Results Generated From:
Embase <1980 to 2011 Week 32>
Embase (updates since 2011-08-04)
<1>
Accession Number
2011397965
Authors
Niccoli G. Leo A. Giubilato S. Cosentino N. Galassi A.R. Minelli S. Porto
I. Leone A.M. Burzotta F. Trani C. Crea F.
Institution
(Niccoli, Leo, Giubilato, Cosentino, Minelli, Porto, Leone, Burzotta,
Trani, Crea) Institute of Cardiology, Catholic University of the Sacred
Heart, Largo Agostino Gemelli, 8, 00168, Rome, Italy
(Galassi) Department of Cardiology, University of Catania, Catania, Italy
Title
A meta-analysis of first-generation drug-eluting vs bare-metal stents for
coronary chronic total occlusion: Effect of length of follow-up on
clinical outcome.
Source
International Journal of Cardiology. 150 (3) (pp 351-354), 2011. Date of
Publication: 04 Aug 2011.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
<2>
Accession Number
2011424892
Authors
Lazar H.L. McCann J. Fitzgerald C.A. Cabral H.J.
Institution
(Lazar, McCann, Fitzgerald, Cabral) Department of Cardiothoracic Surgery,
Boston Medical Center, Boston University School of Medicine, 88 East
Newton Street, Boston, MA 02118, United States
Title
Adhesive strips versus subcuticular suture for mediansternotomy wound
closure.
Source
Journal of Cardiac Surgery. 26 (4) (pp 344-347), 2011. Date of
Publication: July 2011.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
Background and Aim: This prospective randomized study was undertaken to
compare the use of the 3M Steri-Strip S Surgical Skin closure system with
a running absorbable subcuticular suture technique for skin closure
following a mediansternotomy for cardiac surgical procedures. Methods:
Thirty-six patients undergoing a mediansternotomy for a cardiac surgical
procedure were prospectively randomized to either Steri-Strip S or
subcuticular suture for wound closure. The wounds were evaluated on
postoperative days 7 and 21 for erythema, edema, pain, cosmesis, and the
time taken to close the incision. Results: Skin closure with Steri-Strip S
was faster (5.33 +/- 1.32 minutes steri-strips vs. 6.07 +/- 0.91 sutures;
p = 0.06) and resulted in significantly less erythema and edema, but no
difference in pain or cosmesis after seven days. Following 21 days, there
was no difference in pain, edema, or cosmesis between the groups. However,
patients receiving steri-strips continue to have less erythema.
Conclusions: Both Steri-Strip S and absorbable sutures are effective
techniques for skin closure following a mediansternotomy incision for
cardiac surgical procedures. Steri-Strip S can decrease the amount of
erythema, but results in no significant difference in pain, cosmesis, or
edema compared to the traditional subcuticular wound closure technique.
2011 Wiley Periodicals, Inc.
<3>
Accession Number
21699760
Authors
Grus T. Lambert L. Grusova G. Rohn V. Lindner J.
Institution
(Grus) 2nd Department of Surgery - Department of Cardiovascular Surgery,
First Faculty of Medicine, Charles University in Prague and General
University Hospital in Prague, Prague, Czech Republic.
Title
Endoscopic versus mini-invasive radial artery graft harvesting for
purposes of aortocoronary bypass.
Source
Prague medical report. 112 (2) (pp 115-123), 2011. Date of Publication:
2011.
Abstract
The aim of the study was to compare three different methods of radial
artery harvesting with regard to postoperative complications and
perioperative stress of the patient. A total of 60 patients admitted for
coronary artery bypass surgery were randomized into three groups. Each
patient underwent extraction of radial artery, all performed by a single
surgeon. The radial artery was harvested by one of the following three
techniques: classical technique (20 patients), mini-invasive technique
(20), and endoscopic technique (20). The time required for the graft
harvest was greater in the group where the endoscopic technique was used
(52.6 +/- 11.3 min) than with the mini-invasive (41.5 +/- 7.3 min) or the
classical (27.8 +/- 4.6 min) technique. Postoperative blood loss into
drains was higher where the classical technique was used (35.5 +/- 9.4 ml)
as compared to the mini-invasive (20 +/- 5 ml) or the endoscopic (10 +/-
7.3 ml) technique. There was no significant difference among the groups in
the rate of local neurological complications, contusion of wound edge,
edema of the extremity, or wound infection rate. We observed no case of
ischemia of the extremity, and a single case of postoperative myocardial
ischemia in the group where the classical technique was used. From a
clinical point of view, the mini-invasive and the endoscopic approach are
comparable, but the latter is more expensive. Both mini-invasive and
endoscopic techniques prolong the operation, reduce perioperative blood
loss, and require additional training time.
<4>
[Use Link to view the full text]
Accession Number
2011386819
Authors
Arora S. Ueland T. Wennerblom B. Sigurdadottir V. Eiskjaer H. Botker H.E.
Ekmehag B. Jansson K. Mortensen S.-A. Saunamaki K. Simonsen S. Gude E.
Bendz B. Solbu D. Aukrust P. Gullestad L.
Institution
(Arora, Simonsen, Gude, Bendz, Gullestad) Department of Cardiology, Oslo
University Hospital, Rikshospitalet, 0027 Oslo, Norway
(Arora, Ueland, Aukrust) Research Institute of Internal Medicine, Oslo
University Hospital, Rikshospitalet, Oslo, Norway
(Ueland) Department of Endocrinology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
(Ueland, Aukrust) Section of Clinical Immunology and Infectious Diseases,
Oslo University Hospital, Rikshospitalet, Oslo, Norway
(Wennerblom, Sigurdadottir) Department of Cardiology, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Eiskjaer, Botker) Department of Cardiology, Skejby University Hospital,
Aarhus, Denmark
(Ekmehag) Department of Cardiology, Skane University Hospital, Lund,
Sweden
(Jansson) Heart Center University Hospital, Linkoping, Sweden
(Mortensen, Saunamaki) Department of Cardiology, Rigshospitalet,
Copenhagen, Denmark
(Solbu) Novartis, Oslo, Norway
(Aukrust, Gullestad) Faculty of Medicine, University of Oslo, Oslo, Norway
Title
Effect of everolimus introduction on cardiac allograft
vasculopathy-results of a randomized, multicenter trial.
Source
Transplantation. 92 (2) (pp 235-243), 2011. Date of Publication: 27 Jul
2011.
Publisher
Lippincott Williams and Wilkins (351 West Camden Street, Baltimore MD
21201-2436, United States)
Abstract
Background. Everolimus reduces the progression of cardiac allograft
vasculopathy (CAV) in de novo heart transplant (HTx) recipients, but the
influence on established CAV is unknown. Methods. In this Nordic Certican
Trial in Heart and lung Transplantation substudy, 111 maintenance HTx
recipients (time post-HTx 5.8+/-4.3 years) randomized to
everolimus+reduced calcineurin inhibitor (CNI) or standard CNI had
matching (intravascular ultrasound) examinations at baseline and 12 months
allowing accurate assessment of CAV progression. Results. No significant
difference in CAV progression was evident between the treatment groups
(P=0.30). When considering patients receiving concomitant azathioprine
(AZA) therapy (n=39), CAV progression was attenuated with everolimus
versus standard CNI (maximal intimal thickness 0.00+/-0.04 and 0.04+/-0.04
mm, percent atheroma volume 0.2%+/-3.0% and 2.6%+/-2.5%, and total
atheroma volume 0.25+/-14.1 and 19.8+/-20.4 mm, respectively [P<0.05]).
When considering patients receiving mycophenolate mofetil (MMF),
accelerated CAV progression occurred with everolimus versus standard CNI
(maximal intimal thickness 0.06+/-0.12 vs. 0.02+/-0.06 mm and percent
atheroma volume 4.0%+/-6.3% vs. 1.4%+/-3.1%, respectively; P<0.05). The
levels of C-reactive protein and vascular cell adhesion molecule-1
declined significantly with AZA+everolimus, whereas MMF+everolimus
patients demonstrated a significant increase in levels of C-reactive
protein, vascular cell adhesion molecule-1, and von Willebrand factor.
Conclusions. Conversion to everolimus and reduced CNI does not influence
CAV progression among maintenance HTx recipients. However, background
immunosuppressive therapy is important as AZA+everolimus patients
demonstrated attenuated CAV progression and a decline in inflammatory
markers, whereas the opposite pattern was seen with everolimus+MMF. The
different effect of everolimus when combined with AZA versus MMF could
potentially reflect hitherto unknown interactions. 2011 Lippincott
Williams & Wilkins.
<5>
Accession Number
2011273179
Authors
Kramer C.K. Rodrigues T.C. Canani L.H. Gross J.L. Azevedo M.J.
Institution
(Kramer, Rodrigues, Canani, Gross, Azevedo) Division of Endocrinology,
Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande
do Sul, Porto Alegre, Rio Grande do Sul, Brazil
Title
Diabetic retinopathy predicts all-cause mortality and cardiovascular
events in both type 1 and 2 diabetes: Meta-analysis of observational
studies.
Source
Diabetes Care. 34 (5) (pp 1238-1244), 2011. Date of Publication: May
2011.
Publisher
American Diabetes Association Inc. (1701 North Beauregard St., Alexandria
VA 22311, United States)
Abstract
OBJECTIVE - The prognostic significance of diabetic retinopathy (DR) for
death and cardiovascular (CV) outcomes is debated. We investigated the
association of DR with all-cause mortality and CV events in patients with
diabetes by a systematic review and meta-analysis. RESEARCH DESIGN AND
METHODS - The electronic databases Medline and Embase were searched for
cohort studies that evaluated DR in type 2 or type 1 diabetic patients and
reported total mortality and/or fatal and nonfatal CV events, including
myocardial infarction, angina pectoris, coronary artery bypass graft,
ischemic changes on a conventional 12-lead electrocardiogram, transient
ischemic attack, nonfatal stroke, or lower leg amputation. Data extraction
was performed by two reviewers independently. Pooled effect estimates were
obtained by using random-effects meta-analysis. RESULTS - The analysis
included 20 studies that fulfilled the inclusion criteria, providing data
from 19,234 patients. In patients with type 2 diabetes (n = 14,896), the
presence of any degree of DR increased the chance for all-cause mortality
and/or CV events by 2.34 (95% CI 1.96-2.80) compared with patients without
DR. In patients with type 1 diabetes (n = 4,438), the corresponding odds
ratio was 4.10 (1.50-11.18). These associations remained after adjusting
for traditional CV risk factors. DR was also predictive of all-cause
mortality in type 2 diabetes (odds ratio 2.41 [1.87-3.10]) and type 1
diabetes (3.65 [1.05-12.66]). CONCLUSIONS - The presence of DR was
associated with an increased risk of all-cause mortality and CV events in
both type 2 and type 1 diabetic patients. 2011 by the American Diabetes
Association.
<6>
Accession Number
2011413094
Authors
Buba F.
Institution
(Buba) Department of Medicine (38), King Khalid University Hospital, King
Saud University, P. O. Box 7805, Riyadh 11472, Saudi Arabia
Title
Cardiovascular opportunistic infections in HIV disease.
Source
Biomedical Research. 22 (3) (pp 279-284), 2011. Date of Publication:
Jul-Sep 2011.
Publisher
Scientific Publishers of India (87- Greater Azad Enclave, Aligarh 202002,
India)
Abstract
Cardiovascular opportunistic infections are fairly encountered in patients
with HIV disease. The search on this topic was carried out electronically
via peer-reviewed articles in PubMed sources, Cochrane reviews and other
medically-oriented search engines. Most opportunistic infections occur
when the CD4 counts fall below 200/mL. The spectrum of presentations
in-cludes pericarditis, pericardial effusion, myocarditis, dilated
cardiomyopathy, endocarditis, pulmonary arterial hypertension and
aneurysmal disease. The incidence of these complica-tions showed
significant difference between the periods prior and after the
introduction of the highly active antiretroviral therapy (HAART). In
addition, some complications are pe-culiar to certain region of the world
notably tuberculous pericarditis in areas of endemic tu-berculosis. The
management of these conditions requires meticulous diagnosis, supportive
therapies, prompt detection and treatment of opportunistic infections.
Furthermore, the early institution of highly active antiretroviral therapy
had altered the course of most of the HIV-related cardiac complications.
The physicians managing these patients should also be aware of
complications of treatment and potential drug-drug interactions.
<7>
Accession Number
2011380444
Authors
Takagi H. Umemoto T.
Institution
(Takagi, Umemoto) Department of Cardiovascular Surgery, Shizuoka Medical
Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan
Title
A meta-analysis of randomized trials of triple versus dual antiplatelet
therapy after stent-based percutaneous coronary intervention.
Source
International Journal of Cardiology. 150 (2) (pp 228-230), 2011. Date of
Publication: 15 Jul 2011.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
<8>
Accession Number
2011405836
Authors
Wohrle J. Birkemeyer R. Markovic S. Nguyen T.-V. Sinha A. Miljak T. Spiess
J. Rottbauer W. Rittger H.
Institution
(Wohrle, Markovic, Nguyen, Spiess, Rottbauer) Clinic of Internal Medicine
II, University of Ulm, Ulm, Germany
(Birkemeyer, Miljak) Innere Medizin III Kardiologie, Schwarzwald-Baar
Klinikum, Villingen-Schwenningen, Germany
(Sinha, Rittger) Medizinische Klinik II, Klinikum Coburg, Coburg, Germany
Title
Prospective randomised trial evaluating a paclitaxel-coated balloon in
patients treated with endothelial progenitor cell capturing stents for de
novo coronary artery disease.
Source
Heart. 97 (16) (pp 1338-1342), 2011. Date of Publication: August 2011.
Publisher
BMJ Publishing Group (Tavistock Square, London WC1H 9JR, United Kingdom)
Abstract
Background: Percutaneous coronary intervention with stent implantation is
limited by the occurrence of re-stenosis and the risk of stent thromboses.
Objective: To define the impact of paclitaxel-coated balloon angioplasty
plus endothelial progenitor cell capturing (EPC) stent implantation in de
novo coronary artery disease. This combination may reduce neointimal
proliferation within the EPC stent and address the risk of stent
thrombosis by facilitating rapid endothelialisation. Methods: In this
prospective single-blind multicentre randomised trial, 120 patients with a
de novo lesion in a native coronary artery were randomly assigned to
undergo treatment with paclitaxel-coated balloon plus EPC stent or EPC
stent alone. Dual antiplatelet therapy was prescribed for 3 months.
Angiographic follow-up was scheduled at 6 months. The primary endpoint was
in-stent late lumen loss. The secondary clinical endpoint was a composite
of death from a cardiac cause, myocardial infarction attributed to the
target vessel or target lesion revascularisation. Results: There was no
difference in patient baseline characteristics or procedural results. The
angiographic follow-up rate was 96%. Treatment with paclitaxel-coated
balloon plus EPC stent was superior to EPC stent alone, with an in-stent
late loss of 0.34+/-0.45 mm versus 0.88+/-0.48 mm (p<0.001). The
re-stenosis rate was reduced from 23.2% to 5.1% (p=0.006) and the clinical
endpoint was reduced from 17.2% to 4.8% (p=0.039). There was no definite
or probable stent thrombosis. Conclusions: Paclitaxel-coated balloon plus
EPC stent implantation is superior to EPC stent implantation alone for
treatment of de novo coronary artery disease. Trial registration:
NCT00732953.
<9>
Accession Number
2011419203
Authors
Shi X.-Y. Zou Z. He X.-Y. Xu H.-T. Yuan H.-B. Liu H.
Institution
(Shi, Zou, He, Xu, Yuan, Liu) Department of Anaesthesiology, Changzheng
Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai
200003, China
Title
Hydroxyethyl starch for cardiovascular surgery: A systematic review of
randomized controlled trials.
Source
European Journal of Clinical Pharmacology. 67 (8) (pp 767-782), 2011.
Date of Publication: August 2011.
Publisher
Springer Verlag (Tiergartenstrasse 17, Heidelberg D-69121, Germany)
Abstract
Purpose: The objective of this study was to appraise the safety profiles
of HES preparations and to find out which HES preparation was the most
acceptable in cardiovascular surgery through a comparison with control
solutions. Methods: Pertinent randomized controlled trials were selected
through a search of Pubmed, Embase, and Cochrane Controlled Trials
Register. Quantitative and qualitative analysis was carried out to
evaluate blood loss, blood transfusion, renal function, complications,
reoperation, and mortality. Results: A total of 3,234 patients from 52
randomized controlled trials were included. HES preparations versus
control solutions in blood loss: HES 130 kD vs. albumin (SMD -0.61, 95% CI
-0.82, -0.40), HES 200 kD vs. albumin (SMD -0.01, 95% CI -0.29, 0.28), HES
450 kD vs. albumin (SMD 0.47, 95% CI 0.26, 0.68). When comparing control
solutions with HES preparations, 50% (HES 450 kD), 40.9% (HES 200 kD), and
18.2% (HES 130 kD) of the comparisons showed more blood/blood products
infusion with HES than with control solutions. A numerically lower
mortality rate seemed to be related to HES preparations (2.68 vs 4.23%).
No difference was found in terms of complications, renal failure, or
reoperation. Conclusions: Perioperative administration of HES preparations
is comparatively safe. The data appraising safety profiles of HES
preparations are insufficient to make direct comparisons among themselves.
As the third generation of HES preparations, HES 130 kD showed a trend
toward lower blood loss and transfusion rates and is a suitable choice for
cardiovascular surgery. 2011 Springer-Verlag.
<10>
Accession Number
2011379474
Authors
Aziz N.A. Chue M.C. Yong C.Y. Hassan Y. Awaisu A. Hassan J. Kamarulzaman
M.H.
Institution
(Aziz, Chue, Hassan, Awaisu) Department of Clinical Pharmacy, School of
Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, 11800 Penang,
Malaysia
(Yong, Hassan) Department of Anesthesiology and Intensive Care, Hospital
Pulau Pinang, 10900 Penang, Malaysia
(Kamarulzaman) Department of Cardiothoracic Surgery, Hospital Pulau
Pinang, 10900 Penang, Malaysia
Title
Efficacy and safety of dexmedetomidine versus morphine in post-operative
cardiac surgery patients.
Source
International Journal of Clinical Pharmacy. 33 (2) (pp 150-154), 2011.
Date of Publication: April 2011.
Publisher
Springer Netherlands (Van Godewijckstraat 30, Dordrecht 3311 GZ,
Netherlands)
Abstract
Objective To compare the efficacy of dexmedetomidine versus morphine as a
sedative/analgesic among post-operative cardiac surgery patients. Method A
randomized controlled open-label study was performed at the cardiothoracic
intensive care unit of Penang Hospital, Malaysia. A total of 28 patients
who underwent cardiac surgeries were randomly assigned to receive either
dexmedetomidine or morphine. Both groups were similar in terms of
preoperative baseline characteristics. Efficacy measures included sedation
scores and pain intensity and requirements for additional
sedative/analgesic. Mean heart rate and arterial blood pressure were used
as safety measures. Other measures were additional inotropes, extubation
time and other concurrent medications. Results The mean dose of
dexmedetomidine infused was 0.12 [SD 0.03] lg kg-1 h-1, while that of
morphine was 13.2 [SD 5.84] lg kg-1 h-1. Dexmedetomidine group showed more
benefits in sedation and pain levels, additional sedative/analgesic
requirements, and extubation time. No significant differences between the
two groups for the outcome measures, except heart rate, which was
significantly lower in the dexmedetomidine group. Conclusion This
preliminary study suggests that dexmedetomidine was at least comparable to
morphine in terms of efficacy and safety among cardiac surgery patients.
Further studies with larger samples are recommended in order to determine
the significant effects of the outcome measures. Copyright 2011 Springer
Science+Business Media B.V.
<11>
Accession Number
21735386
Authors
Heran B.S. Chen J.M. Ebrahim S. Moxham T. Oldridge N. Rees K. Thompson
D.R. Taylor R.S.
Institution
(Heran) Department of Anesthesiology, Pharmacology and Therapeutics,
University of British Columbia, 2176 Health Sciences Mall, Vancouver,
British Columbia, Canada, V6T 1Z3.
Title
Exercise-based cardiac rehabilitation for coronary heart disease.
Source
Cochrane database of systematic reviews (Online). (7) (pp CD001800),
2011. Date of Publication: 2011.
Abstract
The burden of coronary heart disease (CHD) worldwide is one of great
concern to patients and healthcare agencies alike. Exercise-based cardiac
rehabilitation aims to restore patients with heart disease to health. To
determine the effectiveness of exercise-based cardiac rehabilitation
(exercise training alone or in combination with psychosocial or
educational interventions) on mortality, morbidity and health-related
quality of life of patients with CHD. RCTs have been identified by
searching CENTRAL, HTA, and DARE (using The Cochrane Library Issue 4,
2009), as well as MEDLINE (1950 to December 2009), EMBASE (1980 to
December 2009), CINAHL (1982 to December 2009), and Science Citation Index
Expanded (1900 to December 2009). Men and women of all ages who have had
myocardial infarction (MI), coronary artery bypass graft (CABG) or
percutaneous transluminal coronary angioplasty (PTCA), or who have angina
pectoris or coronary artery disease defined by angiography. Studies were
selected and data extracted independently by two reviewers. Authors were
contacted where possible to obtain missing information. This systematic
review has allowed analysis of 47 studies randomising 10,794 patients to
exercise-based cardiac rehabilitation or usual care. In medium to longer
term (i.e. 12 or more months follow-up) exercise-based cardiac
rehabilitation reduced overall and cardiovascular mortality [RR 0.87 (95%
CI 0.75, 0.99) and 0.74 (95% CI 0.63, 0.87), respectively], and hospital
admissions [RR 0.69 (95% CI 0.51, 0.93)] in the shorter term (< 12 months
follow-up) with no evidence of heterogeneity of effect across trials.
Cardiac rehabilitation did not reduce the risk of total MI, CABG or PTCA.
Given both the heterogeneity in outcome measures and methods of reporting
findings, a meta-analysis was not undertaken for health-related quality of
life. In seven out of 10 trials reporting health-related quality of life
using validated measures was there evidence of a significantly higher
level of quality of life with exercise-based cardiac rehabilitation than
usual care. Exercise-based cardiac rehabilitation is effective in reducing
total and cardiovascular mortality (in medium to longer term studies) and
hospital admissions (in shorter term studies) but not total MI or
revascularisation (CABG or PTCA). Despite inclusion of more recent trials,
the population studied in this review is still predominantly male, middle
aged and low risk. Therefore, well-designed, and adequately reported RCTs
in groups of CHD patients more representative of usual clinical practice
are still needed. These trials should include validated health-related
quality of life outcome measures, need to explicitly report clinical
events including hospital admission, and assess costs and
cost-effectiveness.
<12>
Accession Number
2011417494
Authors
Imazio M. Brucato A. Markel G. Cemin R. Trinchero R. Spodick D.H. Adler Y.
Institution
(Imazio, Trinchero) Cardiology Department, Maria Vittoria Hospital, Turin,
Italy
(Brucato) Departement of Medicine, Ospedali Riuniti, Bergamo, Italy
(Markel, Adler) Cardiac Rehabilitation Institute, Chaim Sheba Medical
Center, Tel-Hashomer, Israel
(Cemin) Department of Cardiology, San Maurizio Regional Hospital, Bolzano,
Italy
(Spodick) Department of Medicine, St. Vincent Hospital, University of
Massachusetts, Worcester, MA, United States
(Markel) Sackler Faculty of Medicine, Tel Aviv, Israel
(Markel) Misgav Ladach Hospital, Jerusalem, Israel
(Markel) Kupat Holim Meuhedet, Israel
Title
Meta-analysis of randomized trials focusing on prevention of the
postpericardiotomy syndrome.
Source
American Journal of Cardiology. 108 (4) (pp 575-579), 2011. Date of
Publication: 15 Aug 2011.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
The natural history of postpericardiotomy syndrome (PPS), a relatively
common complication of cardiac surgery, varies from mild self-limited
episodes to cases with protracted courses, recurrences, and readmissions.
Preventive strategies may be valuable to decrease morbidity and management
costs. We thus aimed to conduct a comprehensive systematic review on
available data for pharmacologic primary prevention of PPS. Controlled
clinical studies were searched in several databases and were included
provided they focused on pharmacologic primary prevention of PPS.
Random-effect odds ratios (ORs) were computed for occurrence of PPS. From
the initial sample of 343 citations, 4 controlled clinical trials for
primary prevention of PPS were finally included (894 patients); 3 studies
were double-blind randomized controlled trials (RCTs). Treatment
comparisons were colchicine versus placebo (2 RCTs enrolling 471
patients), methylprednisolone versus placebo (1 RCT on 246 pediatric
patients), and aspirin versus historical controls (1 nonrandomized study
on 177 pediatric patients). Meta-analytic pooling showed that colchicine
was associated with decreased risk of PPS (OR 0.38, 0.22 to 0.65). Data on
methylprednisolone (OR 1.13, 0.57 to 2.25) or aspirin (OR 1.00, 0.16 to
6.11) were negative but inconclusive because these were based on 1 study
and/or a nonrandomized design. In conclusion, clinical evidence for
primary prevention of PPS is still limited to few studies of variable
quality. Nevertheless, available data suggest a beneficial profile for
colchicine and open a new therapeutic strategy for prevention of PPS.
2011 Elsevier Inc.
<13>
Accession Number
2011407822
Authors
Beijk M.A.M. Klomp M. Van Geloven N. Koch K.T. Henriques J.P.S. Baan J.
Vis M.M. Tijssen J.G.P. Piek J.J. De Winter R.J.
Institution
(Beijk, Klomp, Van Geloven, Koch, Henriques, Baan, Vis, Tijssen, Piek, De
Winter) Department of Cardiology, Academic Medical Center, University of
Amsterdam, B2-213, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
Title
Two-year follow-up of the genous endothelial progenitor cell capturing
stent versus the taxus liberte stent in patients with de Novo coronary
artery lesions with a high-risk of restenosis: A randomized,
single-center, pilot study.
Source
Catheterization and Cardiovascular Interventions. 78 (2) (pp 189-195),
2011. Date of Publication: 01 Aug 2011.
Publisher
Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)
Abstract
Background: In the prospective randomized TRIAS pilot study, the
bio-engineered Genous endothelial progenitor cell capturing stent was
compared with the Taxus Liberte SR paclitaxel-eluting stent. At 1 yr, a
statistically nonsignificant difference in the rates of target vessel
failure (cardiac death, myocardial infarction, or target vessel
revascularization) was observed. We have evaluated the safety and efficacy
up to 2 yr. Methods: A total of 193 patients with de novo coronary artery
lesions carrying a high risk of restenosis were randomized to a Genous
stent versus a Taxus stent. Dual antiplatelet therapy was prescribed for
>=1 month after Genous stent implantation and for >=6 months after a Taxus
stent. Results: Between 1 and 2 yr, patients treated with the Genous stent
tended to have fewer episodes of target lesion revascularization (2.0%
versus 5.3%), but nearly similar rates of cardiac death (1.0% versus 0%),
myocardial infarction (0% versus 1.1%), and stent thrombosis (0% versus
1.1%) when compared with the Taxus stent. As a result, at 2-yr follow-up
treatment with the Genous stent compared with the Taxus stent resulted in
a nonsignificant difference in target vessel failure (TVR) (20.4% versus
15.8%; risk difference 4.6%, 95% CI -6.2-15.5%). No stent thrombosis was
observed in the Genous group compared to five cases (in four patients) in
the Taxus group, resulting in a difference as compared with the Taxus
stent (risk difference -4.2%; 95%CI -8.2% to -0.2%). Conclusions: In the
TRIAS pilot study, treatment of coronary artery lesions carrying a high
risk of restenosis with the Genous compared with the Taxus stent resulted
in a nonsignificant difference of TVR at 2-yr follow-up, with convergence
of the Kaplan-Meier curves between 1 and 2 yr. Stent thrombosis was only
observed after Taxus stent implantation. Copyright 2011 Wiley-Liss, Inc.
<14>
Accession Number
2011405480
Authors
Samantaray A. Hemanth N.
Institution
(Samantaray, Hemanth) Department of Anesthesiology and Critical Care, Sri
Venkateswara Institute of Medical Sciences, Tirupati 517507, Andhra
Pradesh, India
Title
Comparison of two ventilation modes in post-cardiac surgical patients.
Source
Saudi Journal of Anaesthesia. 5 (2) (pp 173-178), 2011. Date of
Publication: April-June 2011.
Publisher
Medknow Publications and Media Pvt. Ltd (B9, Kanara Business Centre, off
Link Road, Ghatkopar (E), Mumbai 400 075, India)
Abstract
Background: The cardiopulmonary bypass (CPB)-associated atelectasis
accounted for most of the marked post-CPB increase in shunt and hypoxemia.
We hypothesized that pressure-regulated volume-control (PRVC) modes having
a distinct theoretical advantage over pressure-controlled ventilation
(PCV) by providing the target tidal volume at the minimum available
pressure may prove advantageous while ventilating these atelactic lungs.
Methods: In this prospective study, 36 post-cardiac surgical patients with
a PaO <sub>2</sub> /FiO <sub>2</sub> (arterial oxygen tension/Fractional
inspired oxygen) < 300 after arrival to intensive care unit (ICU), (n =
34) were randomized to receive either PRVC or PCV. Air way pressure
(P<sub>aw</sub> ) and arterial blood gases (ABG) were measured at four
time points [T1: After induction of anesthesia, T2: after CPB (in the
ICU), T3: 1 h after intervention mode, T4: 1 h after T3]. Oxygenation
index (OI) = [PaO <sub>2</sub> / {FiO <sub>2</sub> mean airway pressure
(P<sub>mean</sub> )}] was calculated for each set of data and used as an
indirect estimation for intrapulmonary shunt. Results: There is a steady
and significant improvement in OI in both the groups at first hour [PCV,
27.5(3.6) to 43.0(7.5); PRVC, 26.7(2.8) to 47.6(8.2) (P = 0.001)] and
second hour [PCV, 53.8(6.4); PRVC, 65.8(7.4) (P = 0.001)] of ventilation.
However, the improvement in OI was more marked in PRVC at second hour of
ventilation owing to significant low mean air way pressure compared to the
PCV group [PCV, 8.6(0.8); PRVC, 7.7(0.5), P = 0.001]. Conclusions: PRVC
may be useful in a certain group of patients to reduce intrapulmonary
shunt and improve oxygenation after cardiopulmonary bypass-induced
perfusion mismatch.
<15>
Accession Number
2011405476
Authors
Sajedi P. Yaraghi A. Dehdari Zadeh M.T.D.
Institution
(Sajedi, Yaraghi, Dehdari Zadeh) Anesthesiology and Critical Care Research
Center, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
Title
Comparison of pre- vs. post-incisional caudal bupivacaine for
postoperative analgesia in unilateral pediatric herniorrhaphy: A
double-blind randomized clinical trial.
Source
Saudi Journal of Anaesthesia. 5 (2) (pp 157-161), 2011. Date of
Publication: April-June 2011.
Publisher
Medknow Publications and Media Pvt. Ltd (B9, Kanara Business Centre, off
Link Road, Ghatkopar (E), Mumbai 400 075, India)
Abstract
Introduction: This study was designed to evaluate the pre- vs.
post-incisional analgesic efficacy of bupivacaine administered caudally in
children undergoing unilateral hernia repair. Methods: Fifty children aged
6 months to 6 years were included in the study. Children were divided
blindly between the two groups to receive pre- vs. post-incisional caudal
bupivacaine. The preincisional group received 1 ml/kg of 0.125%
bupivacaine caudally after induction of anesthesia and the postincisional
group received the same dose caudally at the end of surgery. Heart rate,
SaO <sub>2</sub> , end tidal CO <sub>2</sub> , and noninvasive arterial
blood pressure were recorded every 10 min. The duration of surgery,
extubation time, and duration of recovery period were also recorded. The
pain scores were measured with using an Oucher chart in the recovery room,
2, 4, 6, 12, and 24 h after surgery. Time to first analgesia, numbers of
supplementary analgesics required by each child in a 24-h period and total
analgesic consumptions were recorded. Any local and systemic complications
were recorded. Quantitative data were compared using a two-tailed t-test.
Sex distribution and frequency of acetaminophen consumption were measured
using <sup>2</sup> test. P<0.05 was considered statistically significant.
Results: The Oucher pain scale at 4, 6, 12, and 24 h after surgery, the
total analgesic consumption and the numbers of demand for supplemental
acetaminophen were lower statistically in preincisional group ( P<0.05).
Extubation time and duration were higher in preincisional group ( P<0.05).
Mean changes of heart rates were statistically lower during the anesthesia
period and recovery time in preincisional group (P<0.05). Conclusion:
Preincisional caudal analgesia with a single injection of 0.125%
bupivacaine is more effective than the postincisional one for
postoperative pain relief and analgesic consumption in unilateral
pediatric herniorrhaphy.
<16>
Accession Number
2011413605
Authors
Goodacre S. Bradburn M. Fitzgerald P. Cross E. Collinson P. Gray A. Hall
A.S.
Institution
(Goodacre, Bradburn, Fitzgerald, Cross) School of Health and Related
Research, University of Sheffield, Sheffield, United Kingdom
(Collinson) St George's Hospital, London, United Kingdom
(Gray) Royal Infirmary of Edinburgh, Lothian Health Board, Edinburgh,
United Kingdom
(Hall) Leeds Institute of Genetics, Health and Therapeutics, University of
Leeds, Leeds, United Kingdom
Title
The RATPAC (randomised assessment of treatment using panel assay of
cardiac markers) trial: A randomized controlled trial of point-of-care
cardiac markers in the emergency department.
Source
Health Technology Assessment. 15 (23) (pp 1-108), 2011. Date of
Publication: May 2011.
Publisher
National Co-ordinating Centre for HTA (Bouldrewood, Mail Point 728,
Highfield, Southhampton, United Kingdom)
Abstract
Objectives: To evaluate the clinical effectiveness and cost-effectiveness
of using a pointof- care cardiac marker panel in patients presenting to
the emergency department (ED) with suspected but not proven acute
myocardial infarction (AMI). Design: Multicentre pragmatic open randomised
controlled trial and economic evaluation. Setting: Six acute hospital EDs
in the UK. Participants: Adults presenting to hospital with chest pain due
to suspected but not proven myocardial infarction, and no other
potentially serious alternative pathology or comorbidity. Interventions:
Participants were allocated using an online randomisation system to
receive either (1) diagnostic assessment using the point-of-care
biochemical marker panel or (2) conventional diagnostic assessment without
the panel. All tests and treatments other than the panel were provided at
the discretion of the clinician. Main outcome measures: The primary
outcome was the proportion of patients successfully discharged home after
ED assessment, defined as patients who had (1) either left the hospital or
were awaiting transport home with a discharge decision having been made at
4 hours after initial presentation and (2) suffered no major adverse event
(as defined below) during the following 3 months. Secondary outcomes
included length of initial hospital stay and total inpatient days over 3
months, and major adverse events (death, non-fatal AMI, life-threatening
arrhythmia, emergency revascularisation or hospitalisation for myocardial
ischaemia). Economic analysis estimated mean costs and quality-adjusted
life-years (QALYs), and then estimated the probability of
cost-effectiveness assuming willingness to pay of 20,000 per QALY gained.
Results: We randomised 1132 participants to point of care and 1131 to
standard care, and analysed 1125 and 1118, respectively [mean age 54.5
years, 1307/2243 (58%) male and 269/2243 (12%) with known coronary heart
disease (CHD)]. In the point-of-care group 358/1125 (32%) were
successfully discharged compared with 146/1118 (13%) in the standard-care
group [odds ratio (OR) adjusted for age, gender and history of CHD 3.81;
95% confidence interval (CI) 3.01 to 4.82, p < 0.001]. Mean length of the
initial hospital stay was 29.6 hours versus 31.8 hours (mean difference =
2.1 hours; 95% CI -3.7 to 8.0 hours, p = 0.462), while median length of
initial hospital stay was 8.8 hours versus 14.2 hours (p < 0.001). More
patients in the point-of-care group had no inpatient days recorded during
follow-up (54% vs 40%, p < 0.001), but mean inpatient days did not differ
between the two groups (1.8 vs 1.7, p = 0.815). More patients in the
point-of-care group were managed on coronary care [50/1125 (4%) vs 31/1118
(3%), p = 0.041]. There were 36 (3%) patients with major adverse events in
the point-of-care group and 26 (2%) in the standard-care group (adjusted
OR 1.31; 95% CI 0.78 to 2.20, p = 0.313). Mean costs per patient were 1217
with point-of-care versus 1006 with standard care (p = 0.056), while mean
QALYs were 0.158 versus 0.161 (p = 0.250). The probability of standard
care being dominant (i.e. cheaper and more effective) was 0.888.
Conclusions: Point-of-care testing increases the proportion of patients
successfully discharged home and reduces the median (but not mean) length
of hospital stay. It is more expensive than standard care and unlikely to
be considered cost-effective. Trial registration: Current Controlled
Trials ISRCTN37823923. Funding: This project was funded by the NIHR Health
Technology Assessment programme and will be published in full in Health
Technology Assessment; Vol. 15, No. 23. See the HTA programme website for
further project information. Queen's Printer and Controller of HMSO 2011.
<17>
Accession Number
2011422577
Authors
Zeydi A.E. Jafari H. Khani S. Esmaeili R. Baradari A.G.
Institution
(Zeydi, Jafari, Esmaeili) Department of Medical-Surgical Nursing, Faculty
of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari,
Iran, Islamic Republic of
(Khani) Department of Midwifery, Faculty of Nursing and Midwifery,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Baradari) Department of Anesthesiology, Faculty of Medicine, Mazandaran
University of Medical Sciences, Sari, Iran, Islamic Republic of
Title
The effect of music on the vital signs and SpO2; of patients after open
heart surgery: A randomized clinical trial.
Source
Journal of Mazandaran University of Medical Sciences. 20 (82) (pp 72-82),
2011. Date of Publication: 2011.
Publisher
Mazandaran University of Medical Sciences (No.2, Moallem Square, Sari,
Mazandaran 4817844718, Iran, Islamic Republic of)
Abstract
Background and purpose: The monitoring of the patients' hemodynamic status
and vital signs is a routine practice in ICU and the use of a low-cost and
soothing method to maintain stable physiological parameters is necessary.
This study aimed at investigating the effect of music on the vital signs
and SpO<sub>2</sub>; of patients after open heart surgery. Materials and
methods: This study was a randomized clinical trial (RCT) conducted on 60
patients hospitalized in the open heart surgery ICU of Mazandaran Heart
Center. Patients were randomly assigned into case and control groups. In
the case group, the patients listened to the music, which they selected
before, through headphones for 30 minutes, while headphones without
playing any music were used for patients in the control group. Vital signs
and SpO<sub>2</sub>; of the patients were assessed before the
intervention, immediately, 30 and 60 minutes after the intervention. The
data were analyzed using Chisquare; T-test and repeated measure
statistical tests. Results: Findings showed that music led to a
significant decrease in the rate of heartbeat, systolic blood pressure,
and mean arterial pressure and a significant increase in SpO<sub>2</sub>;
rate (P<0.05) was also observed. But music had no significant effect on
the respiratory rate and diastolic blood pressure (P>0.05). Conclusion: As
a non-pharmacologic, inexpensive, non-invasive method and without any side
effects, music can improve the vital signs of the patients after open
heart surgery.
