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Penetrating aortic ulcer post migration of thoracic aortic endoprosthesis: Case report.

Int J Surg Case Rep 2021 Jul 20;85:106219. Epub 2021 Jul 20.

Vascular Surgery Unit, AOUP Policlinico 'P. Giaccone', Palermo, Italy; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy.

Introduction: Thoracic endovascular aortic repair (TEVAR) is the first treatment option for many thoracic aortic pathologies. Especially after aortic dissections, it is possible to have progression during follow-up with appearance of new lesions on arterial wall. Herein, we report a case of Penetrating Aortic Ulcer (PAU) post release of Thoracic endoprosthesis. Read More

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Added burden of major depressive disorder on cardiovascular morbidity and mortality among patients with cardiovascular disease and the modifying effects of antidepressants: A national retrospective cohort study.

J Affect Disord 2021 Jul 22;294:580-585. Epub 2021 Jul 22.

Department of Healthcare Administration, Asia University, Taiwan; Department of Psychology, Asia University, Taiwan. Electronic address:

Background: To evaluate the likelihood of a future cardiovascular event (i.e., in-hospital mortality or cardiovascular disease [CVD] complications/interventions) among patients with CVD and major depressive disorder (MDD) compared to those without MDD, and the antidepressant use on future cardiovascular events between the two groups. Read More

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Endocytosis of peroxiredoxin 1 links sterile inflammation to immunoparalysis in pediatric patients following cardiopulmonary bypass.

Redox Biol 2021 Jul 28;46:102086. Epub 2021 Jul 28.

Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taiwan; Center of Precision Medicine, College of Medicine, National Taiwan University, Taiwan. Electronic address:

After cardiopulmonary bypass (CPB), the occurrence of systemic inflammatory response is often accompanied by a persistent compensatory anti-inflammatory response syndrome that can lead to a compromised immune competence termed immunoparalysis, rendering the patients susceptible to infections which is a leading complication following cardiac surgery. However, the underlying mechanisms of CPB-elicited immunoparalysis remain obscure. In this study we showed that peroxiredoxin 1 (Prdx1), a putative cytosolic antioxidant, was released immediately after CPB in a cohort of pediatric patients receiving congenital cardiac surgery. Read More

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Comparison of Surgical Invasiveness and Morbidity of Adult Spinal Deformity Surgery to Other Major Operations.

Spine J 2021 Jul 28. Epub 2021 Jul 28.

Department of Orthopaedic Surgery, Och Spine Hospital, Columbia University Medical Center, New York, NY; Department of Neurological Surgery, Vanderbilt University, Nashville, TN. Electronic address:

Background Context: Adult spinal deformity (ASD) surgeries are complex, involving long operative times and surgical morbidity. It is currently unclear how the invasiveness of ASD surgery compares to other major operations.

Purpose: To: a) develop a quantitative metric of surgical morbidity and invasiveness, and b) compare this score between ASD surgery and other major operations. Read More

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The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care.

J Hosp Infect 2021 Jul 28. Epub 2021 Jul 28.

Department of Diabetes and Endocrinology, Royal Melbourne Hospital; Department of Medicine, Royal Melbourne Hospital, University of Melbourne.

Background: Although diabetes is a recognised risk factor for post-operative infections, the seminal Portland Diabetic Project studies in cardiac surgery demonstrated intravenous insulin infusions following open-cardiac surgery achieved near normal glycaemia and decreased deep sternal wound infection to similar rates to those without diabetes.

Aim: We sought to examine a contemporary cohort of patients undergoing coronary artery bypass graft surgery (CABGS) to evaluate the relationship between diabetes, hyperglycaemia and risk of surgical site infection (SSI) in current-era models of care.

Methods: Consecutive patients who underwent CABGS between 2016 and 2018 were identified through a state-wide data repository for healthcare-associated infections. Read More

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A systematic review of carbohydrate-based microneedles: current status and future prospects.

J Mater Sci Mater Med 2021 Jul 31;32(8):89. Epub 2021 Jul 31.

Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, Vile Parle [W], Mumbai, 400056, Maharashtra, India.

Microneedles (MNs) are minimally invasive tridimensional biomedical devices that bypass the skin barrier resulting in systemic and localized pharmacological effects. Historically, biomaterials such as carbohydrates, due to their physicochemical properties, have been used widely to fabricate MNs. Owing to their broad spectrum of functional groups, carbohydrates permit designing and engineering with tunable properties and functionalities. Read More

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Characteristics and outcomes of unsuccessful percutaneous coronary intervention.

Catheter Cardiovasc Interv 2021 Jul 31. Epub 2021 Jul 31.

School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Objectives: To examine predictors and outcomes of unsuccessful percutaneous coronary intervention (PCI) cases in a contemporary Australian registry cohort.

Background: With improvements in techniques and pharmacotherapy in PCI, more complex lesions in older patients are now being attempted. In the context of PCI performance assessment, there are limited data regarding the characteristics and outcomes of unsuccessful PCI. Read More

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Giant aneurysmal coronary artery fistula originating from the left circumflex artery: Two case reports.

J Card Surg 2021 Jul 30. Epub 2021 Jul 30.

Department of Thoracic and Cardiovascular Surgery, Saga University Faculty of Medicine, Saga, Japan.

Coronary artery fistula (CAF) is one of the most common coronary artery anomalies. The most common fistulas originate from the right coronary artery and drain into the right heart structures. Due to the variety of coronary fistulas, the surgical treatment strategy is individualized for each case. Read More

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Endoscopic Evaluation and Management of Late Complications After Bariatric Surgery: a Narrative Review.

Obes Surg 2021 Jul 30. Epub 2021 Jul 30.

The Center for the Treatment of Obesity and Diabetes, Hospital Oswaldo Cruz, Sao Paulo, Brazil.

Despite ongoing evolution in technique and a low mortality rate, clinicians may care for patients who suffer late complications (> 90 days of surgery) after bariatric surgery. Endoscopic techniques are used to identify and manage many of the late complications of the two most commonly performed bariatric surgeries: sleeve gastrectomy and Roux-en-Y gastric bypass. Stenosis at the incisura angularis and gastroesophageal reflux disease may occur in patients who have undergone a sleeve gastrectomy. Read More

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Early invasive coronary angiography and acute ischaemic heart failure outcomes.

Eur Heart J 2021 Jul 30. Epub 2021 Jul 30.

Department of Medicine, University of Toronto, Toronto, ON, Canada.

Aims : While myocardial ischaemia plays a major role in the pathogenesis of heart failure (HF), the indications for coronary angiography during acute HF are not established. We determined the association of early coronary angiography during acute HF hospitalization with 2-year mortality, cardiovascular death, HF readmissions, and coronary revascularization.

Methods And Results : In a two-stage sampling process, we identified acute HF patients who presented to 70 emergency departments in Ontario (April 2010 to March 2013) and determined whether they underwent early coronary angiography within 14 days after presentation using administrative databases. Read More

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Coronary Artery Bypass Grafting in Patients With High Risk of Bleeding.

Heart Lung Circ 2021 Jul 27. Epub 2021 Jul 27.

Research Unit of Surgery, Anesthesiology and Critical Care, University of Oulu, Oulu, Finland; Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Department of Surgery, University of Turku, Turku, Finland.

Background: Postoperative bleeding after cardiac surgery is associated with increased morbidity and mortality. We tested the hypothesis that patients with a preoperatively estimated high risk of severe perioperative bleeding may have impaired early outcome after on-pump versus off-pump coronary artery bypass grafting (CABG).

Method: Data from 7,352 consecutive patients who underwent isolated CABG from January 2015 to May 2017 were included in the multicentre European Coronary Artery Bypass Grafting registry. Read More

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Survival of Tricuspid Valve Replacement in Patients With Previous Tricuspid Valve Surgery.

Heart Lung Circ 2021 Jul 27. Epub 2021 Jul 27.

Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Vessel Disease, Beijing, China. Electronic address:

Objectives: This study was performed to investigate the short-term and long-term survival of patients who underwent reoperative tricuspid valve replacement (TVR).

Methods: A retrospective analysis was performed of 273 patients who underwent TVRs while hospitalised in Beijing Anzhen Hospital from November 1993 to August 2018. Fifty-six (56) of them underwent reoperative TVR: 36 had previous tricuspid valve repair and 20 had previous TVR. Read More

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Preoperative weight loss is linked to improved mortality and leaks following elective bariatric surgery: an analysis of 548,597 patients from 2015-2018.

Surg Obes Relat Dis 2021 Jul 7. Epub 2021 Jul 7.

Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.

Background: The effects of preoperative weight loss on bariatric surgery outcomes are still unclear, despite the practice being adopted by bariatric centers worldwide. Ongoing studies are needed for routine adoption of this practice given the multiple issues patients face with following difficult preoperative weight loss protocols.

Objectives: The aim of this study was to characterize the prevalence of preoperative weight loss and evaluate its impact on outcomes following elective bariatric surgery. Read More

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New-Onset Atrial Fibrillation After Cardiac Surgery is a Significant Risk Factor for Long-Term Stroke: An Eight-Year Prospective Cohort Study.

J Cardiothorac Vasc Anesth 2021 Jul 8. Epub 2021 Jul 8.

Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Objectives: This study sought to determine the incidence and significance of new-onset atrial fibrillation as a risk factor for long-term stroke and mortality after cardiac surgery.

Design: A prospective cohort study.

Setting: Two large tertiary public hospitals. Read More

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Hyperchloremia and Postoperative Acute Kidney Injury in Adult Cardiac Patients: A Propensity-Matched Cohort Study.

J Cardiothorac Vasc Anesth 2021 Jul 8. Epub 2021 Jul 8.

Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.

Objectives: Hyperchloremia is a potential risk factor for acute kidney injury (AKI) in critically ill patients. However, the relationship between hyperchloremia and postoperative AKI in adult patients undergoing cardiovascular surgery with cardiopulmonary bypass (CPB) remains unclear. The authors aimed to determine whether postoperative hyperchloremia was associated with postoperative AKI in these populations. Read More

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Development and Validation of a Predictive Score for Prolonged Mechanical Ventilation After Cardiac Surgery.

J Cardiothorac Vasc Anesth 2021 Jul 10. Epub 2021 Jul 10.

Sorbonne Université, Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, Institute of Cardiology, GRC 29, Pitié-Salpêtrière Hospital, Paris, France. Electronic address:

Objectives: The authors aimed to identify risk factors associated with prolonged mechanical ventilation (PMV) after scheduled cardiac surgery under cardiopulmonary bypass (CPB).

Design: A single-center, observational study.

Setting: Tertiary hospital. Read More

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Left subclavian artery revascularization in thoracic endovascular aortic repair: single center's clinical experiences from 171 patients.

J Cardiothorac Surg 2021 Jul 30;16(1):207. Epub 2021 Jul 30.

Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210000, Jiangsu, People's Republic of China.

Background: Left subclavian artery revascularization (LSA) is frequently performed in the setting of thoracic endovascular repair (TEVAR). The purpose of this study was to compare different techniques for LSA revascularization during TEVAR.

Methods: We performed a single center's retrospective cohort study from 2016 to 2019. Read More

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Surgical outcomes of DeBakey type I and type II acute aortic dissection: a propensity score-matched analysis in 599 patients.

J Cardiothorac Surg 2021 Jul 30;16(1):208. Epub 2021 Jul 30.

Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan.

Background: The DeBakey classification divides Stanford acute type A aortic dissection (ATAAD) into DeBakey type I (D1) and type II (D2) according to the extent of acute aortic dissection (AAD). This retrospective study aimed to compare the early and late outcomes of D1-AAD and D2-AAD through a propensity score-matched analysis.

Methods: Between January 2009 and April 2020, 599 consecutive patients underwent ATAAD repair at our institution, and were dichotomized into D1 (n = 543; 90. Read More

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Quantum algorithm for quicker clinical prognostic analysis: an application and experimental study using CT scan images of COVID-19 patients.

BMC Med Inform Decis Mak 2021 Jul 30;21(1):227. Epub 2021 Jul 30.

Department of Information System, Indian Institute of Management, Rohtak, India.

Background: In medical diagnosis and clinical practice, diagnosing a disease early is crucial for accurate treatment, lessening the stress on the healthcare system. In medical imaging research, image processing techniques tend to be vital in analyzing and resolving diseases with a high degree of accuracy. This paper establishes a new image classification and segmentation method through simulation techniques, conducted over images of COVID-19 patients in India, introducing the use of Quantum Machine Learning (QML) in medical practice. Read More

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Utilization of ECMO in vascular surgery: A presentation of two cases.

Int J Surg Case Rep 2021 Jun 29;85:106141. Epub 2021 Jun 29.

Department of Surgery, Division of Vascular Surgery, Mayo Clinic, Jacksonville, FL, USA. Electronic address:

Introduction: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a form of temporary mechanical circulatory support commonly used during cardiothoracic interventions. Malperfusion during complex vascular procedures remains a significant risk that may potentially lead to multiple complications. Here, we report two cases highlighting the efficacy of VA-ECMO in both planned and emergent vascular interventions. Read More

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Clinical features and treatment outcomes of cerebral arteriovenous malformation associated with moyamoya disease.

World Neurosurg 2021 Jul 27. Epub 2021 Jul 27.

Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Division of Pediatric Radiology, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, Korea, (3)Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea. Electronic address:

Purpose: Cerebral arteriovenous malformation (AVM) can rarely occur in conjunction with moyamoya disease (MMD). There is still no consensus on how to treat AVM when accompanied by MMD. In this study, we assessed the clinical features and suggested appropriate management when AVM was combined with MMD. Read More

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Validation and comparison of 28 risk prediction models for coronary artery disease.

Eur J Prev Cardiol 2021 Jul 30. Epub 2021 Jul 30.

Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.

Aims: Risk prediction models (RPMs) for coronary artery disease (CAD), using variables to calculate CAD risk, are potentially valuable tools in prevention strategies. However, their use in the clinical practice is limited by a lack of poor model description, external validation, and head-to-head comparisons.

Methods And Results: CAD RPMs were identified through Tufts PACE CPM Registry and a systematic PubMed search. Read More

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Noninvasive Urine Oxygen Monitoring and the Risk of Acute Kidney Injury in Cardiac Surgery.

Anesthesiology 2021 Jul 30. Epub 2021 Jul 30.

Background: Acute kidney injury (AKI) is a common complication of cardiac surgery. An intraoperative monitor of kidney perfusion is needed to identify patients at risk for AKI. The authors created a noninvasive urinary oximeter that provides continuous measurements of urinary oxygen partial pressure and instantaneous urine flow. Read More

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Intimal aortic atherosclerosis in cardiac surgery: surgical strategies to prevent embolic stroke.

Eur J Cardiothorac Surg 2021 Jul 30. Epub 2021 Jul 30.

Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, Netherlands.

Objectives: Although the incidence of perioperative stroke after cardiac surgery gradually decreased over the last decades, there is much variation between centres. This review aimed to create a concise overview of the evidence on possible surgical strategies to prevent embolic stroke in patients with intimal aortic atherosclerosis.

Methods: The PubMed and EMBASE databases were searched for studies on surgical management of aortic atherosclerosis and the association with perioperative stroke in cardiac surgery, including specific searches on the most common types of surgery. Read More

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Tyrosine-Templated Dual-Component Silver Nanomaterials Exhibit Photoluminescence and Versatile Antimicrobial Properties through ROS Generation.

ACS Appl Mater Interfaces 2021 Jul 30. Epub 2021 Jul 30.

Department of Chemistry, Indian Institute of Science Education and Research Bhopal, Bhopal Bypass Road, Bhopal 462066, Madhya Pradesh, India.

The role of small molecules in the preparation of metal nanomaterials generates considerable interest in the fields from materials science to interdisciplinary sciences. In this study, a small amino acid, l-tyrosine (Tyr), has been used as a ligand precursor for the preparation of silver nanomaterials (AgNMs) comprising a dual system: smaller silver nanoclusters (responsible exclusively for the photophysical properties) and larger silver nanoparticles (responsible exclusively for the antimicrobial properties). The luminescent properties of this AgNM system substantiate the role played by Tyr as a capping and a reducing agent outside the protein environment. Read More

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Fluorine Substituted Proline Enhances the Tubulin Binding Potential of a Tetrapeptide at the GTP Binding Pocket Causing the Inhibition of Microtubule Motility and an Antimitotic Effect.

J Phys Chem B 2021 Jul 30. Epub 2021 Jul 30.

Organic and Medicinal Chemistry and Structural Biology and Bioinformatics Division, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata, West Bengal 700 032, India.

The microtubule is regarded as the key target for designing anticancer and neurotherapeutic drugs due to its functional importance in eukaryotic cells including neurons. The microtubule is a dynamic hollow polymer tube consisting of α,β-tubulin heterodimer. Polymerization of α,β-tubulin heterodimer resulted in microtubule formation. Read More

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Topical nanocarriers for management of Rheumatoid Arthritis: A review.

Biomed Pharmacother 2021 Jul 14;141:111880. Epub 2021 Jul 14.

Department of Regulatory Affairs, Rusan Pharma Limited, Charkop, Kandivali (West), Mumbai 400067, India.

Rheumatoid arthritis (RA) is a systemic autoimmune disease manifested by chronic joint inflammation leading to severe disability and premature mortality. With a global prevalence of about 0.3%-1% RA is 3-5 times more prevalent in women than in men. Read More

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Intraoperative renal hypoxia and risk of cardiac surgery-associated acute kidney injury.

J Card Surg 2021 Jul 29. Epub 2021 Jul 29.

Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia.

Background: Acute kidney injury (AKI) is common after cardiac surgery requiring cardiopulmonary bypass. Renal hypoxia may precede clinically detectable AKI. We compared the efficacy of two indices of renal hypoxia, (i) intraoperative urinary oxygen tension (UPO ) and (ii) the change in plasma erythropoietin (pEPO) during surgery, in predicting AKI. Read More

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Cardiac Surgery 2020 Reviewed.

Thorac Cardiovasc Surg 2021 Jul 29. Epub 2021 Jul 29.

Department of Cardiothoracic Surgery, Friedrich-Schiller-University of Jena, Jena, Germany.

In 2020, nearly 30,000 published references appeared in the PubMed for the search term "cardiac surgery." While SARS-CoV-2 affected the number of surgical procedures, it did not affect outcomes reporting. Using the PRISMA approach, we selected relevant publications and prepared a results-oriented summary. Read More

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Postcardiotomy Extracorporeal Membrane Oxygenation in Neonates.

Thorac Cardiovasc Surg 2021 12 29;69(S 03):e41-e47. Epub 2021 Jul 29.

Department of Pediatric Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Background: Extracorporeal membrane oxygenation (ECMO) provides circulatory support in children with congenital heart disease, particularly in the setting of cardiopulmonary failure and inability to wean from cardiopulmonary bypass. This study summarized the clinical application of ECMO in the treatment of heart failure after cardiac surgery in neonates.

Materials And Methods: Clinical data of 23 neonates who received ECMO support in our center from January 2017 to June 2019 were retrospectively analyzed. Read More

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December 2021