi M.; Balaji M.; Balaji V.;
Chamukuttan S.; Aravind S.; Fatima S.; Ganapathy B.; George O.; George P.;
Jaffar M.; Jain P.; Kamath P.; Karthik V.; Koshy G.; Krishnan L.; Kumar
H.; Lal P.; Mithal A.; Modi S.; Mohan V.; Moses V.; Oomen R.; Pais P.;
Pati P.; Pendsey S.; Rai P.; Rajagopal R.; Ramu M.; Ranjit U.; Rao P.;
Senthil V.; Seshaiah V.; Sethi B.; Shah P.; Sharma R.; Shetty S.; Shobha
A.; Siddharth R.; Sridhar G.; Sudeep K.; Sunil C.; Sunitha S.; Suresh S.;
Thomas N.; Vageesh A.; Anwer Z.; Barton J.; Behan L.; Bell M.; Cullen M.;
Dineen S.; Draman Yusof M.; Dunne F.; Gibney J.; Hussain T.; Khan M.;
Kinsley B.; Kyithar P.; Lavin F.; McGowan A.; McGurk C.; Mirza A.;
Mohammadi B.; O'Brien T.; O'Connell J.; O'Halloran D.; O'Shea D.; Roberts
G.; Tomkin G.; Wan Mahmood W.; Abramod-Ness R.; Adawi F.; Aharon B.;
Backer M.; Beniashvili A.; Berliner A.; Bloch L.; Bugelman D.; Butnaru A.;
Cohen O.; Cohen Y.; Frenkel M.; Glant M.; Gustava B.; Guttman H.; Halabi
S.; Harman-Boehm I.; Ilany J.; Karkabi B.; Khader N.; Khaskia A.; Khudyak
Y.; Klainman E.; Kogan N.; Lender D.; Levin I.; Mardi T.; Marmor A.;
Mosseri M.; Nabriski D.; Omary M.; Orlovsky S.; Peres D.; Quasim M.; Raz
I.; Remesnik M.; Rogowski O.; Rozenfeld I.; Scharr D.; Shnifer I.; Shuster
T.; Solomon R.; Steiner H.; Tzivoni D.; Wolfson N.; Yossef Z.; Zahger D.;
Zeltser D.; Zimlichman R.; Aina F.; Ariatti C.; Bonetti R.; Cacciatore F.;
Calcinaro F.; Corona G.; De Maria P.; Del Prato S.; Derosa G.; Di Pasquale
G.; Falorni A.; Fanelli R.; Fedele D.; Filorizzo G.; Fogari R.; Furgi G.;
Ghio A.; Giorda C.; Gregori G.; Iannuzzi G.; Lapolla A.; Luciano B.;
Lucotti P.; Maggi A.; Marafetti L.; Marchese T.; Martino G.; Marzotti S.;
Miccoli R.; Monti L.D.; Moretti L.; Palvarini M.; Petacchi R.; Piarulli
F.; Piatti P.M.; Rudi S.; Santeusanio F.; Sesti G.; Setola E.; Sforza A.;
Shehaj E.; Veniani M.; Viviani G.; Zigoura E.; Chae S.; Cho D.; Cho E.;
Cho Y.; Choi Y.; Chung M.; Hong E.; Hong Y.; Jeong M.; Kim B.; Kim D.; Kim
H.; Kim I.; Kim J.; Kim P.; Kim S.; Koo B.; Kwok S.; Kwon H.; Lee J.; Lim
J.; Oh S.; Ohn J.; Park C.; Park H.; Park K.; Seung K.; Son H.; Woo J.;
Yoon K.; Ansmite B.; Balcere I.; Bumbure A.; Ducena K.; Lejnieks A.; Rasa
I.; Ritenberga R.; Romanova M.; Salmina I.; Steina S.; Badariene J.;
Gailiuniene S.; Grigonis S.; Juskiene R.; Petrulioniene Z.; Sakalyte G.;
Stasiunas T.; Sulskiene M.; Urbonaite B.; Zarankiene R.; Ziukaite R.;
Arechavaleta R.; Beltran-Jaramillo T.; Calvo-Vargas C.; Campillo-Cardenas
C.; Cardona D.; Carmona-Huerta J.; Cedano-Limon M.; Comellas-De M.;
Dominguez C.; Gomez-Cruz J.; Gonzalez-Perez R.; Illescas J.; Jimenez-Ramos
S.; Lopez-Alvarado A.; Marquez-Rodriguez E.; Martinez G.; Pascoe S.;
Plascencia Vazquez O.; Rodriguez H.; Ruiz-Cornejo M.; Velasco-Sanchez G.;
Vidrio-Velazquez M.; Villeda-Espinosa E.; Badings E.; Bartels G.;
Bruggink-Andre de la Porte P.; Bruijns E.; Cornel J.; De Milliano P.; De
Mulder M.; De Swart J.; Derks A.; Dirkali A.; Droste J.; Galjee M.;
Hautvast R.; Hermans W.; Holwerda N.; Ilmer B.; Kofflard M.;
Kooistra-Huizer J.; Kurvers M.; Langerveld J.; Leenders C.; Liem A.; Lok
D.; Neumann D.; Nierop P.; Plomp K.; Posma J.; Reichert C.; Roeters Van
Lennep H.; Ronner E.; Said S.; Takens L.; Umans V.; Van der Sluis A.A.;
Van der Zwaan C.; Van Dobbenburgh J.; Van Es A.; Van Hessen M.; Van
Mechelen R.; Van Miltenburg-Van Zijl A.; Van Zeijl L.; Veerhoek M.;
Viergever E.; Weijers E.E.; Willems F.; Blix I.; Cooper J.; Debowska A.;
Erichsen K.; Fossum J.; Gjertsen E.; Grill V.; Gudnason S.; Hoye K.; Istad
H.; Winther J.; Joakimsen R.; Jorde R.; Larsen I.; Mella B.; Otterstad J.;
Risberg K.; Skare K.; Skeie S.; Sommervoll L.; Tandberg A.; Whitfield R.;
Wium C.; Cunanan E.; Fernando-Catindig E.; Gomez M.; Jaring C.;
Lantion-Ang F.; Licaros M.; Lim-Abrahan M.; Madronio E.; Panelo A.; Raboca
J.; Ramos G.; Tugna S.; Aksamit-Bialoszewska E.; Bandurska-Stankiewicz E.;
Baranska M.; Bronisz A.; Bronisz M.; Chrustowski W.; Cieslak B.;
Czupryniak L.; Drazkowicz-Gozdzik B.; Galuszka-Bilinska A.; Gmytrasiewicz
M.; Janik K.; Jedynasty K.; Kania G.; Kawka-Urbanek T.; Kinalska I.;
Kincel K.; Kleszczewska U.; Kruszewski J.; Loba J.; Malicka J.;
Mielecka-Kincel M.; Milczarczyk A.; Milosz D.; Mrowczynska A.; Mytnik M.;
Nowakowski A.; Nowakowski P.; Oleskowska L.; Omelanczuk-Wiech E.;
Pawlowski M.; Poplawska A.; Rucinska M.; Rucinski M.; Rutkowska J.;
Saryusz-Wolska M.; Siewko K.; Sikora-Frac M.; Stecka-Wierzbicka J.;
Swiatkowski M.; Swierczynski R.; Szpajer M.; Szymkowiak K.; Tarach J.;
Tarasiewicz U.; Wiatr D.; Wojewoda P.; Woszczak-Marcinkowska H.; Zadrozny
J.; Hancu N.; Albota A.; Bala C.; Barbonta D.; Botnariu G.; Bradescu O.;
Busegeanu M.; Bzduch M.; Catrinoiu D.; Caziuc R.; Cerghizan A.; Cheta D.;
Cif A.; Ciomos D.; Cosma D.; Creteanu G.; Crisan I.; Danciulescu R.;
Dobjanschi C.; Dodan R.; Duma L.; Ferariu I.; Ghenes T.; Ghise G.; Graur
M.; Ilinca M.; Marton R.; Mindrescu N.; Morosanu A.; Morosanu M.; Mota M.;
Nafornita V.; Negrisan G.; Nicodim S.; Nicolau A.; Nita C.; Onaca A.;
Panus C.; Pletea N.; Pop C.; Pop L.; Popa B.; Roman G.; Rosu M.; Sandu N.;
Serban V.; Sima A.; Stamoran L.; Strugariu M.; Suciu G.; Szilagyi I.;
Vacaru G.; Veresiu I.; Vlad A.; Adasheva T.; Ageev F.; Akhmedganov N.;
Akinina A.; Alexandrov A.; Ambatiello L.; Ametov A.; Ausheva A.; Babaeva
L.; Babenko A.; Balyasnikova E.; Bart B.; Belova J.; Berstein L.;
Bondarenko I.; Bondarev E.; Bulkina O.; Chernikova N.; Chumak B.; Deeva
T.; Demicheva O.; Demidova T.; Doskina E.; Duganova A.; Dzhaiani N.;
Egorova I.; Ettinger O.; Feofanova S.; Fofanova T.; Galaktionov P.;
Gavrilova N.; Gilyarevsky S.; Gnidkina N.; Golubev A.; Gornyakova N.;
Grigorova S.; Grineva E.; Gurevich V.; Irtuganov N.; Ivanova L.; Jaiani
N.; Kalashnikova M.; Karpov Y.; Khalimov Y.; Khorocheva G.; Kirillova E.;
Kistner J.; Kobalava Z.; Kochergina I.; Kravchenko T.; Krylov K.; Kulkova
P.; Kuparev I.; Kurbanova E.; Lysenko T.; Markovich A.; Martyanova I.;
Martynyuk T.; Masiinvets M.; Mavlyavieva E.; Maychuk E.; Melnichenko G.;
Mikhailusova M.; Mkrtumyan A.; Mychka V.; Nebieridze D.; Nesterova E.;
Orlov V.; Orlova V.; Orlova Y.; Papov F.; Patroucherva I.; Petunina N.;
Pirozhinskaya S.; Podachina S.; Postnikova S.; Pshikova O.; Rogova L.;
Romashevskiy B.; Runikhina N.; Sadulayeva I.; Safaryan A.; Sakovich E.;
Saprikina T.; Sargsyan V.; Semikozova O.; Shkolnik E.; Shubina A.; Shustov
S.; Sinitsina I.; Solovyeva E.; Storogakov G.; Stovpyuk O.; Sussekov A.;
Telnova M.; Temirov A.; Terekhov V.; Tereschenko S.; Tiourina T.;
Tolkacheva V.; Tsoy U.; Urazgyldeeva S.; Vasyuk Y.; Vinnitskay N.;
Voevodina E.; Volkova A.; Zadionchenko V.; Zalevskaya A.; Zhelninova T.;
Zhukova N.; Zilov A.; Bernatova J.; Duris T.; Markova I.; Martinka E.;
Michalova L.; Minarik P.; Peter L.; Raslova K.; Silvia D.; Subadova M.;
Tisonova J.; Vohnout B.; Adam M.; Badat A.; Bester A.; Bester F.; Blacking
L.; Bouwer D.; Brice B.; Cassimjee S.; Cronje T.; Deftereos J.; Distiller
L.; Ellis G.; Forster O.; Fulat M.; Gani M.; Gibson G.; Hansa S.;
Hendricks N.; Herbst L.; Hitzeroth J.; Joffe B.; Kelbe C.; Kelbe D.; King
J.; Kramer B.; Landau S.; Levitt N.; Meyer-Nell S.; Moore R.; Muller D.;
Nell H.; Omar M.; Randeree H.; Seeber M.; Seedat; Siebert M.; Van den Berg
E.; Van der Walt P.; Van Dyk C.; Van Niekerk F.; Van Zyl L.; Segynu D.;
Bertomeu V.; Botella M.; Buno M.; Calle A.; Cano Perez J.; Coves M.;
Juanatey J.G.; Garcia-Mayor R.; Gaztambide S.; Gippini A.; Goikolea I.;
Gonzalez J.; Hillman N.; Lopez Garcia Aranda V.; Magueda I.; Mato J.;
Mazon P.; Morillas P.; Novials A.; Pallardo L.; Perez L.; Rodriguez J.;
Romero L.; Sagarra E.; Shamagian L.; Soto A.; Torrealday H.; Valero R.;
Agergaard S.; Agewall S.; Andersson K.; Bergstrom O.; Bjornstedt Bennermo
M.; Blomgren J.; Boman K.; Brohall G.; Cherfan C.; Dahlen C.; Dotevall A.;
Enander P.; Ericsson U.; Hallgren P.; Hansson A.; Henareh L.; Henriksson
P.; Herlitz J.; Holmqvist J.; Jarevi G.; Linderfalk C.; Jonasson L.;
Jovinge S.; Kalen J.; Kilstrup M.; Leosdotir M.; Leppert J.; Ljungberg J.;
Lofdahl B.; Lundman P.; Lysell-Bergstrom C.; Mathiesen U.; Mellbin L.;
Morner S.; Nathanson D.; Nilsson L.; Peterson M.; Quittenbaum S.;
Rosengren A.; Ryttberg B.; Scheel S.; Svensson K.; Tenerz A.; Vasko P.;
Waldenstrom A.; Wieloch M.; Spinas G.; Braendle M.; Felix B.; Gerber P.;
Moccetti T.; Pitteloud N.; Kultursay H.; Aydinalp A.; Balci M.; Cayli M.;
Hatipoglu E.; Ilkova H.; Kayikcioglu M.; Koc M.; Muderrisoglu H.; Sari R.;
Saygili F.; Tekin K.; Tutuncu N.; Yurekli B.; Adler A.; Ali A.;
Balasubramanian; Barakat O.; Barnett A.; Borthwick L.; Brookes; Cecil J.;
Chaterjee S.; Clark J.; Collinson D.; Collinson S.; Bandypadhyay P.;
Donnelly R.; du Plessis J.; Egan S.; Ellery A.; Burton J.; Ewing J.; Fox
C.; Gibson M.; Hall T.; Higgs E.; Hollway M.; Hughes E.; Jackson N.;
Jalihawi H.; Jones G.; Knights H.; Korsheed S.; Kumar Singh R.; Laithwaite
D.; Lawrence I.; Litchfield J.; Manning G.; McNally P.; Millar-Craig M.;
Mohammed I.; Narayanan R.; Nayani G.; Norris A.; Purohit J.; Quinn M.;
Ramtoola; Rea R.; Reckless J.; Richardson T.; Robertson D.; Robinson A.;
Salem K.; Sampson M.; Savage M.; Shaker J.; Srinivasan T.; Tracy I.;
Tringham J.; Viljoen A.; Ward A.; Waterhouse H.; Wijenaike N.; Wiles P.;
Ahmann A.; Ahmed I.; Alam A.; Arakaki R.; Asad S.; Banarer S.; Baum H.;
Belew K.; Bergenstal R.; Bethel M.; Boyer C.; Catton S.; Challans P.;
Childs B.; Christian R.; Clement S.; Cuddihy R.; Dailey G.; Damberg G.; De
Bold C.; De Lemos J.; Donovan D.; Dudl J.; Dunbar J.; Ebner S.; Failor R.;
Feinglos M.; Flaker G.; Freiburghaus M.; Furlong K.; Gardner D.; Gillespie
E.; Goland R.; Goldberg R.; Gotham A.; Guthrie R.; Hamaty M.; Hirsch I.;
Jabbour S.; Janci M.; Javorsky B.; Jones S.; Kamana V.; Kashyap M.;
Kaufman S.; Kearns P.; Khera A.; Klopfenstein B.; Kniffen W.; Kringas P.;
Licata A.; Lopez-Jimenez C.; Madden M.; Marx C.; McCall A.; McCallum J.;
McFarlane S.; McGuire D.; Melish J.; Meneghini L.; Miller S.;
Miranda-Palma B.; Mitchell R.; Nasr C.; Nelson J.; Niblack P.; Nylen E.;
Osei K.; Pandey A.; Papademetriou V.; Pilar Solano M.; Sameshima L.;
Savarese V.; Schnure J.; Schuster D.; Shin J.; Taylor A.; Thomson P.;
Ting-Ryan M.; Trence D.; Vo A.; Weiland K.; Wells K.; Wu P.; Zimering M.;
Zimmerman R.; Ascanio P.; Brajkovich I.; Carrillo E.; Coll J.; Gonzalez
K.; Gonzalez N.; Jimenez E.; Lopez R.; Marante D.; Morr I.; Paolillo M.;
Perche D.; Portillo M.; Valbuena H.; Velarde M.; Vergara G.; Augensen N.;
Azzalina J.; Fidaly S.; Bollero G.; Casiello A.I.; Ferraro F.; Guridi
M.J.; Ines M.; Martin M.E.; Pascual A.; Pereyra J.; Toscanelli M.; Appiah
M.; Grech S.; Pouras S.; Watts C.; Denke E.; Feik C.; Litvinenko M.;
Platonenko O.; Shadur S.; Johnson J.; Bonilla E.; Carraway B.; Faith J.;
Greer C.; Harding A.; Heston J.; Lin Y.; Mecca T.; Schuler M.; Rizk C.;
Sissoko A.; Strickland K.; Andrade A.; Lux L.; Machado D.; Mancin E.;
Aquino J.; Belanger B.; Bourque C.; Gagnier K.; Hagerimana A.; McNeil A.;
Osachoff J.; Richard B.; Rogan J.; Styner L.; Maturana X.; Naranjo M.E.;
Li E.; Liu Q.; Shuai M.; Tan Z.; Tang M.; Zhao J.; Ardila M.; Gomez A.M.;
Uscategui A.M.; Marinkovic N.; Miocevic V.V.; Pezo S.; Andersen I.;
Bastrup-Larsen B.; Jeppesen E.; Kofoed-Djursner M.; Joe H.; Hiironen V.;
Tarvainen M.; Von Hedenberg H.; Guillarme C.; Rastelli O.; Roy P.; Igel
L.; Lenz T.; Leptich A.; Peikert S.; Domokos S.; Szotyorine-Polcza G.;
Wenczl M.; Chaudhary S.; Jaiswal G.; Khatri P.; Shah K.; Gibson S.; Bechar
Y.; Erdheim D.; Eyal N.; Frankel M.; Shimoni S.; Tsuri J.; Bianco L.; Cali
R.; Sganga P.; Jang M.; Kim J.M.; Kim Y.; Lim S.; Park J.S.; Song Y.;
Kalve E.; Dienyte E.; Alvarado F.; Rodriguez R.; Bar J.; Lijfering-Lorie
K.; Palstra M.; Van der Kuijl K.; Van de Wetering A.; Eriksen S.;
Hejazifar S.; Jendeberg A.; Johannessen G.; Khammari I.; Meredith E.L.;
Dayag A.M.; Figueroa P.; Hoffmann Korpalska A.; Przemyk M.; Craciunescu
A.; Lupu D.; Osanu A.; Popscu L.; Toader C.; Kirsanova T.; Timoshina E.;
Gomez B.; Jankularova I.; Brett S.; Meyer A.; Pereira V.; Vawda N.;
Castano B.; Farre Avella J.M.; Jimenez I.; Turet N.; Froberg M.; Reppert
E.; Wessman S.; Boschung Y.; Carrozzino F.; Gerstl K.; Cetin Z.; Demirci
S.; Ovalioglu S.; Lenehan A.; McLean H.; Mutsaers K.; Redfern P.; Scoggins
A.; Isea Y.; Alvarez M.; Alvarez D'Amelio A.; Aqueveque S.; Argenta M.;
Aviles A.; Barreiro E.; Battistessa Y.; Bergamo S.; Bertran B.; Bocanera
M.; Bowen L.; Brescia H.; Caceres M.; Cappi A.; Cardelli A.; Carolini E.;
Carpintero S.; Carrique A.; Carrique P.; Casquero M.; Castro M.; Cendali
G.; Chatelain M.; Costanzi A.; Cristofaro C.; Crunger P.; Ehrich S.;
Espinosa M.; Esposito L.; Flenche M.; Fracaro V.; Funosas C.; Garrido I.;
Gomez Garrido A.; Guzman A.; Izzicupo M.; Luca S.; Luciani C.; Majul S.;
Moreno Cepeda I.; Moschin Y.; Niemann G.; Novas V.; Olmi M.; Palma F.;
Peralta A.; Puig A.; Rodera Vigil M.; Ronderos G.; Rosell M.; Samudio M.;
Santicchia C.; Szczygiel V.; Takla M.; Tinnirello C.; Tonin S.; Tristan
A.; Troncoso C.; Vignau S.; Yanez K.; Zarate M.; Appeldorf R.; Batrouney
B.; Bonner A.; Bonner M.; Cahill P.; Carr J.; Caruana M.; Chare J.; Doran
A.; Flavel; Griek S.; Hulley A.; Keays P.; Kent S.; Lai N.; Legg H.; Long
A.; Lynch L.; Maxwell V.; McNamara K.; Nairn J.; Nichols V.; Peeler C.;
Phillips J.; Gein J.; Ryan S.; Stockle P.; Tapp E.; Taverner P.; Tulloch
G.; Viola V.; Wilson L.; Beck A.; Damon S.; Drexel V.; Grabner E.;
Hofurthner A.; Kivioja P.; Kretschmer S.; Lener P.; Maiweg J.; Tscherner
D.; Weichelt H.; Winkler J.; Jones D.; Alves L.; Batista R.; Bernardes A.;
Demore de Souza A.; Ferraz R.; Ferreira A.; Freitas E.; Guanaes D.;
Kuschel K.; Muniz R.; Nasser-Hissa V.; Nhan P.; Osorio R.; Queirantes C.;
Reboucas R.; Souza C.; Tonani M.; Vicente C.; Zilli A.; Andersen K.; Aro
L.; Barber C.; Barnable B.; Berard L.; Bernier A.; Boudreault C.;
Bourbonnais A.; Bourgeois L.; Boutin D.; Boyer D.; Branco N.; Briol L.;
Brousseau M.; Burke M.; Chambers C.; Champoux A.; Chan S.; Colborne C.;
Coles K.; Couture M.; Cryderman C.; DeCurtis D.; Dewar C.; Drown J.; Dunn
P.; Eichmann D.; Eikel L.; Fox B.; Gauthier S.; Gibbons D.; Hicks R.; Ho
V.; Kitagawa H.; Kooistra L.; Landry F.; Lapointe F.; Larrivee L.; Leonard
P.; Louch D.; MacNair D.; Magennis L.; Mallette D.; Marchand C.; McLean
S.; Meilleur M.; Murdock H.; Naud M.; Olson K.; Otis J.; Ouimet F.;
Paquette H.; Peck C.; Pelletier A.; Perkins L.; Petrie F.; Pockett S.;
Poulin F.; Poulin M.; Primbas K.; Renton J.; Rouatt S.; Roy M.; Scarcelli
D.; Schellenberg S.; Schellevis K.; Schmidt N.; Scott L.; Skarpinsky B.;
Smith B.; Smith E.; Stafford C.; Stata C.; Sternberg B.; St-Jean N.;
Stoger S.; Thibodeau C.; Toupin A.; Ullyatt L.; Velonas J.; Vienneau R.;
Wall C.; Zaniol D.; Arau M.; Fuentes J.; Hidalgo J.; Landaeta O.; Padilla
I.; Sanzana S.; Tellos G.; Toro F.; Vergara R.; Che T.; Du Y.; He Y.;
Huang C.; Li H.; Liu S.; Luo X.; Ma Y.; Pan S.; Wan Q.; Wang H.; Wang S.;
Xie Y.; Xu X.; Xu Y.; Zhao F.; Zhou M.; Accini M.; Bello O.; Caceres A.;
Camargo S.; Figueroa J.; Florez M.; Gomez Morales K.; Granados L.;
Martinez M.; Medina Ramos M.; Mejia C.; Montoya L.; Ramos C.; Restrepo P.;
Rodriguez D.; Santamaria A.; Valencia T.; Spanic V.; Borre Hansen A.;
Bulow M.; Ehlers G.; Frederiksen A.; Gottschalck H.; Hejlskov B.; Holm
Fruesnsgaard Pedersen L.; Hornum H.; Jansen S.; Johansen A.; Jorgensen A.;
Kjaeulff Svaneborg T.; Kruse A.; Lund K.; Lundgaard M.; Madsen J.; Meier
A.; Muurholm A.; Nedergaard A.; Nielsen S.; Norgaard D.; Olsen A.; Raae
D.; Reiter P.; Sigsgaard U.; Vestergaar I.; Witt A.; Mitt T.; Timmusk P.;
Heikkila E.; Heiskanen R.; Huotari E.; Keskitalo A.; Kylmala L.; Laitinen
M.; Laukkanen M.; Leskinen S.; Liesivuori J.; Lukkari-Kuronen L.; Merisalo
P.; Muurinen E.; Nikkanen P.; Niskanen T.; Pasanen P.; Pekkonen L.; Retsu
A.; Soppela A.; Andreu N.; Ankotche A.; Bairras C.; Boch C.; Camachon L.;
Cherchouly A.; Coudret S.; Demer C.; Gilg R.; Lemonade L.; Madec O.;
Pinotti D.; Poirier I.; Tenne N.; Vogler C.; Amman M.; Andratschke-Gentsch
B.; Beckmann H.; Bischoff S.; Bleich B.; Bueschges G.; Busch E.;
Deigentasch S.; Dietze S.; Dollinger M.; El-Bahay C.; Flehmig G.; Frenzel
I.; Geissler K.; Guerro J.; Heike B.; Holler D.; Inhoffen C.; Klein K.;
Kraehe I.; Kress P.; Krueger H.; Lenz R.; Linnebach B.; Lueck A.; Markhof
P.; Matthies K.; Meier C.; Metzler E.; Moor E.; Noll I.; Paulsen S.;
Pfeffer B.; Promnitz N.; Saljew B.; Schad S.; Schoner C.; Sellmann R.;
Tanis M.; Vogelbusch J.; Wagner E.; Winkler S.; Zenker K.; Zvork S.;
Balogh E.; Buncsikne Molnar S.; Gulyasne Gaspar E.; Herold M.; Kovacs E.;
Kozmane Paszternak A.; Maarne Nagy S.; Nagyne Zoltan A.; Nemeth Z.; Roth
T.; Rozsa I.; Szalai M.; Anuradha M.; Bawa T.; Bhaskar B.; Chalkhore S.;
Choudhary D.; Dhanalaxmi T.; Dhingra V.; Gayatri R.; Gnanasundram R.;
Gopal U.; Govindaraj S.; Indira P.; James S.; Karkuzhli K.; Koppikar V.;
Malhotra N.; Manmohan B.; Mazher A.; Menon R.; Nalini S.; Panda M.; Patel
K.; Poongothai S.; Ramanathan S.; Ramu I.; Sangeetha K.; Sankar K.;
Savitha; Shrinivas K.; Sudha S.; Tripathi S.; Vaseem A.; Yamuna A.;
Banques R.; Chong J.; Courcy M.; Donnelly E.; Fauzi A.; Gately M.; Hanlon
G.; Kelly-Conroy M.; McAteer S.; McGovern G.; Meaney E.; Seeli Abraham C.;
Todd M.; Aharonof-Segal M.; Aliazarov N.; Arbeli S.; Butbul E.; Chagai E.;
Confino K.; Domb L.; Dvir R.; Erez N.; Foiening O.; Frishberg A.; Genin
I.; Gertman R.; Golan L.; Grosberd A.; Hadad D.; Israeli S.; Kaplunski Y.;
Karpf D.; Katzir A.; Kivity Z.; Li L.; Livshitz L.; Nachmias A.; Orr I.;
Peer E.; Platner N.; Pritulo L.; Rojansky A.; Rosenblat T.; Saranga H.;
Schterchman G.; Shenhar S.; Shkliar T.; Stam T.; Stinmann S.; Suliman A.;
Tsirulnikov E.; Uziel K.; Weinshtock S.; Yedid-Am S.; Yuval R.; Zuker S.;
Brunella L.; Durante A.; Nada E.; Pugolotti M.; Robusto A.; Testa M.;
Toniato R.; Ha I.; Jung S.; Kim C.; Mi Ran K.; Song B.; Wi Y.; Yang K.;
You J.; Gaisute R.; Ozolina L.; Dzagajeva N.; Kasperaviciene V.;
Krikstaponiene Z.; Montviliene R.; Morkunaite K.; Piepoliene L.; Stoniene
E.; Stonkus S.; Ulpaityte I.; Arenas-Vanhorn M.; Espitia-Serrato L.;
Garcia-Munoz E.; Nunez V.; Sainz T.; Bakker H.; Danse I.; De Greef S.; De
Jong C.; De Wit M.; Didden E.; Dommerholt R.; Goddrie M.; Haazer C.;
Havenaar J.; Hendriks-Van Woerden M.; Jongenotter M.; Kort I.; Koster L.;
Kramer H.; Maarssen E.; Posthuma-Visscher M.; Reijnierse-Buitenwerf H.;
Rood P.; Swets E.; Tousain W.A.; Van Buchem-Damming G.; Van
Buijsen-Nutters A.; Van de Loo R.; Van den Hondel M.; Van den Berg A.; Van
der Knaap-van Keulen M.; Van der Zeijst M.; Van Setten-Van der Meer L.;
Von Bannisseht E.E.; Wouda Z.; Aarsland T.; Amlie L.; Andresen B.;
Bakketun A.; Bognaes A.; Botten C.; Coucheron S.; Halsne A.; Hansen H.;
Holthe T.; Husby E.; Iversen E.; Kvalvik A.; Landbakk T.; Lovseth E.; Moen
S.; Orvik E.; Ovrehus G.; Salater S.; Sorgard B.; Sorstrom A.; Tandberg
L.; Veiding B.; Vinje G.; Winge A.; Abquina G.; Patena B.; Reyes R.;
Tamondong A.; Vega A.; Vitug L.; Makuch M.; Torun A.; Adam A.; Basaraba
M.; Chira C.; Darida C.; Haica C.; Nedelcu A.; Patru D.; Patrut L.; Rau
I.; Rotaru N.; Szabo L.; Vrinceanu G.; Sovenko T.; Zatsevskaya O.;
Horynova Z.; Vankova L.; Barkhuizen M.; Barnard L.; Bekker D.; Botha D.;
Commerford A.; de Klerk A.; De Waal A.; Devchand S.; Drummond F.; Du Toit
A.; Du Toit S.; Ellis T.; Engelbrecht M.; Eramus T.; Fonda K.; Goosen A.;
Gopel E.; Govender P.; Hodge E.; Ismael F.; Jonker E.; Jonker L.; Joubert
A.; Kilian M.; Koegenlenberg N.; Lehner L.; Lingham R.; Llyod T.; Mangoeng
P.; Mapele S.; Meiring J.; Methusi P.; Mmethi M.; Mohamed K.; Moore A.;
Ndiweni H.; Parker F.; Schoneman J.; Smit M.; Steyn A.; Van Dongren J.;
Van Schalkwyk S.; Van Staden L.; van Wyngaard G.; Wolf A.; Ashbaugh R.;
Bande C.; Barquero R.; Gaspar R.; Martin E.; Megia B.; Rodriguez C.;
Seoane A.; Viaplana J.; Akesson Jacobsson I.; Andersson C.; Asperen M.;
Backlund M.; Berglund M.; Bjorck L.; Borjesson M.; Brolin G.; Danielsson
Frojd M.; Duckert A.; Eriksson K.; Fehling K.; Glaas A.; Hage C.; Hoglund
K.; Jernhed H.; Johansson K.; Johansson S.; Lidin M.; Lundell L.; Lundgren
C.; Magnusson K.; Matsson E.; Norman J.; Nystrom K.; Ojutkangas M.;
Olofsson M.; Olsson C.; Pettersson U.; Pramberg E.; Raschperger A.; Sjolin
M.; Soderlund M.; Stensgaard Nake E.; Torebo E.; Uggeldahl I.; Walldin C.;
Welin-Berger B.; Dwyer A.; Meyer-Lazzarini V.; Morello R.; Schefer M.;
Oney S.; Seker T.; Tavlayan S.; Appleby M.; Astin J.; Baker M.; Brann H.;
Brennan C.; Bryan L.; Campbell D.; Carey J.; Cox K.; Davis C.; Dyson B.;
Everdell R.; Gammon B.; Godden J.; Gray T.; Griffiths E.; Grimes Y.; Hall
D.; Hall K.; Holme A.; Howe J.; Lambley-Burke R.; Nation M.; Norcott K.;
Mitchell K.; Poxon S.; Quick C.; Shute C.; Thomas J.; Vinnell T.; Bawa S.;
Bogan C.; Fallye O.; Ginsberg J.; Gregory B.; House B.; Isonaga M.;
Keanne-Richmond P.; Kelly C.; Kimpel J.; Leiby A.; Lyons L.; McCoy B.;
Monk A.; Pelayo E.; Perron M.; Posey D.; Rehan M.; Suarez R.; Tilton L.;
Waite K.; White G.; Chacon R.; Meza Y.; Misticchio F.; Torres M.; Urbaneja
H.
Publisher
American Diabetes Association Inc.
Abstract
OBJECTIVE: The Outcome Reduction With Initial Glargine Intervention
(ORIGIN) trial reported neutral effects of insulin glargine on
cardiovascular outcomes and cancers and reduced incident diabetes in
high-cardiovascular risk adults with dysglycemia after 6.2 years of active
treatment. Omega-3 fatty acids had neutral effects on cardiovascular
outcomes. The ORIGIN and Legacy Effects (ORIGINALE) study measured
posttrial effects of these interventions during an additional 2.7 years.
RESEARCH DESIGN AND METHODS: Surviving ORIGIN participants attended up to
two additional visits. The hazard of clinical outcomes during the entire
follow-up period from randomization was calculated. RESULT(S): Of
12,537 participants randomized, posttrial data were analyzed for 4,718
originally allocated to insulin glargine (2,351) versus standard care
(2,367), and 4,771 originally allocatedto omega-3 fatty acid supplements
(2,368) versus placebo (2,403). Posttrial, small differences in median
HbA1c persisted (glargine 6.6% [49 mmol/mol], standard care 6.7% [50
mmol/mol], P = 0.025). From randomization to the end of posttrial
follow-up, no differences were found between the glargine and standard
care groups in myocardial infarction, stroke, or cardiovascular death
(1,185 vs. 1,165 events; hazard ratio 1.01 [95%CI 0.94-1.10]; P = 0.72);
myocardial infarction, stroke, cardiovascular death, revascularization, or
hospitalization for heart failure (1,958 vs. 1,910 events; 1.03
[0.97-1.10]; P = 0.38); or any cancer (524 vs. 529 events; 0.99
[0.88-1.12]; P = 0.91) or between omega-3 and placebo groups in
cardiovascular death (688 vs. 700; 0.98 [0.88-1.09]; P = 0.68) or other
outcomes. CONCLUSION(S): During >6 years of treatment followed by
>2.5 years of observation, insulin glargine had neutral effects on health
outcomes and salutary effects on metabolic control, whereas omega-3 fatty
acid supplementation had no effect. Copyright © 2016 by the
American Diabetes Association.

<57>
Accession Number
365300092
Title
Basal insulin and cardiovascular and other outcomes in dysglycemia.
Source
New England Journal of Medicine. 367 (4) (pp 319-328), 2012. Date of
Publication: 26 Jul 2012.
Author
Gerstein H.C.; Bosch J.; Dagenais G.R.; Jung H.; Maggioni A.P.; Pogue J.;
Probstfield J.; Ramachandran A.; Riddle M.C.; Ryden L.E.; Yusuf S.;
Richardson L.; Diaz R.; Johnston P.; Vige R.; Birkeland K.; Budaj A.;
Cardona E.; Chazova I.; Commerford P.; Danilova L.; Davies M.; Fernando
R.; Fodor G.; Gilbert R.; Gomis R.; Hanefeld M.; Hildebrandt P.;
Kacerovsky-Bielesz G.; Keltai M.; Kim J.H.; Krum H.; Lanas F.; Lewis B.S.;
Lonn E.; Lopez-Jaramillo P.; Marin-Neto J.; Marre M.; McKelvie R.; McQueen
M.; Mendoza I.; Morillo C.; Pan C.; Profozic V.; Ratner R.; Rosenstock J.;
Spinas G.A.; Sreenan S.; Stoel I.; Syvanne M.; Yale J.F.; Avezum A.; Bahit
M.C.; Bogaty P.; Bordeleau L.; Chacomicronn C.; Corson M.; Harper W.L.;
Halon D.; Magloire P.; Mann J.; Pavlova V.; Punthakee Z.; Silva J.; Tsang
B.; Yakubovich N.; Abdallah A.; Ahmad S.; Chandra J.; Chandra R.;
Cukierman-Yaffee T.; Dyal L.; Joldersma L.; MacRae L.; MacRae S.; Malik
S.; Mead A.; Pasha F.; Pazmino-Canizares J.; Pohl K.; Sakalas A.; Tyrwhitt
J.; Ahuad Guerrero R.; Alebuena A.; Alvarez N.; Alzogaray M.; Amuchastegui
M.; Andres M.; Angos M.; Baglivo H.; Barbieri M.; Bassi F.; Bello F.; Bono
J.; Bustamante Labarta M.; Bustos B.; Caccavo A.; Calveira M.; Camino A.;
Cantero M.; Capozzi M.; Cardone M.; Cartasegna L.; Cassetari A.;
Castellanos R.; Chavez Caballero R.; Cipullo M.; Contreras A.; Coria J.;
Corinaldesi F.; Costa G.; Crespo C.; Cruz M.; Cuello J.; Cuneo C.; Del
Corro I.; Diez R.; Dituro C.; Dominguez A.; Facta A.; Faingold C.; Farah
M.; Fares Taie A.; Fernandez A.; Ferrari A.; Ferrari N.; Garcia Monteverde
C.; Garrido M.; Giachello C.; Gonzalez M.; Gutierrez N.; Guzman L.; Guzman
P.; Hasbani E.; Henquin R.; Hershon A.; Hirschon Alvarez Prado A.; Hominal
M.; Hrabar A.; Imposti H.; La Grutta M.; Lanchiotti P.; Lobo Marquez L.;
Lopez Santi R.; Lowenstein J.; Lugo M.; Luqueci M.; Mainini S.; Majul C.;
Manzano R.; Manzur S.; Marcucci G.; Marino M.; Massari F.; Mendez N.;
Molina M.; Montana O.; Mulazzi M.; Nardone L.; Odetto I.; Orlandini A.;
Oviedo A.; Paez O.; Parnas A.; Patron F.R.; Pedernera C.; Pelagagge M.;
Plastino M.; Polari P.; Pomposiello J.; Porta A.; Prado A.; Quiroz M.;
Ramirez A.; Rodriguez M.; Ronderos R.; Sago L.; Sanchez A.; Sanchez R.;
Sandrin A.; Schygiel P.; Sernia V.; Sinay I.; Smith Casabella T.; Sosa
Liprandi A.; Sosa Liprandi M.; Soso L.; Sposetti G.; Stisman D.;
Streitenberger P.; Suarez G.; Tonin H.; Ulla M.; Valdez J.; Vico M.;
Villamil A.; Villarino A.; Viscaya Castro A.; Visco V.; Vogel D.; Waisman
F.; Zaidman C.; Amerena J.; Applebe A.; Aylward P.; Binnekamp M.; Bruce
I.; Burdeniuk C.; Burnet R.; Colman P.; Colquhoun D.; Davis S.; De Looze
F.; De Pasquale C.; D'Emden M.; Eaton H.; Farshid A.; Foulanos S.; Galanos
J.; Gordon G.; Guhu M.; Ho J.; Jeffery I.; Jerums G.; Kwan M.; Lefkovits
J.; Luu S.; MacIsaac R.; Marjason J.; Mohabbati V.; Nankervis A.; O'Neal
D.; Perera N.; Poynten A.; Rahman A.; Razak S.; Roberts T.; Sebastian M.;
Simpson R.; Soldatos G.; Sullivan D.; Teede H.; Tiong F.; Topliss D.;
Torpy D.; Waddell-Smith K.; Waites J.; Wenman J.; Whelan A.; Williams L.;
Yeap B.; Yeow W.; Yong G.; Aczel S.; Azimy N.; Bertha P.; Blocher J.;
Bohnel C.; Brath H.; Breuss J.; De Campo A.; Drexel H.; Ettmuller Y.;
Feder A.; Feinboeck C.; Gulz E.; Hofmann M.; Hoppichler F.; Jahnel H.;
Jankovic V.; Kann T.; Kathrein T.; Kotter T.; Kratz E.; Kreuzwieser E.;
Loreck C.; Ludvik B.; Marte T.; Mellitzer K.; Nistler S.; Placher-Sorko
G.; Prager R.; Rein P.; Riedl M.; Saly C.; Schernthaner G.; Schichka E.;
Seidlhofer C.; Sonnenfeld M.; Stefan H.; Steiner K.; Thomas B.; Toplak H.;
Urstoger K.; Vetter B.; Vonbank A.; Waldschutz W.; Wallner F.; Winkler F.;
Goncharik D.; Lazareva I.; Lichorad N.; Mrochek A.; Murashko N.; Radyuk
D.; Ramanovski A.; Sudzhaeva S.; Sujayeva V.; Yarashevich N.; Campbell G.;
Marshall S.; West A.; Abreu F.; Alves M.; Ayoub-Aidar J.; Barros M.;
Barros-Silveira J.; Blacher M.; Costa E.; Costa F.; Daltro C.; Delana J.;
Eliaschewitz F.; Facanha C.; Feitosa G.; Figueiredo J.; Forti A.; Franco
D.; Franken M.; Freire F.; Garcia V.; Gouvea-Neto A.; Grofallo S.;
Kanedlai N.; Kerr-Saraiva J.; Ladeira R.; Leaes P.; Lemos M.; Lima F.;
Lima Filho M.; Macedo L.; Manenti E.; Monte O.; Mossman A.; Mothe F.;
Mouco O.; Moyses Golbert M.; Nasser Hissa L.; Nasser-Hissa M.; Nicolau J.;
Nigro Maia L.; Ninno T.; Nunes C.; Oliveira C.; Oliveira O.; Passos da
silva R.; Pericles-Esteves J.; Rabelo L.; Rabelo-Alves Junior A.; Rassi
S.; Rech R.; Roldan F.; Salles J.; Sampaio C.; Seabra A.; Sealissi N.;
Seixas A.; Sena R.; Shehadeh I.; Teixeira M.; Turin H.; Vicente Serrano
C.; Vidigal M.; Vilela M.; Wajchenberg B.; Abbott C.; Abu-Bakare A.;
Ardilouze J.; Auersperg E.; Bailey A.; Bailey G.; Baillargeon J.;
Beaurivage C.; Belair J.; Belanger A.; Bellabarba D.; Berlingieri J.;
Bernier F.; Bhargava R.; Bhesania T.; Booth W.; Bose S.; Boulianne M.;
Bourgeois S.; Breton D.; Brossoit R.; Buithieu J.; Campeau J.; Carlson B.;
Carpentier A.; Cavalcanti R.; Cha J.; Chagnon P.; Chan Y.; Chessex C.;
Chiasson J.; Chouinard S.; Clayton D.; Conway J.; Crepeau J.; Cudmore D.;
D'Ignazio G.; Doig G.; Dominguez M.; Dube F.; Dumas R.; Dupuis R.; Dyrda
I.; Eddy D.; Eiley D.; Fox H.; Fratesi S.; Gallant S.; Garceau C.;
Garfield N.; Germain C.; Glazer S.; Gosselin G.; Gould D.; Grills G.;
Halle J.; Hardin P.; Harper W.; Heath J.; Heath V.; Hivert M.; Ho K.;
Houde G.; Hramiak I.; Hutchinson A.; Huynh T.; Ilie-Haynes R.; Imran S.;
Islam A.; Iwanochko M.; Jones C.; Joyce C.; Kirouac I.; Kumar R.; Lamothe
M.; Langlois M.; Lauzon C.; Lavoie M.; Leader R.; Lecours S.; Lepage S.;
Lochnan H.; Ma P.; McLean A.; Mecci S.; Mehta P.; Mercier M.; Miller D.;
Morisset A.; Nawaz S.; Nisker W.; Nyomba G.; O'Keefe D.; Palardy J.;
Parekh P.; Paul T.; Perron P.; Pesant M.; Phillips R.; Pruneau G.; Quintin
I.; Raby K.; Richard C.; Rosenfeld G.; Saulnier D.; Shaban J.; Shah A.;
Shu D.; Sigal R.; Silverman M.; Singh J.; Sivucha W.; Skamene A.;
Sliwowicz D.; Smith R.; St Hilaire R.; Steinson D.; Sussex B.; Tan K.;
Tannous R.; Telner A.; Theroux P.; Tsoukas C.; Tsoukas G.; van Buuren J.;
VanRossum N.; Vexler R.; Vizel S.; Warnica W.; Weingert M.; Wilson R.;
Wong W.; Woo V.; Yale J.; Acevedo M.; Alwyn C.; Baier E.; Baier S.;
Galloso R.; Lahsen R.; Lorenas G.; Montecinos A.; Montecinos M.; Pineda
P.; Pollak F.; Sapunar J.; Serrano V.; Stockins B.; Varleta P.; Yovanovich
J.; Zambra F.; Ba J.; Bao Y.; Bi Y.; Bu S.; Chen B.; Chen H.; Chen J.;
Chen L.; Chen M.; Chen Y.; Cui J.; Dong M.; Feng P.; Feng Z.; Gao C.; Gao
F.; Gao X.; Gao Z.; Gong Y.; Guang L.; Guo X.; Han F.; Han X.; Hou X.; Hu
R.; Ji L.; Jia J.; Jia W.; Jiao X.; Jin X.; Kuang J.; Li M.; Li Q.; Li X.;
Li Y.; Ling Y.; Liu F.; Liu Z.; Lu B.; Lu J.; Lu Z.; Lv X.; Ning G.; Peng
Y.; Ren Y.; Shao Y.; Shi Y.; Shu X.; Sun H.; Sun L.; Sun X.; Tang K.; Tian
H.; Wang C.; Wang F.; Wang L.; Wang Q.; Wang W.; Wang X.; Wang Y.; Wen J.;
Wu C.; Wu H.; Wu J.; Wu M.; Xing X.; Xue Y.; Yan L.; Yan S.; Yang H.; Yang
N.; Yang W.; Yang Z.; Yao J.; Yao L.; Yu D.; Yu H.; Yu M.; Yu X.; Yuan L.;
Yuan M.; Yuan S.; Yuan W.; Yuan Y.; Yuan Z.; Zeng T.; Zhang J.; Zhang R.;
Zhang X.; Zhao L.; Zheng B.; Zheng J.; Zhou W.; Zhu N.; Zhu Y.; Zou D.;
Zou J.; Accini J.L.; Bohorquez R.; Botero R.; Cure C.; Figueredo M.;
Hernandez E.; Kattah W.; Llamas A.; Orozco L.; Pava L.; Perez M.; Pineda
M.; Quintero A.; Quiros R.; Urina M.; Velez S.; Altabas V.; Baotic I.;
Berkovic M.; Goldoni V.; Kerum T.; Mirosevic G.; Tarle D.; Vidovic I.;
Zjacic-Rotkvic V.; Abbas R.; Andersen H.; Auscher S.; Baumbach L.;
Brockstedt H.; Christensen P.; Christiansen M.; Clemmensen K.; Egstrup K.;
Gislason G.; Haar D.; Hansen K.; Heden Andersen P.; Helleberg K.;
Hermansen K.; Holmer J.; Jeppesen J.; Klausen I.; Koustrup-Sonder T.;
Krarup T.; Lerche S.; Lervang H.; Linde B.; Lund P.; Lund S.; Madsbed S.;
Molvig J.; Orskov C.; Ostergaaard O.; Perrild H.; Pietraszek A.; Ralfkjaer
N.; Roenne H.; Rokkedal Nielsen J.; Seibaek M.; Soendergaard H.; Sorensen
L.; Sundahl Mortensen L.; Torp-Pedersen C.; Tuxen C.; Urhammer S.;
Vadstrup E.; Pirags V.; Ambos A.; Janson A.; Rudenko P.; Viitas L.; Aranko
S.; Badeau M.; Eriksson J.; Haapamaki H.; Kajander O.; Kuusisto A.;
Luukkonen S.; Makela J.; Nieminen S.; Niskanen L.; Ripatti J.;
Ruotsalainen S.; Saltevo J.; Savela K.; Strand J.; Valle T.; Virkamaki A.;
Aboud E.; Alavoine L.; Bekherraz A.; Bohme P.; Bourezane H.; Catargi B.;
Charpentier G.; Clergeot A.; Courreges J.; Delmas T.; Duengler F.; Feknous
C.; Gendre D.; Guerci B.; Hadjadj S.; Kerlan V.; Laguerre N.; Le Potier
J.; Lombardo F.; Malville E.; Marechaud R.; Mattei C.; Moreira J.;
Penfornis A.; Petit C.; Pinel J.; Piquel X.; Raccah D.; Reznik Y.; Rod A.;
Roudaut N.; Rousseau E.; Schillo F.; Schmitt B.; Sonnet E.; Torremocha F.;
Travert F.; Vanhoute C.; Vimeux M.; Abdollahnia R.; Adamidou A.; Arslan
S.; Bach-Kliegel B.; Bartusch B.; Bauer N.; Bieler T.; Blankenfeld H.;
Boeckmann U.; Busch K.; Butzer R.; Chenchanna-Merzhaeuser M.; Denger R.;
Deutsch C.; Diessel S.; Donati-Hirsch I.; Dornisch M.; Enghofer K.; Fleig
T.; Forst T.; Frommherz M.; Goeller K.; Habbig J.; Hadziselimovic S.;
Hamann A.; Hampel T.; Heger S.; Helmes C.; Hoffman C.; Hohberg C.; Humpert
P.; Kamke A.; Kamke W.; Kindermann P.; Klein C.; Klein D.; Koehler A.;
Kuehn A.; Langer K.; Limmer S.; Loew A.; Maimer A.; Marck C.; Meier G.;
Methner-Friederich M.; Metzler W.; Meyer K.; Miftari N.; Milde J.; Minnich
J.; Molkewehrum M.; Morcos M.; Mueller-Hoff C.; Nguyen M.; Nishwitz M.;
Oldenburg J.; Ott P.; Pauli K.; Pauly B.; Pfeiffer A.; Pfuetzner A.;
Pischa U.; Radke R.; Reismann P.; Riemer M.; Rochlitz H.; Rudofsky G.;
Ruhla S.; Sammler A.; Schaper F.; Schiemenz K.; Scholz G.; Schumm-Draeger
P.; Segiet T.; Segner A.; Seissler J.; Spahn S.; Stier U.; Tonon G.; von
Amelunxen S.; von Schacky C.; Wilhelm B.; Wilhelm K.; Witt K.;
Wuechner-Hofmann S.; Baranyai M.; Birkus Z.; Foldesi I.; Gaal Z.; Harcsa
E.; Hati K.; Hohmann Z.; Istenes I.; Jozsef I.; Juhasz E.; Kempler P.;
Keresztes B.; Keresztes K.; Kis-Gombos P.; Kovacs I.; Kozma T.; Laszlo Z.;
Noori E.; Nyirati G.; Papp Z.; Patkay J.; Poor F.; Pusztai P.; Putz Z.;
Rigo E.; Sereg M.; Simon K.; Somogyi A.; Sumegi J.; Szabo A.; Szabo J.;
Szigeti S.; Szilveszter D.; Tarko M.; Varga C.; Varga Szabo L.; Voros P.;
Arathi; Badgandi M.; Balaji M.; Aravind S.; Chamukuttan S.; Devi Manduva
P.; Fatima S.; Ganapathy B.; George O.; George P.; Jaffar M.; Jain P.;
Kamath P.; Karthik V.; Koshy G.; Krishnan L.; Kumar H.; Lal P.; Mithal A.;
Modi S.; Mohan V.; Moses V.; Oomen R.; Pais P.; Pati P.; Pendsey S.; Rai
P.; Rajagopal R.; Ramu M.; Ranjit U.; Rao P.; Senthil V.; Seshaiah V.;
Sethi B.; Shah P.; Sharma R.; Shetty S.; Shobha A.; Siddharth R.; Sridhar
G.; Sudeep K.; Sunil C.; Sunitha S.; Suresh S.; Thomas N.; Vageesh A.;
Anwer Z.; Barton J.; Behan L.; Bell M.; Cullen M.; Dineen S.; Draman Yusof
M.; Dunne F.; Gibney J.; Hussain T.; Khan M.; Kinsley B.; Kyithar P.;
Lavin F.; McGowan A.; McGurk C.; Mirza A.; Mohammadi B.; O'Brien T.;
O'Connell J.; O'Halloran D.; O'Shea D.; Roberts G.; Tomkin G.; Wan Mahmood
W.; Abramod-Ness R.; Adawi F.; Aharon B.; Backer M.; Beniashvili A.;
Berliner A.; Bloch L.; Bugelman D.; Butnaru A.; Cohen O.; Cohen Y.;
Frenkel M.; Glant M.; Gustava B.; Guttman H.; Halabi S.; Harman-Boehm I.;
Ilany J.; Karkabi B.; Khader N.; Khaskia A.; Khudyak Y.; Klainman E.;
Kogan N.; Lender D.; Levin I.; Mardi T.; Marmor A.; Mosseri M.; Nabriski
D.; Omary M.; Orlovsky S.; Peres D.; Quasim M.; Raz I.; Remesnik M.;
Rogowski O.; Rozenfeld I.; Scharr D.; Shnifer I.; Shuster T.; Solomon R.;
Steiner H.; Tzivoni D.; Wolfson N.; Yossef Z.; Zahger D.; Zeltser D.;
Zimlichman R.; Aina F.; Ariatti C.; Bonetti R.; Cacciatore F.; Calcinaro
F.; Corona G.; De Maria P.; Del Prato S.; Derosa G.; Di Pasquale G.;
Falorni A.; Fanelli R.; Fedele D.; Filorizzo G.; Fogari R.; Furgi G.; Ghio
A.; Giorda C.; Gregori G.; Iannuzzi G.; Lapolla A.; Luciano B.; Lucotti
P.; Maggi A.; Marafetti L.; Marchese T.; Martino G.; Marzotti S.; Miccoli
R.; Monti L.D.; Moretti L.; Palvarini M.; Petacchi R.; Piarulli F.; Piatti
P.M.; Rudi S.; Santeusanio F.; Sesti G.; Setola E.; Sforza A.; Shehaj E.;
Veniani M.; Viviani G.; Zigoura E.; Chae S.; Cho D.; Cho E.; Cho Y.; Choi
Y.; Chung M.; Hong E.; Hong Y.; Jeong M.; Kim B.; Kim D.; Kim H.; Kim I.;
Kim J.; Kim P.; Kim S.; Koo B.; Kwok S.; Kwon H.; Lee J.; Lim J.; Oh S.;
Ohn J.; Park C.; Park H.; Park K.; Seung K.; Son H.; Woo J.; Yoon K.;
Ansmite B.; Balcere I.; Bumbure A.; Ducena K.; Lejnieks A.; Rasa I.;
Ritenberga R.; Romanova M.; Salmina I.; Steina S.; Badariene J.;
Gailiuniene S.; Grigonis S.; Juskiene R.; Petrulioniene Z.; Sakalyte G.;
Stasiunas T.; Sulskiene M.; Urbonaite B.; Zarankiene R.; Ziukaite R.;
Arechavaleta R.; Beltran-Jaramillo T.; Calvo-Vargas C.; Campillo-Cardenas
C.; Cardona D.; Carmona-Huerta J.; Cedano-Limon M.; Comellas-De M.;
Dominguez C.; Gomez-Cruz J.; Gonzalez-Perez R.; Illescas J.; Jimenez-Ramos
S.; Lopez-Alvarado A.; Marquez-Rodriguez E.; Martinez G.; Pascoe S.;
Plascencia Vazquez O.; Rodriguez H.; Ruiz-Cornejo M.; Velasco-Sanchez G.;
Vidrio-Velazquez M.; Villeda-Espinosa E.; Badings E.; Bartels G.;
Bruggink-Andre de la Porte P.; Bruijns E.; Cornel J.; De Milliano P.; De
Mulder M.; De Swart J.; Derks A.; Dirkali A.; Droste J.; Galjee M.;
Hautvast R.; Hermans W.; Holwerda N.; Ilmer B.; Kofflard M.;
Kooistra-Huizer J.; Kurvers M.; Langerveld J.; Leenders C.; Liem A.; Lok
D.; Neumann D.; Nierop P.; Plomp K.; Posma J.; Reichert C.; Roeters Van
Lennep H.; Ronner E.; Said S.; Takens L.; Umans V.; Van der Sluis A.A.;
Van der Zwaan C.; Van Dobbenburgh J.; Van Es A.; Van Hessen M.; Van
Mechelen R.; Van Miltenburg-Van Zijl A.; Van Zeijl L.; Veerhoek M.;
Viergever E.; Weijers E.E.; Willems F.; Blix I.; Cooper J.; Debowska A.;
Erichsen K.; Fossum J.; Gjertsen E.; Grill V.; Gudnason S.; Hoye K.; Istad
H.; Winther J.; Joakimsen R.; Jorde R.; Larsen I.; Mella B.; Otterstad J.;
Risberg K.; Skare K.; Skeie S.; Sommervoll L.; Tandberg A.; Whitfield R.;
Wium C.; Cunanan E.; Fernando-Catindig E.; Gomez M.; Jaring C.;
Lantion-Ang F.; Licaros M.; Lim-Abrahan M.; Madronio E.; Panelo A.; Raboca
J.; Ramos G.; Tugna S.; Aksamit-Bialoszewska E.; Bandurska-Stankiewicz E.;
Baranska M.; Bronisz A.; Bronisz M.; Chrustowski W.; Cieslak B.;
Czupryniak L.; Drazkowicz-Gozdzik B.; Galuszka-Bilinska A.; Gmytrasiewicz
M.; Janik K.; Jedynasty K.; Kania G.; Kawka-Urbanek T.; Kinalska I.;
Kincel K.; Kleszczewska U.; Kruszewski J.; Loba J.; Malicka J.;
Mielecka-Kincel M.; Milczarczyk A.; Milosz D.; Mrowczynska A.; Mytnik M.;
Nowakowski A.; Nowakowski P.; Oleskowska L.; Omelanczuk-Wiech E.;
Pawlowski M.; Poplawska A.; Rucinska M.; Rucinski M.; Rutkowska J.;
Saryusz-Wolska M.; Siewko K.; Sikora-Frac M.; Stecka-Wierzbicka J.;
Swiatkowski M.; Swierczynski R.; Szpajer M.; Szymkowiak K.; Tarach J.;
Tarasiewicz U.; Wiatr D.; Wojewoda P.; Woszczak-Marcinkowska H.; Zadrozny
J.; Hancu N.; Albota A.; Bala C.; Barbonta D.; Botnariu G.; Bradescu O.;
Busegeanu M.; Bzduch M.; Catrinoiu D.; Caziuc R.; Cerghizan A.; Cheta D.;
Cif A.; Ciomos D.; Cosma D.; Creteanu G.; Crisan I.; Danciulescu R.;
Dobjanschi C.; Dodan R.; Duma L.; Ferariu I.; Ghenes T.; Ghise G.; Graur
M.; Ilinca M.; Marton R.; Mindrescu N.; Morosanu A.; Morosanu M.; Mota M.;
Nafornita V.; Negrisan G.; Nicodim S.; Nicolau A.; Nita C.; Onaca A.;
Panus C.; Pletea N.; Pop C.; Pop L.; Popa B.; Roman G.; Rosu M.; Sandu N.;
Serban V.; Sima A.; Stamoran L.; Strugariu M.; Suciu G.; Szilagyi I.;
Vacaru G.; Veresiu I.; Vlad A.; Adasheva T.; Ageev F.; Akhmedganov N.;
Akinina A.; Alexandrov A.; Ambatiello L.; Ametov A.; Ausheva A.; Babaeva
L.; Babenko A.; Balyasnikova E.; Bart B.; Belova J.; Berstein L.;
Bondarenko I.; Bondarev E.; Bulkina O.; Chernikova N.; Chumak B.; Deeva
T.; Demicheva O.; Demidova T.; Doskina E.; Duganova A.; Dzhaiani N.;
Egorova I.; Ettinger O.; Feofanova S.; Fofanova T.; Galaktionov P.;
Gavrilova N.; Gilyarevsky S.; Gnidkina N.; Golubev A.; Gornyakova N.;
Grigorova S.; Grineva E.; Gurevich V.; Irtuganov N.; Ivanova L.; Jaiani
N.; Kalashnikova M.; Karpov Y.; Khalimov Y.; Khorocheva G.; Kirillova E.;
Kistner J.; Kobalava Z.; Kochergina I.; Kravchenko T.; Krylov K.; Kulkova
P.; Kuparev I.; Kurbanova E.; Lysenko T.; Markovich A.; Martyanova I.;
Martynyuk T.; Masiinvets M.; Mavlyavieva E.; Maychuk E.; Melnichenko G.;
Mikhailusova M.; Mkrtumyan A.; Mychka V.; Nebieridze D.; Nesterova E.;
Orlov V.; Orlova V.; Orlova Y.; Papov F.; Patroucherva I.; Petunina N.;
Pirozhinskaya S.; Podachina S.; Postnikova S.; Pshikova O.; Rogova L.;
Romashevskiy B.; Runikhina N.; Sadulayeva I.; Safaryan A.; Sakovich E.;
Saprikina T.; Sargsyan V.; Semikozova O.; Shkolnik E.; Shubina A.; Shustov
S.; Sinitsina I.; Solovyeva E.; Storogakov G.; Stovpyuk O.; Sussekov A.;
Telnova M.; Temirov A.; Terekhov V.; Tereschenko S.; Tiourina T.;
Tolkacheva V.; Tsoy U.; Urazgyldeeva S.; Vasyuk Y.; Vinnitskay N.;
Voevodina E.; Volkova A.; Zadionchenko V.; Zalevskaya A.; Zhelninova T.;
Zhukova N.; Zilov A.; Bernatova J.; Duris T.; Markova I.; Martinka E.;
Michalova L.; Minarik P.; Peter L.; Raslova K.; Silvia D.; Subadova M.;
Tisonova J.; Vohnout B.; Adam M.; Badat A.; Bester A.; Bester F.; Blacking
L.; Bouwer D.; Brice B.; Cassimjee S.; Cronje T.; Deftereos J.; Distiller
L.; Ellis G.; Forster O.; Fulat M.; Gani M.; Gibson G.; Hansa S.;
Hendricks N.; Herbst L.; Hitzeroth J.; Joffe B.; Kelbe C.; Kelbe D.; King
J.; Kramer B.; Landau S.; Levitt N.; Meyer-Nell S.; Moore R.; Muller D.;
Nell H.; Omar M.; Randeree H.; Seeber M.; Seedat; Siebert M.; Van den Berg
E.; Van der Walt P.; Van Dyk C.; Van Niekerk F.; Van Zyl L.; Wellman H.;
Bertomeu V.; Botella M.; Buno M.; Calle A.; Cano Perez J.; Coves M.;
Juanatey J.G.; Garcia-Mayor R.; Gaztambide S.; Gippini A.; Goikolea I.;
Gonzalez J.; Hillman N.; Lopez Garcia Aranda V.; Magueda I.; Mato J.;
Mazon P.; Morillas P.; Novials A.; Pallardo L.; Perez L.; Rodriguez J.;
Romero L.; Sagarra E.; Shamagian L.; Soto A.; Torrealday H.; Valero R.;
Agergaard S.; Agewall S.; Andersson K.; Bergstrom O.; Bjornstedt Bennermo
M.; Blomgren J.; Boman K.; Brohall G.; Cherfan C.; Dahlen C.; Dotevall A.;
Enander P.; Ericsson U.; Hallgren P.; Hansson A.; Henareh L.; Henriksson
P.; Herlitz J.; Holmqvist J.; Jarevi G.; Linderfalk C.; Jonasson L.;
Jovinge S.; Kalen J.; Kilstrup M.; Leosdotir M.; Leppert J.; Ljungberg J.;
Lofdahl B.; Lundman P.; Lysell-Bergstrom C.; Mathiesen U.; Mellbin L.;
Morner S.; Nathanson D.; Nilsson L.; Peterson M.; Quittenbaum S.;
Rosengren A.; Ryttberg B.; Scheel S.; Svensson K.; Tenerz A.; Vasko P.;
Waldenstrom A.; Wieloch M.; Spinas G.; Braendle M.; Felix B.; Gerber P.;
Moccetti T.; Pitteloud N.; Kultursay H.; Aydinalp A.; Balci M.; Cayli M.;
Hatipoglu E.; Ilkova H.; Kayikcioglu M.; Koc M.; Muderrisoglu H.; Sari R.;
Saygili F.; Tekin K.; Tutuncu N.; Yurekli B.; Adler A.; Ali A.;
Balasubramanian; Barakat O.; Barnett A.; Borthwick L.; Brookes; Cecil J.;
Chaterjee S.; Clark J.; Collinson D.; Collinson S.; Crasto W.; Donnelly
R.; du Plessis J.; Egan S.; Ellery A.; Evans R.; Ewing J.; Fox C.; Gibson
M.; Hall T.; Higgs E.; Hollway M.; Hughes E.; Jackson N.; Jalihawi H.;
Jones G.; Knights H.; Korsheed S.; Kumar Singh R.; Laithwaite D.; Lawrence
I.; Litchfield J.; Manning G.; McNally P.; Millar-Craig M.; Mohammed I.;
Narayanan R.; Nayani G.; Norris A.; Purohit J.; Quinn M.; Ramtoola; Rea
R.; Reckless J.; Richardson T.; Robertson D.; Robinson A.; Salem K.;
Sampson M.; Savage M.; Shaker J.; Srinivasan T.; Tracy I.; Tringham J.;
Viljoen A.; Ward A.; Waterhouse H.; Wijenaike N.; Wiles P.; Ahmann A.;
Ahmed I.; Alam A.; Arakaki R.; Asad S.; Banarer S.; Baum H.; Belew K.;
Bergenstal R.; Bethel M.; Boyer C.; Catton S.; Challans P.; Childs B.;
Christian R.; Clement S.; Cuddihy R.; Dailey G.; Damberg G.; De Bold C.;
De Lemos J.; Donovan D.; Dudl J.; Dunbar J.; Ebner S.; Failor R.; Feinglos
M.; Flaker G.; Freiburghaus M.; Furlong K.; Gardner D.; Gillespie E.;
Goland R.; Goldberg R.; Gotham A.; Guthrie R.; Hamaty M.; Hirsch I.;
Jabbour S.; Janci M.; Javorsky B.; Jones S.; Kamana V.; Kashyap M.;
Kaufman S.; Kearns P.; Khera A.; Klopfenstein B.; Kniffen W.; Kringas P.;
Licata A.; Lopez-Jimenez C.; Madden M.; Marx C.; McCall A.; McCallum J.;
McFarlane S.; McGuire D.; Melish J.; Meneghini L.; Miller S.;
Miranda-Palma B.; Mitchell R.; Nasr C.; Nelson J.; Niblack P.; Nylen E.;
Osei K.; Pandey A.; Papademetriou V.; Pilar Solano M.; Sameshima L.;
Savarese V.; Schnure J.; Schuster D.; Shin J.; Taylor A.; Thomson P.;
Ting-Ryan M.; Trence D.; Vo A.; Weiland K.; Wells K.; Wu P.; Zimering M.;
Zimmerman R.; Ascanio P.; Brajkovich I.; Carrillo E.; Coll J.; Gonzalez
K.; Gonzalez N.; Jimenez E.; Lopez R.; Marante D.; Morr I.; Paolillo M.;
Perche D.; Portillo M.; Valbuena H.; Velarde M.; Vergara G.; Augensen N.;
Azzalina J.; Fidaly S.; Bollero G.; Casiello A.I.; Ferraro F.; Guridi
M.J.; Ines M.; Martin M.E.; Pascual A.; Pereyra J.; Toscanelli M.; Appiah
M.; Grech S.; Pouras S.; Watts C.; Denke E.; Feik C.; Litvinenko M.;
Platonenko O.; Shadur S.; Johnson J.; Bonilla E.; Carraway B.; Faith J.;
Greer C.; Harding A.; Heston J.; Lin Y.; Mecca T.; Schuler M.; Rizk C.;
Sissoko A.; Strickland K.; Andrade A.; Lux L.; Machado D.; Mancin E.;
Aquino J.; Belanger B.; Bourque C.; Gagnier K.; Hagerimana A.; McNeil A.;
Osachoff J.; Richard B.; Rogan J.; Styner L.; Maturana X.; Naranjo M.E.;
Li E.; Liu Q.; Shuai M.; Tan Z.; Tang M.; Zhao J.; Ardila M.; Gomez A.M.;
Uscategui A.M.; Marinkovic N.; Miocevic V.V.; Pezo S.; Andersen I.;
Bastrup-Larsen B.; Jeppesen E.; Kofoed-Djursner M.; Joe H.; Hiironen V.;
Tarvainen M.; Von Hedenberg H.; Guillarme C.; Rastelli O.; Roy P.; Igel
L.; Lenz T.; Leptich A.; Peikert S.; Domokos S.; Szotyorine-Polcza G.;
Wenczl M.; Chaudhary S.; Jaiswal G.; Khatri P.; Shah K.; Gibson S.; Bechar
Y.; Erdheim D.; Eyal N.; Frankel M.; Shimoni S.; Tsuri J.; Bianco L.; Cali
R.; Sganga P.; Jang M.; Kim J.M.; Kim Y.; Lim S.; Park J.S.; Song Y.;
Kalve E.; Dienyte E.; Alvarado F.; Rodriguez R.; Bar J.; Lijfering-Lorie
K.; Palstra M.; Van der Kuijl K.; Van de Wetering A.; Eriksen S.;
Hejazifar S.; Jendeberg A.; Johannessen G.; Khammari I.; Meredith E.L.;
Dayag A.M.; Figueroa P.; Hoffmann Korpalska A.; Przemyk M.; Craciunescu
A.; Lupu D.; Osanu A.; Popscu L.; Toader C.; Kirsanova T.; Timoshina E.;
Gomez B.; Jankularova I.; Brett S.; Meyer A.; Pereira V.; Vawda N.;
Castano B.; Farre Avella J.M.; Jimenez I.; Turet N.; Froberg M.; Reppert
E.; Wessman S.; Boschung Y.; Carrozzino F.; Gerstl K.; Cetin Z.; Demirci
S.; Ovalioglu S.; Lenehan A.; McLean H.; Mutsaers K.; Redfern P.; Scoggins
A.; Isea Y.; Alvarez M.; Alvarez D'Amelio A.; Aqueveque S.; Argenta M.;
Aviles A.; Barreiro E.; Battistessa Y.; Bergamo S.; Bertran B.; Bocanera
M.; Bowen L.; Brescia H.; Caceres M.; Cappi A.; Cardelli A.; Carolini E.;
Carpintero S.; Carrique A.; Carrique P.; Casquero M.; Castro M.; Cendali
G.; Chatelain M.; Costanzi A.; Cristofaro C.; Crunger P.; Ehrich S.;
Espinosa M.; Esposito L.; Flenche M.; Fracaro V.; Funosas C.; Garrido I.;
Gomez Garrido A.; Guzman A.; Izzicupo M.; Luca S.; Luciani C.; Majul S.;
Moreno Cepeda I.; Moschin Y.; Niemann G.; Novas V.; Olmi M.; Palma F.;
Peralta A.; Puig A.; Rodera Vigil M.; Ronderos G.; Rosell M.; Samudio M.;
Santicchia C.; Szczygiel V.; Takla M.; Tinnirello C.; Tonin S.; Tristan
A.; Troncoso C.; Vignau S.; Yanez K.; Zarate M.; Appeldorf R.; Batrouney
B.; Bonner A.; Bonner M.; Cahill P.; Carr J.; Caruana M.; Chare J.; Doran
A.; Flavel; Griek S.; Hulley A.; Keays P.; Kent S.; Lai N.; Legg H.; Long
A.; Lynch L.; Maxwell V.; McNamara K.; Nairn J.; Nichols V.; Peeler C.;
Phillips J.; Price-Smith S.; Ryan S.; Stockle P.; Tapp E.; Taverner P.;
Tulloch G.; Viola V.; Wilson L.; Beck A.; Damon S.; Drexel V.; Grabner E.;
Hofurthner A.; Kivioja P.; Kretschmer S.; Lener P.; Maiweg J.; Tscherner
D.; Weichelt H.; Winkler J.; Jones D.; Alves L.; Batista R.; Bernardes A.;
Demore de Souza A.; Ferraz R.; Ferreira A.; Freitas E.; Guanaes D.;
Kuschel K.; Muniz R.; Nasser-Hissa V.; Nhan P.; Osorio R.; Queirantes C.;
Reboucas R.; Souza C.; Tonani M.; Vicente C.; Zilli A.; Andersen K.; Aro
L.; Barber C.; Barnable B.; Berard L.; Bernier A.; Boudreault C.;
Bourbonnais A.; Bourgeois L.; Boutin D.; Boyer D.; Branco N.; Briol L.;
Brousseau M.; Burke M.; Chambers C.; Champoux A.; Chan S.; Colborne C.;
Coles K.; Couture M.; Cryderman C.; DeCurtis D.; Dewar C.; Drown J.; Dunn
P.; Eichmann D.; Eikel L.; Fox B.; Gauthier S.; Gibbons D.; Hicks R.; Ho
V.; Kitagawa H.; Kooistra L.; Landry F.; Lapointe F.; Larrivee L.; Leonard
P.; Louch D.; MacNair D.; Magennis L.; Mallette D.; Marchand C.; McLean
S.; Meilleur M.; Murdock H.; Naud M.; Olson K.; Otis J.; Ouimet F.;
Paquette H.; Peck C.; Pelletier A.; Perkins L.; Petrie F.; Pockett S.;
Poulin F.; Poulin M.; Primbas K.; Renton J.; Rouatt S.; Roy M.; Scarcelli
D.; Schellenberg S.; Schellevis K.; Schmidt N.; Scott L.; Skarpinsky B.;
Smith B.; Smith E.; Stafford C.; Stata C.; Sternberg B.; St-Jean N.;
Stoger S.; Thibodeau C.; Toupin A.; Ullyatt L.; Velonas J.; Vienneau R.;
Wall C.; Zaniol D.; Arau M.; Fuentes J.; Hidalgo J.; Landaeta O.; Padilla
I.; Sanzana S.; Tellos G.; Toro F.; Vergara R.; Che T.; Du Y.; He Y.;
Huang C.; Li H.; Liu S.; Luo X.; Ma Y.; Pan S.; Wan Q.; Wang H.; Wang S.;
Xie Y.; Xu X.; Xu Y.; Zhao F.; Zhou M.; Accini M.; Bello O.; Caceres A.;
Camargo S.; Figueroa J.; Florez M.; Gomez Morales K.; Granados L.;
Martinez M.; Medina Ramos M.; Mejia C.; Montoya L.; Ramos C.; Restrepo P.;
Rodriguez D.; Santamaria A.; Valencia T.; Spanic V.; Borre Hansen A.;
Bulow M.; Ehlers G.; Frederiksen A.; Gottschalck H.; Hejlskov B.; Holm
Fruesnsgaard Pedersen L.; Hornum H.; Jansen S.; Johansen A.; Jorgensen A.;
Kjaeulff Svaneborg T.; Kruse A.; Lund K.; Lundgaard M.; Madsen J.; Meier
A.; Muurholm A.; Nedergaard A.; Nielsen S.; Norgaard D.; Olsen A.; Raae
D.; Reiter P.; Sigsgaard U.; Vestergaar I.; Witt A.; Mitt T.; Timmusk P.;
Heikkila E.; Heiskanen R.; Huotari E.; Keskitalo A.; Kylmala L.; Laitinen
M.; Laukkanen M.; Leskinen S.; Liesivuori J.; Lukkari-Kuronen L.; Merisalo
P.; Muurinen E.; Nikkanen P.; Niskanen T.; Pasanen P.; Pekkonen L.; Retsu
A.; Soppela A.; Andreu N.; Ankotche A.; Bairras C.; Boch C.; Camachon L.;
Cherchouly A.; Coudret S.; Demer C.; Gilg R.; Lemonade L.; Madec O.;
Pinotti D.; Poirier I.; Tenne N.; Vogler C.; Amman M.; Andratschke-Gentsch
B.; Beckmann H.; Bischoff S.; Bleich B.; Bueschges G.; Busch E.;
Deigentasch S.; Dietze S.; Dollinger M.; El-Bahay C.; Flehmig G.; Frenzel
I.; Geissler K.; Guerro J.; Heike B.; Holler D.; Inhoffen C.; Klein K.;
Kraehe I.; Kress P.; Krueger H.; Lenz R.; Linnebach B.; Lueck A.; Markhof
P.; Matthies K.; Meier C.; Metzler E.; Moor E.; Noll I.; Paulsen S.;
Pfeffer B.; Promnitz N.; Saljew B.; Schad S.; Schoner C.; Sellmann R.;
Tanis M.; Vogelbusch J.; Wagner E.; Winkler S.; Zenker K.; Zvork S.;
Balogh E.; Buncsikne Molnar S.; Gulyasne Gaspar E.; Herold M.; Kovacs E.;
Kozmane Paszternak A.; Maarne Nagy S.; Nagyne Zoltan A.; Nemeth Z.; Roth
T.; Rozsa I.; Szalai M.; Anuradha M.; Bawa T.; Bhaskar B.; Chalkhore S.;
Choudhary D.; Dhanalaxmi T.; Dhingra V.; Gayatri R.; Gnanasundram R.;
Gopal U.; Govindaraj S.; Indira P.; James S.; Karkuzhli K.; Koppikar V.;
Malhotra N.; Manmohan B.; Mazher A.; Menon R.; Nalini S.; Panda M.; Patel
K.; Poongothai S.; Ramanathan S.; Ramu I.; Sangeetha K.; Sankar K.;
Savitha; Shrinivas K.; Sudha S.; Tripathi S.; Vaseem A.; Yamuna A.;
Banques R.; Chong J.; Courcy M.; Donnelly E.; Fauzi A.; Gately M.; Hanlon
G.; Kelly-Conroy M.; McAteer S.; McGovern G.; Meaney E.; Storey S.; Todd
M.; Aharonof-Segal M.; Aliazarov N.; Arbeli S.; Butbul E.; Chagai E.;
Confino K.; Domb L.; Dvir R.; Erez N.; Foiening O.; Frishberg A.; Genin
I.; Gertman R.; Golan L.; Grosberd A.; Hadad D.; Israeli S.; Kaplunski Y.;
Karpf D.; Katzir A.; Kivity Z.; Li L.; Livshitz L.; Nachmias A.; Orr I.;
Peer E.; Platner N.; Pritulo L.; Rojansky A.; Rosenblat T.; Saranga H.;
Schterchman G.; Shenhar S.; Shkliar T.; Stam T.; Stinmann S.; Suliman A.;
Tsirulnikov E.; Uziel K.; Weinshtock S.; Yedid-Am S.; Yuval R.; Zuker S.;
Brunella L.; Durante A.; Nada E.; Pugolotti M.; Robusto A.; Testa M.;
Toniato R.; Ha I.; Jung S.; Kim C.; Mi Ran K.; Song B.; Wi Y.; Yang K.;
You J.; Gaisute R.; Ozolina L.; Dzagajeva N.; Kasperaviciene V.;
Krikstaponiene Z.; Montviliene R.; Morkunaite K.; Piepoliene L.; Stoniene
E.; Stonkus S.; Ulpaityte I.; Arenas-Vanhorn M.; Espitia-Serrato L.;
Garcia-Munoz E.; Nunez V.; Sainz T.; Bakker H.; Danse I.; De Greef S.; De
Jong C.; De Wit M.; Didden E.; Dommerholt R.; Goddrie M.; Haazer C.;
Havenaar J.; Hendriks-Van Woerden M.; Jongenotter M.; Kort I.; Koster L.;
Kramer H.; Maarssen E.; Posthuma-Visscher M.; Reijnierse-Buitenwerf H.;
Rood P.; Swets E.; Tousain W.A.; Van Buchem-Damming G.; Van
Buijsen-Nutters A.; Van de Loo R.; Van den Hondel M.; Van den Berg A.; Van
der Knaap-van Keulen M.; Van der Zeijst M.; Van Setten-Van der Meer L.;
Von Bannisseht E.E.; Wouda Z.; Aarsland T.; Amlie L.; Andresen B.;
Bakketun A.; Bognaes A.; Botten C.; Coucheron S.; Halsne A.; Hansen H.;
Holthe T.; Husby E.; Iversen E.; Kvalvik A.; Landbakk T.; Lovseth E.; Moen
S.; Orvik E.; Ovrehus G.; Salater S.; Sorgard B.; Sorstrom A.; Tandberg
L.; Veiding B.; Vinje G.; Winge A.; Abquina G.; Patena B.; Reyes R.;
Tamondong A.; Vega A.; Vitug L.; Makuch M.; Torun A.; Adam A.; Basaraba
M.; Chira C.; Darida C.; Haica C.; Nedelcu A.; Patru D.; Patrut L.; Rau
I.; Rotaru N.; Szabo L.; Vrinceanu G.; Sovenko T.; Zatsevskaya O.;
Horynova Z.; Vankova L.; Barkhuizen M.; Barnard L.; Bekker D.; Botha D.;
Commerford A.; de Klerk A.; De Waal A.; Devchand S.; Drummond F.; Du Toit
A.; Du Toit S.; Ellis T.; Engelbrecht M.; Eramus T.; Fonda K.; Goosen A.;
Gopel E.; Govender P.; Hodge E.; Ismael F.; Jonker E.; Jonker L.; Joubert
A.; Kilian M.; Koegenlenberg N.; Lehner L.; Lingham R.; Llyod T.; Mangoeng
P.; Mapele S.; Meiring J.; Methusi P.; Mmethi M.; Mohamed K.; Moore A.;
Ndiweni H.; Parker F.; Schoneman J.; Smit M.; Steyn A.; Van Dongren J.;
Van Schalkwyk S.; Van Staden L.; van Wyngaard G.; Wolf A.; Ashbaugh R.;
Bande C.; Barquero R.; Gaspar R.; Martin E.; Megia B.; Rodriguez C.;
Seoane A.; Viaplana J.; Akesson Jacobsson I.; Andersson C.; Asperen M.;
Backlund M.; Berglund M.; Bjorck L.; Borjesson M.; Brolin G.; Danielsson
Frojd M.; Duckert A.; Eriksson K.; Fehling K.; Glaas A.; Hage C.; Hoglund
K.; Jernhed H.; Johansson K.; Johansson S.; Lidin M.; Lundell L.; Lundgren
C.; Magnusson K.; Matsson E.; Norman J.; Nystrom K.; Ojutkangas M.;
Olofsson M.; Olsson C.; Pettersson U.; Pramberg E.; Raschperger A.; Sjolin
M.; Soderlund M.; Stensgaard Nake E.; Torebo E.; Uggeldahl I.; Walldin C.;
Welin-Berger B.; Dwyer A.; Meyer-Lazzarini V.; Morello R.; Schefer M.;
Oney S.; Seker T.; Tavlayan S.; Appleby M.; Astin J.; Baker M.; Brann H.;
Brennan C.; Bryan L.; Campbell D.; Carey J.; Cox K.; Davis C.; Dyson B.;
Everdell R.; Gammon B.; Godden J.; Gray T.; Griffiths E.; Grimes Y.; Hall
D.; Hall K.; Holme A.; Howe J.; Lambley-Burke R.; Nation M.; Norcott K.;
Mitchell K.; Poxon S.; Quick C.; Shute C.; Thomas J.; Vinnell T.; Bawa S.;
Bogan C.; Fallye O.; Ginsberg J.; Gregory B.; House B.; Isonaga M.;
Keanne-Richmond P.; Kelly C.; Kimpel J.; Leiby A.; Lyons L.; McCoy B.;
Monk A.; Pelayo E.; Perron M.; Posey D.; Rehan M.; Suarez R.; Tilton L.;
Waite K.; White G.; Chacon R.; Meza Y.; Misticchio F.; Torres M.; Urbaneja
H.
Institution
(Gerstein, Yusuf) Department of Medicine, Population Health Research
Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Bosch) Population Health Research Institute and School of Rehabilitation
Science, McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Dagenais) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec, QC, Canada
(Diaz) Estudios Clinicos Latino America, Rosario, Argentina
(Jung) McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Maggioni) Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
Research Center, Florence, Italy
(Pogue) Population Health Research Institute, McMaster University and
Hamilton Health Sciences, Hamilton, ON, Canada
(Probstfield) University of Washington, Seattle, United States
(Ramachandran) India Diabetes Research Foundation, Chennai, India
(Riddle) Oregon Health and Science University, Portland, United States
(Ryden) Department of Medicine, Karolinska Institute, Stockholm, Sweden
Publisher
Massachussetts Medical Society
Abstract
Background: The provision of sufficient basal insulin to normalize fasting
plasma glucose levels may reduce cardiovascular events, but such a
possibility has not been formally tested. Method(s): We randomly
assigned 12,537 people (mean age, 63.5 years) with cardiovascular risk
factors plus impaired fasting glucose, impaired glucose tolerance, or type
2 diabetes to receive insulin glargine (with a target fasting blood
glucose level of <=95 mg per deciliter [5.3 mmol per liter]) or standard
care and to receive n-3 fatty acids or placebo with the use of a 2-by-2
factorial design. The results of the comparison between insulin glargine
and standard care are reported here. The coprimary outcomes were nonfatal
myocardial infarction, nonfatal stroke, or death from cardiovascular
causes and these events plus revascularization or hospitalization for
heart failure. Microvascular outcomes, incident diabetes, hypoglycemia,
weight, and cancers were also compared between groups. Result(s): The
median follow-up was 6.2 years (interquartile range, 5.8 to 6.7). Rates of
incident cardiovascular outcomes were similar in the insulin-glargine and
standard-care groups: 2.94 and 2.85 per 100 person-years, respectively,
for the first coprimary outcome (hazard ratio, 1.02; 95% confidence
interval [CI], 0.94 to 1.11; P = 0.63) and 5.52 and 5.28 per 100
person-years, respectively, for the second coprimary outcome (hazard
ratio, 1.04; 95% CI, 0.97 to 1.11; P = 0.27). New diabetes was diagnosed
approximately 3 months after therapy was stopped among 30% versus 35% of
1456 participants without baseline diabetes (odds ratio, 0.80; 95% CI,
0.64 to 1.00; P = 0.05). Rates of severe hypoglycemia were 1.00 versus
0.31 per 100 person-years. Median weight increased by 1.6 kg in the
insulin-glargine group and fell by 0.5 kg in the standard-care group.
There was no significant difference in cancers (hazard ratio, 1.00; 95%
CI, 0.88 to 1.13; P = 0.97). Conclusion(s): When used to target
normal fasting plasma glucose levels for more than 6 years, insulin
glargine had a neutral effect on cardiovascular outcomes and cancers.
Although it reduced new-onset diabetes, insulin glargine also increased
hypoglycemia and modestly increased weight. Copyright © 2012
Massachusetts Medical Society.

<58>
Accession Number
365062670
Title
Antiplatelet Therapy in Children: Why So Different from Adults'?.
Source
Current Pharmaceutical Design. 18 (21) (pp 3019-3033), 2012. Date of
Publication: August 2012.
Author
Bassareo P.P.; Fanos V.; Iacovidou N.; Mercuro G.
Institution
(Bassareo, Mercuro) Department of Cardiovascular and Neurological
Sciences, University of Cagliari, Policlinico Universitario, S.S. 554,
bivio di Sestu, 09042 Monserrato (Cagliari), Italy
(Fanos) Department of Pediatrics and Clinical Medicine, Section of
Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy
(Iacovidou) National and Kapodistrian University of Athens, Medical
School, Athens, Greece
Publisher
Bentham Science Publishers
Abstract
Antiplatelet agents are administered in the treatment of a large number of
adult diseases: coronary heart disease, ischemic stroke, peripheral
arterial disease, arrhythmias with their thromboembolic complications,
primary and secondary prevention. In childhood however, the situation is
substantially different. The lack of large interventional trials on the
use of antiplatelet drugs in children, has led to greater uncertainty, and
a less extensive use of these drugs, limited to fewer indications. The
purpose of this article was to review the studies conducted to date on the
use of antiplatelet agents in children. A concerted effort has been made
to identify which are the shared therapeutic indications of this class of
compounds, the recommended dose, the contraindications and the possible
side effects. In brief, an attempt has been made to ascertain the
interesting potential of these drugs which are so often neglected in
children. © 2012 Bentham Science Publishers.

<59>
Accession Number
358607085
Title
Early management of unstable angina and non-ST segment elevation
myocardial infarction: Summary of NICE guidance.
Source
BMJ (Online). 340 (7750) (pp 805-807), 2010. Article Number: c1134. Date
of Publication: 10 Apr 2010.
Author
Crowe E.; Lovibond K.; Gray H.; Henderson R.; Krause T.; Camm J.
Institution
(Crowe, Lovibond, Krause) National Clinical Guideline Centre, Royal
College of Physicians of London, London NW1 4LE, United Kingdom
(Gray) Southampton University Hospital, Southampton SO16 6YD, United
Kingdom
(Henderson) Nottingham University Hospitals, Nottingham NG5 1PB, United
Kingdom
(Camm) St. George's, University of London, London SW17 0RE, United Kingdom
Publisher
BMJ Publishing Group

<60>
Accession Number
2010716122
Title
Adult cardiovascular surgery and the coronavirus disease 2019 (COVID-19)
pandemic: The Italian experience.
Source
Interactive Cardiovascular and Thoracic Surgery. 31 (6) (pp 755-762),
2021. Date of Publication: 01 Dec 2021.
Author
Donatelli F.; Miceli A.; Glauber M.; Cirri S.; Maiello C.; Coscioni E.;
Napoli C.
Institution
(Donatelli, Miceli, Glauber) Chair of Cardiac Surgery, Department of
Cardiothoracic Center, Istituto Clinico Sant'Ambrogio, University of
Milan, Milan, Italy
(Cirri) Department of Anaesthesia and Intensive Care, Cardiothoracic
Center, Istituto Clinico Sant'Ambrogio, Milan, Italy
(Maiello) Cardiac Transplantation Unit, Department of Cardiac Surgery and
Transplantation, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples,
Italy
(Coscioni) Department of Cardiac Surgery, Azienda Ospedaliera
Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
(Napoli) Clinical Department of Internal Medicine and Specialists, Azienda
Ospedaliera Universitaria, University Department of Advanced Medical and
Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples,
Italy
(Napoli) IRCCS-SDN, Istituto di Ricovero e Cura a Carattere Scientifico,
Naples, Italy
Publisher
Oxford University Press
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected
all health care professionals. The outbreak required a thorough
reorganization of the Italian regional local health care system to
preserve resources such as ventilators, beds in intensive care units and
surgical and anaesthesiological staff. Levels of priority were created,
together with a rigorous triage procedure for patients with COVID-19,
which led to postponement of all elective procedures. Urgent cases were
discussed with the local heart team and percutaneous approaches were
selected as the first treatment option to reduce hospital stay. COVID-19
and COVID-19-free pathways were created, including adequate preparation of
the operating room, management of anaesthesiological procedures,
transportation of patients and disinfection. It was determined that
patients with chronic diseases were at increased risk of adverse outcomes.
Systemic inflammation, cytokine storm and hypercoagulability associated
with COVID-19 increased the risk of heart failure and cardiac death. In
this regard, the early use of extracorporeal membrane oxygenation could be
life-saving in patients with severe forms of acute respiratory distress
syndrome or refractory heart failure. The goal of this paper was to report
the Italian experience during the COVID-19 pandemic in the setting of
cardiovascular surgery. Copyright © 2020 The Author(s) 2020.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<61>
Accession Number
2005422214
Title
A systematic review and trial sequential analysis of intravenous vs. oral
peri-operative paracetamol.
Source
Anaesthesia. 76 (2) (pp 270-276), 2021. Date of Publication: February
2021.
Author
Mallama M.; Valencia A.; Rijs K.; Rietdijk W.J.R.; Klimek M.; Calvache
J.A.
Institution
(Mallama, Valencia, Calvache) Department of Anaesthesiology, Universidad
del Cauca, Popayan, Colombia
(Rijs, Klimek, Calvache) Department of Anaesthesiology, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Rietdijk) Department of Intensive Care, Erasmus University Medical
Centre, Rotterdam, Netherlands
Publisher
Blackwell Publishing Ltd
Abstract
Postoperative pain might be different after intravenous vs. oral
paracetamol. We systematically reviewed randomised controlled trials in
patients >15 years that compared intravenous with oral paracetamol for
postoperative pain. We identified 14 trials with 1695 participants. There
was inconclusive evidence for an effect of route of paracetamol
administration on postoperative pain at 0-2 h (734 participants), 2-6 h
(766 participants), 6-24 h (1115 participants) and >24 h (248
participants), with differences in standardised mean (95%CI) pain scores
for intravenous vs. oral of -0.17 (-0.45 to 0.10), -0.09 (-0.24 to 0.06),
0.06 (-0.12 to 0.23) and 0.03 (-0.22 to 0.28), respectively. Trial
sequential analyses suggested that a total of 3948 participants would be
needed to demonstrate a meaningful difference in pain or its absence at
0-2 h. There were no differences in secondary outcomes. Intravenous
paracetamol is more expensive than oral paracetamol. Substitution of oral
paracetamol in half the patients given intravenous paracetamol in our
hospital would save around 38,711 ( 43,960 or US$ 47,498) per
annum. Copyright © 2020 The Authors. Anaesthesia published by
John Wiley & Sons Ltd on behalf of Association of Anaesthetists

<62>
Accession Number
2006719088
Title
The 90% effective dose of intranasal dexmedetomidine for procedural
sedation in children with congenital heart disease before and after
surgery: A biased-coin design up-and-down sequential allocation trial.
Source
Acta Anaesthesiologica Scandinavica. 65 (2) (pp 188-194), 2021. Date of
Publication: February 2021.
Author
Zhang J.; Chen Y.; Li S.; Liu H.; Tu S.
Institution
(Zhang, Li, Liu, Tu) Department of Anesthesiology, Children's Hospital of
Chongqing Medical University, Chongqing, China
(Zhang, Liu) Ministry of Education Key Laboratory of Child Development and
Critical Disorders, Chongqing, China
(Zhang, Li, Liu) China International Science and Technology Cooperation
Base of Child Development and Critical Disorders, Chongqing, China
(Zhang, Liu) Chongqing Key Laboratory of Pediatrics, Chongqing, China
(Chen) Department of Anesthesiology, Affiliated Hospital of North Sichuan
Medical College, Nanchong, China
Publisher
Blackwell Munksgaard
Abstract
Background: Intranasal dexmedetomidine can provide adequate sedation
during short procedures. However, there are few reports investigating the
effective dose of intranasal dexmedetomidine for sedation in children with
congenital heart disease (CHD) before and after surgery. Method(s):
Children aged 13-36 months with acyanotic CHD requiring trans-thoracic
echocardiography before cardiac surgery were recruited for this study. One
month after the cardiac surgery, the same children were studied again. The
90% effective dose was established using a biased-coin design up-and-down
sequential method. Onset time, examination time, wake-up time and adverse
effects were measured. Safety was evaluated in terms of changes in vital
signs. Result(s): A total of fifty-eight subjects were recruited for
this study. The 90% effective dose of intranasal dexmedetomidine for
sedation was 2.13 mug/kg (95% CI, 1.73-2.34 mug/kg) in children with CHD
before cardiac surgery and 3.51 mug/kg (95% CI, 2.99-3.63 mug/kg) after
cardiac surgery (P <.01). There were no differences between the groups in
terms of demographic variables, onset time, examination time, wake-up time
or adverse effects. Conclusion(s): The 90% effective dose of
intranasal dexmedetomidine for sedation in children with CHD was 2.13
mug/kg before cardiac surgery and 3.51 mug/kg after cardiac
surgery. Copyright © 2020 The Acta Anaesthesiologica Scandinavica
Foundation. Published by John Wiley & Sons Ltd

<63>
Accession Number
2008363299
Title
Systematic review and consensus definitions for the Standardized Endpoints
in Perioperative Medicine (StEP) initiative: cardiovascular outcomes.
Source
British Journal of Anaesthesia. 126 (1) (pp 56-66), 2021. Date of
Publication: January 2021.
Author
Beattie W.S.; Lalu M.; Bocock M.; Feng S.; Wijeysundera D.N.; Nagele P.;
Fleisher L.A.; Kurz A.; Biccard B.; Leslie K.; Howell S.; Grocott H.; Lamy
A.; Richards T.; Myles P.; Gan T.J.; Peyton P.; Sessler D.; Tramer M.;
Cyna A.; De Oliveira G.S.; Wu C.; Jensen M.; Kehlet H.; Botti M.; Boney
O.; Haller G.; Grocott M.; Cook T.; Fleisher L.; Neuman M.; Story D.;
Gruen R.; Bampoe S.; Evered L.; Scott D.; Silbert B.; van Dijk D.; Kalkman
C.; Chan M.; Eckenhoff R.; Rasmussen L.; Eriksson L.; Beattie S.;
Wijeysundera D.; Landoni G.; Bartlett R.J.; McMonnies R.; Gerstl J.; Jay
M.; Kishlyansky D.; Machina M.; Bobcock M.; Pearse R.; Mythen M.; Canet
J.; Moller A.; Gin T.; Schultz M.; Pelosi P.; Gabreu M.; Futier E.;
Creagh-Brown B.; Abbott T.; Klein A.; Corcoran T.; Cooper D.J.; Dieleman
S.; Diouf E.; McIlroy D.; Bellomo R.; Shaw A.; Prowle J.; Karkouti K.;
Billings J.; Mazer D.; Jayarajah M.; Murphy M.; Bartoszko J.; Sneyd R.;
Morris S.; George R.; Moonesinghe R.; Shulman M.; Lane-Fall M.; Nilsson
U.; Stevenson N.; Cooper J.D.; van Klei W.; Cabrini L.; Miller T.; Pace
N.; Jackson S.; Buggy D.; Short T.; Riedel B.; Gottumukkala V.; Alkhaffaf
B.; Johnson M.
Institution
(Beattie) Cardiovascular Anesthesia, University Health Network, University
of Toronto, Toronto, ON, Canada
(Lalu, Bocock, Feng) Department of Anesthesia, University of Ottawa,
Ottawa, ON, Canada
(Wijeysundera) Li Ka Shing Knowledge Institute, St Michaels Hospital,
University of Toronto, Toronto, ON, Canada
(Nagele) Department of Anesthesia and Critical Care, University of
Chicago, Chicago, IL, United States
(Fleisher) Department of Anesthesiology and Critical Care, University of
Pennsylvania Health System, Philadelphia, PA, United States
(Kurz) Outcomes Research, Cleveland Clinic, Cleveland, OH, United States
(Biccard) Department of Anesthesia and Perioperative Medicine, University
of Cape Town, Cape Town, South Africa
(Leslie) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, Vic., Australia
(Howell) University of Leeds School of Medicine, Leeds, United Kingdom
(Landoni) Center for Intensive Care and Anesthesiology, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Grocott) Department of Anesthesia and Perioperative Medicine, University
of Manitoba, Winnipeg, MB, Canada
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
(Richards) University of Western Australia, Perth, Australia
(Myles) Alfred Health and Monash University Department of Anaesthesia and
Perioperative Medicine, Melbourne, Vic., Australia
Publisher
Elsevier Ltd
Abstract
Background: Adverse cardiovascular events are a leading cause of
perioperative morbidity and mortality. The definitions of perioperative
cardiovascular adverse events are heterogeneous. As part of the
international Standardized Endpoints in Perioperative Medicine initiative,
this study aimed to find consensus amongst clinical trialists on a set of
standardised and valid cardiovascular outcomes for use in future
perioperative clinical trials. Method(s): We identified currently
used perioperative cardiovascular outcomes by a systematic review of the
anaesthesia and perioperative medicine literature (PubMed/Ovid, Embase,
and Cochrane Library). We performed a three-stage Delphi consensus-gaining
process that involved 55 clinician researchers worldwide. Cardiovascular
outcomes were first shortlisted and the most suitable definitions
determined. These cardiovascular outcomes were then assessed for validity,
reliability, feasibility, and clarity. Result(s): We identified 18
cardiovascular outcomes. Participation in the three Delphi rounds was 100%
(n=19), 71% (n=55), and 89% (n=17), respectively. A final list of nine
cardiovascular outcomes was elicited from the consensus: myocardial
infarction, myocardial injury, cardiovascular death, non-fatal cardiac
arrest, coronary revascularisation, major adverse cardiac events,
pulmonary embolism, deep vein thrombosis, and atrial fibrillation. These
nine cardiovascular outcomes were rated by the majority of experts as
valid, reliable, feasible, and clearly defined. Conclusion(s): These
nine consensus cardiovascular outcomes can be confidently used as
endpoints in clinical trials designed to evaluate perioperative
interventions with the goal of improving perioperative
outcomes. Copyright © 2020 British Journal of Anaesthesia

<64>
Accession Number
2006876233
Title
Effects of different mean arterial pressure targets on plasma volume, ANP
and glycocalyx-A randomized trial.
Source
Acta Anaesthesiologica Scandinavica. 65 (2) (pp 220-227), 2021. Date of
Publication: February 2021.
Author
Damen T.; Saadati S.; Forssell-Aronsson E.; Hesse C.; Bentzer P.; Ricksten
S.-E.; Nygren A.
Institution
(Damen, Ricksten, Nygren) Department of Anaesthesiology and Intensive Care
Medicine, Institute of Clinical Sciences at the Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
(Damen, Ricksten, Nygren) Section of Cardiothoracic Anaesthesia and
Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
(Saadati, Forssell-Aronsson) Department of Radiation Physics, Institute of
Clinical Sciences, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Forssell-Aronsson) Department of Medical Physics and Biomedical
Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
(Hesse) Department of Laboratory Medicine, Institute of Biomedicine,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Bentzer) Department of Anaesthesia and Intensive Care, Helsingborg
Hospital, Helsingborg and Lund University, Helsingborg, Sweden
(Bentzer) Department of Clinical Sciences, Anaesthesiology, Lund
University, Lund, Sweden
Publisher
Blackwell Munksgaard
Abstract
Background: Arterial haematocrit (Hct) has been shown to decrease after
anaesthesia induction, most probably because of an increased plasma volume
(PV). The primary objective was to quantify change in PV if mean arterial
pressure (MAP) was kept at baseline level or allowed to decrease to 60 mm
Hg. Our secondary objective was to evaluate underlying mechanisms of this
response. Method(s): Twenty-four coronary artery bypass patients were
randomized to a higher (90 mm Hg, intervention group) or lower (60 mm Hg,
control group) MAP by titration of norepinephrine. During the experimental
procedure, no fluids were administered. Baseline PV was measured by
125I-albumin and the change in PV was calculated from the
change in Hct. Changes in MAP, plasma 125I-albumin, colloid
osmotic pressure, albumin, Mid Regional-pro Atrial Natriuretic Peptide
(MR-proANP) and endothelial glycocalyx components were measured from
baseline to 50 minutes after anaesthesia induction. Result(s): The
MAP during the trial was 93 +/- 9 mm Hg in the intervention group and 62
+/- 5 mm Hg in the control group. PV increased with up to 420 +/- 180 mL
in the control group and 45 +/- 130 mL in the intervention group (P
<.001). Albumin and colloid osmotic pressure decreased significantly more
in the control group. MR-proANP increased in the control group but no
shedding of the glycocalyx layer was detected in either of the groups.
 Conclusion(s): Allowing mean arterial pressure to fall to 60 mm Hg
during anaesthesia induction, increases the plasma volume due to
reabsorption of interstitial water, with no ANP-induced degradation of the
endothelial glycocalyx. Copyright © 2020 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation

<65>
[Use Link to view the full text]
Accession Number
2007636779
Title
Misplacement of transjugular intrahepatic portosystemic shunts: A surgical
challenge for liver transplantation?.
Source
Surgery (United States). 169 (2) (pp 447-454), 2021. Date of Publication:
February 2021.
Author
Addeo P.; Schaaf C.; Faitot F.; Terrone A.; Julliard O.; Besch C.; Serfaty
L.; Bachellier P.
Institution
(Addeo, Schaaf, Faitot, Terrone, Julliard, Bachellier)
Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pole des
Pathologies Digestives, Hepatiques et de la Transplantation, Hopital de
Hautepierre-Hopitaux Universitaires de Strasbourg, Universite de
Strasbourg, France
(Besch, Serfaty) Hepatology Department, Pole des Pathologies Digestives,
Hepatiques et de la Transplantation, Hopital de Hautepierre-Hopitaux
Universitaires de Strasbourg, Universite de Strasbourg, France
Publisher
Mosby Inc.
Abstract
Background: The impact of transjugular intrahepatic portosystemic shunt
misplacement on outcomes of liver transplantation remains controversial.
We systematically reviewed the literature on the outcomes of liver
transplantation with transjugular intrahepatic portosystemic shunt
misplacement. Method(s): This systematic review was conducted
according to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines. The Cochrane library, PubMed, and Embase were
searched (January 1990-April 2020) for studies reporting patients
undergoing liver transplantation with transjugular intrahepatic
portosystemic shunt misplacement. Result(s): Thirty-six studies
reporting 181 patients who underwent liver transplantation with
transjugular intrahepatic portosystemic shunt misplacement were
identified. Transjugular intrahepatic portosystemic shunt was misplaced
with a variable degree of extension toward the inferior vena cava/right
heart in 63 patients (34%), the spleno/portal/superior mesenteric venous
confluence in 105 patients (58%), and both in 15 patients (8%).
Transjugular intrahepatic portosystemic shunt thrombosis was also present
in 21 cases (12%). The median interval between transjugular intrahepatic
portosystemic shunt placement and liver transplantation ranged from 1 day
to 6 years. Complete transjugular intrahepatic portosystemic shunt removal
was successfully performed in all but 12 (7%) patients in whom part of the
transjugular intrahepatic portosystemic shunt was left in situ. Cardiac
surgery under cardiopulmonary bypass was necessary to remove transjugular
intrahepatic portosystemic shunt from the right heart in 4 patients (2%),
and a venous graft interposition was necessary for a portal anastomosis in
5 patients (3%). Postoperative mortality (90 days) was 1.1% (2 patients),
and portal vein thrombosis developed postoperatively in 4 patients (2%).
 Conclusion(s): Misplaced transjugular intrahepatic portosystemic
shunt removal is possible in most cases during liver transplantation with
extremely low mortality and good postoperative outcomes. Preoperative
surgical strategy and intraoperative tailored surgical technique reduces
the potential consequences of transjugular intrahepatic portosystemic
shunt misplacement. Copyright © 2020 Elsevier Inc.

<66>
Accession Number
2005574621
Title
Brazilian cardio-oncology guideline-2020.
Source
Arquivos Brasileiros de Cardiologia. 115 (5) (pp 1006-1043), 2020. Date of
Publication: November 2020.
Author
Hajjar L.A.; Da Costa I.B.S.S.; Lopes M.A.C.Q.; Hoff P.M.G.; Diz M.D.P.E.;
Fonseca S.M.R.; Bittar C.S.; Rehder M.H.H.S.; Rizk S.I.; Almeida D.R.;
Fernandes G.D.S.; Beck-Da-Silva L.; Campos C.A.H.M.; Montera M.W.; Alves
S.M.M.; Fukushima J.T.; Dos Santos M.V.C.; Negrao C.E.; Feliciano Da Silva
T.L.; Ferreira S.M.A.; Malachias M.V.B.; Moreira M.D.C.V.; Neto M.M.R.V.;
Fonseca V.C.Q.; Soeiro M.C.F.A.; Alves J.B.S.; Silva C.M.P.D.C.; Sbano J.;
Pavanello R.; Pinto I.M.F.; Simao A.F.; Dracoulakis M.D.A.; Hoff A.O.;
Assuncao B.M.B.L.; Novis Y.; Testa L.; Filho A.C.D.A.; Cruz C.B.B.V.;
Pereira J.; Garcia D.R.; Nomura C.H.; Rochitte C.E.; Macedo A.V.S.;
Marcatti P.T.F.; Junior W.M.; Wiermann E.G.; Do Val R.; Freitas H.;
Coutinho A.; Mathias C.M.D.C.; Vieira F.M.A.C.; Sasse A.D.; Rocha V.;
Ramires J.A.F.; Filho R.K.
Institution
(Hajjar, Rizk, Campos, Negrao, Feliciano Da Silva, Ferreira, Soeiro,
Sbano, Cruz, Garcia, Nomura, Rochitte, Junior, Do Val, Ramires, Filho)
Instituto do Coracao do Hospital das Clinicas da Faculdade de Medicina da
Universidade de Sao Paulo, Sao Paulo, Brazil
(Hajjar, Da Costa, Hoff, Diz, Fonseca, Bittar, Rehder, Rizk, Fukushima,
Neto, Fonseca, Alves, Silva, Hoff, Assuncao, Testa, Cruz, Pereira, Rocha,
Filho) Instituto do Cancer Hospital das Clinicas da Faculdade de Medicina
da Universidade de Sao Paulo, Sao Paulo, Brazil
(Lopes) Hospital Alberto Urquiza Wanderley, Joao Pessoa, Brazil
(Hoff) Instituto D'or Pesquisa e Ensino, Rio de Janeiro, Brazil
(Fonseca, Bittar, Rehder, Fernandes, Novis) Hospital Sirio Libanes, Sao
Paulo, Brazil
(Almeida) Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
(Beck-Da-Silva) Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
(Beck-Da-Silva) Universidade Federal do Rio Grande do Sul, Porto Alegre,
Brazil
(Montera) Hospital Pro-Cardiaco, Rio de Janeiro, Brazil
(Alves) Pronto Socorro Cardiologico de Pernambuco (PROCAPE), Recife,
Brazil
(Dos Santos) Sociedade Brasileira de Oncologia Pediatrica (SOBOPE), Sao
Paulo, Brazil
(Dos Santos) Departamento de Cardiopatias Congenitas e Cardiologia
Pediatrica (DCC/CP) da Sociedade Brasileira de Cardiologia (SBC), Rio de
Janeiro, Brazil
(Malachias) Faculdade de Ciencias Medicas de Minas Gerais, Belo Horizonte,
Brazil
(Moreira) Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
(Pavanello) Hospital do Coracao da Associacao do Sanatorio Sirio-HCor, Sao
Paulo, Brazil
(Pinto) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Simao) Instituto de Cardiologia de Santa Catarina, Sao Jose, Brazil
(Dracoulakis) Hospital da Bahia, Salvado, Brazil
(Filho) Universidade Federal do Amazonas, Manaus, Brazil
(Rochitte) Hospital do Coracao (HCOR), Sao Paulo, Brazil
(Macedo) Santa Casa de Misericordia de Sao Paulo, Sao Paulo, Brazil
(Marcatti) Rede Mater Dei de Saude, Belo Horizonte, Brazil
(Wiermann) Centro de Oncologia do Parana, Curitiba, Brazil
(Freitas) A.C. Camargo Cancer Center, Sao Paulo, Brazil
(Coutinho) Hospital Alianca, Salvador, Brazil
(Mathias) NOB/Oncoclinicas, Salvador, Brazil
(Mathias) Sociedade Brasileira de Oncologia Clinica, Sao Paulo, Brazil
(Vieira) Grupo Americas Oncologia, Rio de Janeiro, Brazil
(Sasse) Grupo SOnhe, Campinas, Brazil
(Sasse) Universidade Estadual de Campinas (Unicamp), Campinas, Brazil
Publisher
Arquivos Brasileiros de Cardiologia

<67>
Accession Number
633838884
Title
Magnetic Non-invasive Auricular Acupuncture During Eye-Exam for
Retinopathy of Prematurity in Preterm Infants: A Multicentre Randomized
Controlled Trial.
Source
Frontiers in Pediatrics. 8 (no pagination), 2020. Article Number: 615008.
Date of Publication: 23 Dec 2020.
Author
Gan K.M.L.; Oei J.-L.; Quah-Smith I.; Kamar A.A.; Lordudass A.A.D.; Liem
K.D.; Lindrea K.B.; Daly M.; Gaunker N.; Mangat A.K.; Yaskina M.;
Schmolzer G.M.
Institution
(Gan) Faculty of Medicine, University of New South Wales, Kensington, NSW,
Australia
(Gan, Oei, Quah-Smith) School of Women's and Children's Health, University
of New South Wales, Kensington, NSW, Australia
(Oei, Lindrea, Daly, Gaunker) Department of Newborn Care, The Royal
Hospital for Women, Randwick, NSW, Australia
(Quah-Smith) Roseville Wellness Group, Roseville, NSW, Australia
(Kamar, Lordudass) Neonatology Unit, University of Malaya Medical Centre,
Kuala Lumpur, Malaysia
(Liem) Department of Neonatology, Radboudumc Amalia Children's Hospital,
Nijmegen, Netherlands
(Mangat, Schmolzer) Neonatal Research Unit, Centre for the Studies of
Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, AB, Canada
(Mangat, Schmolzer) Department of Paediatrics, University of Alberta,
Edmonton, AB, Canada
(Yaskina) Women and Children's Health Research Institute (WCHRI),
University of Alberta, Edmonton, AB, Canada
Publisher
Frontiers Media S.A.
Abstract
Background: Eye exam for Retinopathy of prematurity (ROP) is a painful
procedure and pharmacological analgesia might be ineffective. We
hypothesized that magnetic auricular acupuncture (MAA) compared to placebo
will decrease pain during ROP exam in preterm infants. Method(s):
Multicentre randomized controlled trial conducted in three hospitals
(Australia, Canada, and Malaysia). Eligibility: >32 weeks, ROP exam, not
sedated, and parental consent. A total of 100 infants were randomized
(1:1) to MAA (n = 50) or placebo (n = 50). MAA stickers or placebo were
placed on both ears by an unblinded investigator. Pain was assessed using
the Premature Infant Pain Profile. Primary analyses were by
intention-to-treat. ClinicalTrials.gov:NCT03650621. Finding(s): The
mean (standard deviation, SD) gestation, birthweight, and postnatal age
were (MAA 28(3) vs. placebo 28(2) weeks; MAA 1,057(455) vs. placebo
952(273) g; MAA 7(3) vs. placebo 7(3) weeks. Placebo infants had
significantly higher PIPP scores during [mean difference 1.6 points (95%CI
0.1-3.1)] and 1 h mean difference 1.5 points (95%CI 0.7-2.2) after the
procedure (p < 0.03). Heart rate was lower (173(22) vs. 184(18)/min) and
oxygen saturations were higher (93.8(6.2) vs. 91.7(6.1)%, p = 0.05) in MAA
infants. No adverse effects. Interpretation(s): MAA may reduce
physiological pain responses during and after ROP exam in preterm infants.
Assessment of long-term effects are warranted. Clinical trial
registration: www.ClinicalTrials.gov, identifier: NCT03650621. ©
Copyright © 2020 Gan, Oei, Quah-Smith, Kamar, Lordudass, Liem,
Lindrea, Daly, Gaunker, Mangat, Yaskina and Schmolzer.

<68>
[Use Link to view the full text]
Accession Number
631588072
Title
Outsmart HF: A randomized controlled trial of routine versus selective
cardiac magnetic resonance for patients with nonischemic heart failure
(IMAGE-HF 1B).
Source
Circulation. 141 (10) (pp 818-827), 2020. Date of Publication: 10 Mar
2020.
Author
Paterson D.I.; Wells G.; Erthal F.; Mielniczuk L.; O'Meara E.; White J.;
Connelly K.A.; Knuuti J.; Radja M.; Laine M.; Chow B.J.W.; Kandolin R.;
Chen L.; Dick A.; Dennie C.; Garrard L.; Ezekowitz J.; Beanlands R.; Chan
K.-L.; Brown P.; Kartikainen J.; Hedman M.; Larose E.; Pibarot P.; Tardif
J.-C.; Leipsic J.; Kiess M.; Howarth A.; Hanninen H.; Duchesne L.; Freeman
M.; Leong H.; Wright G.; Ukkonen H.
Institution
(Paterson, Ezekowitz) Mazankowski Alberta Heart Institute, University of
Alberta, Edmonton, Canada
(Wells, Chen) School of Epidemiology and Public Health, Department of
Medicine and Cardiovascular Research Methods Centre, University of Ottawa,
ON, Canada
(Erthal, Mielniczuk, Chow, Kandolin, Dick, Dennie, Garrard, Chan,
Duchesne) University of Ottawa Heart Institute, University of Ottawa, ON,
Canada
(O'Meara) Institut de Cardiologie de Montreal, Universite de Montreal, QC,
Canada
(White) Calgary Foothills Medical Centre, University of Calgary, AB,
Canada
(Connelly, Freeman, Leong, Wright) Keenan Research Centre of the Li Ka
Shing Knowledge Institute, St Michael's Hospital, University of Toronto,
ON, Canada
(Knuuti) Turku PET Center, Turku University Hospital, University of Turku,
Finland
(Radja) Queen Elizabeth II Hospital, Dalhousie University, Halifax, NS,
Canada
(Laine, Hanninen) Helsinki University Central Hospital, University of
Helsinki, Finland
(Brown) Dalhousie University, Halifax, NS, Canada
(Kartikainen, Hedman) Kuopio University, Finland
(Larose, Pibarot) Universite de Laval, QC, Canada
(Tardif) Universite de Montreal, QC, Canada
(Leipsic, Kiess) University of British Columbia, Vancouver, Canada
(Howarth) University of Calgary, AB, Canada
(Ukkonen) University of Turku, Finland
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Cardiac magnetic resonance (CMR) is a recommended imaging test
for patients with heart failure (HF); however, there is a lack of evidence
showing incremental benefit over transthoracic echocardiography. Our
primary hypothesis was that routine use of CMR will yield more specific
diagnoses in nonischemic HF. Our secondary hypothesis was that routine use
of CMR will improve patient outcomes. METHOD(S): Patients with
nonischemic HF were randomized to routine versus selective CMR. Patients
in the routine strategy underwent echocardiography and CMR, whereas those
assigned to selective use underwent echocardiography with or without CMR
according to the clinical presentation. HF causes was classified from the
imaging data as well as by the treating physician at 3 months (primary
outcome). Clinical events were collected for 12 months. RESULT(S): A
total of 500 patients (344 male) with mean age 59+/-13 years were
randomized. The routine and selective CMR strategies had similar rates of
specific HF causes at 3 months clinical follow-up (44% versus 50%,
respectively; P=0.22). At image interpretation, rates of specific HF
causes were also not different between routine and selective CMR (34%
versus 30%, respectively; P=0.34). However, 24% of patients in the
selective group underwent a nonprotocol CMR. Patients with specific HF
causes had more clinical events than those with nonspecific caused on the
basis of imaging classification (19% versus 12%, respectively; P=0.02),
but not on clinical assessment (15% versus 14%, respectively; P=0.49).
 CONCLUSION(S): In patients with nonischemic HF, routine CMR does not
yield more specific HF causes on clinical assessment. Patients with
specific HF causes from imaging had worse outcomes, whereas HF causes
defined clinically did not. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT01281384. Copyright © 2020 Lippincott Williams and Wilkins.
All rights reserved.

<69>
Accession Number
2007149852
Title
IMPROV-ED trial: eHealth programme for faster recovery and reduced
healthcare utilisation after CABG.
Source
Netherlands Heart Journal. 29 (2) (pp 80-87), 2021. Date of Publication:
February 2021.
Author
van Steenbergen G.J.; van Veghel D.; ter Woorst J.; van Lieshout D.;
Dekker L.
Institution
(van Steenbergen, van Veghel, ter Woorst, Dekker) Catharina Heart Center,
Catharina Hospital, Eindhoven, Netherlands
(van Lieshout) Dutch Heart Foundation, The Hague, Netherlands
Publisher
Bohn Stafleu van Loghum
Abstract
Background: After coronary artery bypass grafting (CABG), healthcare
utilisation is high and is partly unplanned. eHealth applications have
been proposed to reduce healthcare consumption and to enable patients to
get actively involved in their recovery. This way, healthcare expenses can
be reduced and the quality of care can be improved. Objective(s): We
aim to evaluate whether the use of an eHealth programme can reduce
unplanned healthcare utilisation and improve mental and physical health in
the first 6 weeks after discharge in patients who underwent CABG. In
addition, patient satisfaction and use of the eHealth programme will be
evaluated. Method(s): For this single-centre randomised controlled
trial, at least 280 patients referred for CABG will be included at the
preoperative outpatient clinic and randomised to an intervention or
control group. The intervention group will have access to an eHealth
programme, which consists of online educational videos developed by the
Dutch Heart Foundation and postoperative video consultations with a
physician. The control group will receive standard care and will not have
access to the eHealth programme. The primary endpoint is healthcare
utilisation; other endpoints include anxiety, duration of recovery,
quality of life and patient satisfaction. Participants will complete
several questionnaires at 6 time points during the study. Result(s):
Patient enrolment started in February 2020 and completion of the follow-up
period is expected in August 2021. Conclusion(s): This randomised
trial was initiated to test the hypothesis that patients who are partaking
in our eHealth programme use less unplanned care and experience a better
quality of life, less anxiety and a faster recovery than
controls. Copyright © 2020, The Author(s).

<70>
Accession Number
2007145670
Title
Sensitivity of lung ultrasound for the detection of pneumothorax one day
after pulmonary resection-a prospective observational study.
Source
European Surgery - Acta Chirurgica Austriaca. 53 (1) (pp 23-28), 2021.
Date of Publication: February 2021.
Author
Galetin T.; Schieren M.; Marks B.; Defosse J.; Stoelben E.
Institution
(Galetin, Stoelben) Lung Clinic, Thoracic Surgery, Medical Centre
Cologne-Merheim, University Witten/Herdecke, Ostmerheimer Str. 200,
Cologne 51109, Germany
(Schieren, Defosse) Department of Anaesthesiology and Intensive Care
Medicine, Medical Centre Cologne-Merheim, University Witten/Herdecke,
Cologne, Germany
(Marks) Department of Radiology, Medical Centre Cologne-Merheim,
University Witten/Herdecke, Cologne, Germany
Publisher
Springer
Abstract
Background: Chest X-ray (CXR) after thoracic surgery contributes to
patient discomfort and costs and is of limited therapeutic value. Lung
ultrasound (LU) for pneumothorax may be an alternative to CXR, but
diagnostic accuracy data are heterogeneous and biased by insufficient
sonographic technique and patient selection. Reported sensitivities range
from 0.21 to 1.0. We evaluated the sensitivity of LU on the first day
after thoracic surgery under routine conditions. Method(s): We
performed a prospective observational study (trial-ID DRKS00014557).
Consecutive patients undergoing lung resection received standardized LU in
addition to routine CXR on the first postoperative day. Ultrasound
examiner and radiologist were blinded to corresponding X-ray and
ultrasound findings. CXR was used as reference to determine diagnostic
test performance of ultrasound. The conformity of sonography- and
routine-based therapeutic decisions was evaluated. Result(s): A total
of 68 patients were examined. The mean duration of ultrasound was 145+/-
64s. CXR identified 23 patients with pneumothorax with a mean
apex-to-cupola size of 1.5+/- 1.0cm. Ultrasound detected 18 patients with
pneumothorax. The computed sensitivity of LU was 0.48 (95% confidence
interval [0.36; 0.60]). Specificity was between 0.81 and 1.0, the negative
predictive value 0.76 [0.66; 0.86]. The sensitivity of CXR was 0.56 [0.44;
0.68]. Air leakage via chest tube correlated weakly with CXR (spearman's
rho= 0.26) and moderately with LU (rho= 0.43). The conformity between
sonographically based recommendations and the actual therapy based on
routine diagnostics was 96%. Conclusion(s): Sensitivity of ultrasound
for pneumothorax detection nearly reached CXR and resulted in equally safe
patient management. Our data can serve as a pilot study for upcoming
larger-scaled controlled trials. Copyright © 2020, The Author(s).

<71>
Accession Number
2010546797
Title
Aortic Valve Replacement in Low-Risk Patients With Severe Aortic Stenosis
Outside Randomized Trials.
Source
Journal of the American College of Cardiology. 77 (2) (pp 111-123), 2021.
Date of Publication: 19 Jan 2021.
Author
Alperi A.; Voisine P.; Kalavrouziotis D.; Dumont E.; Dagenais F.; Perron
J.; Silva I.; Bernardi F.; Mohammadi S.; Rodes-Cabau J.
Institution
(Alperi, Voisine, Kalavrouziotis, Dumont, Dagenais, Perron, Silva,
Bernardi, Mohammadi, Rodes-Cabau) Quebec Heart & Lung Institute, Laval
University, Quebec City, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Recent randomized trials including low-risk patients showed
positive results for transcatheter aortic valve replacement (TAVR)
compared to surgical aortic valve replacement (SAVR), but patients with
non-tricuspid aortic valve (NTAV), severe coronary artery disease
(SevCAD), and those requiring concomitant mitral/tricuspid valve (CMTV) or
concomitant ascending aorta replacement (CAAR) interventions were
excluded. Objective(s): This study sought to evaluate the presence
and impact of the main clinical variables not evaluated in TAVR versus
SAVR trials (NTAV, SevCAD, and CMTV or CAAR intervention) in a large
series of consecutive low-risk patients with severe aortic stenosis (SAS)
undergoing SAVR. Method(s): Single-center study including consecutive
patients with SAS and low surgical risk (Society of Thoracic Surgeons
score of <4%) undergoing SAVR. Baseline, procedural characteristics, and
30-day outcomes were prospectively collected. Result(s): Of 6,772
patients with SAS who underwent SAVR between 2000 and 2019, 5,310 (78.4%)
exhibited a low surgical risk (mean Society of Thoracic Surgeons score:
1.94 +/- 0.87%). Of these, 2,165 patients (40.8%) had at least 1 of the
following: NTAV (n = 1,468, 27.6%), SevCAD (n = 307, 5.8%), CMTV (n = 306,
5.8%), and CAAR (n = 560, 10.5%). The 30-day mortality and stroke rates
for the overall low-risk SAS cohort were 1.9% and 2.4%, respectively. The
mortality rate was similar in the SevCAD (2.6%) and CAAR (2.1%) groups
versus the rest of the cohort (odds ratio [OR]: 1.79; 95% confidence
interval [CI]: 0.85 to 3.75, and OR: 1.64; 95% CI: 0.88 to 3.05,
respectively), lower in the NTAV group (0.9%; OR: 0.42; 95% CI: 0.22 to
0.81), and higher in the CMTV group (5.9%; OR: 2.61; 95% CI: 1.51 to 4.5).
 Conclusion(s): In a real-world setting, close to one-half of the
low-risk patients with SAS undergoing SAVR exhibited at least 1 major
criterion not evaluated in TAVR versus SAVR randomized trials. Clinical
outcomes were better than or similar to those predicted by surgical scores
in all groups but those patients requiring CMTV intervention. These
results may help determine the impact of implementing the results of
TAVR-SAVR trials in real practice and may inform future trials in specific
groups. Copyright © 2021 American College of Cardiology
Foundation

<72>
Accession Number
2010642803
Title
Outcomes of transcarotid versus trans-subclavian transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Amer M.R.; Mosleh W.; Megaly M.; Shah T.; Ooi Y.S.; McKay R.G.
Institution
(Amer, Ooi) Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Mosleh) University of Connecticut, Farmington, CT, United States
(Megaly) Banner University Medical Center- UA College of Medicine,
Phoenix, AZ, United States
(Shah) St. Vincent's Hospital, Worcester, MA, United States
(McKay) Heart and Vascular Institute, Hartford Hospital, Hartford, CT,
United States
Publisher
Elsevier Inc.
Abstract
Objectives: This study aimed to perform the first meta-analysis of studies
comparing transcarotid (TC) and trans-subclavian (TSc) transcatheter
aortic valve replacement (TAVR). Background(s): The safety and
feasibility of a TC and a TSc approach for performing TAVR in patients
with prohibitive femoral anatomy have been well described. The potential
advantage of one approach over the other is yet to be ascertained.
 Method(s): A computerized literature search of key medical databases
through September 2020 was performed. Randomized controlled trials (RCTs)
and observational studies comparing TC and TSc TAVR with reported 30-day
outcomes were considered. The primary endpoint was a composite of
all-cause mortality, stroke, life-threatening, and/or major bleeding or
major vascular complications. Statistical analysis using random-effects
models to report the odds ratio (OR) with 95% confidence interval (CI) was
performed. Result(s): A total of 5 observational studies inclusive of
4164 patients (TC = 1788 and TSc = 2376) met the eligibility criteria. The
average age of patients was 81.1 years. There was no difference in the
occurrence of the composite endpoint between the groups at 30-days. A
statistically insignificant trend towards higher rates of major vascular
complications (OR 1.65; 95% CI 0.94-2.89; P = 0.08; I2 = 0%)
and the need for permanent pacemaker placement was observed with the TSc
approach. Conclusion(s): This meta-analysis of studies comparing TC
and TSc TAVR showed similar 30-day outcomes between the 2 approaches. A
notable trend towards higher rates of major vascular complications and the
need for permanent pacemaker placement was observed with the TSc
approach. Copyright © 2021 Elsevier Inc.

<73>
[Use Link to view the full text]
Accession Number
2007540285
Title
A mortality risk score for heart transplants after contemporary
ventricular assist device bridging.
Source
Journal of Cardiac Surgery. 36 (2) (pp 449-456), 2021. Date of
Publication: February 2021.
Author
Huckaby L.V.; Seese L.M.; Hickey G.; Sultan I.; Kilic A.
Institution
(Huckaby, Seese, Sultan, Kilic) Division of Cardiac Surgery, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Hickey) Division of Cardiology, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
Publisher
Blackwell Publishing Inc.
Abstract
Background: We sought to derive a risk score for 1-year mortality
following orthotopic heart transplantation (OHT) in patients bridged with
a contemporary centrifugal left ventricular assist device (LVAD).
 Method(s): Adult patients (>=18 years) in the United Network for
Organ Sharing database undergoing OHT between 2010 and 2019 who were
bridged with a HeartWare or HeartMate III device were included. Derivation
and validation cohorts were randomly assigned with a 2:1 ratio. Threshold
analysis and multivariable logistic regression were utilized to obtain
adjusted odds ratios for 1-year post-OHT mortality. A risk score was
generated using these adjusted odds ratios in the derivation cohort and
the predictive performance of the composite index was evaluated in the
validation set. Result(s): A total of 3434 patients were identified.
In the derivation cohort, the mean age was 53.5 +/- 12.1 years and 1758
(76.8%) were male; 1789 (78.1%) were bridged with a HeartWare device.
Multivariable logistic regression revealed that recipient age >=50 years,
bilirubin level >=2.4 mg/dl, ischemic time >=4 h, and preoperative
hemodialysis predicted 1-year post-transplant mortality. Stratification
into risk groups in the validation cohort revealed significant differences
in postoperative renal failure, stroke, and short-term mortality. One-year
post-transplant mortality was 5%, 6.7%, and 14.8% in the low-, moderate-,
and high-risk categories, respectively (p <.001). Conclusion(s):
Among patients bridged to OHT with newer generation centrifugal LVADs,
older age, increasing bilirubin, longer ischemic time, and pre-OHT
dialysis independently predicted post-transplant mortality. The composite
risk score based on these factors may assist in patient selection and
prognostication in those supported with contemporary LVADs. Copyright
© 2020 Wiley Periodicals LLC

<74>
[Use Link to view the full text]
Accession Number
2007540281
Title
Open heart surgery in an infant with hereditary spherocytosis and a review
of literature.
Source
Journal of Cardiac Surgery. 36 (2) (pp 720-722), 2021. Date of
Publication: February 2021.
Author
Menon S.; Saxena M.S.; Rajalakshmi M.S.
Institution
(Menon) Division of Pediatric Cardiac Surgery, Department of
Cardiovascular and Thoracic surgery, Sree Chitra Tirunal Institute for
Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
(Saxena) Department of Cardiovascular and Thoracic surgery, Sree Chitra
Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram,
Kerala, India
(Rajalakshmi) Department of Pathology, Sree Chitra Tirunal Institute for
Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
Publisher
Blackwell Publishing Inc.
Abstract
Hemolytic anemia often challenges congenital heart surgery. Hereditary
spherocytosis is a rare familial hemolytic anemia. When associated with
congenital heart disease, the safe performance of cardiopulmonary bypass
becomes a priority. The increased risk of hemolysis during cardiopulmonary
bypass could potentially lead to significant secondary organ damage. Till
now, only very few reports of successful repair of a congenital heart
defect in patients with hereditary spherocytosis have been reported. We
report the only case of successful repair of a congenital heart defect in
an infant with hereditary spherocytosis. Copyright © 2020 Wiley
Periodicals LLC

<75>
Accession Number
2007495769
Title
Short-term and long-term outcomes of revascularization interventions for
patients with severely reduced left ventricular ejection fraction: a
meta-analysis.
Source
ESC Heart Failure. 8 (1) (pp 634-643), 2021. Date of Publication: February
2021.
Author
Pei J.; Wang X.; Xing Z.; Zheng K.; Hu X.
Institution
(Pei, Wang, Xing, Hu) Department of Cardiovascular Medicine, The Second
Xiangya Hospital, Central South University, 139 Middle Renmin Road,
Changsha, Hunan 410011, China
(Xing) Department of Emergency Medicine, Second Xiangya Hospital, Central
South University, Changsha, China
(Zheng) Department of Cardiovascular Medicine, Beijing Anzhen Hospital,
Capital Medical University, Beijing, China
Publisher
Wiley-Blackwell
Abstract
Aims: This meta-analysis aimed to determine whether coronary artery bypass
grafting (CABG) or percutaneous coronary intervention (PCI) should be
preferred in patients with severely reduced left ventricular (LV) ejection
fraction. Methods and Results: We searched the PubMed, EMBASE, and
Cochrane Library databases from the conception of the databases till 1 May
2020 for studies on patients with severely reduced LV ejection fraction
undergoing CABG and PCI. The primary clinical endpoints were 30 day and
long-term mortalities. The secondary endpoints were 30 day and long-term
incidences of myocardial infarction (MI) and stroke, long-term
cardiovascular mortality, and repeat revascularization. Eighteen studies
involving 11 686 patients were analysed. Compared with PCI, CABG had lower
long-term mortality [hazard ratio (HR): 0.70, 95% confidence interval
(CI): 0.61-0.80, P < 0.01], cardiovascular mortality (HR: 0.60, 95% CI:
0.43-0.85, P < 0.01), MI (HR: 0.51, 95% CI: 0.36-0.72, P < 0.01), and
repeat revascularization (HR: 0.32, 95% CI: 0.23-0.47, P < 0.01) risk.
Significant differences were not observed for long-term stroke (HR: 1.18,
95% CI: 0.74-1.87, P = 0.49), 30 day mortality (HR: 1.18, 95% CI:
0.89-1.56, P = 0.25), and MI (HR: 0.42, 95% CI: 0.16-1.11, P = 0.08) risk.
CABG was associated with a higher risk of stroke within 30 days (HR: 2.88,
95% CI: 1.07-7.77, P = 0.04). In a subgroup analysis of propensity
score-matched studies, CABG was associated with a higher long-term risk of
stroke (HR: 1.61, 95% CI: 1.20-2.16, P < 0.01). Conclusion(s): Among
patients with severely reduced LV ejection fraction, CABG resulted in a
lower mortality rate and an increased risk of stroke. Copyright ©
2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on
behalf of European Society of Cardiology

<76>
Accession Number
2007371725
Title
Techniques for blood loss estimation in major non-cardiac surgery: a
systematic review and meta-analysis.
Source
Canadian Journal of Anesthesia. 68 (2) (pp 245-255), 2021. Date of
Publication: February 2021.
Author
Tran A.; Heuser J.; Ramsay T.; McIsaac D.I.; Martel G.
Institution
(Tran, Heuser, Martel) Department of Surgery, University of Ottawa,
Ottawa, ON, Canada
(Ramsay, McIsaac, Martel) Ottawa Hospital Research Institute, The Ottawa
Hospital - General Campus, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
(McIsaac) Department of Anesthesiology, University of Ottawa, Ottawa, ON,
Canada
Publisher
Springer
Abstract
Purpose: Estimated blood loss (EBL) is an important tool in clinical
decision-making and surgical outcomes research. It guides perioperative
transfusion practice and serves as a key predictor of short-term
perioperative risks and long-term oncologic outcomes. Despite its
widespread clinical and research use, there is no gold standard for blood
loss estimation. We sought to systematically review and compare techniques
for intraoperative blood loss estimation in major non-cardiac surgery with
the objective of informing clinical estimation and research standards.
Source: A structured search strategy was applied to Ovid Medline, Embase,
and Cochrane Library databases from inception to March 2020, to identify
studies comparing methods of intraoperative blood loss in adult patients
undergoing major non-cardiac surgery. We summarized agreement between
groups of pairwise comparisons as visual estimation vs formula estimation,
visual estimation vs other, and formula estimation vs other. For each of
these comparisons, we described tendencies for higher or lower EBL values,
consistency of findings, pooled mean differences, standard deviations, and
confidence intervals. Principle findings: We included 26 studies involving
3,297 patients in this review. We found that visual estimation is the most
frequently studied technique. In addition, visual techniques tended to
provide lower EBL values than formula-based estimation or other
techniques, though this effect was not statistically significant in pooled
analyses likely due to sample size limitations. When accounting for the
contextual mean blood loss, similar case-to-case variation exists for all
estimation techniques. Conclusion(s): We found that significant
case-by-case variation exists for all methods of blood loss evaluation and
that there is significant disagreement between techniques. Given the
importance placed on EBL, particularly for perioperative prognostication
models, clinicians should consider the universal adoption of a practical
and reproducible method for blood loss evaluation. Trial registration:
PROSPERO (CRD42015029439); registered: 18 November 2015.PROSPERO
(CRD42015029439); registered: 18 November 2015. Copyright © 2020,
Canadian Anesthesiologists' Society.

<77>
Accession Number
2010179069
Title
Aspergillus flavus costochondritis following coronary artery bypass
grafting: a case report and a brief review of literature.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2021. Date of
Publication: 2021.
Author
Mohammad A.; Benjamin S.R.; Mallampati S.; Gnanamuthu B.R.; Prabhu A.J.;
Ninan M.M.
Institution
(Mohammad, Benjamin, Mallampati, Gnanamuthu) Department of Cardiothoracic
Surgery, The Christian Medical College, Vellore, India
(Prabhu) Department of Pathology, The Christian Medical College, Vellore,
India
(Ninan) Department of Microbiology, The Christian Medical College,
Vellore, India
Publisher
SAGE Publications Inc.
Abstract
Bacterial sternal wound infections following cardiac surgery are not
uncommon. However, sternal wound infection by a fungus is a rarity, and it
warrants a correct diagnosis followed by specific treatment. We report a
case of Aspergillus sternal wound infection with costochondritis following
cardiac surgery, and briefly review the relevant literature. Copyright
© The Author(s) 2021.

<78>
Accession Number
2010177224
Title
Update in carcinoid heart disease - the heart of the matter.
Source
Reviews in Endocrine and Metabolic Disorders. (no pagination), 2021. Date
of Publication: 2021.
Author
Oleinikov K.; Korach A.; Planer D.; Gilon D.; Grozinsky-Glasberg S.
Institution
(Oleinikov, Grozinsky-Glasberg) Neuroendocrine Tumor Unit, Endocrinology
and Metabolism Department, Division of Medicine, Hadassah-Hebrew
University Medical Center, P.O.B. 12000, Jerusalem 91120, Israel
(Oleinikov, Korach, Planer, Gilon, Grozinsky-Glasberg) ENETS Center of
Excellence, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
(Korach) Department of Cardiothoracic Surgery, Hadassah-Hebrew University
Medical Center, Jerusalem, Israel
(Planer, Gilon) Department of Cardiology, Hadassah-Hebrew University
Medical Center, Jerusalem, Israel
Publisher
Springer
Abstract
Carcinoid heart disease (CHD) is a paraneoplastic cardiac manifestation
occurring in patients with carcinoid syndrome (CS) and advanced
neuroendocrine malignancy. In about 20-40% of patients with CS, chronic
exposure to tumor-released circulating vasoactive peptides typically
results in right-sided valvular fibrosis leading to valve dysfunction and
right heart failure. CHD remains a significant cause of morbidity and
mortality. The management of patients with CHD is complex, as both the
systemic malignant disease and the heart involvement have to be addressed.
Early diagnosis and timely surgical intervention in selected patients are
of utmost importance and offer a survival benefit. In patients with
advanced carcinoid heart disease, valve replacement surgery is the most
effective option to alleviate cardiac symptoms and contribute to survival
outcomes. A collaboration of a multidisciplinary team in centers with
experience is required to provide optimal patient management. Here, we
review the current literature regarding CHD presentation, pathophysiology,
diagnostic tools, and available treatment strategies. Copyright ©
2021, The Author(s), under exclusive licence to Springer Science+Business
Media, LLC part of Springer Nature.

<79>
Accession Number
2010173236
Title
Cardiovascular events in patients undergoing hip fracture surgery treated
with remote ischaemic preconditioning: 1-year follow-up of a randomised
clinical trial.
Source
Anaesthesia. (no pagination), 2021. Date of Publication: 2021.
Author
Ekeloef S.; Koyuncu S.; Holst-Knudsen J.; Gundel O.; Meyhoff C.S.;
Homilius M.; Stilling M.; Ekeloef P.; Munster A.M.B.; Mathiesen O.;
Gogenur I.
Institution
(Ekeloef, Gogenur) Center for Surgical Science, Department of Surgery,
Zealand University Hospital, Koege, Denmark
(Koyuncu, Holst-Knudsen, Mathiesen) Centre for Anaesthesiological
Research, Department of Anaesthesiology, Zealand University Hospital,
Koege, Denmark
(Gundel, Meyhoff) Department of Anaesthesia and Intensive Care, Bispebjerg
and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
(Homilius, Stilling) Department of Orthopaedic Surgery, University Clinic
for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Holstebro,
Denmark
(Ekeloef) Department of Anaesthesiology, Regional Hospital West Jutland,
Holstebro, Denmark
(Munster) Unit for Thrombosis Research, Department of Clinical
Biochemistry, Hospital of South West Denmark, Esbjerg, Denmark
Publisher
Blackwell Publishing Ltd
Abstract
Remote ischaemic preconditioning reduces the risk of myocardial injury
within 4 days of hip fracture surgery. We aimed to investigate the effect
of remote ischaemic preconditioning on the incidence of major adverse
cardiovascular events 1 year after hip fracture surgery. We performed a
phase-2, multicentre, randomised, observer-blinded, clinical trial between
February 2015 and September 2017. We studied patients aged >= 45 years
with a hip fracture and a minimum of one cardiovascular risk factor.
Patients were allocated randomly to remote ischaemic preconditioning
applied just before surgery or no treatment (control group). Remote
ischaemic preconditioning was performed on the upper arm with a tourniquet
in four cycles of 5 min ischaemia and 5 min reperfusion. Primary outcome
was the occurrence of major adverse cardiovascular events within 1 year of
surgery. A total of 316 patients were allocated randomly to the remote
ischaemic preconditioning group and 309 patients to the control group.
Major adverse cardiovascular events occurred in 43 patients (13.6%) in the
remote ischaemic preconditioning group compared with 51 patients (16.5%)
in the control group (adjusted hazard ratio (95%CI) 0.83 (0.55-1.25); p =
0.37). Fewer patients in the remote ischaemic preconditioning group had a
myocardial infarction (11 (3.5%) vs. 22 (7.1%); hazard ratio (95%CI) 0.48
(CI 0.23-1.00); p = 0.04). Remote ischaemic preconditioning did not reduce
the occurrence of major adverse cardiovascular events within 1 year of hip
fracture surgery. The effect of remote ischaemic preconditioning on
clinical cardiovascular outcomes in non-cardiac surgery needs confirmation
in appropriately powered randomised clinical trials. Copyright ©
2021 Association of Anaesthetists

<80>
Accession Number
2010173210
Title
Midterm outcomes of transaortic and transapical TAVI in patients with
unsuitable vascular anatomy for femoral access: A propensity score inverse
probability weight study.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Casado A.P.; Barili F.; D'Auria F.; Raviola E.; Parolari A.; Le Houerou
D.; Romano M.
Institution
(Casado, Barili) Department of Cardiovascular Surgery, A. O. Santa Croce e
Carle, Cuneo, Italy
(Casado, Raviola, Le Houerou) Department of Cardiovascular Surgery,
Hopital Prive Jacques Cartier, Massy, France
(D'Auria) Department of Cardiovascular Surgery, A. O. Maggiore della
Carita, Novara, Italy
(Raviola) Department of Cardiac Surgery, GVM Care & Research, Maria
Cecilia Hospital, Cotignola, Italy
(Parolari, Romano) Department of Cardiac Surgery, Policlinico S. Donato
IRCCS, University of Milan, Milan, Italy
Publisher
Blackwell Publishing Inc.
Abstract
Aims: Transaortic (TAo) and transapical (TA) implantation can be used in
transcatheter aortic valve implantation (TAVI) when the transfemoral (TF)
approach is precluded. We compare the safety and efficacy of these
alternative techniques. Method(s): From October 2007 to February
2016, TAo and TA patients' data were collected. Propensity score inverse
probability of treatment weight (IPTW) method was employed to minimize the
impact of no-randomization bias. Result(s): From our single-center
non-TF-TAVI registry, 282 patients were included: 235 (83.3%) underwent
TAo and 47 (16.7%) TA. Differences in baseline characteristics were
statistically significant in age, sex, risk profile according to
logistic-EuroSCORE, and previous cardiac surgery. No difference in
hospital morbidity and mortality, but lower stroke-rate in TAo (1.27% vs.
8.5% p <.01) was observed. This was confirmed at logistic regression after
IPTW adjustment (odds ratio [OR]: 0.16, 95% CI 0.03-0.71, p =.01),
together with reduced risk of the paravalvular leak (PVL) (OR: 0.14, 95%
confidence interval [CI]: 0.02-0.81, p =.02). Kaplan-Meier estimates did
not demonstrate differences in long-term mortality among access routes
(logrank test p =.13). At the IPTW-Cox regression model, long-term
mortality was related to New York Heart Association III-IV (hazard ratio
[HR]: 2.92, 95% CI: 1.15-7.40, p =.026), chronic renal failure (HR: 3.25;
95% CI: 1.02-10.32 p =.046), previous transient ischemic attack/stroke
(HR: 2.29, 95% CI: 1.25-4.20 p =.007). Sapien-3 device resulted to be a
protective factor, reducing long-term mortality (HR: 0.18, 95% CI 0.04-
0.90 p =.03). Conclusion(s): TAo is safe and feasible in case of
contraindication to femoral approach demonstrating comparable midterm
outcomes to TA, thus representing a central access alternative, to
increase the overall safety of high-risk TAVI procedures. Copyright
© 2021 Wiley Periodicals LLC

<81>
Accession Number
2010162465
Title
Results of surgical ventricular reconstruction in a specialized center and
in comparison to the STICH trial: Rationale and study protocol for a
patient-level pooled analysis.
Source
Journal of Cardiac Surgery. 36 (2) (pp 689-692), 2021. Date of
Publication: February 2021.
Author
Gaudino M.; Castelvecchio S.; Rahouma M.; Robinson N.B.; Audisio K.;
Soletti G.J.; Garatti A.; Benedetto U.; Girardi L.N.; Menicanti L.
Institution
(Gaudino, Rahouma, Robinson, Audisio, Soletti, Girardi) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Castelvecchio, Garatti, Menicanti) Department Cardiac Surgery, IRCCS
Policlinico San Donato, Milan, Italy
(Benedetto) Bristol Heart Institute, University of Bristol, Bristol,
United Kingdom
Publisher
Blackwell Publishing Inc.
Abstract
Introduction: Post-infarction left ventricular remodeling is associated
with increased mortality in patients with ischemic heart disease. Surgical
ventricular reconstruction (SVR) in addition to coronary artery bypass
grafting (CABG) has been proposed to reduce left ventricular volume and
improve clinical outcomes. The Surgical Treatment for Ischemic Heart
Failure (STICH) trial found that the addition of SVR to CABG did not
reduce the rates of death or rehospitalization in the 5 years after
surgery compared to CABG alone. Like all randomized trials, STICH has
limitations and it has been hypothesized that it may have underestimated
the treatment effect of SVR. The aim of this study is to evaluate the
results of SVR in one of the largest contemporary single-center series and
to compare the results with those of the STICH trial using individual
patient's data. Methods and Analysis: Individual data of patients who
underwent SVR with or without CABG will be obtained from San Donato
University Hospital in Milan. Using multivariable Cox regression analysis,
significant prognostic indicators in this cohort will be identified. We
will then compare the San Donato cohort to individual patient's data from
the SVR arm of Hypothesis 2 of the STICH trial and from both arms of the
STICH Extended Study (STICHES). To reduce confounders, propensity score
adjustment will be used for this comparison. The primary endpoint will be
all-cause mortality. Data will be merged and analyzed independently at
Weill Cornell Medicine in New York. Copyright © 2021 Wiley
Periodicals LLC

<82>
Accession Number
2010157957
Title
Risk factors for unplanned reintubation caused by acute airway compromise
after general anesthesia: a case-control study.
Source
BMC Anesthesiology. 21 (1) (no pagination), 2021. Article Number: 17. Date
of Publication: December 2021.
Author
Chen S.; Zhang Y.; Che L.; Shen L.; Huang Y.
Institution
(Chen, Che, Shen, Huang) Department of Anesthesiology, Peking Union
Medical College Hospital, Chinese Academy of Medical Science & Peking
Union Medical College, Beijing 100730, China
(Zhang) Medical Research Center, Peking Union Medical College Hospital,
Chinese Academy of Medical Science & Peking Union Medical College, Beijing
100730, China
Publisher
BioMed Central Ltd
Abstract
Background: This study aimed to identify the risk factors and evaluate the
prognosis of unplanned reintubation caused by acute airway compromise
(AAC) after general anesthesia. Method(s): This case-control study
included surgical patients who underwent unplanned reintubation in the
operating room and postanesthesia care unit after general anesthesia
between January 1, 2014, and December 31, 2018. Cases due to AAC were
matched 1:4 with randomly selected controls. Result(s): A total of
123,068 patients were included, and reintubation due to AAC was performed
in 36 patients (approximate incidence 0.03%). Univariable analysis
revealed that male sex, age > 65, ASA physical status 3, sepsis, heart
disease history, cerebral infarction history, Cormack Lehane grade,
surgery type, fresh frozen plasma infusion, increased intubation duration,
white blood cell count, and creatinine clearance rate were related to
AAC-caused unplanned reintubation. Multivariable analysis revealed that
age > 65 (OR = 7.50, 95% CI 2.47-22.81, P < 0.001), ASA physical status 3
(OR = 6.51, 95% CI 1.18-35.92, P = 0.032), head-neck surgery (OR = 4.94,
95% CI 1.33-18.36, P = 0.017) or thoracic surgery (OR = 12.56, 95% CI
2.93-53.90, P < 0.001) and a high fluid load (OR = 3.04, 95% CI 1.16-7.99,
P = 0.024) were associated with AAC-caused unplanned reintubation.
AAC-caused unplanned reintubation patients had longer postoperative
hospital (OR = 5.26, 95% CI 1.57-8.95, P < 0.001) and intensive care unit
days (OR = 3.94, 95% CI 1.69-6.18, P < 0.001). Conclusion(s): Age >
65, ASA physical status 3, head-neck or thoracic surgery and high fluid
load were found to be associated with AAC-caused unplanned
reintubation. Copyright © 2021, The Author(s).

<83>
Accession Number
2007616701
Title
Evidence-based indications of platelet-rich plasma therapy.
Source
Expert Review of Hematology. 14 (1) (pp 97-108), 2021. Date of
Publication: 2021.
Author
Gupta S.; Paliczak A.; Delgado D.
Institution
(Gupta) Department of Medicine, Queen's University, Kingston, ON, Canada
(Paliczak) Vita Medical Aesthetics Center, Toronto, ON, Canada
(Delgado) University of Toronto, Toronto, ON, Canada
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Platelet-rich plasma (PRP) is an autologous blood-derived
product that contains platelet concentrations at least 2/3 times above the
normal level and includes platelet-related growth factors. The concept of
PRP began in the 1970s in the field of hematology to treat patients with
thrombocytopenia. In the 1980s and 1990s, PRP began to be used in surgical
procedures such as maxillofacial surgery and plastic surgery. Since then,
PRP had been used in orthopedic procedures, cardiac surgery, sports
injuries, plastic surgery, gynecology, urology, and more recently in
medical esthetics. Areas covered: This review analyzes the mechanisms of
action, current indications, clinical evidence, safety and future
directions of PRP in the management of various medical conditions. The
literature search methodology included using medical subject headings
terms to search in PubMed. Articles used were screened and critically
appraised by the coauthors of this review. Expert Opinion: Platelet-rich
plasma is a therapeutic option used to treat many medical conditions. PRP
could be used alone or in combination with other procedures. The
effectiveness and safety of PRP has been demonstrated in many medical
scenarios, however there is limited availability of large randomized
clinical trials. Copyright © 2020 Informa UK Limited, trading as
Taylor & Francis Group.

<84>
Accession Number
633647372
Title
Transcatheter Mitral Valve Repair in Patients with Heart Failure: A
Meta-Analysis.
Source
Cardiology (Switzerland). 146 (1) (pp 42-48), 2021. Date of Publication:
January 2021.
Author
Vallakati A.; Hasan A.K.; Boudoulas K.D.
Institution
(Vallakati, Hasan, Boudoulas) Division of Cardiovascular Medicine, Ohio
State University, 410 W 10th Avenue, Columbus, OH 43210, United States
Publisher
S. Karger AG
Abstract
Background: Severe secondary mitral regurgitation (MR) is associated with
poor prognosis in heart failure patients with left ventricular systolic
dysfunction. Few observational and randomized controlled studies
demonstrated the efficacy of transcatheter mitral valve repair in heart
failure patients with significant MR. A meta-Analysis of published studies
was performed to evaluate the role of transcatheter mitral valve repair
using the MitraClip device in heart failure patients with significant
secondary MR. Method(s): A literature search was performed using
PubMed, Cochran CENTRAL, and Embase databases using the search terms
"percutaneous mitral valve repair"or "transcatheter mitral valve
repair"and "heart failure."Studies that compared medical therapy plus
transcatheter mitral valve repair using MitraClip to medical therapy alone
in heart failure patients with significant secondary MR were included for
pooled analysis. A random-effects model with the Mantel-Haenszel method
was used to analyze the data. Result(s): Four studies, 2 randomized
controlled and 2 nonrandomized studies met the criteria for analysis.
Pooled analysis included a total of 1,421 patients, of which 746 patients
underwent transcatheter mitral valve repair and 675 patients received
medical therapy alone. When compared to medical therapy, transcatheter
mitral valve repair significantly decreased all-cause mortality (OR 0.58,
95% CI 0.37-0.91; p = 0.02). A trend toward significant reduction in
rehospitalizations (OR 0.35, 95% CI 0.12-1.00; p = 0.05) was also
observed. Periprocedural complications ranged from 7.5 to 12.6%.
 Conclusion(s): Evidence from pooled analysis suggests that
transcatheter mitral valve repair using MitraClip on top of medical
therapy, in appropriately selected symptomatic heart failure patients with
significant secondary MR, provides survival benefit and may decrease
hospitalizations when compared with guideline-directed medical therapy
alone. Copyright © 2021 S. Karger AG. All rights reserved.

<85>
Accession Number
632908960
Title
Clinical performance of decellularized heart valves versus standard tissue
conduits: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 15 (1) (pp 260), 2020. Date of
Publication: 18 Sep 2020.
Author
Waqanivavalagi S.W.F.R.; Bhat S.; Ground M.B.; Milsom P.F.; Cornish J.
Institution
(Waqanivavalagi, Bhat, Ground, Cornish) Department of Medicine, Faculty of
Medical and Health Sciences, University of Auckland, Grafton, Auckland
1023, New Zealand
(Waqanivavalagi) Adult Emergency Department, Auckland City Hospital
,Auckland District Health Board, Grafton, Auckland 1023, New Zealand
(Bhat) Department of Surgery, Faculty of Medical and Health Sciences,
University of Auckland, Grafton, Auckland 1023, New Zealand
(Ground) Department of Medicine, Dunedin School of Medicine, University of
Otago, Dunedin 9054, New Zealand
(Milsom) Green Lane Cardiothoracic Surgical Unit, Auckland City Hospital
,Auckland District Health Board, Grafton, Auckland 1023, New Zealand
Publisher
NLM (Medline)
Abstract
BACKGROUND: Valve replacement surgery is the definitive management
strategy for patients with severe valvular disease. However, valvular
conduits currently in clinical use are associated with significant
limitations. Tissue-engineered (decellularized) heart valves are
alternative prostheses that have demonstrated promising early results. The
purpose of this systematic review and meta-analysis is to perform robust
evaluation of the clinical performance of decellularized heart valves
implanted in either outflow tract position, in comparison with standard
tissue conduits. METHOD(S): Systematic searches were conducted in the
PubMed, Scopus, and Web of Science databases for articles in which
outcomes between decellularized heart valves surgically implanted within
either outflow tract position of human subjects and standard tissue
conduits were compared. Primary endpoints included postoperative mortality
and reoperation rates. Meta-analysis was performed using a random-effects
model via the Mantel-Haenszel method. RESULT(S): Seventeen articles
were identified, of which 16 were included in the meta-analysis. In total,
1418 patients underwent outflow tract reconstructions with decellularized
heart valves and 2725 patients received standard tissue conduits.
Decellularized heart valves were produced from human pulmonary valves and
implanted within the right ventricular outflow tract in all cases. Lower
postoperative mortality (4.7% vs. 6.1%; RR 0.94, 95% CI: 0.60-1.47;
P=0.77) and reoperation rates (4.8% vs. 7.4%; RR 0.55, 95% CI: 0.36-0.84;
P=0.0057) were observed in patients with decellularized heart valves,
although only reoperation rates were statistically significant. There was
no statistically significant heterogeneity between the analyzed articles
(I2 =31%, P=0.13 and I2 =33%, P =0.10 respectively). CONCLUSION(S):
Decellularized heart valves implanted within the right ventricular outflow
tract have demonstrated significantly lower reoperation rates when
compared to standard tissue conduits. However, in order to allow for more
accurate conclusions about the clinical performance of decellularized
heart valves to be made, there need to be more high-quality studies with
greater consistency in the reporting of clinical outcomes.

<86>
Accession Number
631227593
Title
Perioperative dexmedetomidine and postoperative delirium in non-cardiac
surgery: a meta-analysis.
Source
Annals of palliative medicine. 9 (2) (pp 264-271), 2020. Date of
Publication: 01 Mar 2020.
Author
Ming S.; Zhang X.; Gong Z.; Xie Y.
Institution
(Ming) Department of Anesthesiology, First Affiliated Hospital of Guangxi
Medical University, Nanning 530021, China
(Zhang) Department of Anesthesiology, second Affiliated Hospital Of Guilin
Medical University
(Gong) Department of Anesthesiology, People's Hospital of Guangxi Zhuang
Autonomous Region, Nanning 530021, China
(Xie) Department of Anesthesiology, Second Affiliated Hospital of Guangxi
Medical University, Nanning 530021, China
(Xie) Department of Anesthesiology, First Affiliated Hospital of Guangxi
Medical University, Nanning 530021, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: To compare the effects of perioperative dexmedetomidine with
placebo (or other sedation) on the rate of postoperative delirium in adult
patients who underwent non-cardiac surgeries. METHOD(S): A
meta-analysis was performed on randomized, controlled trials. MEDLINE, the
Cochrane Central Register of Controlled Trials, and Embase (to March 20,
2019) were searched for literature retrieval. The standardized primary
outcome was postoperative delirium. We pooled risk ratios using a
random-effects model. RESULT(S): From 10 trials with 2,286 total
participants, we recorded 363 postoperative delirium events during the
follow-up periods. Compared with the control group, patients in the
dexmedetomidine group had a postoperative delirium relative risk of 0.53
[95% confidence interval (CI), 0.37-0.76]. When the dexmedetomidine
infusion rate was higher than 0.2 mug/kg/h, the relative risk of
postoperative delirium reduced significantly by 34%, compared with other
sedation methods (relative risk =0.66; 95% CI, 0.47-0.94; P=0.02), with no
heterogeneity (I2=31%, P=0.18). While it reduced by 62% when the
dexmedetomidine infusion rate was lower than 0.2 mug/kg/h (relative risk
=0.38; 95% CI, 0.27-0.54). CONCLUSION(S): Compared to the placebo (or
other sedation methods), perioperative dexmedetomidine sedation resulted
in lower rates of postoperative delirium in adult patients who underwent
non-cardiac surgery.

<87>
Accession Number
631125099
Title
Effect of Delirium on Physical Function in Noncardiac Thoracic Surgery
Patients.
Source
American journal of critical care : an official publication, American
Association of Critical-Care Nurses. 29 (2) (pp e39-e43), 2020. Date of
Publication: 01 Mar 2020.
Author
Khan S.H.; Xu C.; Wang S.; Gao S.; Lasiter S.; Kesler K.; Khan B.A.
Institution
(Khan) Sikandar H. Khan is an assistant research professor
(Xu) Chenjia Xu is a doctoral student
(Wang) Department of Psychiatry, Indiana University School of Medicine,
Sophia Wang is an assistant clinical professor
(Gao) Department of Biostatistics, Indiana University School of Medicine,
Sujuan Gao is a professor
(Lasiter) University of Missouri-Kansas City School of Nursing and Health
Studies, Sue Lasiter is an associate professor, Kansas City, MO, United
States
(Kesler) Department of Cardiothoracic Surgery, Indiana University School
of Medicine, Kenneth Kesler is a professor
(Khan) Division of Pulmonary, Critical Care, Sleep and Occupational
Medicine, Department of Medicine, Indiana University School of Medicine,
IU Center for Aging Research, Regenstrief Institute, Babar A. Khan is an
associate professor, Indianapolis, IN, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The effect of delirium on physical function in patients
undergoing noncardiac thoracic surgery has not been well described and may
differ from that in other surgical populations. OBJECTIVE(S): To
determine the effects of delirium on muscle strength and functional
independence. The primary end point was change in Medical Research Council
sum score (MRC-SS) by delirium status. METHOD(S): A secondary
analysis of data from a clinical trial involving English-speaking adults
aged 18 years or older who were undergoing major noncardiac thoracic
surgery. Exclusion criteria were history of schizophrenia, Parkinson
disease, dementia, alcohol abuse, or neuroleptic malignant syndrome;
haloperidol allergy; being pregnant or nursing; QT prolongation; and
taking levodopa or cholinesterase inhibitors. Delirium was assessed twice
daily using the Confusion Assessment Method for the Intensive Care Unit.
Preoperatively and postoperatively, muscle strength was assessed using the
modified MRC-SS and functional independence was assessed using the Katz
scale of activities of daily living. Changes in MRC-SS and Katz score by
delirium status were analyzed using the Fisher exact test. RESULT(S):
Seventy-three patients were included in the analysis. Median
(interquartile range) MRC-SS and Katz score before surgery did not differ
significantly between patients without and with delirium (MRC-SS: 30
[30-30] vs 30 [30-30], P > .99; Katz score: 6 [6-6] vs 6 [6-6], P = .63).
The percentage of patients with a change in MRC-SS was similar in patients
without and with delirium (17% vs 13%, respectively; P > .99). More
patients in the delirium group had a change in Katz score (13% vs 0%, P =
.04). CONCLUSION(S): Postoperative delirium was not associated with
change in muscle strength. Follow-up studies using other muscle measures
may be needed. Copyright ©2020 American Association of
Critical-Care Nurses.

<88>
Accession Number
633463243
Title
Is preoperative anxiety associated with postoperative delirium in older
persons undergoing cardiac surgery? Secondary data analysis of a
randomized controlled trial.
Source
BMC geriatrics. 20 (1) (pp 478), 2020. Date of Publication: 18 Nov 2020.
Author
Milisen K.; Van Grootven B.; Hermans W.; Mouton K.; Al Tmimi L.; Rex S.;
Detroyer E.
Institution
(Milisen, Van Grootven, Hermans, Mouton, Detroyer) Department of Public
Health and Primary Care, Academic Centre for Nursing and Midwifery, KU
Leuven - University of Leuven, Kapucijnenvoer 35/4, Leuven B-3000, Belgium
(Milisen, Detroyer) Department of Geriatric Medicine, KU Leuven -
University Hospitals Leuven, Herestraat 49, Leuven B-3000, Belgium
(Van Grootven) Research Foundation Flanders, Brussels, Belgium
(Al Tmimi, Rex) Department of Anesthesiology, KU Leuven - University of
Leuven, University Hospitals of Leuven, Herestraat 49, Leuven B-3000,
Belgium
(Al Tmimi, Rex) Department of Cardiovascular Sciences, KU Leuven -
University of Leuven, Leuven B-3000, Belgium
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although many studies have reported numerous risk factors for
postoperative delirium, data are scarce about preoperative anxiety as a
risk factor. The study aimed to investigate the association between
preoperative anxiety and postoperative delirium in older patients
undergoing cardiac surgery. METHOD(S): Secondary data analysis of a
randomized, observer-blind, controlled trial. A total of 190 patients
65years or older and admitted to the intensive care unit and cardiac
surgery unit of a university hospital scheduled for elective on-pump
cardiac surgery were included. State anxiety was measured preoperatively
using the Amsterdam Preoperative Anxiety and Information Scale and the
Visual Analogue Scale for anxiety. Incidence of delirium was measured
during the first 5 postoperative days using the Confusion Assessment
Method for Intensive Care Unit (when ventilated), or the 3Minute
Diagnostic Interview for Confusion Assessment Method (when extubated) and
by daily chart review. RESULT(S): Preoperative state anxiety was
reported by 31% of the patients and 41% had postoperative delirium. A
multiple step logistic regression analyses revealed no association between
preoperative anxiety and postoperative delirium. Significant risk factors
for postoperative delirium were age (OR=1.10, 95% CI (1.03-1.18)),
activities of daily living (0.69, 95% CI (0.50-0.96)), diabetes mellitus
(OR=3.15, 95% CI (1.42-7.00)) and time on cardiopulmonary bypass (OR=1.01,
95% CI (1.00 to 1.02)). CONCLUSION(S): No relationship could be found
between preoperative anxiety and postoperative delirium.

<89>
Accession Number
633215062
Title
Adjuvant chemotherapy after radical nephroureterectomy improves the
survival outcome of high-risk upper tract urothelial carcinoma patients
with cardiovascular comorbidity.
Source
Scientific reports. 10 (1) (pp 17674), 2020. Date of Publication: 19 Oct
2020.
Author
Luo Y.; Feng B.; Wei D.; Han Y.; Li M.; Zhao J.; Lin Y.; Hou Z.; Jiang Y.
Institution
(Luo, Feng, Wei, Han, Li, Zhao, Lin, Hou, Jiang) Department of Urology,
Beijing Anzhen Hospital, Capital Medical University, Anzhenli Street,
Chaoyang District, Beijing 100029, China
Publisher
NLM (Medline)
Abstract
This prospective randomized comparative trial study aimed to evaluate the
therapeutic outcomes of radical nephroureterectomy and adjuvant
chemotherapy (ACT) used in combination in high risk upper tract urothelial
carcinoma (UTUC) patients with cardiovascular comorbidity. Based on the
inclusion criteria of high-risk UTUC in EAU guidelines (updated in 2014),
all eligible patients treated in our hospital from January 2014 to March
2018 were included, and cases with late disease, renal dysfunction, severe
cardiopulmonary disease or other malignant tumors were excluded. The cases
were randomized into two groups based on treatment regimen. Multivariate
analyses were performed to analyze the influencing factors of survival
outcome in the enrolled patients. The Cox proportional-hazards model and
the Kaplan-Meier method were employed to assess progression free survival
(PFS), overall survival (OS) and cancer specific survival (CSS). In
addition, the potential adverse effects of chemotherapy were actively
monitored. A total of 176 high-risk UTUC individuals with cardiovascular
comorbidity were enrolled and evaluated in this study. Median follow-up
durations were 30 months (range 6-54) in the RNU (n=82) group and 36
months (range 6-54) in the RNU+ACT (n=94) group. Multivariable analysis
indicated that peri-operative cardiovascular events risk grade was
independent prognostic factor for OS. Tumor size was independent
prognostic factor for PFS and CSS. BMI and lymphovacular invasion were
significant predictors of PFS. Clinical stage, lymph node involvement, and
tumor grade were significant predictors of PFS, OS and CSS in these
patients. Especially, chemotherapy was helpful in improving PFS [P<0.001,
HR=6.327 (5.115-7.793)], OS [P=0.013, HR=2.336 (1.956-2.883)] and CSS
[P=0.008, HR=3.073 (2.533-3.738)]. Kaplan-Meier analysis demonstrated that
the oncologic outcomes of RNU treated high-risk UTUC patients were
improved much significantly by ACT, including PFS [P=0.0033, HR=3.78
(3.13-4.55)], OS [P=0.0397, HR=1.39 (1.01-1.75)] and CSS [P=0.0255,
HR=1.26 (1.07-1.45)]. Further analysis of the lymph node positive subgroup
showed that the median time of oncologic events was enhanced in RNU+ACT
treated individuals in comparison with the RNU group, including PFS (11.4
months vs. 31.9 months, P=0.0018), OS (26.8 months vs. 36.3 months,
P=0.0255) and CSS (28.2 months vs. 39.3 months, P=0.0197). In the T3/4
cohort, significantly increased median PFS (13.9 months vs. 36.3 months,
P=0.0217), OS (20.6 months vs. 32.2 months, P=0.0183) and CSS (21.9 months
vs. 38.4 months, P=0.0226) were obtained in the combination group.
Additionally, no severe adverse events (over grade 4) associated with
chemotherapy were detected in the RNU+ACT group. In conclusion, ACT after
radical surgery has statistically significant therapeutic effects on PFS,
OS and CSS in high-risk UTUC patients with cardiovascular comorbidity.

<90>
Accession Number
632196787
Title
Efficacy and safety outcomes in novel oral anticoagulants versus vitamin-K
antagonist on post-TAVI patients: a meta-analysis.
Source
BMC cardiovascular disorders. 20 (1) (pp 307), 2020. Date of Publication:
26 Jun 2020.
Author
Liang H.; He Q.; Zhang Q.; Liu X.; Cui K.; Chen G.; Xiu J.
Institution
(Liang, Zhang, Liu, Cui, Chen, Xiu) Department of Cardiology, Nanfang
Hospital, Southern Medical University, Guangzhou, Guangdong, China
(He) Pediatric Cardiac Surgery Center, National Center for Cardiovascular
Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking
Union Medical College, Beijing, China
(He) Faculty of Medicine, International School, Jinan University,
Guangzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been a
favored option for the patient who suffered from symptomatic aortic
stenosis. However, the efficacy and safety outcomes in novel oral
anticoagulants (NOACs) versus Vitamin-K antagonist (VKA) for post-TAVI
patients are still controversial. This meta-analysis aims at comparing the
clinical outcome and safety of NOACs and VKA in the patients after
receiving TAVI. METHOD(S): We searched literature articles in all
reachable databases, and observational study as well as randomized
controlled trial would be included in order to perform a comprehensive
analysis. All-cause mortality, major or life-threatening bleeding,
disabling or nondisabling stroke were main pooled outcome measures.
Subgroup analysis and meta-regression were adopted to explore
heterogeneity. Assessment of bias was performed under the suggestion of
Cochrane's Collaboration Tool. RESULT(S): We collected 3841
non-duplicate citations from PubMed, Embase, Cochrane and
ClinicalTrials.gov, and eventually 7 studies were included for this
meta-analysis. As a result, VKA showed priority against NOACs in the field
of anti-thromboembolism (4435 participants, RR:1.44, 95% CI: 1.05 to 1.99,
I2 =0%, P=0.02). CONCLUSION(S): With corroborative analysis of severe
complications, VKA is shown to be more protective on post-TAVI patients in
disabling or nondisabling stroke scenario but not in mortality or bleeding
event.

<91>
Accession Number
634011164
Title
T.E.D.R.A.S. trial: Transesophageal echocardiography-dysphagia risk in
acute stroke.
Source
International Journal of Stroke. Conference: 12th World Stroke Congress
2020. Austria. 15 (1 SUPPL) (pp 57), 2020. Date of Publication: 2020.
Author
Hamzic S.; Braun T.; Butz M.; Khilan H.; Weber S.; Yeniguen M.; Kaps M.;
Gerriets T.; Juenemann M.
Institution
(Hamzic, Braun, Butz, Weber, Yeniguen, Kaps, Gerriets, Juenemann)
University Hospital Giessen, Neurology, Germany
(Khilan) Gesundheitszentrum Wetterau, Neurology / Stroke Unit, Germany
Publisher
SAGE Publications Inc.
Abstract
Background And Aims: Dysphagia is common in patients with acute stroke and
deteriorates the overall outcome. Transesophageal echocardiography (TEE)
is a routine examination in the diagnostic workup of stroke etiology. In
cardiac surgery it is known as cause of postoperative dysphagia. The
prevalence of dysphagia in acute stroke patients undergoing TEE is
unknown. The aim of T.E.D.R.A.S. was to assess the influence of TEE on
swallowing in acute stroke patients. Method(s): T.E.D.R.A.S., as
prospective, blinded, randomized, controlled study, included 34 patients
in two groups: 19 in the intervention group (IG), 15 in the control group
(CG). Flexible endoscopic evaluation of swallowing (FEES) was performed
for analysis of swallowing in the IG (1) one day before a TEE, (2) max.
2-4 hours after TEE, (3) 24 hours after a TEE. In the CG FEES was
performed on three consecutive days with TEE any time after the last FEES.
Validated scores assessed dysphagia severity. Difference scores were built
from pre to post TEE for all dysphagia measures. Result(s): In
between group comparison the IG shows an increase in dysphagia measures
immediately after TEE and 24 hours after TEE in
penetration-aspiration-score for saliva (p=<0.001/p=0.007), for small
liquid bolus (p=0.009/p=0.059) and for large liquid bolus
(p=0.009/p=0.025). Secretion severity score is increased immediately after
TEE and 24 hours after TEE in the IG (p=<0.001/ p=<0.001) as well as the
residue severity score for saliva, liquid boli and for puree.
 Conclusion(s): The results of the T.E.D.R.A.S. trial indicate that
TEE has a negative influence on swallowing in acute stroke patients.

<92>
Accession Number
634010933
Title
Application and cooperation analysis of programmed nursing based on
'operating room work schedule' in cardiopulmonary bypass.
Source
Basic and Clinical Pharmacology and Toxicology. Conference: 2020
International Conference on Biomedical Engineering, Bioinformatics and
Health Science, ICBBH 2020. 127 (SUPPL 3) (pp 311), 2020. Date of
Publication: November 2020.
Author
Xu N.; Dong J.
Institution
(Xu, Dong) Anesthesiology operating room, Beijing Chaoyang Hospital
Affiliated, Capital Medical University, China
Publisher
Blackwell Publishing Ltd
Abstract
Objective: Cardiopulmonary bypass surgery is an important surgical method
for the treatment of congenital heart disease, macrovascular disease,
etc., and has a good therapeutic effect on cardiovascular disease. The
success rate of cardiopulmonary bypass surgery is related to many factors.
Therefore, improving the level of doctors' operation skills and improving
the cooperation of nursing staff are the keys to improving the success
rate of surgery. The aim of this research was to explore the application
and cooperation analysis of programmed nursing based on 'operating room
work schedule' in cardiopulmonary bypass surgery. Method(s): From
January 2018 to December 2018, 100 patients undergoing cardiopulmonary
bypass cardiac surgery in our hospital were selected as the research
object, and randomly divided into two groups. The control group adopted
routine intraoperative nursing mode. The observation group adopted
program-based nursing based on the 'operating room work schedule' based on
the control group. The extubation time, operation time, hospitalization
time, incidence of adverse nursing events during operation, postoperative
pressure ulcers, abnormal gastrointestinal function, infection, massive
bleeding and the satisfaction of nurses with nurses were compared between
the control group and observation group. Result(s): The operation
time in the observation group was 231.21 +/- 62.09 min, the
hospitalization time was 14.08 +/- 2.58 d, and the extubation time was
8.24 +/- 1.95 h, which was significantly lower than that in the control
group (P < 0.05). The incidence of adverse events in the observation group
was 0.00%, which was significantly lower than the control group (P <
0.05). The incidence of intraoperative adverse events in the observation
group was 0.00%, which was significantly lower than the control group that
was 10.00% (P < 0.05). The nursing satisfaction of the observation group
was 96% (48 / 50), which was significantly higher than the control group
(P < 0.05). Conclusion(s): Programmatic nursing based on 'operating
room work schedule' is used in cardiopulmonary bypass surgery, can
effectively reduce the operation time and hospital stay, reduce the
incidence of intraoperative adverse events and complications, improve the
success rate of surgery, and improve the patient satisfaction with
nursing. It is worthy of further promotion in clinical nursing work.

<93>
Accession Number
634009800
Title
Prevention of perioperative stroke during carotid endarterectomy: An
anesthesiologist perspective.
Source
International Journal of Stroke. Conference: 12th World Stroke Congress
2020. Austria. 15 (1 SUPPL) (pp 483), 2020. Date of Publication: 2020.
Author
D'Souza S.
Institution
(D'Souza) University of Massachusetts Medical School, Baystate Medical
center, Division Chief, Neuroanesthesiology, Springfield, United States
Publisher
SAGE Publications Inc.
Abstract
Background and Aims: Identify the risk factors for perioperative stroke
during carotid endarterectomy (CEA): Symptomatic patients: review of
incidence of 30 day stroke and mortality phase 3 trials of symptomatic and
asymptomatic carotid artery surgery trials and current literature update
Presence of contralateral stenosis ( review of prospective and
retrospective data) Hypertension ( review of literature) Hyperglycemia
with brief literature review Presence of ulcerated plaque with data
analysis Emergency CEA and the risk of stroke, literature update Early
surgery vs. late surgery after embolic stroke or transient ischemic attack
(TIA): CEA in a patient who requires coronary artery bypass grafting
(CABG): Prior CEA vs combined CEA and CABG: Review of the current
literature CEA in patient who needs clipping of intracranial aneurysm:
Methods: Anesthesia for CEA Regional vs General anesthesia (GA): Review of
GALA trial and Cochrane systemic review with regard to incidence of
perioperative stroke and patient's 30 day neurological outcome. Shunting
during CEA: Routine shunting vs selective shunting and risk of
perioperative stroke, review of the literature Neuromonitoring techniques
and their limitations during CEA Awake patient during regional anesthesia
EEG,SSEP.MEP Cerebral oximetry Carotid artery stump pressure Transcranial
Doppler monitor (TCD) Results: Blood pressure targets :during unclamping
and clamping to avoid perioperative stroke: current data review Prevention
of carotid sinus reflex: Description of advantages and disadvantages of
routine carotid sheath infiltration with lidocaine and postoperative
hypertension Cerebral hyperperfusion syndrome (CHS) Etiology, prevention,
management and neurological outcome of CHS reduction with evidence based
practice Conclusion(s): Periopetive stroke reduction in a patient
undergoing carotid endarterectomy.

<94>
Accession Number
634009466
Title
Cost-effectiveness of vitamin C suppletion in CABG: A prospective, single
centre randomised clinical trial.
Source
Intensive Care Medicine Experimental. Conference: 33rd European Society of
Intensive Care Medicine Annual Congress, ESICM 2020. 8 (SUPPL 2) (no
pagination), 2020. Date of Publication: 2020.
Author
Annaert E.; Van Der Vekens N.; Kalmar A.; Vanoverschelde H.; Allaert S.;
Heerman J.
Institution
(Annaert, Van Der Vekens, Kalmar, Vanoverschelde, Allaert, Heerman)
Anesthesiology, Maria Middelares, Gent, Belgium
Publisher
Springer
Abstract
Introduction: Vitamin C has been investigated for a wide variety of uses
within intensive care due to its anti-oxidative properties (1, 2, 3).
Research regarding its potential for the prevention of postoperative
atrial fibrillation (POAF) after cardiac surgery is ongoing but results
remain inconsistent (4, 5, 6). Due to a broad intracellular anti-oxidant
effect, several postoperative pathological effects might be mitigated.
Taking into account the low cost of vitamin C, it might be more valuable
to investigate a pharmaco-economic benefit in addition to an effect on
POAF. Objective(s): Our primary goal was to investigate the
pharmaco-economic impact of perioperative supplementary oral ascorbic acid
intake in patients undergoing coronary artery bypass graft surgery (CABG).
Secondary endpoints were the effects on the length of stay in both the
intensive care unit (ICU) and the hospital and the incidence of POAF.
 Method(s): After IRB approval, patients planned for CABG who met the
inclusion criteria (in cardiac sinus rhythm preoperatively and not taking
supplementary vitamin C independently) were randomized into a placebo
group and an intervention group. The medication was given orally, 1 gram
twice a day, starting from 5 days preoperatively until 10 days
postoperatively. The used medication, length of hospital and ICU stay and
development of POAF in ICU were recorded. We report the preliminary
results with a calculated target sample size of 75 patients. Significant
differences were assessed using an independent T-test and a Mann-Whitney U
test. Result(s): Of the 119 screened patients, 68 patients completed
the study. Except for BMI (p=0.029), there was no statistically
significant difference in baseline characteristics. (Table 1) The median
pharmacoeconomic cost was significantly lower (P=0.009) in the vitamin C
group ( 1636) than in the placebo group (1687). There was no significant
difference in the incidence of POAF or length of stay. (Table 2)
 Conclusion(s): In this preliminary analysis, Vitamin C had a small
pharmaco- economic benefit when used in the perioperative period of CABG
surgery. No effect was found on the length of stay or the incidence of
POAF. However, we should acknowledge the fact this is preliminary data and
further inclusion is warranted. Potential benefits in other types of
cardiac surgeries should also be investigated.

<95>
Accession Number
634008901
Title
Hemoadsorption in liver failure-subgroup analysis of the cytosorb
international registry.
Source
Intensive Care Medicine Experimental. Conference: 33rd European Society of
Intensive Care Medicine Annual Congress, ESICM 2020. 8 (SUPPL 2) (no
pagination), 2020. Date of Publication: 2020.
Author
Ocskay K.; Tomescu D.; Faltlhauser A.; Jacob D.; Friesecke S.; Malbrain
M.; Kogelmann K.; Bogdanski R.; Bach F.; Fritz H.; Hartjes A.; Kortgen A.;
Soukup J.; Utzolino S.; Van Tellingen M.; Trager K.; Molnar Z.; Schumacher
U.; Brunkhorst F.
Institution
(Ocskay, Molnar) Institute for Translational Medicine, University of Pecs
Medical School, Pecs, Hungary
(Tomescu) Anesthesiology and intensive care, Fundeni Clinical Institute,
Bucuresti, Romania
(Faltlhauser) Medizinische klinik i, Weiden Clinic, Weiden in der
Oberpfalz, Germany
(Jacob) Klinik fur anaesthesiologie und intensivtherapie, University
Hospital Magdeburg, Magdeburg, Germany
(Friesecke) Klinik und poliklinik fur innere medizin b,
Universitatsmedizin Greifswald, Greifswald, Germany
(Malbrain) Intensive care unit, University Hospital Brussels (UZB), Jette,
Belgium
(Kogelmann) Klinik fur anasthesiologie und intensivmedizin, Klinikum
Emden-Hans-Susemihl-Krankenhaus, Emden, Germany
(Bogdanski) Klinik fur anasthesiologie, Klinikum rechts der Isar der
Technischen Universitat Munchen, Munchen, Germany
(Bach) Klinik Fur Anasthesiologie, Intensive Notfallmedizin,
Transfusionsmedizin Und Schmerztherapie, Evangelisches Krankenhaus
Bielefeld, Bielefeld, Germany
(Fritz) Klinik Fur Anaesthesiologie Und Intensivmedizin, Hospital
Martha-Maria Halle-Dolau, Halle (Saale), Germany
(Hartjes) Anasthesie, Intensiv-Und Palliativmedizin, Krankenhaus Der
Barmherzigen Schwestern Ried, Ried im Innkreis, Austria
(Kortgen) Klinik fur anasthesiologie und intensivmedizin,
Universitatsklinikum Jena, Jena, Germany
(Soukup) Klinik Fur Anasthesiologie, Intensivtherapie Und
Palliativmedizin, Hospital Carl-Thiem-Klinikum Cottbus, Cottbus, Germany
(Utzolino) Abteilung allgemein-und viszeralchirurgie, Universitatsklinikum
Freiburg, Freiburg im Breisgau, Germany
(Van Tellingen) Intensive care, De Tsjongerskans, Heerenveen, Netherlands
(Trager) Kardioanasthesiologie, University Hospital Of Ulm, Ulm, Germany
(Schumacher) Zentrum fur klinische studien, Universitatsklinikum Jena,
Jena, Germany
(Brunkhorst) Department of anesthesiology and intensive care medicine,
Universitatsklinikum Jena, Jena, Germany
Publisher
Springer
Abstract
Introduction: CytoSorb (CytoSorbents, USA) is a relatively new
extracorporeal blood purification device. It was primarily used in septic
shock and other hyperinflammatory conditions for removing inflammatory
mediators, preventing the harmful effects of cytokine storm. Acute liver
failure is a severe, devastating condition that usually necessitates
intensive care. Data from the International CytoSorb Registry shows that
Cytosorb is often used in liver failure to prevent the development of
multiple organ failure. Objective(s): We report on the biggest
case-series to date on Cyto-Sorb use in liver failure as a subgroup from
the International Cytosorb Registry. Method(s): The International
CytoSorb Registry (NCT02312024) prospectively collects data from adult
patients who underwent CytoSorb treatment. No exclusion criteria are
defined. Data was recorded at baseline, up to 24 hours before treatment
(T1), up to 24 hours after the last CytoSorb therapy (T2) and at discharge
from hospital or mortality onelectronic case report forms. Descriptive
statistical methods were used. Changes were calculated form T1 and T2
values using t-test as well as a linear model for selected variables. 95%
confidence intervals (CI) were provided. Result(s): From May 2015
until November 2019, 930 patients were entered into the Registry from 9
countries by 42 centres. In 89 cases the stated indication for therapy was
liver failure, being the third most frequent indication after sepsis and
pre-emptive use during cardiac surgery. In this subgroup the mean age was
48.2 years and the majority of patients were male (56.2%). Patients
received a median of 2 treatments (i.e.: 2 adsorbers), with a median
overall treatment duration of 43 hours. The median time of use per
adsorber was one day and time between treatments was less than 1 hour
(median). More than 90% of patients were alive at the termination of
CytoSorb therapy. Forty-seven patients died in the ICU and 3 more during
hospitalization, which corresponds to a 57.5 % in-hospital mortality.
Attending physicians observed improvement in 62 cases (70.4%). No change
was registered in 15 cases (17%) and in 4 patients the condition worsened.
SOFA scores hardly changed (T2-T1). Changes in CRP and PCT were not
significant. Serum total bilirubin (TBIL) showed a significant reduction
(T2-T1; mean [CI]: -61.7 [-92.7 to -30.8]). Regarding safety,
device-related serious adverse events were not reported.
 Conclusion(s): We report on the largest case series on CytoSorb
application in patients with liver failure. The therapy proved safe,
reduced TBIL significantly and resulted in subjective improvement in the
patient's condition due to CytoSorb treatment in 70% of the cases. These
encouraging results underline the need for randomized controlled trials
assessing CytoSorb in liver failure.

<96>
Accession Number
634008734
Title
Intellivent-ASV mode is superior to conventional ventilation modes after
uncomplicated cardiac surgery during all phases of postoperative
respiratory support.
Source
Intensive Care Medicine Experimental. Conference: 33rd European Society of
Intensive Care Medicine Annual Congress, ESICM 2020. 8 (SUPPL 2) (no
pagination), 2020. Date of Publication: 2020.
Author
Komnov R.; Eremenko A.
Institution
(Komnov) Cardiac Intencive Care Unit, Petrovsky National Research Center
of Surgery, Moscow, Russian Federation
(Eremenko) Cardiac Intensive Care Unit, Petrovsky National Research Centre
of Surgery, Moskva, Russian Federation
Publisher
Springer
Abstract
Introduction: Respiratory support plays an important role in patient's
recovery after cardiovascular surgery. Intellivent-ASV is a closed-loop
ventilation mode that adjusts automatically ventilation and oxygenation
settings according to patient weight, lung function (as assessed by the
ventilator) and continuous input of end-tidal carbon dioxide and oxygen
saturation in both passive and spontaneous breathing patients. There is an
ability to improve patient's safety and reduce physician's workload with
using intellectual modes of ventilation. Objective(s): To compare the
effect(s) of Intellivent-ASV and conventional ventilation modes.
 Method(s): In this randomized controlled trial 40 adult patients were
ventilated with conventional ventilation modes and 40 with Intellivent-
ASV after uncomplicated cardiac surgery. Hamilton G5 ventilators were used
and 8 physicians were involved into the study. All actions of physician's,
ventilator settings and changes were monitored and recorded during
respiratory support in ICU. Care of both groups was standardized, except
modes of postoperative ventilation. We compared: the physician's workload,
through accounting number of manual ventilator settings and time they
spent near the ventilator in every group; duration of tracheal intubation
in ICU; evaluation of ventilation safety by considering driving pressure,
mechanical power, positive end expiratory pressure and tidal volume level.
 Result(s): There were significant differences in the duration of
respiratory support in ICU: 226 +/- 31 min (Intellivent group) vs 271 +/-
78 min (control) (p = 0,001267). In Intellivent group the number of manual
ventilator settings and physicians time spent near the ventilator before
tracheal extubation were lower: 0 vs 4 (2-6), and 35 (25-53) sec vs 164
+/- 69 sec respectively (p < 0,001 in both cases). Intellivent-ASV
provided a significant more protective ventilation through reduction in
the driving pressure, tidal volume, FiO<inf>2</inf> and PEEP levels, but
without differences between PaO<inf>2</inf>/ FiO<inf>2</inf> ratio. 1.
DELTAP and Vt were significantly lower in Intellivent group - DELTAP on
mechanical ventilation was 6 (5-7) cm H<inf>2</inf>O vs 7,25 (6,5-9,5) cm
H<inf>2</inf>O (p < 0,001) and pressure support level - 5 (5-5) cm
H<inf>2</inf>O vs 8 (7-10) cm H<inf>2</inf>O; Vt on mechanical ventilation
was 6 (5,2-7) vs 7 (6-9,5) ml/kg/PBW (p = 0,000003). 2. PEEP and
FiO<inf>2</inf> level were also significantly lower in Intellivent group
during all phases of respiratory support in ICU. PEEP on mechanical
ventilation was 5 (5-7,5) cm H<inf>2</inf>O vs 7 (5-11,5) cm
H<inf>2</inf>O and FiO<inf>2</inf> level was 26 (22-30) % vs 34 (30-40) %.
During spontaneous ventilation phase in Intellivent group PEEP was 5
(5-5,5) cm H<inf>2</inf>O vs 7 (5-10) cm H<inf>2</inf>O and
FiO<inf>2</inf> 26 +/- 4 % vs 30 (29- 40) %. 3. Mechanical power
(simplified equation) was lower in Intellivent group 8,17 (5,99-10) vs
8,58 (6,34-13,7) J/min (p = 0,0467). There were no significant differences
between the groups in Vt values during spontaneous ventilation: 8 (7-9) vs
8 (7-10) ml/kg/PBW in control group, as well as in undesirable events and
duration of ICU and hospital stay. Conclusion(s): Application of
IntelliVent-ASV mode after uncomplicated cardiac surgery provides more
protective mechanical ventilation and reduces the physician's workload
without compromising the quality of respiratory support and safety of
patients.

<97>
Accession Number
634008619
Title
Role of Levosimendan in heart failure patient undergoin cardiac surgery.
Source
Intensive Care Medicine Experimental. Conference: 33rd European Society of
Intensive Care Medicine Annual Congress, ESICM 2020. 8 (SUPPL 2) (no
pagination), 2020. Date of Publication: 2020.
Author
Marchese F.; Lm M.; Gs S.; Mr R.; Gc C.
Institution
(Marchese) Ospedali Riuniti, Foggia, Italy
(Lm, Mr, Gc) Anestesia e rianimazione, Hospital Oo Rr Di Foggia, Foggia,
Italy
(Gs) Cardiochirurgia, Citta di Lecce Hospital, Lecce, Italy
Publisher
Springer
Abstract
Introduction: Levosimendan is a calcium sensitizer developed for
intravenous use in hospitalized patients with acute heart failure (AHF)
(1). Aim of this study is to observe the cardiac function's index, Mean
Arterial Pressure (MAP) and diuresis after the administration of
Levosimendan (G1) rather than control group (G2) started 12 hours before
cardiac surgery (2). Objective(s): In this prospective observational
study 47 patients consecutive admitted in ICU of 'Citta di Lecce
Hospital-GVM Care and Research' with AHF (Ejection Fraction <40%) were
included. Method(s): Patients admitted in ICU were randomized to
receive either Levosimendan infusion duration up to 24 hours(0,1
mcg/Kg/min) (G1) (18 patients). Patients undergoing urgent cardiac
surgery, severe ipotensive syndrome or left ventricular ejection stenosis
were excluded (29 patients). Measurement were collected at TO (before to
start Levosimendan infusion), T1 (in operation room before to start
cardiac surgery), T2 (when was interrupted extra corporeal circulation),
T3 (in Intensive Care Unit) and T4 (24 h after Levosimendan
administration). Were recordered major functional cardiac index such as
Ejection Fraction, Stroke Volume, Cardiac Output and TAPSE with
echocardiography transesofageal (T0, T1, T2) and transthoracic (T3, T4)
and were collected Mean Arterial Pressure, ScvO2, lactate in blood gas
analysis, diuresis. Pvalue of 0,05% was considered statistically
significant. Result(s): Echocardiografy showed no statistically
significant difference in Stroke Volume (p=0.8) and Cardiac Output
(p=0.99) between two groups. In both groups SV and CO parametres increased
progressively rather than baseline, expecially in G1. Ejection Fraction
increased significantly at any time vs baseline in G1 (p<0,049), whilst
they remained stable over time in G2. TAPSE was stable during the study
period in G2, while the trend increased progressively only in G1. Howewer
no statistically difference between groups. Comparisons between groups
showed similar ScvO2 levels at baseline, whilst they significanlty
increased in G1 vs G2 at T2, T3 and T4 (p>0.05) as anaerobic metabolism'
index. In both groups lactate levels increased during the study period
especially at T2, but non statistically difference between G1 vs G2. In
postoperative times blood-gas assessment showed impaired lactate values in
G1 vs G2. The analysis found that diuresis was lower in patients treated
with Levosimendan (G1) vs placebo (G2) in 24 hour after surgery. Perhaps
no statistical difference between two groups. No patient had adverse
reactions or oversensitiveness to Levosimendan infusion.
 Conclusion(s): The preliminary data of the study support these
conclusions: (i) the optimal dosing is 0.1 mcg/kg/min for 24 hours of
Levosimendan did not increased the SV and CO value, whilst increased EF
statistically significant (ii)lactate concentration in gas analysis
decrease in patients treated with Levosimendan, whilst also suggest that
Levoimendan improved ScvO2 (iii) levosimendan did not enhance the diuresis
in G1 vs G2 and (iv) Levosimendan infusion should be started before
surgery to exert its preconditioning effect. Levosimendan infusion
sustained haemodynamic improvement in the acute heart failure patients.

<98>
Accession Number
634008538
Title
Tricuspid valve replacement: Mechanical or biological prostheses? A
Systematic review and Meta-Analysis.
Source
Intensive Care Medicine Experimental. Conference: 33rd European Society of
Intensive Care Medicine Annual Congress, ESICM 2020. 8 (SUPPL 2) (no
pagination), 2020. Date of Publication: 2020.
Author
Cheng Z.
Institution
(Cheng) Cardiovascular Surgery, West China Hospital, Sichuan University,
Chengdu, China
Publisher
Springer
Abstract
Introduction: Tricuspid valve replacement (TVR) is seldom performed in
cardiac valve surgery, and there are currently no clinical guidelines
suggest which type of prostheses is better in tricuspid valve position.
This meta-analysis was performed to compare the results of mechanical and
biological prostheses for TVR. Method(s): We searched Pubmed,
Cochrane, Embase, Clinical trial databases to collect all the related
studies published during recent 10 years (from January 1, 2000 to October
31, 2019). A random-effects model was used to evaluate the OR (odds
ratios) and its 95% CI (confidence intervals) of time-to-event related
effects of the surgical procedures, every study's quality evaluated by the
Newcastle-Ottawa Scale (NOS). Result(s): A total of 13 retrospective
studies including 1407 patients were analyzed. There were no statistically
differences between mechanical and biological prostheses with respect to
prosthetic valve failure [OR=1.35, 95% CI(0.21,2.96), P=0.46],
bleeding[OR=0.68, 95% CI(0.33,1.40), P=0.29], reoperation[OR=1.00, 95%
CI(0.59,1.72), P=0.99], early mortality [OR=1.13, 95% CI(0.58,2.18),
P=0.73]and long-time survival [OR=1.06, 95% CI(0.68,1.66), P=0.80]. A
trend toward greater risk of thrombosis can be seen in mechanical
prostheses [OR=0.19, 95% CI(0.06,0.65), P=0.008, I2=0%].
 Conclusion(s): In tricuspid valve position, mechanical valve
prostheses has a higher risk of thrombosis than biological prostheses, but
no statistically differences between mechanical and biological prostheses
with respect to prosthetic valve failure, bleeding, reoperation, early
mortality and long-time survival. The more specific conclusion need to be
further proved by large-sample, multi-center, randomized, doubleblind and
control trials.

<99>
Accession Number
634008449
Title
Dexamethasone for patients undergoing major noncardiac surgery.
Source
Intensive Care Medicine Experimental. Conference: 33rd European Society of
Intensive Care Medicine Annual Congress, ESICM 2020. 8 (SUPPL 2) (no
pagination), 2020. Date of Publication: 2020.
Author
Asehnoune K.; Le Moal C.; Lepenndu M.; Chatel J.N.; Boisson M.; Faucher
M.; Jaber S.; Godet T.; Leone M.; Motamed C.; David J.S.; El Amine Y.;
Roquilly A.; Garrot M.; Futier E.
Institution
(Asehnoune, Lepenndu, Roquilly) Service D'anesthesie-Reanimation, Nantes
University Hospital Hotel-Dieu, Nantes, France
(Le Moal) Service d'anesthesie, C.H. - Le Mans, Le Mans, France
(Chatel) Service anesthesie, Hopital Prive du Confluent, Nantes, France
(Boisson) Service D'anesthesie-Reanimation, (5) CHU de Poitiers, Poitiers,
France
(Faucher) Service d'anesthesie, Institute Paoli-Calmettes, Marseille,
France
(Jaber) Anesthesia and Critical Care Department B, Centre Hospitalier
Universitaire Montpellier, Montpellier, France
(Godet) Service d'anesthesie et reanimation, Chu Estaing,
Clermont-Ferrand, France
(Leone) Department of Anesthesiology and Critical Care Medicine, Hospital
Nord, Marseille, France
(Motamed) Service d'anesthesie, Institut Gustave Roussy, Villejuif, France
(David) Service D'anesthesie-Reanimation, Hopital Edouard Herriot,
Hospices Civils de Lyon, Lyon, France
(El Amine) Serviced'anesthesie, Hospital Center De Valenciennes,
Valenciennes, France
(Garrot) Pole Anesthesie Reanimation, (3) Centre Hospitalier Universitaire
(CHU) Lille, Lille, France
(Futier) Department of Anesthesiology and Intensive Care Medicine,
University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
Publisher
Springer
Abstract
Introduction: Surgery initiates inflammation which contributes to
postoperative morbidity and mortality. Objective(s): We aimed to
assess the effects of dexamethasone on postoperative complications in
patients undergoing major surgery. Method(s): In a multicenter,
randomized, double-blind trial, patients over 50 years of age undergoing
non-cardiac surgery with expected duration of more than 90 minutes were
recruited from 34 centers. We randomly assigned patients to dexamethasone
(0.2 mg.kg-1 immediately after the procedure, and on day + 1) or to
placebo. Randomization was stratified on two criteria: cancer and thoracic
procedure. The primary outcome was a composite of major complications
(including sepsis, pneumonia and the need for mechanical ventilation) and
allcause mortality occurring within the first 14 days following surgery.
 Result(s): Of the 1,222 patients, 613 patients were randomized to
dexamethasone, and 609 to placebo. In intention-to-treat analysis after
multiple imputation for missing data, 104 patients (17.1%) in the
dexamethasone group and 123 patients (20.4%) in the placebo group had
major complications or died within 14 days after surgery (adjusted odds
ratio, 0.78; 95% confidence interval [CI], 0.59-1.04; P = 0.09, crude odds
ratio 0.79; 95%CI, 0.60-1.07, P = 0.13). The hazard ratios with
dexamethasone for sepsis (including pneumonia) and for mechanical
ventilation were respectively 0.82 (95%CI 0.61-1.12, P = 0.21) and 0.68
(95%CI 0.53-0.88, P = 0.003). In the a priori defined randomization
stratum of patients with non-thoracic surgery, primary outcome occurred
less frequently in the dexamethasone group than in the placebo group (P =
0.04). Adverse events were reported in 47% and 48.6% of patients who
received dexamethasone or placebo (odds ratio: 0.92; 95%CI 0.74-1.15).
 Conclusion(s): After major non-cardiac surgery, dexamethasone did not
result in significantly less mortality or fewer major complications 14
days after surgery.

<100>
Accession Number
634008377
Title
Free hemoglobin ratio as a novel predictive biomarker of acute kidney
injury after cardiac surgery: Secondary analysis of a randomized
controlled trial.
Source
Intensive Care Medicine Experimental. Conference: 33rd European Society of
Intensive Care Medicine Annual Congress, ESICM 2020. 8 (SUPPL 2) (no
pagination), 2020. Date of Publication: 2020.
Author
Hu J.; Francesco Z.; Edward A.B.; Chong L.; Rezoagli E.; Lorenzo B.
Institution
(Hu) Department of Critical Care Medicine, PLA general hospital, Beijing,
China
(Francesco) Department of Pathophysiology and Transplantation, University
of Milan, Via Della Commenda, Milan, Italy
(Edward, Lorenzo) Department of Anesthesia,Critical Care and Pain
Medicine, Mass General Hospital, Boston, United States
(Chong) Department of Anesthesiology and Perioperative Medicine, Fourth
Military Medical University Xijing Hospital, Xian Shi, China
(Rezoagli) School of Medicine and Surgery, University of Milano-Bicocca,
Monza, Italy
Publisher
Springer
Abstract
Introduction: Acute kidney injury (AKI) is a common complication among
patients undergoing cardiopulmonary bypass (CPB) [1-3], leading to
prolonged stay in the intensive care unit (ICU) and higher postoperative
mortality [4]. Early identification paired with effective intervention has
reduced the frequency and severity of postoperative AKI [2], indicating
that early diagnosis is extremely warranted. Currently, AKI diagnosis is
based on KDIGO criteria evaluating serum creatinine (SCr) and urine output
[5]. However, SCr has been challenged as it rises slowly after an initial
insult (usually 48-72 h) and is influenced by numerous non-renal factors
[6-8]. Urinary biomarkers have been extensively studied as promising
strategy for early diagnosis. However, the following issues may limit
urinary biomarkers from being widely used: (1) The detection needs
specific testing facilities, which may not be available in all the
hospitals; (2) The visible elevation can only be observed several hours
after surgery [9], which still delayed the treatment to get maximum
clinical benefit; (3) Most studies involved with urinary biomarkers [9-12]
have been limited by the absence of statistical methods to account for
overfitting due to small sample size [13] and non-linear correlation [14],
leading to poor generalizability and flexibility; and (4) Urinary
biomarkers prominently manifest tubular epithelium injury. New biomarkers
for AKI induced by open-heart surgery are needed. Hemolysis with
subsequent free hemoglobin (fHb) released by redblood cells is a
significant contributor to AKI among patients undergoing CPB [15, 16].
Levels of fHb peaked 15 min after weaning of CPB [17] and patients with
AKI display significantly higher fHb levels compared to patients without
AKI [16]. In addition, the difference between levels of fHb at the end of
CPB and baseline (DELTAfHb) was associated with AKI in pediatric patients
[18]. Whether DELTAfHb or fHb ratio, defined as levels of fHb at the end
of CPB divided by fHb at baseline, are independent risk factors of AKI in
adult patients requires further investigation. Moreover, whether DELTAfHb
or fHb ratio could predict AKI remains unclear. Therefore, we performed a
secondary analysis on the control arm of a randomized controlled trial [3]
to determine whether DELTAfHb or fHb ratio, an easily detected surrogate
of hemolysis, could be identified as an early biomarker for postoperative
AKI after open-heart surgery and whether incorporation of fHb ratio could
improve predictive performance, compared with using urinary biomarkers
alone. Objective(s): To determine whether free hemoglobin (fHb) ratio
could predict AKI immediately after open-heart surgery. Method(s):
This is a secondary analysis of a randomized controlled trial comparing
the effect of nitric oxide (intervention)versus nitrogen (control) on AKI
after cardiac surgery (NCT01802619) [1]. 110 adult patients in the control
arm were included. First, we determined whether fHb ratio (i.e., levels of
fHb at the end of CPB divided by baseline fHb) was associated with AKI via
univariable and multivariable analyses. Second, we verified whether fHb
ratio could predict AKI and incorporation of fHb ratio could improve
predictive performance of AKI at an early stage, compared with prediction
using urinary biomarkers alone. We conducted restricted cubic spline in
logistic regression for model development. We used bootstrap-based
internal validation to account for overfitting. We also employed
concordance (c) statistic, area under curve (AUC) test, resampling model
calibration, and likelihood ratio test to compare the predictive
performance (i.e., discrimination and calibration) between competing
models. Result(s): Data stratified by median fHb ratio showed that
subjects with an fHb ratio > 2.23 presented higher incidence of AKI (80.0%
vs. 49.1%, p = 0.001), more need of renal replacement therapy (10.9% vs.
0%, p = 0.036), and higher 28-day mortality (10.9% vs. 0%, p = 0.036) than
subjects with an fHb ratio <=2.23. fHb ratio was associated with AKI after
adjustment for pre-established factors. Among the four biomarkers, fHb
ratio outperformed other biomarkers with the highest AUC of 0.703
(0.600-0.806), best calibration, and minimaloptimism (bootstrap-adjusted
AUC 0.704, 95% CI 0.592-0.804). Incorporation of fHb ratio achieved better
predictive performance in terms of better discrimination (0.771 versus
0.653, p = 0.012) and calibration (p < 0.001) at an early stage, compared
with prediction using urinary biomarkers alone. Conclusion(s): fHb
ratio at the end of CPB is a novel, widely applicable biomarker for AKI
after open-heart surgery and incorporation of fHb ratio can achieve better
predictive performance at an early stage, compared with prediction using
urinary biomarkers alone.

<101>
Accession Number
634005866
Title
New cerebral microbleeds in patients treated with heparin during cardiac
procedure.
Source
International Journal of Stroke. Conference: 12th World Stroke Congress
2020. Austria. 15 (1 SUPPL) (pp 573), 2020. Date of Publication: 2020.
Author
Braemswig T.B.; Kusserow M.; Beckhoff F.; Reinthaler M.; Erdur H.; Scheitz
J.; Landmesser U.; Audebert H.; Endres M.; Lauten A.; Fiebach J.; Nolte C.
Institution
(Braemswig, Erdur, Audebert) Charite - Universitatsmedizin Berlin,
Department of Neurology, Berlin, Germany
(Kusserow, Beckhoff, Reinthaler, Landmesser, Lauten) Charite -
Universitatsmedizin Berlin, Department of Cardiology, Germany
(Scheitz, Nolte) Charite Universitatsmedizin Berlin, Neurology, Berlin,
Germany
(Endres) Charite, Universitatsmedizin Berlin, Centrum Fur
Schlaganfallforschung Berlin (csb), Germany
(Fiebach) Charite-University Medicine Berlin, Center for Stroke Research
Berlin, Germany
Publisher
SAGE Publications Inc.
Abstract
Background And Aims: Cerebral microbleeds (CMB) are a common incidental
finding on magnetic resonance imaging (MRI). Previously, we showed that
new CMBs occur in approximately 4% of patients with acute ischemic stroke
after intravenous thrombolysis. Currently, it is unknown if new CMBs also
occur after other treatments, in particular in patients treated with
heparin. The aim of this analysis was to explore whether new CMBs occur in
patients who received repeated boluses of unfractionated heparin during
transcatheter mitral-valve repair due to mitral-valve insufficiency with
the MitraClip device. Method(s): In this subgroup analysis of the
prospective, observational Silent sTROke duriNG MitraClip Implantation
(STRONG) trial (clinicaltrials.gov: NCT03104556), we included patients who
underwent pretreatment and follow-up cerebral MRI examinations.
T2*-weighted MRIs were co-registered using SPM12 (reference: pretreatment
T2*-weighted MRI) to minimize false-positive findings. The primary
endpoint was occurrence of new CMBs. Result(s): New CMBs occurred in
9/24 patients. Six patients had 1 new CMB and 3/9 patients had 2 new CMBs.
Distribution of new CMBs was strictly lobar in 6/9 patients,
infratentorial in 2/9 patients and mixed in 1/9 patients. There was a
trend towards a higher heparin dose given in patients with new CMBs
(14,000 IU [IQR, 10,500-16,000]) compared to patients without new CMBs
(11,000 IU [IQR, 9,000-14,000]; p=0.055, Mann-Whitney U test).
 Conclusion(s): New CMBs occur frequently in patients who received
repeated boluses of intravenous heparin during transcatheter mitral-valve
repair. The occurrence of new CMBs in these patients might be influenced
by the heparin dose administered.

<102>
Accession Number
634004432
Title
The role of multidisciplinary collaboration in the modern-day chest wall
reconstruction.
Source
British Journal of Surgery. Conference: Association of Surgeons in
Training International Surgical Conference. United Kingdom. 107 (SUPPL 3)
(pp 37-38), 2020. Date of Publication: June 2020.
Author
Vyas R.; Rathinam S.
Institution
(Vyas, Rathinam) University Hospitals of Leicester, Leicester, United
Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: There is an increasing trend towards a multidisciplinary approach
between Plastic Surgery and Thoracic Surgery in chest wall reconstruction.
This study systematically reviewed the literature on chest wall
reconstruction, including outcomes from a multidisciplinary approach
compared with a Thoracic Surgeon-only approach. Method(s): MEDLINE
database was searched for English language articles between 2013 and 2018
that researched chest wall reconstruction with the use of flaps. All case
reports and review articles were excluded. Result(s): 5 papers
fulfilled the criteria. 10 out of 15 (75%) documented a multidisciplinary
approach with Plastic Surgeons. There was a slightly higher median overall
complication rate with the use of Plastic Surgeons (24%) versus without
Plastic Surgeons (18.7%). In articles involving Plastic Surgery, 77.2% of
all patients underwent chest wall reconstruction with flaps, with 13
different flaps used; non-Plastic Surgery articles had fewer varieties of
flaps (seven) and fewer patients undergoing flap reconstruction (65.3%).
 Conclusion(s): The majority of recent chest wall reconstruction
studies demonstrate a multidisciplinary approach between Plastic and
Thoracic Surgery. The slightly higher complication rate may be related to
more radical resection margins in a higher risk patient cohort, who
benefit from advanced soft tissue reconstruction techniques by Plastic
Surgeons.

<103>
Accession Number
634004285
Title
Evaluation of the efficacy and effectiveness of interventions to reduce
systemic inflammatory response in cardiac surgery.
Source
British Journal of Surgery. Conference: Association of Surgeons in
Training International Surgical Conference. United Kingdom. 107 (SUPPL 3)
(pp 36), 2020. Date of Publication: June 2020.
Author
Ramzi J.; Rizzello A.; Abbasciano R.; Roman M.; Pathak S.; Lucarelli C.;
Layton G.; Lai F.; Kumar T.; Wozniak M.; Murphy G.
Institution
(Ramzi) Addenbrookes Hospital, Cambridge, United Kingdom
(Rizzello, Abbasciano, Roman, Pathak, Wozniak, Murphy) Department of
Cardiovascular Sciences, University of Leicester, Glenfield Hospital,
Leicester, United Kingdom
(Lucarelli) Department of Cardiac Surgery, University of Verona, Verona,
Italy
(Layton) UniversityHospitals of Leicester NHS Trust, Leicester, United
Kingdom
(Lai, Kumar) Leicester Clinical Trials Unit, University of Leicester,
Glenfield Hospital, Leicester, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: Systemic inflammatory response syndrome is a common complication of
cardiac surgery. It is associated with organ damage, longer postoperative
stay and higher mortality rates. There is a wide variety of interventions
implemented in cardiac surgery to reduce the post-operative inflammatory
response. The aim of this review is to evaluate the efficacy and
effectiveness of these interventions Method: Data was collected in a
preliminary search and the complete dataset was analysed. Included studies
were randomised controlled trials (RCTs) investigating interventions that
attenuate haematological activation, ones that attenuate ischaemic
reperfusion (IR) injury, and those with non-specific anti-inflammatory
activity. Result(s): 247 RCTs were evaluated. In a preliminary
analysis, results for both IL8 and IL6 were affected by high heterogeneity
(IL8: SMD = -0.63, 95% CI -0.88 to -0.38, I2 = 93%, SMD = -0.68, 95% CI
-0.89, -0.47, I2 = 94%). However, the combined effect on mortality was
significant: RR = 0.75, 95% CI 0.60 to 0.94, I2 = 0%. In subgroup
analysis, there was no proven efficacy shown for interventions targeting
IR. Interventions targeting haematological activation had significant
effect on mortality (SMD = 0.71, 95% CI 0.55 to 0.91, I2 =
0).Meta-regression showed how all these interventions have less impact on
inflammatory response in older patients. Conclusion(s): Interventions
targeting haematological activation are effective at reducing post cardiac
surgery mortality.

<104>
Accession Number
634004192
Title
Pedicled or skeletonized internal mammary artery in elective coronary
artery bypass? A systematic review and meta-analysis.
Source
British Journal of Surgery. Conference: Association of Surgeons in
Training International Surgical Conference. United Kingdom. 107 (SUPPL 3)
(pp 35), 2020. Date of Publication: June 2020.
Author
MacCarthy-Ofosu B.; Harky A.; Eriksen P.; Oguamana N.; Kusu-Orkar T.; Muir
A.
Institution
(MacCarthy-Ofosu) Countess of Chester, Chester, United Kingdom
(Harky, Kusu-Orkar, Muir) Liverpool Heart and Chest Hospital, Liverpool,
United Kingdom
(Eriksen) University of Liverpool, Liverpool, United Kingdom
(Oguamana) Barts Heart Centre, London, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: We sought to compare the clinical outcomes of harvesting internal
mammary artery through pedicled or skeletonized approach in patients
undergoing elective coronary artery bypass surgery. Method(s):
Electronic database search performed from inception to July 2019. Only
articles that directly compared the outcomes using both techniques were
included. Primary outcome was sternal wound infection(SWI). Secondary
outcomes were 30-day mortality and flow rate post anastomosis.
 Result(s): Nineteen articles met the inclusion criteria. A total of
8,567 patients were included,4,494 patients in the pedicled group. There
were no differences in preoperative patient demographics except diabetes
mellitus being higher in the skeletonized cohort (23% vs 17%, p = 0.03).
Skeletonized IMA were longer (18+/-3.1 cm vs 15+/-2.3, 95% CI -2.37
[-3.57, -1.17], p = 0.0001). SWI was lower in skeletonized IMA (3.5% vs
2%, 95% CI 1.95 [1.36, 2.78], p = 0.0002). New onset of acute MI and
30-day mortality rate were equal (p>0.05). The flow rates post anastomosis
were higher in skeletonized IMA (51+/-16 vs 39+/-12 mls / mins, 95% CI
-11.51 [-20.54, -2.49], p = 0.01). Conclusion(s): Harvesting the IMA
with skeletonized technique is associated with lower SWI rates and higher
post-anastomosis flow rates. The results should be interpreted carefully
due to significant heterogeneity in the included studies.

<105>
Accession Number
634004129
Title
Transcatheter aortic valve implantation in bicuspid aortic valve with
aortic stenosis: A systematic review and meta-analysis.
Source
British Journal of Surgery. Conference: Association of Surgeons in
Training International Surgical Conference. United Kingdom. 107 (SUPPL 3)
(pp 34), 2020. Date of Publication: June 2020.
Author
Chan J.S.K.; Harky A.; Singh S.; Eriksen P.; Tsui L.H.; Abdulsalam A.;
Field M.; Nawaytou O.
Institution
(Chan) Division of Cardiology, Department of Medicine and Therapeutics,
Prince of Wales Hospital, Hong Kong, Hong Kong
(Chan, Singh) Faculty of Medicine, Chinese University of Hong Kong, Hong
Kong, Hong Kong
(Harky, Abdulsalam, Field, Nawaytou) Department of Cardiothoracic Surgery,
Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Eriksen) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
(Tsui) Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong
Kong, Hong Kong
Publisher
John Wiley and Sons Ltd
Abstract
Aim: Bicuspid aortic valve (BAV) is an important aetiology of aortic
stenosis. This systematic review and meta-analysis compared the outcomes
of TAVI in stenotic BAV against tricuspid aortic valve (TAV).
 Method(s): PubMed, MEDLINE, EMBASE, and Scopus were searched
electronically to identify all studies comparing TAVI in stenotic BAV
versus TAV. Only studies comparing TAVI in BAV versus TAV were included.
Primary endpoints were 30-day and 1-year mortality; secondary endpoints
were postoperative rates of stroke, acute kidney injury (AKI), and
permanent pacemaker (PPM) requirement. Trial sequential analysis (TSA) was
performed for all endpoints. Result(s): Thirteen studies were
included (1,077 BAV and 4,165 TAV patients). The BAV cohort was younger (p
= 0.0002), had higher trans-aortic valve gradient (p = 0.005), and larger
aortic annular (p<0.0001) and ascending aortic (p<0.0001) diameters. No
significant difference was shown for primary (30-daymortality (p = 0.09)
and 1-yearmortality (p = 0.48)) and secondary endpoints (postoperative
stroke (p = 0.32), AKI (p = 0.39), and PPM requirement (p = 0.57)). The
BAV group had higher rates of conversion to open surgery (p = 0.03) and
significant postoperative aortic regurgitation (p = 0.02). TSA showed that
sufficient evidence existed to conclude the above effects for AKI and PPM
requirements. Conclusion(s): In conclusion, TAVI gave satisfactory
outcomes in stenotic BAV, but larger trials are required to confirm such
findings.

<106>
Accession Number
634004025
Title
Comparison of outcomes of transfemoral versus trans-subclavian approach
for transcatheter aortic valve implantation: A meta-analysis.
Source
British Journal of Surgery. Conference: Association of Surgeons in
Training International Surgical Conference. United Kingdom. 107 (SUPPL 3)
(pp 33), 2020. Date of Publication: June 2020.
Author
Al-Balah A.; Houbby N.; Chien L.; Salmasi M.; Athanasiou T.
Institution
(Al-Balah, Houbby, Chien, Salmasi, Athanasiou) Imperial College London,
London, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: To determine the safety and efficacy of the trans-subclavian (TSc)
compared to the trans-femoral (TF) approach. Method(s): A systematic
review was conducted on two online databases: Embase and Medline.
 Result(s): The initial search returned 650 titles. Six observational
studies were included: n = 2938 patients (2382 TF and 556 TSc). Outcomes
were comparable. Thirty-day mortality rates(OR 0.833, 95% CI 0.502 -
1.381, p = 0.478); rates of in-hospital stroke (OR 0.789, 95% CI 0.341 -
1.823; p = 0.578);myocardial infarction (OR 1.984, 95% CI 0.705 - 5.585, p
= 0.194); paravalvular leaks(OR 1.199, 95% CI 0.757 - 1.899;p = 0.439);
rates of postoperative permanent pacemaker implantation (OR 1.340; 95% CI
0.704 - 2.551, p = 0.373); in-hospital bleeding and meta-analysis
demonstrated no significant difference between access points (OR 1.254,
95% CI 0.774 - 2.033,p = 0.357). Procedural time was found to be longer in
the TSc group (OR 1.02;95% CI 0.815 - 1.219,p<0.001). Major vascular
complications were significantly higher in the TF group (OR 0.501,95% CI
0.263 - 0.954;p = 0.035). Meta regression found no influence of the
covariates on the outcomes. Conclusion(s): Subclavian access is both
a safe and feasible alternative access route for TAVI with lower risks of
major vascular complications. This study supports the use of subclavian
access as a viable alternative in patient groups where transfemoral TAVI
is contraindicated.

<107>
Accession Number
634004002
Title
Association of Surgeons in Training International Surgical Conference.
Source
British Journal of Surgery. Conference: Association of Surgeons in
Training International Surgical Conference. United Kingdom. 107 (SUPPL 3)
(no pagination), 2020. Date of Publication: June 2020.
Author
Anonymous
Publisher
John Wiley and Sons Ltd
Abstract
The proceedings contain 1006 papers. The topics discussed include: a
systematic review and meta-analysis of transeptal vs left atrial approach
for mitral valve surgery; outcomes following prehabilitation for major
intra-abdominopelvic cancer surgery: a systematic review and meta-analysis
of randomized-controlled trials; oncological, sexual, and urinary outcomes
following organ-sparing cystectomy versus standard radical cystectomy: a
systematic review and meta-analysis; perioperative outcomes after
laparoscopic cholecystectomy in the elderly patients: a systematic review
and meta-analysis; prophylactic topical tranexamic acid versus placebo in
surgical patients: a systematic review and meta-analysis; pelvic
exenteration: a comparison of long term outcomes between locally advanced
primary and recurrent rectal cancers; alpha blockers for medical expulsive
therapy: a meta-analysis of high-quality trials; impact of serum albumin
concentration and neutrophil-lymphocyte ratio score on gastric cancer
prognosis; and post-oesophagectomy anastomotic leaks - the relationship
between primary management and the overall outcomes in patients.

<108>
Accession Number
634003844
Title
A systematic review and meta-analysis of transeptal vs left atrial
approach for mitral valve surgery.
Source
British Journal of Surgery. Conference: Association of Surgeons in
Training International Surgical Conference. United Kingdom. 107 (SUPPL 3)
(pp 5), 2020. Date of Publication: June 2020.
Author
Harky A.; Noshirwani A.; Kusu-Orkar T.; Pousios D.; Muir A.
Institution
(Harky, Noshirwani, Kusu-Orkar, Pousios, Muir) Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: We sought to compare the clinical outcomes of mitral valve surgery
through conventional left atriotomy [LA] and transeptal approach [TS].
 Method(s): Electronic search performed from inception to March 2019.
Only articles including both approaches were included. Primary outcomes
were operative times and secondary outcomes were new onset of atrial
fibrillation, re-operation for bleeding, permanent pacemaker need and
operative mortality. Result(s): Fifteen articles met the inclusion
criteria. A total of 4,457 patients were included (n = 3,025 LA and n =
1,432 TS). There were no differences in preoperative patient demographics.
No differences noted in operative mortality (OR = 0.92, 95% CI [0.60,
1.40], p = 0.69), rate of new onset atrial fibrillation (OR = 0.82, 95%CI
[0.62, 1.07], p = 0.15), and reoperation for bleeding (OR = 0.95, 95% CI
[0.58, 1.53], p = 0.82). Cardiopulmonary bypass and aortic cross clamp
times were longer with TS (130+/-32 vs 113+/-31 mins, p = 0.03; 88+/-23 vs
75+/-23 mins, p = 0.0007 respectively), and permanent pacemaker was higher
in with TS (5% vs 3%, OR 0.61, 95%CI [0.43, 0.87], p = 0.006).
 Conclusion(s): Transeptal approach for mitral valve surgery is
associated with longer operative times and higher postoperative pacemaker
requirement; however, no significant differences in other outcomes are
evident. A randomized controlled trial is required to confirm those
findings.

<109>
Accession Number
634025226
Title
Aortic occlusion by tumour embolus complicating surgical resection of a
pulmonary carcinosarcoma: A post-mortem case report.
Source
Virchows Archiv. Conference: 32nd Congress of the ESP and 33rd
International Congress of the IAP. 477 (SUPPL 1) (pp S216), 2020. Date of
Publication: 2020.
Author
Hawrot H.; Griffin K.; Carling E.
Institution
(Hawrot) United Kingdom
Publisher
Springer
Abstract
Background & objectives: Occlusion of the aorta by embolic tumour material
is rare, and, to our knowledge, has never been reported in association
with pulmonary carcinosarcoma. Our objective is to review the literature
and increase awareness of this uncommon complication of thoracic surgery.
 Method(s): Case Presentation (Methods/ Results) A 69-year-old man
underwent right pneumonectomy for a screen-detected, asymptomatic, 10 cm
carcinosarcoma of the right upper lung. On recovery after anaesthetic, the
patient developed immediate postoperative paraesthesia and mottling of
both lower limbs. A computerised tomography (CT) scan revealed an aortic
thrombus with focal ischaemia of the spleen and left kidney..
 Result(s): Case Presentation (Methods/ Results) (continued)
...following failed angioplasty attempts and bilateral axillo-femoral
bypass grafts, above-knee amputations were performed. However, despite
these measures, the patient's clinical condition deteriorated and he sadly
died. The case was referred to the Coroner and post-mortem examination
revealed occlusion of the aorta and other large arteries by firm
palematerial. This was histologically confirmed to represent tumour
embolus and ischaemia and infarction were identified in multiple organ
systems including the spleen, kidneys and intestine. Conclusion(s):
This patient died of arterial obstruction by embolic tumour, causing
ischaemia of vital organs. Although rare, autopsy pathologists should be
vigilant to the fact that advanced lung cancers can invade large pulmonary
veins, facilitating embolization of tumour around the body.

<110>
Accession Number
634024122
Title
24th International Congress of the Polish Cardiac Society.
Source
Kardiologia Polska. Conference: 24th International Congress of the Polish
Cardiac Society. 78 (1) (no pagination), 2020. Date of Publication: 2020.
Author
Anonymous
Publisher
Medycyna Praktyczna
Abstract
The proceedings contain 158 papers. The topics discussed include: clinical
characteristics and prognosis of heart failure patients with current
malignant disease: insights from the heart failure pilot and long term
registries of the European society of cardiology; catheter ablation of
supraventricular and ventricular arrhythmias without fluoroscopy in
pregnancy: validation of a standard approach in a large multicenter
registry; the usefulness of cardiac computed tomography in the diagnosis
of perivalvular complications in patients with prosthetic valve
endocarditis; calcified mitro aortic continuity and mitral regurgitation
in patients undergoing transcatheter aortic valve replacement; copeptin,
albumin and routine inflammatory markers are associated with higher
mortality in patients with advanced heart failure who underwent cardiac
transplantation evaluation; and high risk plaque regression after
intensive dietary intervention in patients with non obstructive coronary
artery disease: a randomized computed tomography angiography study (DISCO
CT).

<111>
Accession Number
634020111
Title
NTM-001 a- Evidence-Based and ModelingSupported Development of a Novel
Alternative to Opioids for Moderately Severe Acute Post-Operative Pain; A
Literature Review Related to Safety and Efficacy Studies of Continuous IV
Infusion of Ketorolac Tromethamine and the Proposed Dosing Regimen of
NTM-001.
Source
Postgraduate Medicine. Conference: 2019 Pain Week Conference. United
States. 131 (SUPPL 1) (pp 35-36), 2019. Date of Publication: 2019.
Author
Steigerwald I.; Schmidt W.; Raffa R.; Diana F.; Pergolizzi J.V.
Institution
(Steigerwald, Raffa, Diana, Pergolizzi) Neumentum, Inc., Palo Alto, CA,
United States
(Schmidt) NorthStar Consulting, LLC, Sacramento, CA, United States
(Diana) FJD-CMC Consulting, LLC, Ocean City, NJ, United States
(Pergolizzi) Nema Research, Naples, FL, United States
Publisher
Taylor and Francis Inc.
Abstract
Purpose NTM-001 (Neumentum, Inc.) is an innovative product consisting of a
new formulation of ketorolac tromethamine in a premixed bag for continuous
IV infusion. NTM-001 is in development for the short-term management of
moderately severe acute pain that requires analgesia at the opioid level,
usually in a postoperative setting, for up to 24 hours. The proposed
formulation of NTM-001 is alcohol-free (vs. about 10% alcohol contained in
currently available injectable formulations) aiming to reduce potential
local irritation for the purpose of continuous infusion. It contains 1.0
mg/mL of ketorolac tromethamine, USP in saline solution (~0.9% NaCl)
adjusted to a pH of ~7.4. NTM-001 is readily available for infusion and
administered from pre-mixed polyolefin infusion bags via preprogrammed
infusion pumps as in regular, daily hospital use. The development of
NTM-001 and its dosing regimen (in adult patients without specific risk
factors for NSID use: 3.5 mg loading dose administered within 60 seconds,
followed by a continuous infusion of 3.5 mg/h for 24h) has been strongly
supported by PK/PD modeling. As in line with the generic IV ketorolac
bolus reference label, a 50% dose reduction has been considered with
NTM-001 for patient populations at special risk for NSAID use. Predictions
of PK/PD modeling have been recently confirmed by results of a
first-in-man randomized, controlled PK study of NTM-001 vs a ketorolac
bolus q6h regimen in cohorts of healthy young and older (>/= 65y of age)
adults with no and with different degrees of renal impairment. Published
literature describing use of infusions of diluted IV ketorolac
tromethamine also strongly supports the regimen of a loading dose followed
by continuous infusion for safe and effective post-operative analgesia. In
this paper, we performed a systematic review of available literature
related to trials that evaluated the efficacy and/or safety of continuous
infusion ketorolac tromethamine for a period of 24a-48 hours with a focus
on adult patients. Methods A PubMed literature search (2018) identified
100 potential references using the terms aketorolac continuous infusion.a
Routes of administration included IV, SC, and IM for durations of
generally 24 or 48 hours to treat postoperative pain. After sorting for
relevance, 39 references were reviewed and evaluated with particular
attention to potential toxicities involving gastrointestinal,
cardiovascular, and renal systems as well as dosing regimens used or
adjusted for elderly patients and/or those with other special risk factors
for NSAID use. Of particular interest was whether the continuous infusion
was preceded by a single bolus injection of ketorolac tromethamine as a
loading dose to achieve therapeutic concentrations as quickly as possible.
The final review included 23 adult studies, 2 pediatric studies, and 2
review articles of previous continuous infusion studies in adults or in
pediatric patients. Additional literature is quoted to point out specific
aspects linked to the rationale for selection of the loading dose for
NTM-001. One study concentrated on cardiovascular safety following
coronary artery bypass graft (CABG) surgery (Howard et al., 2016), and
another study focused on renal safety in patients undergoing laparoscopic
donor nephrectomy (LDN) or percutaneous nephrolithotomy (PNL) (Grimsby et
al., 2012). Another study evaluated the pharmacokinetics of continuous SC
infusion of ketorolac for 24 hours (Burdick et al., 2017). Evidence on
ketorolac postoperative continuous infusions lasting 24 to 48+ hours was
studied in 23 primary published papers involving adults (N = 3191) and in
2 primary published papers in infants or children (N = 122) for an overall
total of 3313 subjects. The results in adult patients are summarized
below. Results The following points summarize the literature review: (1)
In adults, effective analgesia was reported in 21 studies with infusion
rates of 1.3 to 5.8 mg/hr (median = 3.6 mg/hr). Two reports indicated that
ketorolac infusion did not produce effective analgesia following infusion
rates of 0.8 mg/hr or 1.75 mg/hr. a. Bolus doses of ketorolac (mean = 16.5
mg, median = 18 mg) were used in 18 of the 22 studies reporting favorable
analgesia. b. Bolus doses were not used in either of the two studies
reporting ineffective analgesia. In non-infusion trials, bolus doses of
10/15/30 mg IV ketorolac provide adequate levels of analgesia for acute
pain in the emergency room (Motov et al., 2017) without significant
differences in efficacy. According to the TORADOL Product Monograph
(Roche, Canada 2015) athe greatest difference between large and small
doses of TORADOL administered by either route is in the duration of
analgesia.a (2) In 10 adult studies, ketorolac infusion was reported to
decrease opioid use by a range of 22 to 89% (mean = 42%; median = 37%).
(3) Ketorolac plasma levels ranged from 0.4 to 2.2 mug/mL at 2a-4 hr after
an initial 10 mg IV bolus dose followed by 48 hr continuous IV infusion of
ketorolac at 3.75 mg/hr. This is modestly lower than C<inf>max</inf>
plasma levels of 2.2a- 3.0 mug/mL following a single 30 mg IM dose of
ketorolac in healthy volunteers. (4) None of the reviewed 24 adult 24a-48
hr continuous infusion references reported adverse GI, cardiovascular, or
renal effects, nor clinically-significant bleeding. (5) Many studies
reported reductions in postoperative nausea/vomiting for ketorolac
infusion compared to placebo groups when combined with rescue opioid
analgesics. Reductions in postoperative nausea/vomiting may have been a
consequence of reduced opioid consumption. (6) Beattie et al. (1997)
reported nonfatal myocardial infarctions in 1 ketorolac and 2 placebo
subjects following total hip or knee replacement; 21 subjects in this
study had a history of previous myocardial infarctions. However, there
were no differences in the number of ischemic episodes between ketorolac
and placebo groups, but ischemic episodes were shorter in subjects
receiving ketorolac. (7) None of the studies reported dose reductions for
elderly subjects or for those with renal dysfunction as required by
current IV/IM ketorolac labeling. However,as a caveat, most studies
excluded subjects with severe renal, and/or relevant cardiovascular or GI
disease. Conclusions Published literature provides strong support for the
efficacy of continuous infusion of ketorolac in adult postoperative
patients for 24 to 48 hours following a variety of major surgical
procedures. Evidence supports PK/PD modeling results that an initial
loading dose is required to ensure a fast onset of analgesia following
surgery. The variety of ketorolac loading dose regimens reflected in our
analysis and further supportive evidence on bolus dosing suggest that
loading doses lower than 30 mg are sufficient to reach effective plasma
levels while avoiding unnecessary overexposure. Based on PK/PD modeling of
different options for NTM-001 a loading dose of 12.5 mg has been selected
as sufficiently effective, fast in onset, and safe for initiating
analgesia in the postoperative setting. The infusion rate of 3.5 mg/hr
proposed by modeling to maintain stable plasma levels and efficacy for 24
hours with NTM-001 is supported by literature (3.6 mg/h median). In line
with published evidence, no increase but potentially a decrease of
safety-related risks is anticipated with NTM-001 vs. a regular (30mg q6)
IV ketorolac bolus regimen considering also lower overall (AUC/total daily
dose) and peak (C<inf>max</inf>) exposure and a maximum duration of
administration of 24 hours.

<112>
Accession Number
2010818355
Title
Use of Pre- And Intensified Postprocedural Physiotherapy in Patients with
Symptomatic Aortic Stenosis Undergoing Transcatheter Aortic Valve
Replacement Study (the 4P-TAVR Study).
Source
Journal of Interventional Cardiology. 2021 (no pagination), 2021. Article
Number: 8894223. Date of Publication: 2021.
Author
Weber M.; Klein U.; Weigert A.; Schiller W.; Bayley-Ezziddin V.; Wirtz
D.C.; Welz A.; Werner N.; Grube E.; Nickenig G.; Sinning J.-M.; Ghanem A.
Institution
(Weber, Klein, Weigert, Werner, Grube, Nickenig, Sinning, Ghanem)
Department of Medicine II, Heart Center Bonn, University Hospital Bonn,
Bonn, Germany
(Schiller, Welz) Department of Cardiac Surgery, Heart Center Bonn,
University Hospital Bonn, Bonn, Germany
(Bayley-Ezziddin, Wirtz) Clinic for Orthopedics and Trauma Surgery,
University Hospital Bonn, Bonn, Germany
Publisher
Hindawi Limited
Abstract
Background. Physiotherapy prior to open-heart surgery lowers the rate of
pneumonia and length of the hospital stay. Pneumonia is a major
contributor to short-term mortality following transcatheter aortic valve
replacement (TAVR). Hence, we hypothesized that pre- and intensified
postprocedural physiotherapy in patients undergoing TAVR might impact the
net functional and clinical outcome. Methods and Results. The 4P-TAVR
study was a prospective, monocentric, randomized trial. The study was
designed to compare the efficacy and safety of intensified periprocedural
physiotherapy including inspiratory muscle training versus standard
postprocedural physiotherapy. Patients were randomized in a 1: 1 fashion.
108 patients were included and followed up for 90 days after TAVR. While
patients in group A (control group: 50 patients, age: 81.7 +/- 5.0 years,
52% male) did not receive physiotherapy prior to TAVR, group B
(intervention group: 58 patients, age: 82.2 +/- 5.82 years, 47% male)
participated in intensive physiotherapy. Compared to the control group,
patients in the interventional group showed a lower incidence of
postinterventional pneumonia (10 [20.0%] vs. 3 [5.1%], p=0.016) and had a
3-day shorter mean hospital stay (13.5 +/- 6.1 days vs. 10.1 +/- 4.7 days,
p=0.02). The primary composite endpoint of mortality and rehospitalization
was not different between the groups. Conclusion. Intensified
physiotherapy is safe and has positive effects on clinical outcomes up to
90 days after TAVR but has no impact on the primary combined endpoint of
mortality and rehospitalization. Longer follow-up, a multicenter design,
and a higher number of subjects are needed to confirm these preliminary
results. This trial is registered with DRKS00017239. Copyright ©
2021 M. Weber et al.

<113>
Accession Number
2010819417
Title
Single versus dual antiplatelet therapy after transcatheter aortic valve
replacement: a meta-analysis of randomized clinical trials.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Ahmad Y.; Howard J.P.; Madhavan M.V.; Leon M.B.; Makkar R.R.
Institution
(Ahmad, Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Howard) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Madhavan, Leon) Columbia University Medical Center, New York, NY, United
States
(Leon) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Guidelines recommend dual antiplatelet therapy (DAPT) after
transcatheter aortic valve replacement (TAVR) but guidelines predate the
publication of the largest randomized trial. There have been few trials in
the field to date, and with a small number of total patients; pooling
their results may therefore be helpful. Method(s): We systematically
identified all randomized trials comparing SAPT to DAPT after TAVR. The
primary endpoint was the risk of major bleeding. Secondary endpoints
included all bleeding, life-threatening bleeding, stroke, myocardial
infarction, death and cardiac death. Result(s): Four trials,
randomizing 1086 participants, were eligible (541 randomized to SAPT and
545 randomized to DAPT). The weighted mean follow-up was 9.1 months. The
risk of major bleeding was significantly increased after DAPT (relative
risk (RR) 2.36, 95% confidence interval (CI) 1.27 to 4.40, P = 0.007).
There was a similar increased risk for all bleeding (RR 1.65, 95% CI 1.24
to 2.19, P < 0.001), although not for life-threatening bleeding (RR 1.44,
95% CI 0.74 to 2.77, P = 0.282). There were no significant differences in
the risk of stroke, myocardial infarction (MI), death or cardiac death.
There was no heterogeneity observed for any endpoint (I2 =
0.0%). Conclusion(s): DAPT after TAVR is associated with an increased
risk of major bleeding and all bleeding. There is no evidence of a
significant difference between DAPT or SAPT for the risks of stroke, MI,
death or cardiac death. However, the total number of patients randomized
is small and the duration of follow-up is short. Larger scale randomized
trials with longer follow-up are required to assess for any potential
differences in ischemic endpoints or mortality. Copyright © 2021
The Authors

<114>
Accession Number
2010260830
Title
Dobutamine-sparing versus dobutamine-to-all strategy in cardiac surgery: a
randomized noninferiority trial.
Source
Annals of Intensive Care. 11 (1) (no pagination), 2021. Article Number:
15. Date of Publication: December 2021.
Author
Franco R.A.; de Almeida J.P.; Landoni G.; Scheeren T.W.L.; Galas F.R.B.G.;
Fukushima J.T.; Zefferino S.; Nardelli P.; de Albuquerque Piccioni M.;
Arita E.C.T.C.; Park C.H.L.; Cunha L.C.C.; de Oliveira G.Q.; Costa
I.B.S.S.; Kalil Filho R.; Jatene F.B.; Hajjar L.A.
Institution
(Franco, de Almeida, Fukushima, Park, de Oliveira, Costa, Hajjar)
Intensive Care Unit, Cancer Institute (ICESP), University of Sao Paulo,
Sao Paulo, Brazil
(Landoni, Nardelli) Department of Anesthesia and Intensive Care, IRCCS San
Raffaele Scientific Institute, Milan, Italy
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
(Scheeren) Department of Anesthesiology, University Medical Center,
Groningen, Netherlands
(Galas, Zefferino, de Albuquerque Piccioni) Department of Anesthesiology,
Heart Institute, University of Sao Paulo, Sao Paulo, Brazil
(Arita, Cunha, Jatene) Division of Cardiovascular Surgery, Heart Institute
(InCor), University of Sao Paulo, Sao Paulo, Brazil
(Kalil Filho) Department of Cardiology, Heart Institute (InCor),
University of Sao Paulo, Sao Paulo, Brazil
(Hajjar) Department of Cardiopneumology, Instituto Do Coracao (InCor),
Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo,
Av. Dr. Eneas de Carvalho Aguiar, 44-05403-900, Sao Paulo, SP, Brazil
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The detrimental effects of inotropes are well-known, and in
many fields they are only used within a goal-directed therapy approach.
Nevertheless, standard management in many centers includes administering
inotropes to all patients undergoing cardiac surgery to prevent low
cardiac output syndrome and its implications. Randomized evidence in favor
of a patient-tailored, inotrope-sparing approach is still lacking. We
designed a randomized controlled noninferiority trial in patients
undergoing cardiac surgery with normal ejection fraction to assess whether
an dobutamine-sparing strategy (in which the use of dobutamine was guided
by hemodynamic evidence of low cardiac output associated with signs of
inadequate tissue perfusion) was noninferior to an inotrope-to-all
strategy (in which all patients received dobutamine). Result(s): A
total of 160 patients were randomized to the dobutamine-sparing strategy
(80 patients) or to the dobutamine-to-all approach (80 patients). The
primary composite endpoint of 30-day mortality or occurrence of major
cardiovascular complications (arrhythmias, acute myocardial infarction,
low cardiac output syndrome and stroke or transient ischemic attack)
occurred in 25/80 (31%) patients of the dobutamine-sparing group (p =
0.74) and 27/80 (34%) of the dobutamine-to-all group. There were no
significant differences between groups regarding the incidence of acute
kidney injury, prolonged mechanical ventilation, intensive care unit or
hospital length of stay. Discussion(s): Although it is common
practice in many centers to administer inotropes to all patients
undergoing cardiac surgery, a dobutamine-sparing strategy did not result
in an increase of mortality or occurrence of major cardiovascular events
when compared to a dobutamine-to-all strategy. Further research is needed
to assess if reducing the administration of inotropes can improve outcomes
in cardiac surgery. Trial registration ClinicalTrials.gov, NCT02361801.
Registered Feb 2nd, 2015.
https://clinicaltrials.gov/ct2/show/NCT02361801. Copyright ©
2021, The Author(s).

<115>
Accession Number
2010260480
Title
Inhaled nitric oxide and acute kidney injury risk: a meta-analysis of
randomized controlled trials.
Source
Renal Failure. 43 (1) (pp 281-290), 2021. Date of Publication: 2021.
Author
Wang J.; Cong X.; Miao M.; Yang Y.; Zhang J.
Institution
(Wang) Journal Editorial Department, Henan Provincial People's Hospital,
People's Hospital of Zhengzhou University, Zhengzhou, China
(Cong, Miao, Yang, Zhang) Department of Anesthesiology and Perioperative
Medicine, Henan Provincial People's Hospital, People's Hospital of
Zhengzhou University, Zhengzhou, China
Publisher
Taylor and Francis Ltd.
Abstract
Purpose: There are conflicting results as to the effect of inhaled nitric
oxide (iNO) therapy on the risk of acute kidney injury (AKI). The aim of
this study was to perform a meta-analysis to assess the updated data.
 Method(s): We systematically searched Web of Science, the Cochrane
Library, Wanfang, and PubMed for relevant randomized control trials
between database inception and 9/07/2020. Relative risks (RRs) with 95%
confidence intervals (CIs) predicting the risk of AKI were extracted to
obtain summary estimates using fixed-effects models. The Trim and Fill
method was used to evaluate the sensitivity of the results and adjust for
publication bias in meta-analysis. Result(s): 15 randomized
controlled studies from 14 articles involving 1853 patients were included
in the study. Analyzing the eligible studies we found: (1) iNO therapy
significantly increased the risk of AKI in acute respiratory distress
syndrome patients (RR 1.55, 95% CI 1.15-2.10, p = 0.004; I 2
for heterogeneity 0%; P <inf>het</inf> = 0.649). (2) The use of iNO was
associated with reduced AKI risk in patients undergoing cardiac surgery
(RR 0.80, 95% CI 0.64-0.99, p = 0.037; I 2 for heterogeneity
0%; P <inf>het</inf> = 0.528). (3) For organ transplantation recipients,
there was no effect of iNO administration on the risk of AKI (RR 0.50, 95%
CI 0.16-1.56, p = 0.233; I 2 for heterogeneity 0%; P
<inf>het</inf> = 0.842). The Trim and Fill analysis showed that the
overall effect of this meta-analysis was stable. Conclusion(s): The
effect of iNO on AKI risk might be disease-specific. Future RCTs with
larger patient populations should aim to validate our
findings. Copyright © 2021 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<116>
Accession Number
2010770133
Title
Mortality 10 Years After Percutaneous or Surgical Revascularization in
Patients With Total Coronary Artery Occlusions.
Source
Journal of the American College of Cardiology. 77 (5) (pp 529-540), 2021.
Date of Publication: 09 Feb 2021.
Author
Kawashima H.; Takahashi K.; Ono M.; Hara H.; Wang R.; Gao C.; Sharif F.;
Mack M.J.; Holmes D.R.; Morice M.-C.; Head S.J.; Kappetein A.P.; Thuijs
D.J.F.M.; Milojevic M.; Noack T.; Mohr F.-W.; Davierwala P.M.; Serruys
P.W.; Onuma Y.
Institution
(Kawashima, Takahashi, Ono, Hara) Department of Cardiology, Academic
Medical Center, University of Amsterdam, Amsterdam, Netherlands
(Kawashima, Ono, Wang, Gao, Sharif, Serruys, Onuma) Department of
Cardiology, National University of Ireland, Galway, Galway, Ireland
(Wang, Gao) Department of Cardiology, Radboud University, Nijmegen,
Netherlands
(Mack) Department of Cardiothoracic Surgery, Baylor Scott and White
Health, Dallas, TX, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Morice) Departement of Cardiologie, Hopital Prive Jacques Cartier,
Generale de Sante Massy, France
(Head, Kappetein, Thuijs, Milojevic) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Milojevic) Department of Cardiovascular Research, Dedinje Cardiovascular
Institute, Belgrade, Serbia
(Noack, Mohr, Davierwala) University Department of Cardiac Surgery, Heart
Centre Leipzig, Leipzig, Germany
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: The long-term clinical benefit after percutaneous coronary
intervention (PCI) or coronary artery bypass grafting (CABG) in patients
with total occlusions (TOs) and complex coronary artery disease has not
yet been clarified. Objective(s): The objective of this analysis was
to assess 10-year all-cause mortality in patients with TOs undergoing PCI
or CABG. Method(s): This is a subanalysis of patients with at least 1
TO in the SYNTAXES (Synergy Between PCI With Taxus and Cardiac Surgery
Extended Survival) study, which investigated 10-year all-cause mortality
in the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) trial,
beyond its original 5-year follow-up. Patients with TOs were further
stratified according to the status of TO recanalization or
revascularization. Result(s): Of 1,800 randomized patients to the PCI
or CABG arm, 460 patients had at least 1 lesion of TO. In patients with
TOs, the status of TO recanalization or revascularization was not
associated with 10-year all-cause mortality, irrespective of the assigned
treatment (PCI arm: 29.9% vs. 29.4%; adjusted hazard ratio [HR]: 0.992;
95% confidence interval [CI]: 0.474 to 2.075; p = 0.982; and CABG arm:
28.0% vs. 21.4%; adjusted HR: 0.656; 95% CI: 0.281 to 1.533; p = 0.330).
When TOs existed in left main and/or left anterior descending artery, the
status of TO recanalization or revascularization did not have an impact on
the mortality (34.5% vs. 26.9%; adjusted HR: 0.896; 95% CI: 0.314 to
2.555; p = 0.837). Conclusion(s): At 10-year follow-up, the status of
TO recanalization or revascularization did not affect mortality,
irrespective of the assigned treatment and location of TOs. The present
study might support contemporary practice among high-volume chronic TO-PCI
centers where recanalization is primarily offered to patients for the
management of angina refractory to medical therapy when myocardial
viability is confirmed. (Synergy Between PCI With TAXUS and Cardiac
Surgery: SYNTAX Extended Survival [SYNTAXES]; NCT03417050; SYNTAX Study:
TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the
Treatment of Narrowed Arteries [SYNTAX]; NCT00114972) Copyright ©
2021 American College of Cardiology Foundation

<117>
Accession Number
2010808672
Title
Risk factors and prognosis of adult-onset post-pump chorea.
Source
Journal of the Neurological Sciences. 422 (no pagination), 2021. Article
Number: 117328. Date of Publication: 15 Mar 2021.
Author
Ahn J.H.; Song J.; Choi I.; Youn J.; Cho J.W.
Institution
(Ahn, Song, Choi, Youn, Cho) Department of Neurology, Samsung Medical
Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro,
Gangnam-gu, Seoul 06351, South Korea
(Ahn, Song, Choi, Youn, Cho) Neuroscience Center, Samsung Medical Center,
81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea
Publisher
Elsevier B.V.
Abstract
Objectives: Post-pump chorea (PPC), defined as the development of chorea
after major cardiac surgery utilizing cardiopulmonary bypass (CPB), has
been rarely reported in adults. Method(s): We compared 17 patients
with adult-onset PPC to controls who did not develop chorea after cardiac
surgery with CPB. Two patients were enrolled using hospital based data and
15 were collected by a systematic literature review. The controls without
chorea after CPB (n = 4208) were collected using hospital based data. We
described the clinical and surgical features of adult-onset PPC and
compared them with those of the controls. Result(s): Ten of 17 PPC
patients were male, the mean age was 46.8 years, and the mean onset
latency was 6.0 days. The adult-onset PPC patients were younger (46.8 +/-
16.7 vs. 59.1 +/- 15.0, p = 0.001), had a lower minimum body temperature
(23.3 +/- 5.5 vs. 29.7 +/- 3.7, p < 0.001) and a longer total circulatory
arrest time (63.7 +/- 7.5 vs. 21.0 +/- 14.6, p < 0.001) than controls.
Forty-three percentage of patients with adult-onset PPC had persistent
chorea on follow-up, and these patients showed a higher rate of abnormal
initial brain MRI compared with the patients with good clinical outcomes
(p = 0.041). Conclusion(s): The onset age, onset latency, underlying
disease, treatment response, and surgical features were variable among PPC
patients, while abnormal initial brain MRI was associated with persistent
chorea. Pooling more cases through multicenter efforts will hopefully
provide more knowledge on the underlying pathophysiology, prevention, and
management of PPC. Copyright © 2021 Elsevier B.V.

<118>
Accession Number
2010775383
Title
Extracorporeal life support in patients with acute myocardial infarction
complicated by cardiogenic shock - Design and rationale of the ECLS-SHOCK
trial.
Source
American Heart Journal. 234 (pp 1-11), 2021. Date of Publication: April
2021.
Author
Thiele H.; Freund A.; Gimenez M.R.; de Waha-Thiele S.; Akin I.; Poss J.;
Feistritzer H.-J.; Fuernau G.; Graf T.; Nef H.; Hamm C.; Bohm M.; Lauten
A.; Schulze P.C.; Voigt I.; Nordbeck P.; Felix S.B.; Abel P.; Baldus S.;
Laufs U.; Lenk K.; Landmesser U.; Skurk C.; Pieske B.; Tschope C.;
Hennersdorf M.; Wengenmayer T.; Preusch M.; Maier L.S.; Jung C.; Kelm M.;
Clemmensen P.; Westermann D.; Seidler T.; Schieffer B.; Rassaf T.;
Mahabadi A.-A.; Vasa-Nicotera M.; Meincke F.; Seyfarth M.; Kersten A.;
Rottbauer W.; Boekstegers P.; Mullenbach R.; Dengler T.; Kadel C.; Schempf
B.; Karagiannidis C.; Hopf H.-B.; Lehmann R.; Bufe A.; Baumanns S.; Oner
A.; Linke A.; Sedding D.; Ferrari M.; Bruch L.; Goldmann B.; John S.;
Mollmann H.; Franz J.; Lapp H.; Lauten P.; Noc M.; Goslar T.; Oerlecke I.;
Ouarrak T.; Schneider S.; Desch S.; Zeymer U.
Institution
(Thiele, Freund, Gimenez, Poss, Feistritzer, Desch) Heart Center Leipzig
at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
(de Waha-Thiele, Fuernau, Graf) University Heart Center Luebeck, Luebeck,
Germany
(Akin) University Clinic Mannheim, Mannheim, Germany
(Nef, Hamm) University Clinic Giessen, Giessen, Germany
(Hamm) Kerckhoff Clinic Bad Nauheim, Bad Nauheim, Germany
(Bohm) University Clinic Homburg, Homburg, Germany
(Lauten) Helios Clinic Erfurt, Erfurt, Germany
(Schulze) University Hospital Jena, Jena, Germany
(Voigt) Contilia Elisabeth-Krankenhaus, Essen, Germany, Essen, Germany
(Nordbeck) University Clinic Wurzburg, Wurzburg, Germany
(Felix, Abel) Dept. of Internal Medicine B, University Medicine
Greifswald, Greifswald, Germany
(Baldus) Heart Center Cologne, University Clinic Cologne, Cologne, Germany
(Laufs, Lenk) University Clinic Leipzig, Leipzig, Germany
(Landmesser, Skurk) Charite, Campus Benjamin Franklin, Berlin, Germany
(Pieske, Tschope) Charite University Medicine, Campus Virchow Klinikum and
German Heart Center and Berlin Brandenburger Center for Regenerative
Therapies (BCRT) of the Berlin Institute of Health (BIH), Berlin, Germany
(Hennersdorf) SLK-Clinic Heilbronn, Heilbronn, Germany
(Wengenmayer) University Heart Center Freiburg - Bad Krozingen, Freiburg,
Germany
(Preusch) University Clinic Heidelberg, Heidelberg, Germany
(Maier) University Clinic Regensburg, Regensburg, Germany
(Jung, Kelm) University Clinic Dusseldorf, Dusseldorf, Germany
(Clemmensen, Westermann) University Heart Center Hamburg, Hamburg, Germany
(Seidler) Heart Center Gottingen, University Medicine Gottingen,
Gottingen, Germany
(Schieffer) University Clinic Marburg, Marburg, Germany
(Rassaf, Mahabadi) Dept. of Cardiology and Vascular Medicine, West German
Heart- and Vascular Center, University Hospital Essen, Germany
(Vasa-Nicotera) University Clinic Frankfurt, Frankfurt, Germany
(Meincke) Asklepios Clinic St. Georg, Hamburg, Germany
(Seyfarth) Heart Center Wuppertal, Witten-Herdecke University, Wuppertal,
Germany
(Kersten) University Clinic Aachen, Aachen, Germany
(Rottbauer) University Clinic Ulm, Ulm, Germany
(Boekstegers) Helios Clinic Siegburg, Siegburg, Germany
(Mullenbach) Klinikum Kassel, Kassel, Germany
(Dengler) SLK Clinic Bad Friedrichshall, Bad Friedrichshall, Germany
(Kadel) Clinic Frankfurt Hochst, Frankfurt, Germany
(Schempf) Clinic Reutlingen, Reutlingen, Germany
(Karagiannidis) ARDS and ECMO Center Cologne-Merheim, Cologne, Germany
(Hopf, Lehmann) Asklepios Clinic Langen, Langen, Germany
(Bufe) Helios Clinic Krefeld, Krefeld, University Witten/Herdecke, Germany
(Baumanns) Kliniken Maria Hilf, Monchengladbach, Germany
(Oner) University Clinic Halle, Halle, Germany
(Linke) Heart Center Dresden - Technical University Dresden, Dresden,
Germany
(Sedding) University Clinic Halle, Halle, Germany
(Ferrari) Helios Klinik HSK Wiesbaden, Wiesbaden, Germany
(Bruch) Unfallkrankenhaus Berlin, Berlin, Germany
(Goldmann) Asklepios Clinic Hamburg-Harburg, Hamburg, Germany
(John) Paracelsius Private University, Clinic Nuremberg, Campus South,
Nuremberg, Germany
(Mollmann) St. Johannes Hospital Dortmund, Dortmund, Germany
(Franz) Clinic Winnenden, Winnenden, Germany
(Lapp, Lauten) Zentralklinik Bad Berka, Bad Berka, Germany
(Noc, Goslar) University Medical Center Ljubljana, Ljubljana, Slovenia
(Oerlecke) Leipzig Heart Institute, Leipzig, Germany
(Ouarrak, Schneider, Zeymer) Institut fur Herzinfarktforschung,
Ludwigshafen, Germany
Publisher
Mosby Inc.
Abstract
Background: In acute myocardial infarction complicated by cardiogenic
shock the use of mechanical circulatory support devices remains
controversial and data from randomized clinical trials are very limited.
Extracorporeal life support (ECLS) - venoarterial extracorporeal membrane
oxygenation - provides the strongest hemodynamic support in addition to
oxygenation. However, despite increasing use it has not yet been properly
investigated in randomized trials. Therefore, a prospective randomized
adequately powered clinical trial is warranted. Study Design: The
ECLS-SHOCK trial is a 420-patient controlled, international, multicenter,
randomized, open-label trial. It is designed to compare whether treatment
with ECLS in addition to early revascularization with percutaneous
coronary intervention or alternatively coronary artery bypass grafting and
optimal medical treatment is beneficial in comparison to no-ECLS in
patients with severe infarct-related cardiogenic shock. Patients will be
randomized in a 1:1 fashion to one of the two treatment arms. The primary
efficacy endpoint of ECLS-SHOCK is 30-day mortality. Secondary outcome
measures such as hemodynamic, laboratory, and clinical parameters will
serve as surrogate endpoints for prognosis. Furthermore, a longer
follow-up at 6 and 12 months will be performed including quality of life
assessment. Safety endpoints include peripheral ischemic vascular
complications, bleeding and stroke. Conclusion(s): The ECLS-SHOCK
trial will address essential questions of efficacy and safety of ECLS in
addition to early revascularization in acute myocardial infarction
complicated by cardiogenic shock. Copyright © 2021 Elsevier Inc.

<119>
Accession Number
2010217649
Title
Enhanced recovery after cardiac surgery and its impact on outcomes: A
systematic review.
Source
Perfusion (United Kingdom). (no pagination), 2021. Date of Publication:
2021.
Author
Zhang Y.; Chong J.H.; Harky A.
Institution
(Zhang) Barts and The London School of Medicine and Dentistry, London,
United Kingdom
(Chong) GKT School of Medical Education, King's College London, London,
United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Life Science,
University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
(Harky) Department of Cardiac Surgery, Alder Hey Children Hospital,
Liverpool, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Background and Aim: Enhanced Recovery After Surgery (ERAS) protocols are a
series of perioperative interventions well-established in improving the
care and outcomes of patients. With recent emergence of studies on its
implementation in cardiac surgery, this paper represents the first
systematic review on current evidence of ERAS efficacy in this field.
 Method(s): Two reviewers independently searched through Pubmed,
Cochrane, Google Scholar, Web of Science, Embase and Scopus. Comparative
studies with controls that described the implementation of ERAS in all
types of cardiac operations from 2001 to 2020 were included. Data
extracted included patient demographics, components of ERAS protocol
described, types of cardiac surgery, and postoperative outcomes.
 Result(s): In the final analysis, nine studies were included, of
which there were one randomized controlled trial (RCT), one
quasi-experiment and seven retrospective/prospective studies. Significant
improvement in hospital and ICU length of stay, as well as reduction in
postoperative opioid consumption were demonstrated. No increase in
postoperative complications were reported. Conclusion(s): ERAS in
cardiac surgery has shown to be potentially safe and effective in
improving certain postoperative outcomes. However, the evidence is limited
by the lack of high-quality RCTs. We also found the lack of practice of
class 1 recommended interventions set forth by the ERAS Cardiac Society.
Furthermore, majority of studies only evaluated the immediate
postoperative outcomes of patients, and not the long-term outcomes. RCTs
that fully implement measures recommended by the ERAS Cardiac Society,
with assessments on both immediate and long-term outcomes, are
warranted. Copyright © The Author(s) 2021.

<120>
Accession Number
2010277195
Title
Multivariable risk scores for predicting short-term outcomes for emergency
department patients with unexplained syncope: A systematic review.
Source
Academic Emergency Medicine. (no pagination), 2021. Date of Publication:
2021.
Author
Sweanor R.A.L.; Redelmeier R.J.; Simel D.L.; Albassam O.T.; Shadowitz S.;
Etchells E.E.
Institution
(Sweanor, Redelmeier, Albassam, Shadowitz, Etchells) Department of
Medicine, University of Toronto, Toronto, ON, Canada
(Redelmeier, Albassam, Shadowitz, Etchells) Department of Medicine
Sunnybrook Health Science Centre, University of Toronto, Toronto, ON,
Canada
(Albassam) Division of Cardiology, King Abdulaziz University Hospital,
King Abdulaziz University, Jeddah, Saudi Arabia
(Simel) Division of General Internal Medicine, Duke Veterans Affairs
Medical Center, Durham, NC, United States
(Simel) Duke University, Durham, NC, United States
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: Emergency department (ED) patients with unexplained syncope
are at risk of experiencing an adverse event within 30 days. Our objective
was to systematically review the accuracy of multivariate risk
stratification scores for identifying adult syncope patients at high and
low risk of an adverse event over the next 30 days. Method(s): We
conducted a systematic review of electronic databases (MEDLINE, Cochrane,
Embase, and CINAHL) from database creation until May 2020. We sought
studies evaluating prediction scores of adults presenting to an ED with
syncope. We included studies that followed patients for up to 30 days to
identify adverse events such as death, myocardial infarction, stroke, or
cardiac surgery. We only included studies with a blinded comparison
between baseline clinical features and adverse events. We calculated
likelihood ratios and confidence intervals (CIs). Result(s): We
screened 13,788 abstracts. We included 17 studies evaluating nine risk
stratification scores on 24,234 patient visits, where 7.5% (95% CI = 5.3%
to 10%) experienced an adverse event. A Canadian Syncope Risk Score (CSRS)
of 4 or more was associated with a high likelihood of an adverse event
(LR<inf>score>=4</inf> = 11, 95% CI = 8.9 to 14). A CSRS of 0 or less
(LR<inf>score<=0</inf> = 0.10, 95% CI = 0.07 to 0.20) was associated with
a low likelihood of an adverse event. Other risk scores were not validated
on an independent sample, had low positive likelihood ratios for
identifying patients at high risk, or had high negative likelihood ratios
for identifying patients at low risk. Conclusion(s): Many risk
stratification scores are not validated or not sufficiently accurate for
clinical use. The CSRS is an accurate validated prediction score for ED
patients with unexplained syncope. Its impact on clinical decision making,
admission rates, cost, or outcomes of care is not known. Copyright
© 2021 by the Society for Academic Emergency Medicine

<121>
Accession Number
2010298979
Title
Association between intra-operative cardiac arrest and country Human
Development Index status: a systematic review with meta-regression
analysis and meta-analysis of observational studies*.
Source
Anaesthesia. (no pagination), 2021. Date of Publication: 2021.
Author
Braz L.G.; Einav S.; Heesen M.A.; Betini M.; Corrente J.E.; Pacchioni M.;
Cury J.B.; Braz M.G.; Braz J.R.C.
Institution
(Braz, Pacchioni, Cury, Braz, Braz) Anaesthesia Cardiac Arrest and
Mortality Study Commission, Department of Surgical Specialties and
Anaesthesiology, Botucatu Medical School, Sao Paulo State University -
UNESP, Botucatu, Brazil
(Einav) Shaare Zedek Medical Centre, Jerusalem, Israel
(Einav) Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem,
Israel
(Heesen) Department of Anaesthesia, Kantonsspital Baden, Baden,
Switzerland
(Betini) Technical Division of Library and Documentation, Institute of
Biosciences, Sao Paulo State University - UNESP, Botucatu, Brazil
(Corrente) Department of Biostatistics, Institute of Biosciences, Sao
Paulo State University - UNESP, Botucatu, Brazil
Publisher
Blackwell Publishing Ltd
Abstract
Intra-operative cardiac arrests differ from most in-hospital cardiac
arrests because they reflect not only the patient's condition but also the
quality of surgery and anaesthesia care provided. We assessed the
relationship between intra-operative cardiac arrest rates and country
Human Development Index (HDI), and the changes occurring in these rates
over time. We searched PubMed, EMBASE, Scopus, LILACS, Web of Science,
CINAHL and SciELO from inception to 29 January 2020. For the global
population, rates of intra-operative cardiac arrest and baseline ASA
physical status were extracted. Intra-operative cardiac arrest rates were
analysed by time, country HDI status and ASA physical status using
meta-regression analysis. Proportional meta-analysis was performed to
compare intra-operative cardiac arrest rates and ASA physical status in
low- vs. high-HDI countries and in two time periods. Eighty-two studies
from 25 countries with more than 29 million anaesthetic procedures were
included. Intra-operative cardiac arrest rates were inversely correlated
with country HDI (p = 0.0001); they decreased over time only in high-HDI
countries (p = 0.040) and increased with increasing ASA physical status (p
< 0.0001). Baseline ASA physical status did not change in high-HDI
countries (p = 0.106), while it decreased over time in low-HDI countries
(p = 0.040). In high-HDI countries, intra-operative cardiac arrest rates
(per 10,000 anaesthetic procedures) decreased from 9.59 (95%CI 6.59-13.16)
pre-1990 to 5.17 (95%CI 4.42-5.97) in 1990-2020 (p = 0.013). During the
same time periods, no improvement was observed in the intra-operative
cardiac arrest rates in low-HDI countries (p = 0.498). Odds ratios of
intra-operative cardiac arrest rates in ASA 3-5 patients were 8.48 (95%CI
1.67-42.99) times higher in low-HDI countries than in high-HDI countries
(p = 0.0098). Intra-operative cardiac arrest rates are related to
country-HDI and decreased over time only in high-HDI countries. The
widening gap in these rates between low- and high-HDI countries needs to
be addressed globally. Copyright © 2021 Association of
Anaesthetists

<122>
Accession Number
633990523
Title
Music intervention to relieve anxiety and pain in adults undergoing
cardiac surgery: A systematic review and meta-Analysis.
Source
Open Heart. 8 (1) (no pagination), 2021. Article Number: e001474. Date of
Publication: 25 Jan 2021.
Author
Kakar E.; Billar R.J.; Van Rosmalen J.; Klimek M.; Takkenberg J.J.M.;
Jeekel J.
Institution
(Kakar, Jeekel) Department of Surgery, Erasmus MC, Rotterdam,
South-Holland, Netherlands
(Kakar, Jeekel) Department of Neuroscience, Erasmus MC, Rotterdam,
South-Holland, Netherlands
(Billar) Pediatric Surgery, Erasmus MC, Rotterdam, South-Holland,
Netherlands
(Van Rosmalen) Department of Biostatics, Erasmus MC, Rotterdam,
South-Holland, Netherlands
(Klimek) Department of Anesthesiology, Erasmus MC, Rotterdam,
South-Holland, Netherlands
(Takkenberg) CardioThoracic Surgery, Erasmus University Medical Center,
Rotterdam, South-Holland, Netherlands
Publisher
BMJ Publishing Group
Abstract
Objectives Previous studies have reported beneficial effects of
perioperative music on patients' anxiety and pain. We performed a
systematic review and meta-Analysis of randomised controlled trials
investigating music interventions in cardiac surgery. Methods Five
electronic databases were systematically searched. Primary outcomes were
patients' postoperative anxiety and pain. Secondary outcomes were hospital
length of stay, opioid use, vital parameters and time on mechanical
ventilation. PRISMA guidelines were followed and PROSPERO database
registration was completed (CRD42020149733). A meta-Analysis was performed
using random effects models and pooled standardised mean differences (SMD)
with 95% confidence intervals were calculated. Results Twenty studies were
included for qualitative analysis (1169 patients) and 16 (987 patients)
for meta-Analysis. The first postoperative music session was associated
with significantly reduced postoperative anxiety (SMD =-0.50 (95% CI-0.67
to-0.32), p<0.01) and pain (SMD =-0.51 (95% CI-0.84 to-0.19), p<0.01).
This is equal to a reduction of 4.00 points (95% CI 2.56 to 5.36) and 1.05
points (95% CI 0.67 to 1.41) on the State-Trait Anxiety Inventory and
Visual Analogue Scale (VAS)/Numeric Rating Scale (NRS), respectively, for
anxiety, and 1.26 points (95% CI 0.47 to 2.07) on the VAS/NRS for pain.
Multiple days of music intervention reduced anxiety until 8 days
postoperatively (SMD =-0.39 (95% CI-0.64 to-0.15), p<0.01). Conclusions
Offering recorded music is associated with a significant reduction in
postoperative anxiety and pain in cardiac surgery. Unlike pharmacological
interventions, music is without side effects so is promising in this
population. Copyright ©

<123>
Accession Number
634017057
Title
Chest keloids: effect of surgical excision and adjuvant radiotherapy on
recurrence, a systematic review and meta-analysis.
Source
ANZ journal of surgery. (no pagination), 2021. Date of Publication: 12 Jan
2021.
Author
Miles O.J.; Zhou J.; Paleri S.; Fua T.; Ramakrishnan A.
Institution
(Miles) Department of Plastic and Reconstructive Surgery, St Vincent's
Hospital Melbourne, VIC, Australia
(Zhou) Department of Plastic and Reconstructive Surgery, Alfred Hospital
Melbourne, Melbourne, VIC, Australia
(Paleri) Department of Cardiology, St Vincent's Hospital Melbourne, VIC,
Australia
(Fua) Department of Radiation Oncology, Peter MacCallum Cancer Centre,
Melbourne, VIC, Australia
(Ramakrishnan) Department of Plastic and Reconstructive Surgery, Royal
Melbourne Hospital, Melbourne, VIC, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Chest keloids are a difficult sub-group of scars to treat,
likely secondary to the high wound tension in the area that promotes
excessive fibroblast proliferation and collagen deposition. Excision and
adjuvant radiotherapy has been demonstrated as an efficacious treatment
for keloids in general, but no meta-analysis exists to support the claims
for chest keloids. This study aims to identify the rate of recurrence
after surgical resection and radiotherapy on patients with chest keloids.
 METHOD(S): A search was performed using Embase, MEDLINE, Pubmed and
Cochrane database on 22 December 2018 for terms 'radiotherapy', 'keloid'
and 'chest'. Papers included met a prospectively designed inclusion
criteria assessed by multiple investigators. RESULT(S): Twelve
studies, including 1 randomized controlled trial, were included for a
total of 400 patients with a chest keloid scar managed with surgical
excision and adjuvant radiotherapy. Overall pooled-estimate of recurrence
rate was 22% (95% CI 12-32%). Meta-regression did not demonstrate a
significant effect for method of wound closure, type of radiotherapy,
radiotherapy dose (BED10 ) and study type. CONCLUSION(S): Excision
and adjuvant radiotherapy represents an effective method of treatment for
chest keloids, however sufficient prospective data, including randomized
controlled trials, did not yet exist to support these findings. Further
studies with sufficient sub-group analysis for keloid location are
required to add to the pool of literature that can be added to this
meta-analysis. Copyright © 2021 Royal Australasian College of
Surgeons.

<124>
[Use Link to view the full text]
Accession Number
633966983
Title
The clinical efficacy and safety of the Chinese herbal medicine Astragalus
(Huangqi) preparation for the treatment of acute myocardial infarction : A
systematic review of randomized controlled trials.
Source
Medicine (United States). 98 (16) (no pagination), 2019. Article Number:
e15256. Date of Publication: 2019.
Author
Zhang Y.; Wu J.; Guo S.; Lin W.; Zhang B.; Chen X.; Mo H.; Zhan T.
Institution
(Zhang, Wu, Lin, Zhang, Chen, Mo, Zhan) School of Chinese Medicine,
Beijing University of Chinese Medicine, Beijing, China
(Guo) Beijing University of Chinese Medicine, Fangshan Hospital, Beijing,
China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In recent years, with the enormous advances in the field of
cardiac intervention technology, the survival rate of patients with acute
myocardial infarction (AMI) has been improved significantly. However, the
risk of arrhythmias and heart failure remains very high in AMI patients
for long-term prognosis. Chinese herbal medicine (CHM) is more and more
used in the treatment of AMI because of its good curative effect and less
side effects. The target of this research is to analyze the efficacy and
safety of Astragalus (Huangqi) preparation in the treatment of AMI by
meta-analysis and also to provide a better evidence for clinical practice.
 Method(s): Seven databases will be searched in this study: The
Cochrane Library, PubMed, Web of Science, the Chinese National Knowledge
Infrastructure (CNKI), the Chinese Scientific Journal Database (CSJD), the
Chinese Biomedical Literature Database (CBM), and Wanfang DATA. The
following search terms will be used: (Huangqi OR Huang Qi OR Astragalus OR
radix astragali) AND (acute myocardial infaction OR myocardial infaction
OR AMI) AND (randomized controlled trial OR RCT OR randomized). No
language limitations and the searches will be conducted up to March, 2019.
Inclusion criteria: Randomized controlled trial (RCT) of Astragalus
(Huangqi) preparation in patients with AMI. Main outcome measures will be
left ventricular end systolic volume (LVESV), left ventricular end
diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), left
ventricularmass index (LVMI), recanalization rate,mortality rate,
incidence of reperfusion arrhythmias, postinfarction angina pectoris, and
re-infarction rate. Secondary outcome indicators were the incidence of
adverse reactions and the effective rate of traditional Chinese medicine
(TCM) treatment. Two independent reviewers will filter the literature and
extract data which based to the Cochrane manual. The relevant data,
including bias risk assessment, data synthesis, subgroup analysis,
meta-analysis, and finalmeta-analysis, will be analyzedwithRevMan 5.3
software. The funnel diagramwill be used to evaluate the reported
deviation, and the Egger test will be used to evaluate the symmetry of the
funnel graph. Result(s): This systematic review study will provide a
clear basis for evaluating the efficacy and safety of Astragalus (Huangqi)
preparation with the treatment of AMI. Conclusion(s): This study will
provide an up-to-date evidence for evaluating the efficacy and safety of
Astragalus (Huangqi) preparation. PROSPERO registration number:
CRD42019124843. Abbreviations: AMI = acute myocardial infarction, CABG =
coronary artery bypass graft, CBM = the Chinese Biomedical Literature
Database, CHM = Chinese Herbal Medicine, CI = confidence interval, CNKI =
the Chinese National Knowledge Infrastructure, CSJD = the Chinese
Scientific Journal Database, ECG = Electrocardiogram, GRADE = The Grading
of Recommendations Assessment, Development and Evaluation, LVEDV = left
ventricular end diastolic volume, LVEF = left ventricular ejection
fraction, LVESV = left ventricular end systolic volume, LVMI = left
ventricular mass index, PCI = percutaneous coronary intervention, PRISMA-P
= Preferred Reporting Items for Systematic Review and Meta-analysis
Protocols, RCT = randomized controlled trial, SMD = standardized mean
difference, TCM = traditional Chinese medicine. Copyright © 2019
the Author(s).

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