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Kwan Mo Yang, In Ja Park, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Na Young Kim, Shinae Hong, Chang Sik Yu, Jin Cheon Kim
PURPOSE: We evaluate the prognostic value of primary tumor location for oncologic outcomes in patients with colon cancer (CC). METHODS: CC patients treated with curative surgery between 2009 and 2012 were classified into 2 groups: right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Recurrence-free survival (RFS) and overall survival (OS) were examined based on tumor stage. Propensity scores were created using eight variables (age, sex, T stage, N stage, histologic grade, presence of lymphovascular invasion/perineural invasion, and microsatellite instability status)...
February 2019: Annals of Coloproctology
Mina Alvandipour, Farzad Mokhtari-Esbuie, Afshin Gholipour Baradari, Abolfazl Firouzian, Mehdi Rezaie
PURPOSE: Despite the use of different surgical methods, surgical site infection is still an important cause of mortality and morbidity in patients and imposes a considerable cost on the healthcare system. Administration of supplemental oxygen during surgery has been reported to reduce surgical site infection (SSI); however, that result is still controversial. This study was performed to evaluate the effect of hyperoxygenation during colorectal surgery on the incidence of wound infection...
February 2019: Annals of Coloproctology
Janeesh Plakkal Ayyappan, Kezia Lizardo, Sean Wang, Edward Yurkow, Jyothi F Nagajyothi
Trypanosoma cruzi infection results in debilitating cardiomyopathy, which is a major cause of mortality and morbidity in the endemic regions of Chagas disease (CD). The pathogenesis of Chagasic cardiomyopathy (CCM) has been intensely studied as a chronic inflammatory disease until recent observations reporting the role of cardio-metabolic dysfunctions. In particular, we demonstrated accumulation of lipid droplets and impaired cardiac lipid metabolism in the hearts of cardiomyopathic mice and patients, and their association with impaired mitochondrial functions and endoplasmic reticulum (ER) stress in CD mice...
March 13, 2019: Biomolecules & Therapeutics
Tom Knauf, Benjamin Bücking, Mathias Bargello, Sebastian Ploch, Christopher Bliemel, Matthias Knobe, Steffen Ruchholtz, Daphne Eschbach
The incidence of hip fractures is increasing due to demographic transition. Data on long-term survival and influencing factors are sparse. Our prospective observational study with 395 patients shows a survival of 38% after 5 years. Significant risk factors were male gender, higher age, lower Barthel Index, lower Charlson Comorbidity Score, lower Mini-Mental State Examination, and delirium during hospitalization. PURPOSE: The incidence of hip fractures is increasing due to demographic transition...
March 16, 2019: Archives of Osteoporosis
Carol A Parise, Vincent Caggiano
PURPOSE: This study compared the demographic and clinicopathologic characteristics and risk of mortality between the triple positive (TP) and ER+/PR+/HER2- breast cancer subtypes. METHODS: Cases of first primary female invasive TP and ER+/PR+/HER2- breast cancer were obtained from the California Cancer Registry. Logistic regression analysis was used to compare differences in factors associated with the TP versus the ER+/PR+/HER2- subtype. Cox regression was used to compute the adjusted risk of breast cancer-specific mortality of the TP versus ER+/PR+/HER2-...
March 16, 2019: Cancer Causes & Control: CCC
Euna Han, Tae Hyun Kim, Heejo Koo, Joonsang Yoo, Ji Hoe Heo, Hyo Suk Nam
OBJECTIVE: Comorbidities are prevalent among stroke patients. The current study assesses the variations in cost and stroke prognosis by concurrent comorbidities in patients with acute ischemic stroke. METHODS: The Charlson comorbidity index was used as the composite comorbidity level (0 none, 1 mild, 2 moderate, and ≥ 3 severe). Outcomes included modified Rankin Scale (mRS) at 3 months and 1-year mortality and stroke recurrence. We utilized a multivariate log-normal model for cost, a proportional Cox hazards model for outcomes, and a decision analytic model for the excess cost per unit change in outcome probability compared with the no-comorbidity group...
March 16, 2019: Journal of Neurology
Sonja Hamed, Bastian Schmack, Florian Mueller, Philipp Ehlermann, Davina Hittmann, Arjang Ruhparwar, Hugo A Katus, Philip W Raake, Michael M Kreusser
BACKGROUND: Ventricular assist devices (VAD) are increasingly used as long-term treatment for advanced heart failure. However, survival after VAD implantation is still unsatisfactory, and no specific outpatient follow-up algorithms have been formally established. Here, we evaluate the effect of an intensified follow-up protocol (IFUP) on survival rates and VAD-associated complications. METHODS AND RESULTS: This is a retrospective study of 57 patients who received a VAD at our center between February 2013 and December 2017...
March 16, 2019: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Dietmar Boethig, Alexander Horke, Mark Hazekamp, Bart Meyns, Filip Rega, Joeri Van Puyvelde, Michael Hübler, Martin Schmiady, Anatol Ciubotaru, Giovanni Stellin, Massimo Padalino, Viktor Tsang, Ramadan Jashari, Dmitry Bobylev, Igor Tudorache, Serghei Cebotari, Axel Haverich, Samir Sarikouch
OBJECTIVES: Decellularized pulmonary homografts (DPH) have shown excellent results for pulmonary valve replacement. However, controlled multicentre studies are lacking to date. METHODS: Prospective European multicentre trial evaluating DPH for pulmonary valve replacement. Matched comparison of DPH to bovine jugular vein (BJV) conduits and cryopreserved homografts (CH) considering patient age, type of heart defect and previous procedures. RESULTS: In total, 121 patients (59 female) were prospectively enrolled (August 2014-December 2016), age 21...
March 15, 2019: European Journal of Cardio-thoracic Surgery
Emilie C Risom, Katrine B Buggeskov, Ulla B Mogensen, Martin Sundskard, Jann Mortensen, Hanne B Ravn
OBJECTIVES: Although reduced lung function and chronic obstructive pulmonary disease (COPD) is associated with higher risk of death following cardiac surgery, preoperative spirometry is not performed routinely. The aim of this study was to investigate the relationship between preoperative lung function and postoperative complications in all comers for cardiac surgery irrespective of smoking or COPD history. METHODS: Preoperative spirometry was performed in elective adult cardiac surgery patients...
March 15, 2019: Interactive Cardiovascular and Thoracic Surgery
Kunal Bhakhri, Sara Volpi, Davide Gori, Martin Goddard, Jason M Ali, Ravi De Silva
OBJECTIVES: Diffuse cardiac amyloidosis is a significant diagnosis with a poor prognosis. Isolated atrial amyloidosis (IAA) is the most common form of cardiac amyloidosis caused by accumulation of alpha-atrial natriuretic peptide. IAA has been associated with dysrhythmia, but otherwise remains a poorly characterized condition. The impact of incidental IAA on postoperative outcome following cardiac surgery has not previously been reported. The purpose of this study was to examine the impact of isolated atrial amyloid on patient outcomes following cardiac surgery...
March 15, 2019: Interactive Cardiovascular and Thoracic Surgery
Alexandra J White, Jacob K Kresovich, Zongli Xu, Dale P Sandler, Jack A Taylor
BACKGROUND: Shift work has been associated with increased risk of age-related morbidity and mortality. Biological age, estimated using DNA methylation (DNAm), may quantify the biological consequences of shift work on the risk of age-related disease. We examined whether prior employment in shift-working occupations was associated with epigenetic age acceleration. METHODS: In a sample of non-Hispanic White women aged 35-74 (n = 2574), we measured DNAm using the Illumina Infinium Human450 BeadChip and calculated DNAm age using three established epigenetic clocks...
March 15, 2019: International Journal of Epidemiology
Per Vikholm, Rafael Astudillo, Stefan Thelin
OBJECTIVES: We sought to analyse perioperative outcome, long-term mortality, frequency and causes of reintervention, and survival benefit in a contemporary cohort of patients undergoing proximal thoracic aortic surgery. METHODS: Participants comprised all patients undergoing open surgery for proximal thoracic aortic aneurysm (TAA) (n = 319) and thoracic aortic dissection type A (TAD) (n = 229) during 2005-2014 at the Department of Thoracic Surgery, Uppsala University Hospital...
March 15, 2019: European Journal of Cardio-thoracic Surgery
Cian McCarthy, Sean Murphy, Joshua A Cohen, Saad Rehman, Maeve Jones-O'Connor, David S Olshan, Avinainder Singh, Muthiah Vaduganathan, James L Januzzi, Jason H Wasfy
Importance: Similar to other patients with acute myocardial infarction, patients with type 2 myocardial infarction (T2MI) are included in several value-based programs, including the Hospital Readmissions Reduction Program and the Hospital Value-Based Purchasing Program. To our knowledge, whether nonischemic myocardial injury is being misclassified as T2MI is unknown and may have implications for these programs. Objective: To determine whether patients with nonischemic myocardial injury are being miscoded as having T2MI and if this has implications for 30-day readmission and mortality rates...
March 17, 2019: JAMA Cardiology
Magnus Helgesson, Bo Johansson, Tobias Nordquist, Eva Vingård, Magnus Svartengren
OBJECTIVES: Studies have found a 'healthy-migrant effect' (HME) among arriving migrants, that is, a better health status compared with others in the home country, but also in comparison with the population in the host country. The aims were to investigate whether the HME hypothesis is applicable to the Swedish context, that is, if health outcomes differed between a group of mainly labour migrants (Western migrants) and a group of mainly refugee/family reunion migrants (non-Western migrants) compared with the native Swedish population, and if there were any correlations between labour market attachment (LMA) and these health outcomes...
March 15, 2019: BMJ Open
Gonçalo Silva Duarte, Afonso Nunes-Ferreira, Filipe Brogueira Rodrigues, Fausto J Pinto, Joaquim J Ferreira, Joao Costa, Daniel Caldeira
OBJECTIVE: Morphine is frequently used in acute coronary syndrome (ACS) due to its analgesic effect, it being recommended in the main cardiology guidelines in Europe and the USA. However, controversy exists regarding its routine use due to potential safety concerns. We conducted a systematic review of randomised-controlled trials (RCTs) and observational studies to synthesise the available evidence. DESIGN: Systematic review and meta-analysis. DATA SOURCES: CENTRAL, MEDLINE, EMBASE and trial registries...
March 15, 2019: BMJ Open
Mark Adams, Thomas M Berger, Cristina Borradori-Tolsa, Myriam Bickle-Graz, Sebastian Grunt, Roland Gerull, Dirk Bassler, Giancarlo Natalucci
OBJECTIVES: To investigate if centre-specific levels of perinatal interventional activity were associated with neonatal and neurodevelopmental outcome at 2 years of age in two separately analysed cohorts of infants: cohort A born at 22-25 and cohort B born at 26-27 gestational weeks, respectively. DESIGN: Geographically defined, retrospective cohort study. SETTING: All nine level III perinatal centres (neonatal intensive care units and affiliated obstetrical services) in Switzerland...
March 15, 2019: BMJ Open
Cristiano Silva Cruz, Valentina Tosatto, Paula Oliveira Nascimento, Rita Barata Moura
Hepatic hydrothorax, a rare and debilitating complication of cirrhosis, carries high morbidity and mortality. First-line treatment consists of dietary sodium restriction and diuretic therapy. Some patients, mainly those who are refractory to medical management, will require invasive pleural drainage. The authors report the case of a 76-year-old man in a late cirrhotic stage of alcoholic chronic liver disease, presenting with recurrent right-sided hepatic hydrothorax, portal hypertension, hepatosplenomegaly and thrombocytopaenia...
March 15, 2019: BMJ Case Reports
Shahzad Gul Khattak, Ian Dady, Devdeep Mukherjee
An ex-30-week gestation, preterm male baby was admitted to a tertiary neonatal unit and noted to have increased ventilator requirements and diagnosed with sepsis. The baby also developed an abscess over the left elbow and over the xiphisternum along with a decrease in movement of the left hand and the right leg. Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus (SA) was isolated from the blood culture. A whole body MRI showed disseminated abscess with multiple foci in the lung, left elbow and over the xiphisternum...
March 15, 2019: BMJ Case Reports
Michal Pardo, Fanfan Xu, Michal Shemesh, Xinghua Qiu, Yoav Barak, Tong Zhu, Yinon Rudich
Nrf2 is an important transcription factor implicated in the oxidative stress response, which has been reported to play an important role in the way by which air pollution particulate matter (PM2.5 ) induces adverse health effects. This study investigates the mechanism by which Nrf2 exerts its protective effect in PM2.5 induced toxicity in lung cells. Lung cells silenced for Nrf2 (shNrf2) demonstrated diverse susceptibility to various PM extracts; water extracts containing high levels of dissolved metals exhibited higher capacity to generate mitochondrial reactive oxygen species (ROS) and hence increased oxidative stress levels...
March 6, 2019: Science of the Total Environment
Belinda M Harris, Melissa L Harris, Kym Rae, Catherine Chojenta
OBJECTIVE: To synthesise primary research regarding the facilitators and barriers to smoking cessation amongst Aboriginal and/or Torres Strait Islander women during pregnancy. DESIGN: An integrative review. REVIEW METHODS: A systematic search of peer-reviewed literature from five databases published from January 2008 to April 2018. Articles were reviewed using the approach outlined by Whittemore and Knafl, with the identified themes collated and synthesised according to study characteristics and barriers and facilitators of smoking cessation...
March 7, 2019: Midwifery
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