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Sample records for cardiovascular surgery department

  1. Open Heart Surgery in a Newly Established Cardiovascular Department: The first 300 cases

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    Kemal Korkmaz

    2016-01-01

    Full Text Available Aim: Evaluation of the results of open heart surgery in a newly established cardiovascular clinic: Ankara Numune Education and Research Hospital. Material and Method: Between June 2012 and January 2014, 300 open heart surgeries were performed. Urgent operation was performed in 22 patients (7.3% because of ST-elevation myocardial infarction and in 1 patient because of left ventricular aneurysm rupture. Coronary artery bypass grafting was performed in 211 (70.3% patients. The other patients underwent various complex operations such as valve repair, Tirone-David procedure and repair of atrioventricular canal defect. Results: In 3 patients (1% hospital mortality was seen. Reoperation was performed in 8 patients (2.6% because of pericardial tamponade and in 9 patients (3% because of bleeding. Atrial fibrillation was developed in 28 patients (9.3% in the postoperative period and normal sinus rhythm was established with medical cardioversion. Intra-aortic balloon pump(IABP was used in 4 patients preoperatively and in 11 patients postoperatively, including 15 patients(%5. Discussion: In the current era, the patients who are consulted to cardiovascular surgery clinics become more chronic, high risk and patients with additional co-morbid diseases because of the developments in interventional cardiology. Our newly established center aims to be a nationally and internationally successful clinic which was proved by low mortality and morbidity rates with a team who follows the developments and constantly educate and trained.

  2. Cognitive dysfunction after cardiovascular surgery

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    Funder, K S; Steinmetz, J; Rasmussen, L S

    2009-01-01

    This review describes the incidence, risk factors, and long-term consequences of cognitive dysfunction after cardiovascular surgery. Postoperative cognitive dysfunction (POCD) is increasingly being recognized as an important complication, especially in the elderly. A highly sensitive neuropsychol...

  3. Cardiovascular benefits of bariatric surgery.

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    Lee, Glenn K; Cha, Yong-Mei

    2016-04-01

    The prevalence of obesity is increasing in the United States and worldwide, bringing with it an excess of morbidity and premature death. Obesity is strongly associated with both traditional cardiovascular risk factors as well as direct effects on hemodynamics and cardiovascular structure and function. In fact, cardiovascular disease is one of the major causes of morbidity and mortality in obese patients. Often, lifestyle and pharmacological weight-loss interventions are of limited efficacy in severely obese patients. Bariatric surgery has been shown to be a feasible option to achieve substantial and sustained weight loss in this group of patients. It is a safe procedure with low in-hospital and 30-day mortality rates even in groups that are considered higher risk for surgery (e.g., the elderly), especially if performed in high-volume centers. There is observational evidence that bariatric surgery in severely obese patients is associated with both a reduction of traditional cardiovascular risk factors as well as improvement in cardiac structure and function. Marked decreases in the levels of inflammatory and prothrombotic markers, as well as markers of subclinical atherosclerosis and endothelial dysfunction, are seen after bariatric surgery. This article summarizes the existing evidence regarding the cardiovascular benefits in patients following bariatric surgery.

  4. Surgical outcomes in native valve infectious endocarditis: the experience of the Cardiovascular Surgery Department – Cluj-Napoca Heart Institute

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    MOLNAR, ADRIAN; MURESAN, IOAN; TRIFAN, CATALIN; POP, DANA; SACUI, DIANA

    2015-01-01

    Background and aims The introduction of Duke’s criteria and the improvement of imaging methods has lead to an earlier and a more accurate diagnosis of infectious endocarditis (IE). The options for the best therapeutic approach and the timing of surgery are still a matter of debate and require a close colaboration between the cardiologist, the infectionist and the cardiac surgeon. Methods We undertook a retrospective, descriptive study, spanning over a period of five years (from January 1st, 2007 to December 31st, 2012), on 100 patients who underwent surgery for native valve infectious endocarditis in our unit. Results The patients’ age varied between 13 and 77 years (with a mean of 54 years), of which 85 were males (85%). The main microorganisms responsible for IE were: Streptococcus Spp. (21 cases – 21%), Staphylococcus Spp. (15 cases – 15%), and Enterococcus Spp. (9 cases – 9%). The potential source of infection was identified in 26 patients (26%), with most cases being in the dental area (16 cases – 16%). The lesions caused by IE were situated in the left heart in 96 patients (96%), mostly on the aortic valve (50 cases – 50%). In most cases (82%) we found preexisting endocardial lesions which predisposed to the development of IE, most of them being degenerative valvular lesions (38 cases – 38%). We performed the following surgical procedures: surgery on a single valve - aortic valve replacement (40 cases), mitral valve replacement (19 cases), mitral valve repair (1 case), surgery on more than one valve – mitral and aortic valve replacement (20 cases), aortic and tricuspid valve replacement (1 case), aortic valve replacement with a mechanical valve associated with mitral valve repair (5 cases), aortic valve replacement with a biological valve associated with mitral valve repair (2 cases), and mitral valve replacement with a mechanical valve combined with De Vega procedure on the tricuspid valve (1 case). In 5 patients (5%) the bacteriological

  5. SURGERY AND CARDIOVASCULAR SURGERY JOURNALS ANALYSIS

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    Alberto Schanaider

    2015-01-01

    Full Text Available Objective: To analyze critically the effectiveness and value of bibliometric indicators in journals of Surgery or Cardiovacular Surgery in the context of the postgraduate programs of CAPES Medicine III. Methods: A sampling with 16 academic programs and one professional master of Medicine III, encompassing the General and Digestive System Surgery, Cardiovascular Surgery and Multidisciplinary courses with such contents, was evaluated. Thomson Reuters/ISI (JCR, Elsevier/Scopus (SJR, and also Scielo databases were used. Results: Only in seven programs, the teachers had an average of Qualis A1 articles greater than the others strata. Eleven journals in the surgical area are in stratum A1 (5% and it reaches 25% in Cardiovascular Surgery. Among the six journals with the largest number of publications Qualis A1 in area Medicine III, five are from non-specific areas. The Acta Cirúrgica Brasileira represented 58% of the publications in the stratum A2. There are some obstacles in the Qualis classification with little uniformity among the Medicine areas I, II and III. Conclusions: A permanent committee should be set to update the Qualis, composed by the three medical areas. It should be considered using other index databases and the unification of the Qualis criteria for journals in medicine. Rating criteria of multi and transdisciplinary journals need to be reviewed. It is essential an institutional financial support for national journals chosen by peers aiming to provide a full computerization process and a professional reviewer of the English language, in order to increase the impact factor.

  6. Medication Errors in a Swiss Cardiovascular Surgery Department: A Cross-Sectional Study Based on a Novel Medication Error Report Method

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    Kaspar Küng

    2013-01-01

    Full Text Available The purpose of this study was (1 to determine frequency and type of medication errors (MEs, (2 to assess the number of MEs prevented by registered nurses, (3 to assess the consequences of ME for patients, and (4 to compare the number of MEs reported by a newly developed medication error self-reporting tool to the number reported by the traditional incident reporting system. We conducted a cross-sectional study on ME in the Cardiovascular Surgery Department of Bern University Hospital in Switzerland. Eligible registered nurses ( involving in the medication process were included. Data on ME were collected using an investigator-developed medication error self reporting tool (MESRT that asked about the occurrence and characteristics of ME. Registered nurses were instructed to complete a MESRT at the end of each shift even if there was no ME. All MESRTs were completed anonymously. During the one-month study period, a total of 987 MESRTs were returned. Of the 987 completed MESRTs, 288 (29% indicated that there had been an ME. Registered nurses reported preventing 49 (5% MEs. Overall, eight (2.8% MEs had patient consequences. The high response rate suggests that this new method may be a very effective approach to detect, report, and describe ME in hospitals.

  7. Cardiovascular surgery in the elderly: an update

    Institute of Scientific and Technical Information of China (English)

    Song WAN; Ahmed A. ARIFI; Calvin S. H. NG; Anthony P. C. YIM

    2005-01-01

    The aging of the population and improvements in outcomes after cardiovascular surgery have resulted in a worldwide growing demand of complex surgical intervention for elderly patients. We briefly review the up-to-date English-language literature with particular focus on cardiovascular surgery in elderly patients. With earlier referral, careful preoperative evaluation, strategic planning, and the continuing efforts in optimizing surgical techniques, operative mortality and morbidity following primary or reoperative coronary artery bypass grafting and valvular interventions are expected to fall in this high-risk patient subset. Importantly,accumulating evidence indicates that elderly patients may benefit from improved functional status and quality of life after cardiovascular surgical therapy

  8. [Clinical characteristics of pancreatitis after cardiovascular surgery].

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    Ikegami, H; Sumiyoshi, T; Ishizuka, N; Ueda, M; Inaba, T; Hosoda, S; Aomi, S; Endo, M; Hashimoto, A; Koyanagi, H

    1995-10-01

    Increases in pancreatic enzyme levels after cardiovascular surgery were studied, and their clinical characteristics evaluated. The subjects were 128 patients who had undergone cardiovascular surgery (65 patients after valve replacement, 32 after coronary bypass surgery and 31 after aortic artificial graft replacement). The pancreatic enzyme (serum amylase and lypase) levels were monitored serially before and after operation, and amylase fractions were measured at their peaks. The relationships of the peak lypase level with underlying cardiac diseases, background factors, factors related to surgery, factors related to the extracorporeal circulation, presence or absence of symptoms, and treatments were examined. The amylase level exhibited biphasic changes consisting of a peak in which salivary glands amylase (S type) was dominant and a peak in which pancreatic amylase (P type) was dominant. The second peak coincided with the peak lypase and occurred mostly 3 to 10 days after operation. The peak lypase level exceeded the normal range in 78% of all the patients. It exceeded 564 U/l, 4 times the normal value in 28% of the patients, many of whom were symptomatic. So, we recommended that these cases should be treated as "postoperative pancreatitis". A high peak lypase level showed a significant correlation with the history of gallbladder and pancreatic diseases and diabetes mellitus among the background factors and emergency operation and the use of IABP among the surgery-related factors.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Principles of risk management in surgery departments

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    Fatemeh Rezaei

    2015-09-01

    Results: We structured the patient journey process in five main phases, 24 activities and 108 tasks. Then, the responsible teams were involved, and the transposition and allocated places for performing were chosen. Because of their importance, some activities and task themes such as patient identification and records review were repeated in each phase. Conclusions: Risk management of surgical departments is significant as this is typically the hospital facility with the both the highest cost and revenue. Communication between the surgical team and other clinical teams outside the surgery department through process-biased perspective could improve the safety of patients. [Arch Clin Exp Surg 2015; 4(3.000: 126-134

  10. Medical Student Examination Questions for Thoracic and Cardiovascular Surgery of Almost 60 Years Ago.

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    Kim, Won-Gon

    2016-08-01

    Medical student examination questions of 60 years ago are very rare to find irrespective of medical specialty. Recently, medical student examination questions for thoracic and cardiovascular surgery were found, which were presented between 1957 and 1959 at Seoul National University Medical College. All examination questions were hand-written in six pages by a professor as examiner. Among the six pages, four examination papers were dated and/or the target grade was identified, while the remaining two did not offer any information. These materials are thought to have a valuable historical meaning for the Korean medical community as well as the Department of Thoracic and Cardiovascular Surgery at Seoul National University Hospital.

  11. [Risk Factor Analysis of Pneumonia after Cardiovascular Surgery].

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    Maekawa, Yoshiyuki; Abe, Shuichi; Nakamura, Ken; Uchida, Tetsuro; Sadahiro, Mitsuaki; Morikane, Keita

    2016-08-01

    Pneumonia is a major and life-threatening complication after cardiovascular surgery. The objective of our study was to describe epidemiology, clinical characteristics, and risk factors of pneumonia after cardiovascular surgery. From January 2007 to December 2011, 511 consecutive patients (age 67.3±11.9;336 men, 175 women) were enrolled in this study. Pneumonia was diagnosed according to Centers of Disease Control and Prevention surveillance criteria for healthcare associated infection. Data collection included preoperative, intraoperative, and post-operative variables. The overall incidence of pneumonia was 72 cases(14.0%). The mortality in pneumonia group was significantly higher than that in non-pneumonia group (16.6% vs 4.3%, Odds ratio 4.4 ppneumonia after cardiovascular surgery.

  12. PREGNANCY IN CARDIO-VASCULAR SURGERY

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    D. Kazemi

    1968-01-01

    Full Text Available The Evol uulan 0 f pregnancy in Cardia V modern. Pertaining Literatu' - asculare Surgery discussed and re revlsed ?4 pe I C thought that any Pregnant . - . rsona ases arc analysed and it was f f . woman suffering fro M' I o allure in the pregnancy sho Id h . III itra stenosis with a history Meanwhilie the causes of our utwo dave hMitral C. omml.ssurotcmy as soon as possible minwhile the causes of our two deaths are discussed.

  13. German Heart Surgery Report 2015: The Annual Updated Registry of the German Society for Thoracic and Cardiovascular Surgery.

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    Beckmann, Andreas; Funkat, Anne-Katrin; Lewandowski, Jana; Frie, Michael; Ernst, Markus; Hekmat, Khosro; Schiller, Wolfgang; Gummert, Jan F; Welz, Armin

    2016-09-01

    On the basis of a long-standing voluntary registry, which was founded by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS), well-defined data of all heart, thoracic, and vascular surgery procedures performed in 78 German heart surgery departments during 2015 are analyzed. In 2015, a total of 103,967 heart surgery procedures (implantable cardioverter defibrillator, pacemaker, and extracardiac procedures without ECC excluded) were submitted to the database. Approximately 14.8% of the patients were at least 80 years old, resulting in an increase of 0.6% compared with the data of 2014. For 38,601 isolated coronary artery bypass grafting procedures (relationship on-/off-pump: 5:1), the unadjusted inhospital mortality was 2.7%. Concerning the 32,346 isolated heart valve procedures (including 10,606 catheter-based implantations) an unadjusted inhospital mortality of 4.4% was observed.This annual updated registry of the GSTCVS represents voluntary public reporting by accumulating actual information for nearly all heart surgical procedures in Germany, demonstrates advancements in heart medicine, and enables internal/external quality assurance for all participants. In addition, the registry demonstrates that the provision of heart surgery in Germany is appropriate and patients are treated nationwide in a round-the-clock service.

  14. Renal protection in cardiovascular surgery [version 1; referees: 2 approved

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    Nora Di Tomasso

    2016-03-01

    Full Text Available Acute kidney injury (AKI is one of the most relevant complications after major surgery and is a predictor of mortality. In Western countries, patients at risk of developing AKI are mainly those undergoing cardiovascular surgical procedures. In this category of patients, AKI depends on a multifactorial etiology, including low ejection fraction, use of contrast media, hemodynamic instability, cardiopulmonary bypass, and bleeding. Despite a growing body of literature, the treatment of renal failure remains mainly supportive (e.g. hemodynamic stability, fluid management, and avoidance of further damage; therefore, the management of patients at risk of AKI should aim at prevention of renal damage. Thus, the present narrative review analyzes the pathophysiology underlying AKI (specifically in high-risk patients, the preoperative risk factors that predispose to renal damage, early biomarkers related to AKI, and the strategies employed for perioperative renal protection. The most recent scientific evidence has been considered, and whenever conflicting data were encountered possible suggestions are provided.

  15. [Evaluation of quality of care in a general surgery department].

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    Visset, J; Paineau, J; Letessier, E; Hamelin, E; Hamy, A; Courant, O

    A permanent evaluation of a department's activity and the quality of health care it provides is needed to avoid inappropriate use resulting from a wide range of causes. The activity of a general surgery department treating and average of 1,500 patients per year and performing 1,200 operations was analyzed over the period 1986 to 1992. Post-operative hospital follow-up was noted for each patient and any complications were analyzed on discharge day by the surgeons, the anaesthesiologists and the nursing staff. A year-end sum up was conducted each year by homogeneous groups. Examples are presented: surgery for cancer of the oesophagus (122 cases), surgery for gastro-oesophageal reflux (120 cases), thyroid surgery (1,314 cases from 1988 to 1992). Complications, hospital stay and former pathologies were evaluated in order to determine the indications, prevent complications and evaluate more rapidly the advantages of modifications in techniques. The results were compared between surgeons. This daily evaluation allowed a better analysis than a retrospective study compared with data in the literature. Permanent personal reevaluation was one of the practical consequences of the study considered to be and enriching experience.

  16. Cardiovascular and respiratory changes and convalescence in laparoscopic colonic surgery

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    Schulze, S; Lyng, K M; Bugge, K

    1999-01-01

    Gasless laparoscopy produces smaller cardiopulmonary and systemic changes than carbon dioxide (CO2) laparoscopy during colonic surgery.......Gasless laparoscopy produces smaller cardiopulmonary and systemic changes than carbon dioxide (CO2) laparoscopy during colonic surgery....

  17. Analysis of reactive oxygen metabolites (ROMs) after cardiovascular surgery as a marker of oxidative stress.

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    Kanaoka, Yuji; Inagaki, Ei-ichirou; Hamanaka, Souhei; Masaki, Hisao; Tanemoto, Kazuo

    2010-10-01

    The transient systemic low perfusion that occurs during cardiovascular surgery leads to oxidative stress and the production of free radicals. A systemic increase of various markers of oxidative stress has been shown to occur during cardiopulmonary bypass (CPB). However, these markers have not been adequately evaluated because they seem to be reactive and short-lived. Here, oxidative stress was measured using the free radical analytical system (FRAS 4) assessing the derivatives of reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP). Blood samples were taken from 21 patients undergoing elective cardiovascular surgery. CPB was used in 15 patients, and abdominal aortic aneurysm (AAA) surgery without CPB was performed in 6. Measurements of d-ROMs and BAP were taken before surgery, 1 day, 1 week, and 2 weeks after surgery, and oxidative stress was evaluated. The d-ROM level increased gradually after cardiovascular surgery up to 2 weeks. Over time, the d-ROM level after surgery involving CPB became higher than that after AAA surgery. This difference reached statistical significance at 1 week and lasted to 2 weeks. The prolongation of CPB was prone to elevate the d-ROM level whereas the duration of the aortic clamp in AAA surgery had no relation to the d-ROM level. The BAP was also elevated after surgery, and was positively correlated with the level of d-ROMs. In this study, patients who underwent cardiovascular surgery involving CPB had significant oxidative damage. The production of ROMs was shown to depend on the duration of CPB. Damage can be reduced if CPB is avoided. When CPB must be used, shortening the CPB time may be effective in reducing oxidative stress.

  18. An update on predictive biomarkers for major adverse cardiovascular events in patients undergoing vascular surgery.

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    Patelis, Nikolaos; Kouvelos, George N; Koutsoumpelis, Andreas; Moris, Demetrios; Matsagkas, Miltiadis I; Arnaoutoglou, Eleni

    2016-09-01

    Cardiovascular complications signify a major cause of morbidity and mortality in patients undergoing vascular surgery adversely affecting both short- and long-term prognosis. During the last decade, unmet needs for a distinct cardiovascular risk assessment have led to an intensive research for establishment of biomarkers with sufficient predictive value. This literature review aims in examining the value of several biomarkers in predicting the incidence of major adverse cardiac events in vascular surgery patients. We reviewed the English language literature and analyzed the biomarkers as independent predictors or in correlation with other factors. We found several biomarkers showing a significant predictive value for a major adverse cardiovascular event in patients undergoing vascular surgery. These biomarkers can be used in clinical practice as outcome predictors, although sensitivity and specificity varies. Detection of subclinical cardiovascular damage may improve total risk estimation and facilitate clinical assessment of patients at risk for future cardiovascular events. The wide variety of sensitivity and specificity in predicting a MACE of these biomarkers exert the need for future trials in which these markers will be tested as adjunctive tools of cardiovascular risk estimation scoring systems.

  19. Analysis of production of the decellularized scaffolds and their potential use in cardiovascular surgery

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    Brumberg V.A.

    2015-12-01

    Full Text Available Data on application of decellularized scaffolds and tissue-engineered vascular conduits in the field of cardiovascular surgery have been analyzed, and also techniques for their procurement have been studied. For finding, selection and synthesis resources of research data from the systems Pubmed, ScienceDirect were used. The preference was given to the most informative, comprehensive and contemporary publications.

  20. Effect of surgery on cardiovascular risk factors in mild primary hyperparathyroidism

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    Bollerslev, Jens; Rosen, Thord; Mollerup, Charlotte

    2009-01-01

    CONTEXT: Mild primary hyperparathyroidism (pHPT) seems to have a good prognosis, and indications for active treatment (surgery) are widely discussed. The extraskeletal effects of PTH, such as insulin resistance, arterial hypertension, and cardiovascular (CV) risk, may however be reversible...

  1. Endocrine, metabolic and cardiovascular responses to adrenaline after abdominal surgery

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    Hilsted, J; Wilken-Jensen, Charlotte; Birch, K

    1990-01-01

    Adrenaline-induced changes in heart rate, blood pressure, plasma adrenaline and noradrenaline, cortisol, glucagon, insulin, cAMP, glucose lactate, glycerol and beta-hydroxybutyrate were studied preoperatively and 4 and 24 h after skin incision in 8 patients undergoing elective cholecystectomy. Late...... postoperative responses of blood glucose, plasma cAMP, lactate and glycerol to adrenaline infusion were reduced, whereas other responses were unaffected. Blood glucose appearance and disappearance rate as assessed by [3H]3-glucose infusion was unchanged pre- and postoperatively. The increase in glucose...... appearance rate following adrenaline was similar pre- and postoperatively. These findings suggest that several beta-receptor-mediated responses to adrenaline are reduced after abdominal surgery....

  2. Cardiovascular disease and renal insufficiency:special considerations with cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    Colin Lenihan; Donal Reddan

    2005-01-01

    Cardiovascular disease is an important cause of mortality in the chronic kidney disease (CKD) population. This review discusses cardiac surgery in the CKD population and considers ostoperative acute renal failure (ARF). CKD patients have worse outcomes following coronary artery bypass grafting (CABG) and cardiac valvular surgery than the general population. However,surgical revascularization is an effective treatment for coronary artery disease (CAD) in this population and may be associated with improved survival over percutaneous intervention (PCI) in advanced CKD. Cardiac surgery in the CKD population requires careful perioperative planning and management. Acute renal failure (ARF) is a serious complication following cardiac surgery, occurring in 1 to 8% of cases. Management of postoperative ARF is largely supportive and emphasis is placed on preoperative risk stratification and prevention.

  3. Potential for polyhydroxyalkanoates and policaprolactone copolymer use as tissue-engineered scaffolds in cardiovascular surgery

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    L. V. Antonova

    2012-01-01

    Full Text Available The absence of reliably functioning small-diameter vascular grafts for coronary artery bypass graft surgery remains one of the most important issues of cardiovascular surgery. Tissue-engineered grafts have to be characterized by highly hemocompatible, biomechanical and biocompatible properties, be quickly biodegradable and have non-toxic degradation products. This article presents polyhydroxyalkanoate and policaprolactone main characteristics and evaluates their potential use as polymers for producing vascular grafts. Biocompatibility, good physical and mechanical properties of these polymers and their better performance in copolymer scaffolds were demonstrated.

  4. Is it possible to prevent morbidity on post cardiovascular surgery applying low level laser therapy?

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    Pinto, Nathali C.; Baptista, Ivany Machado d. C.; Pereira, Mara Helena C.; Serrão, Nelson F.; Pomerantzeff, Pablo M. A.; Chavantes, Maria Cristina

    2014-03-01

    Background and Objective: Complications following cardiovascular surgery incision are common in mediastinitis and wound dehiscence form, a 47% mortality rate remaining. Low Level Laser Therapy (LLLT) has been employed mainly to its effectiveness analgesic and anti-inflammatory actions, aiding the tissue repair process. The aim of this study was to evaluate infrared LLLT onto surgical incision in patients submitted to cardiovascular surgery. Materials and Methods: 40 patients were divided in two groups: Placebo Group (G1) - conventional therapy + "Laser pointer" and Laser Group (G2) - conventional therapy + Infrared Laser irradiation on surgical incision. Diode Laser was employed, C.W. mode, around the surgical wound bed, on immediate Post Operative (PO), 1st PO and 3rd PO with the following parameters: wavelength (λ): 830nm, P=35mW, E=0,75J. Results: G2 didn't present any complication and 5% of patients in G1 developed incision dehiscence and infection. On 7thPO, still a large amount of G1 patients showed pain and unquestionable inflammatory signs surrounding the surgical wound, when compared to G2. Besides, hospital stay in Laser Group was 2 times shorter than in Placebo Group (p-value=0.001). Conclusion: Infrared Laser denoted to be safe and exceptionally valuable tools in preventing morbidities on post cardiovascular surgeries.

  5. Influence of age on perioperative major adverse cardiovascular events and mortality risks in elective non-cardiac surgery

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    Hansen, Peter Wæde; Gislason, Gunnar H.; Jørgensen, Mads Emil;

    2016-01-01

    -cause mortality were analyzed by multivariable logistic regression models (adjusted for comorbidities, revised cardiac risk index, cardiovascular pharmacotherapy, body mass index, and surgery type). RESULTS: A total of 386,818 procedures on 302,459 patients were included; mean age was 54.8years (min-max 20......BACKGROUND AND AIMS: Advanced age increases the risk of perioperative cardiovascular complications and may pose reluctance to subject elderly patients to surgery. We examined the impact of high age on perioperative major adverse cardiovascular events (MACE) and mortality in a nationwide cohort...... of patients undergoing elective surgery. METHODS: All Danish patients aged ≥20years undergoing non-cardiac, elective surgery in 2005-2011 were identified from nationwide administrative registers. Risks of 30-day MACE (non-fatal ischemic stroke, non-fatal myocardial infarction, or cardiovascular death) and all...

  6. Emprego de sistemas robóticos na cirurgia cardiovascular Robotic systems in cardiovascular surgery

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    Roberto T. Sant'Anna

    2004-06-01

    Full Text Available O desenvolvimento de sistemas robóticos para cirurgia teve início na década de 80, por solicitação do exército norte-americano, que antevia a possibilidade de realizar operações em teatros de guerra, distantes do local onde estava o cirurgião. Entretanto, o primeiro uso em humanos só ocorreu anos mais tarde, numa ressecção transuretral de hiperplasia benigna de próstata. Cirurgiões cardíacos foram logo atraídos pela técnica robótica devido a possível aplicação com reduzido caráter invasivo; esperava-se menor trauma cirúrgico e redução da dor, morbidade, tempo de internação e custo do procedimento. Atualmente, de forma restrita e em casos selecionados, robôs são usados para revascularização do miocárdio e implante de marcapasso em cirurgias cardíacas totalmente endoscópicas; podendo também constituir apoio visual na retirada de artéria torácica interna, reconstrução valvar mitral e correção de defeitos congênitos. Utilizando o robô auxiliar AESOP® para controle do videotoracoscópio, com controle vocal por meio do sistema HERMES®, temos realizado dissecção da artéria torácica interna, implante de eletrodo ventricular esquerdo e abordagem de defeitos congênitos na cirurgia de correção. Apesar do entusiasmo científico inicial com a cirurgia robótica, ainda não existe evidência clara de superioridade desta técnica em relação à operação convencional, em termos de resultado. Isto se aplica também ao custo, pois o investimento inicial na aquisição de sistema cirúrgico completo (console, controle de vídeo, instrumental provavelmente é compensado após muitos procedimentos e longo intervalo. Mas é certo que a cirurgia robótica terá um lugar no futuro, possibilitando aprendizagem, telepresença e realização de procedimentos pouco invasivos, embora complexos.The development of robotic systems for surgery started in the 80's, motivated by the US army's need for surgical procedure in

  7. The Evolution of Cardiovascular Surgery in Elderly Patient: A Review of Current Options and Outcomes

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    Francesco Nicolini

    2014-01-01

    Full Text Available Due to the increase in average life expectancy and the higher incidence of cardiovascular disease with advancing age, more elderly patients present for cardiac surgery nowadays. Advances in pre- and postoperative care have led to the possibility that an increasing number of elderly patients can be operated on safely and with a satisfactory outcome. Currently, coronary artery bypass surgery, aortic and mitral valve surgery, and major surgery of the aorta are performed in elderly patients. The data available show that most cardiac surgical procedures can be performed in elderly patients with a satisfactory outcome. Nevertheless, the risk for these patients is only acceptable in the absence of comorbidities. In particular, renal dysfunction, cerebrovascular disease, and poor clinical state are associated with a worse outcome in elderly patients. Careful patient selection, flawless surgery, meticulous hemostasis, perfect anesthesia, and adequate myocardial protection are basic requirements for the success of cardiac surgery in elderly patients. The care of elderly cardiac surgical patients can be improved only through the strict collaboration of geriatricians, anesthesiologists, cardiologists, and cardiac surgeons, in order to obtain a tailored treatment for each individual patient.

  8. Contribution of the outpatient surgery unit ITO the general surgery department of a district hospital.

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    Carrasco; Flores; Aguayo; de Andres B; Moreno Egea A; Cartagena; De Vicente JP; Martin

    2000-07-01

    Introduction: The creation of Outpatient Surgery (OPS) units to combine the quality of medical attention and rationalize costs allows for greater efficiency in the use of resources. Aim: To report our series of patients undergoing surgery at the OPS units integrated into our Hospital (Type II): Patients and method: Between May 1994 and March 1998, 832 outpatients, of a total of 5230, underwent surgery at our General Surgery Unit. The criteria for exclusion from the programme depended on the patient and the enviroment or resulted from the operation itself. Results: Mean patient age was 47.5 years; there were 420 males and 412 females. Surgery was performed for 229 inguinofemoral hernias, 47 umbilical-epigastric hernias, nine incisional hernias, 193 pilonidal sinuses, 156 mammary nodules, 65 varicose veins, 64 arteriovenous fistulae and 69 proctology operations. The most common anesthesia techniques performed were rachianesthesia and local anesthesia. Eight point seven percent of the patients required admission (OPS failure), the most frequent causes being excessive pain, orthostatic-syncopal hypotension, nausea and vomiting and urine retention. There was no morbidity or mortality. Conclusion: OPS is a highly efficient procedure for resolving the most common pathologies in General Surgery. The anesthesia technique was an important factor in the rate of failure.

  9. Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models

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    Miguel Angel Maluf

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. METHODS: First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. RESULTS: The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. CONCLUSION: 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

  10. Gram-negative rod bacteremia after cardiovascular surgery: Clinical features and prognostic factors

    OpenAIRE

    田子, さやか

    2016-01-01

    博士(医学) 乙第2895号(主論文の要旨、要約、本文),著者名:Sayaka Tago・Yuji Hirai・Yusuke Ainoda・Takahiro Fujita・Ken Kikuchi,タイトル:Gram-negative rod bacteremia after cardiovascular surgery: Clinical features and prognostic factors,掲載誌:Journal of microbiology(1684-1182), immunology and infection,著作権関連情報:ℂ2015, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. All rights reserved.DOI: 10.1016/j.jmii.2015.07.008

  11. The majority of surgical departments adhere to national Danish guidelines for surveillance after colorectal cancer surgery

    DEFF Research Database (Denmark)

    Lykke, Jakob; Roikjær, Ole; Jess, Per

    2013-01-01

    In 2003 the use of post-operative surveillance (POS) after surgery for colorectal cancer (CRC) in Denmark was studied. Diversity in the choice and frequency of surveillance modalities was found. Subsequently, the Danish Colorectal Cancer Group (DCCG) has published guidelines for POS. In the same...... period, the number of departments performing CRC surgery has been reduced by 50% nationally. The aim of the present study was to describe the POS after CRC in Denmark following a reduction in the number of departments performing operations for CRC and the DCCG's publication of national recommendations...

  12. Current Trend of Robotic Thoracic and Cardiovascular Surgeries in Korea: Analysis of Seven-Year National Data

    Science.gov (United States)

    Kang, Chang Hyun; Bok, Jin San; Lee, Na Rae; Kim, Young Tae; Lee, Seon Heui; Lim, Cheong

    2015-01-01

    Background Robotic surgery is an alternative to minimally invasive surgery. The aim of this study was to report on current trends in robotic thoracic and cardiovascular surgical techniques in Korea. Methods Data from the National Evidence-based Healthcare Collaborating Agency (NECA) between January 2006 and June 2012 were used in this study, including a total of 932 cases of robotic surgeries reported to NECA. The annual trends in the case volume, indications for robotic surgery, and distribution by hospitals and surgeons were analyzed in this study. Results Of the 932 cases, 591 (63%) were thoracic operations and 340 (37%) were cardiac operations. The case number increased explosively in 2007 and 2008. However, the rate of increase regained a steady state after 2011. The main indications for robotic thoracic surgery were pulmonary disease (n=271, 46%), esophageal disease (n=199, 34%), and mediastinal disease (n=117, 20%). The main indications for robotic cardiac surgery were valvular heart disease (n=228, 67%), atrial septal defect (n=79, 23%), and cardiac myxoma (n=27, 8%). Robotic thoracic and cardiovascular surgeries were performed in 19 hospitals. Three large volume hospitals performed 94% of the case volume of robotic cardiac surgery and 74% of robotic thoracic surgery. Centralization of robotic operation was significantly (probotic surgeries. However, only 27% of cardiac surgeons and 23% of thoracic surgeons performed more than 10 cases of robotic surgery. Conclusion Trend analysis of robotic and cardiovascular operations demonstrated a gradual increase in the surgical volume in Korea. Meanwhile, centralization of surgical cases toward specific surgeons in specific hospitals was observed. PMID:26509124

  13. Role of prophylactic coronary revascularisation in improving cardiovascular outcomes during non-cardiac surgery: A narrative review.

    Science.gov (United States)

    Rahat, T; Nguyen, T; Latif, F

    2016-10-01

    Coronary revascularisation has been a topic of debate for over three decades in patients undergoing high-risk non-cardiac surgery. The paradigm shifted from routine coronary angiography toward stress test guided decision-making based on larger randomised trials. However, this paradigm is challenged by relatively newer data where routine coronary angiography and revascularisation is shown to improve perioperative cardiovascular outcomes. We review major studies performed over a long period including more contemporary data with regard to the 2014 American College of Cardiology/American Heart Association as well as 2014 European Society of Cardiology guideline on perioperative cardiovascular evaluation of patients undergoing non-cardiac surgery.

  14. Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery.

    Science.gov (United States)

    Duceppe, Emmanuelle; Parlow, Joel; MacDonald, Paul; Lyons, Kristin; McMullen, Michael; Srinathan, Sadeesh; Graham, Michelle; Tandon, Vikas; Styles, Kim; Bessissow, Amal; Sessler, Daniel I; Bryson, Gregory; Devereaux, P J

    2017-01-01

    The Canadian Cardiovascular Society Guidelines Committee and key Canadian opinion leaders believed there was a need for up to date guidelines that used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of evidence assessment for patients who undergo noncardiac surgery. Strong recommendations included: 1) measuring brain natriuretic peptide (BNP) or N-terminal fragment of proBNP (NT-proBNP) before surgery to enhance perioperative cardiac risk estimation in patients who are 65 years of age or older, are 45-64 years of age with significant cardiovascular disease, or have a Revised Cardiac Risk Index score ≥ 1; 2) against performing preoperative resting echocardiography, coronary computed tomography angiography, exercise or cardiopulmonary exercise testing, or pharmacological stress echocardiography or radionuclide imaging to enhance perioperative cardiac risk estimation; 3) against the initiation or continuation of acetylsalicylic acid for the prevention of perioperative cardiac events, except in patients with a recent coronary artery stent or who will undergo carotid endarterectomy; 4) against α2 agonist or β-blocker initiation within 24 hours before surgery; 5) withholding angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker starting 24 hours before surgery; 6) facilitating smoking cessation before surgery; 7) measuring daily troponin for 48 to 72 hours after surgery in patients with an elevated NT-proBNP/BNP measurement before surgery or if there is no NT-proBNP/BNP measurement before surgery, in those who have a Revised Cardiac Risk Index score ≥1, age 45-64 years with significant cardiovascular disease, or age 65 years or older; and 8) initiating of long-term acetylsalicylic acid and statin therapy in patients who suffer myocardial injury/infarction after surgery.

  15. Canadian Cardiovascular Society/Canadian Society of Cardiac Surgeons/Canadian Society for Vascular Surgery Joint Position Statement on Open and Endovascular Surgery for Thoracic Aortic Disease.

    Science.gov (United States)

    Appoo, Jehangir J; Bozinovski, John; Chu, Michael W A; El-Hamamsy, Ismail; Forbes, Thomas L; Moon, Michael; Ouzounian, Maral; Peterson, Mark D; Tittley, Jacques; Boodhwani, Munir

    2016-06-01

    In 2014, the Canadian Cardiovascular Society (CCS) published a position statement on the management of thoracic aortic disease addressing size thresholds for surgery, imaging modalities, medical therapy, and genetics. It did not address issues related to surgical intervention. This joint Position Statement on behalf of the CCS, Canadian Society of Cardiac Surgeons, and the Canadian Society for Vascular Surgery provides recommendations about thoracic aortic disease interventions, including: aortic valve repair, perfusion strategies for arch repair, extended arch hybrid reconstruction for acute type A dissection, endovascular management of arch and descending aortic aneurysms, and type B dissection. The position statement is constructed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, and has been approved by the primary panel, an international secondary panel, and the CCS Guidelines Committee. Advent of endovascular technology has improved aortic surgery safety and extended the indications of minimally invasive thoracic aortic surgery. The combination of safer open surgery with endovascular treatment has improved patient outcomes in this rapidly evolving subspecialty field of cardiovascular surgery.

  16. Ear, Nose, Throat, Head and Neck Surgery Department Functioning as a Team in Nigeria: Any Benefit?

    OpenAIRE

    Adobamen, P. R. O. C.; Egbage, E. E.

    2012-01-01

    To call attention to the synergistic benefit of working as a team in a clinical department and to encourage others, to emulate this pattern of patients’ care for better results. Patients that were seen at the Ear, Nose, Throat, Head and Neck Surgery Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria, who had the benefit of their cases reviewed by more than one consultant were included into the study. Parameters retrieved from the case notes included number of consultants...

  17. The University of Florida Department of Surgery: building a stronger tomorrow on yesterday's foundation.

    Science.gov (United States)

    Behrns, Kevin E; Copeland, Edward M; Howard, Richard J

    2012-01-01

    Established in 1957, the University of Florida Department of Surgery has a solid foundation on which current faculty are driven to build a stronger tomorrow. The department is focused on promoting patient-centered care, expanding its research portfolio to improve techniques and outcomes, and training the surgical leaders of tomorrow. It fosters an environment where faculty, residents, students, and staff challenge long-held traditions with the goal of improving the health of our patients, the quality of our care, and the vitality of our work environment.

  18. Goal-directed hemostatic therapy using the rotational thromboelastometry in patients requiring emergent cardiovascular surgery

    Directory of Open Access Journals (Sweden)

    Danièle Sartorius

    2014-01-01

    Full Text Available Aims and Objectives: We assessed the clinical impact of goal-directed coagulation management based on rotational thromboelastometry (ROTEM in patients undergoing emergent cardiovascular surgical procedures. Materials and Methods: Over a 2-year period, data from 71 patients were collected prospectively and blood samples were obtained for coagulation testing. Administration of packed red blood cells (PRBC and hemostatic products were guided by an algorithm using ROTEM-derived information and hemoglobin level. Based on the amount of PRBC transfused, two groups were considered: High bleeders (≥5 PRBC; HB and low bleeders (<5 PRBC; LB. Data were analyzed using Chi-square test, unpaired t-test and analysis of variance as appropriate. Results: Pre-operatively, the HB group (n = 31 was characterized by lower blood fibrinogen and decreased clot amplitude at ROTEM compared with the LB group (n = 40. Intraoperatively, larger amounts of fibrinogen, fresh frozen plasma and platelets were required to normalize the coagulation parameters in the HB group. Post-operatively, the incidence of major thromboembolic and ischemic events did not differ between the two groups (<10% and the observed in-hospital mortality was significantly less than expected by the Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM score, 22% vs. 35% in HB and 5% vs. 13% in LB group. Conclusions: ROTEM-derived information is helpful to detect early coagulation abnormalities and to monitor the response to hemostatic therapy. Early goal-directed management of coagulopathy may improve outcome after cardiovascular surgery.

  19. [Basic standards for a department of cardiac surgery. Quality requirements for the care of cardiac patients in connection with operations on the heart, the heart vessels and thoracic organ transplantation].

    Science.gov (United States)

    Beckmann, Andreas; Beyersdorf, F; Diegeler, A; Mohr, F W; Welz, A; Rein, J-G; Cremer, J

    2013-12-01

    Current evolutions and substantial amendments of the German health care system in combination with distinguished progress in cardiac surgery over the past years require both a reflection of principles in patient-centered care and an update of basic standard requirements for a department of cardiac surgery in Germany. In due consideration of the data from the voluntary registry of the German Society for Thoracic and Cardiovascular Surgery, this article accurately defines core requirements for a cardiac surgical department (cardiac surgery on-site), subdivided into facilities, staff and processes. If based on these standards, one may anticipate that cardiac surgical care is performed under appropriate conditions leading to an intrinsic benefit for patients.

  20. [Pathogenic variants of brain injuries and pharmalogic cerebroprotection performed on the model of brain condition during cardiovascular bypass surgery].

    Science.gov (United States)

    Tsygan, N V; Trashkov, A P

    2014-10-01

    Developed and approved a pathogenic grounded experimental model of brain condition during cardiovascular bypass surgery. Undertaken in Wistar rats research allowed to evaluate in detail effectiveness and safety of protracted cerebroprotective treatment. Advantages of this model are researches in laboratory animals with the aim to research condition of nerve tissue, not intensive procedures and consequently high reproducibility and possibility of complex evaluation of changes at every stage of research. Results of neurons, neuroglia and activation of neurotrophic mechanisms prove that simulation of brain condition during cardiovascular bypass surgery is accompanied with acute and delayed brain injuries. Use of Cytoflavin under pharmalogic cerebroprotection had prolonged multimodal and neuroprotactive effect, leading to improvement of neurotrophic protection from the first days.

  1. Sheep (Ovis aries) as a Model for Cardiovascular Surgery and Management before, during, and after Cardiopulmonary Bypass

    OpenAIRE

    DiVincenti, Louis; Westcott, Robin; Lee, Candice

    2014-01-01

    Because of its similarity to humans in important respects, sheep (Ovis aries) are a common animal model for translational research in cardiovascular surgery. However, some unique aspects of sheep anatomy and physiology present challenges to its use in these complicated experiments. In this review, we discuss relevant anatomy and physiology of sheep and discuss management before, during, and after procedures requiring cardiopulmonary bypass to provide a concise source of information for veteri...

  2. Sheep (Ovis aries) as a model for cardiovascular surgery and management before, during, and after cardiopulmonary bypass.

    Science.gov (United States)

    DiVincenti, Louis; Westcott, Robin; Lee, Candice

    2014-09-01

    Because of its similarity to humans in important respects, sheep (Ovis aries) are a common animal model for translational research in cardiovascular surgery. However, some unique aspects of sheep anatomy and physiology present challenges to its use in these complicated experiments. In this review, we discuss relevant anatomy and physiology of sheep and discuss management before, during, and after procedures requiring cardiopulmonary bypass to provide a concise source of information for veterinarians, technicians, and researchers developing and implementing protocols with this model.

  3. The role of preoperative cerebral magnetic resonance angiography in the prevention of cerebral complications following cardiovascular surgery

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Masakazu; Sakai, Akira; Kodera, Koujirou; Sudo, Kyouichi; Oosawa, Mikio [Seirei Hamamatsu General Hospital, Shizuoka (Japan)

    1997-11-01

    Screening of carotid and intracranial artery diseases by magnetic resonance angiography (MRA) was performed in forty-one adult patients prior to elective cardiovascular surgery. In twenty patients (48.8%), MRA demonstrated significant cerebrovascular lesions: carotid or main cerebral artery stenosis in 7, diffuse cerebral arteriosclerotic change in 6, vertebral artery lesion in 5 and berry aneurysm in 2. Advanced age (over 70 years) and previous cerebrovascular events increased the incidence of cerebrovascular lesions on MRA. Forty patients underwent scheduled surgery under cardiopulmonary bypass, and pulsatile flow perfusion was used in patients in whom significant cerebrovascular lesions were demonstrated on MRA. One patient with aortic arch aneurysm was judged to be an unacceptable candidate for surgery in light of his marked diffuse arteriosclerotic lesions on MRA. In five patients, staged operation was performed from 10 to 30 days after cerebrovascular surgery (bypass surgery for internal carotid occlusion in 2, aneurysm clipping in 2, carotid endarterectomy in 1). Postoperative neurological complications occurred in one patient (2.5%). In conclusion, screening of carotid and intracranial artery diseases by MRA is a safe and useful method for evaluation of cerebrovascular lesions in patients with advanced age, previous cerebrovascular events and/or arteriosclerotic diseases. (author)

  4. [ANALYSIS OF A NEW ORGANIZATIONAL MODEL APPLIED TO THE PHYSIOTERAPY SERVICE C/O SURGERY DEPARTMENTS].

    Science.gov (United States)

    Rancati, Jacopo Matteo; Incarbone, Fina Maria Teresa; Pinna, Selene; Panella, Lorenzo

    2015-01-01

    The lowering number of physiotherapists c/o surgery departments of Orthopaedic Institute Gaetano Pini of Milan, required the application of a new organizational model based on the centralization of government activities, in order to optimize employment of staff. A programming and reporting tool was developed throught a database. The collected data (from January to December 2013) related to the reported physiotherapists activities were analysed and matched to operating theater's activities in order to find the correlation value. The results are lined up the hypothesis stated in the planning phase of the organizational model's project (in absence of hystorical referral). Correlation between Physiotherapists and Operation Theather's activities was good (r=0.59), giving us a reliable predictional model. This study has some limitations mostly related to the resistence expressed by employees in the change management.

  5. cardiovasculares

    Directory of Open Access Journals (Sweden)

    Cristina Guerrero

    2006-01-01

    Full Text Available Uno de los aspectos que más discusión ha suscitado en los últimos tiempos entre quienes nos dedicamos al estudio de la emoción tiene que ver con la eventual asociación entre percepción, valoración y respuesta fisiológica. Esto es, siguiendo la máxima aristotélica, cabría cuestionar si las cosas son como son o son como cada quien las percibe. El objetivo de este experimento ha sido establecer la existencia de una conexión entre percepción de control y responsividad cardiovascular. La muestra estudiada ha estado conformada por estudiantes de la Universidad de Castellón; todos ellos han participado de forma voluntaria. La prueba de estrés ha consistido en un examen real de una asignatura troncal de la titulación que cursaban los participantes. Así pues, utilizando una situación de estrés real, hipotetizamos que las respuestas cardiovasculares (medidas a través de la tasa cardiaca, la presión sanguínea sistólica y la presión sanguínea diastólica dependen de la percepción de control que el individuo tiene, o cree tener, sobre la situación.

  6. Mediastinite no pós-operatório de cirurgia cardiovascular: análise de 1038 cirurgias consecutivas Postoperative mediastinitis in cardiovascular surgery postoperation: analysis of 1038 consecutive surgeries

    Directory of Open Access Journals (Sweden)

    Michel Pompeu Barros de Oliveira Sá

    2010-03-01

    Full Text Available OBJETIVO: Relatar a incidência de mediastinite no pós-operatório de cirurgia cardiovascular. MÉTODOS: Foram analisados os prontuários de 1038 pacientes submetidos à cirurgia cardiovascular entre maio/ 2007 e junho/2009. Todas as operações foram realizadas na Divisão de Cirurgia Cardiovascular do Pronto Socorro Cardiológico de Pernambuco - PROCAPE. RESULTADOS: A mediastinite ocorreu, em média, 13 dias após a cirurgia, num total de 25 (2,4% casos, com taxa de letalidade 32,0% (n=8. Vários fatores de risco foram identificados: 56% diabéticos, 56% tabagistas, 20% obesos, 16% portadores de doença pulmonar obstrutiva crônica e 8% com insuficiência renal crônica. A maioria (n=21; 84,0% dos casos foi observada em pacientes submetidos à revascularização do miocárdio, sendo esta associada a maior risco de desenvolvimento da infecção (IC 3.44-8.30, P=0,0001. Observou-se alto índice de complicações: insuficiência respiratória (44%, acidente vascular cerebral (16%, choque cardiogênico (12%, insuficiência renal aguda (28%, infecção pulmonar (36%, falência de múltiplos órgãos (16% e deiscência de esterno (48%. A cultura do exsudato foi positiva em 84% dos casos, sendo o Staphylococcus aureus o patógeno mais observado (28,8%. CONCLUSÕES: A mediastinite continua como complicação cirúrgica bastante grave e de difícil manuseio no pós-operatório de cirurgia cardiovascular. A doença permanece como de baixa incidência, entretanto, ainda com alta letalidade. A cirurgia de revascularização está associada a maior risco de desenvolvimento da infecção.OBJECTIVE: To report the incidence of mediastinitis in cardiovascular surgery postoperation. METHODS: The records of all 1038 patients who underwent cardiovascular surgical procedures between May/2007 and June/2009 were reviewed. All operations were performed in Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE. RESULTS: The

  7. Ear, nose, throat, head and neck surgery department functioning as a team in Nigeria: any benefit?

    Science.gov (United States)

    Adobamen, P R O C; Egbage, E E

    2014-01-01

    To call attention to the synergistic benefit of working as a team in a clinical department and to encourage others, to emulate this pattern of patients' care for better results. Patients that were seen at the Ear, Nose, Throat, Head and Neck Surgery Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria, who had the benefit of their cases reviewed by more than one consultant were included into the study. Parameters retrieved from the case notes included number of consultants that reviewed each case, age, sex of patients, diagnosis, whether there was controversy, complimentary or synergistic benefit from the team work. 124 patients completed the study. 99 patients (79.84%) were reviewed by two consultants and 25 (20.16%) were reviewed by three of the four consultants available in the department. 79 (63.71%) patients had the benefit of a complimentary management, while 38 (30.65%) had synergistic benefit from the team work. Intradepartmental team work in patient management produces synergistic benefit for patients and more experience among consultant staff.

  8. Perioperative hyperoxia - Long-term impact on cardiovascular complications after abdominal surgery, a post hoc analysis of the PROXI trial

    DEFF Research Database (Denmark)

    Fonnes, Siv; Gogenur, Ismail; Sondergaard, Edith Smed;

    2016-01-01

    BACKGROUND: Increased long-term mortality was found in patients exposed to perioperative hyperoxia in the PROXI trial, where patients undergoing laparotomy were randomised to 80% versus 30% oxygen during and after surgery. This post hoc follow-up study assessed the impact of perioperative hyperoxia...... on long-term risk of cardiovascular events. METHODS: A total of 1386 patients undergoing either elective or emergency laparotomy were randomised to 80% versus 30% oxygen during and two hours after surgery. At follow-up, the primary outcome of acute coronary syndrome was assessed. Secondary outcomes...... included myocardial infarction, other heart disease, and acute coronary syndrome or death. Data were analysed in the Cox proportional hazards model. RESULTS: The primary outcome, acute coronary syndrome, occurred in 2.5% versus 1.3% in the 80% versus 30% oxygen group; HR 2.15 (95% CI 0.96-4.84). Patients...

  9. Comparison of effects of thiopental, propofol or ketamine on the cardiovascular responses of the oculocardiac reflex during strabismus surgery

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Safavi

    2007-10-01

    Full Text Available BACKGROUND: The oculocardiac reflex (OCR, which is most often encountered during strabismus surgery in children,
    may cause bradycardia, arrhythmias and cardiac arrest following a variety of stimuli arising in or near the eyeball. The
    main purpose of this study was to evaluate the effects of various anesthetic regimens on modulation of the cardiovascular
    effects of the OCR during strabismus surgery.
    METHODS: Three hundred ASA physical status I-II patients, scheduled for elective strabismus surgery under general
    anesthesia, randomly allocated in a double blind fashion to one of the three anesthetic regimens: group P: propofol (2
    mg/kg, alfentanil 0.02 mg/kg and atracurium 0.5 mg/kg at induction; group K: ketamine racemate (2 mg/kg, alfentanil
    0.02 mg/kg and atracurium 0.5 mg/kg at induction; group T: thiopental (5 mg/kg, alfentanil 0.02 mg/kg, and atracurium
    0.5 mg/kg at induction. Mean arterial pressure (MAP and heart rate (HR were recorded just before induction, at
    1, 15, 30, 45 and 60 minutes after induction. OCR was defined as a 20 beats/minute change in HR induced by traction
    compared with basal value.
    RESULTS: Mean HR (± SD during total period of surgery in group P was significantly slower than that in group K
    (111.90 ± 1.10 vs. 116.7 ± 0.70, respectively; P<0.05. Mean HR changes (± SD in group K was significantly higher
    than that in group P (11.2 ± 1.44 vs. 8.7 ± 1.50 respectively, P<0.05. MAP changes (± SD was significantly lower in
    patients in group P compared with patients in group K or T (12.5 ± 1.13 vs. 19.3 ± 0.80 or 18.9 ± 0.91, respectively;
    P<0.05. Incidence of OCR was significantly lower in patients in group K compared with patients in group T or P (9%
    vs. 16% and 13%. Respectively; P<0.05.
    CONCLUSIONS: Induction of anesthesia with ketamine is associated with the least

  10. Effects of bariatric surgery on pericardial ectopic fat depositions and cardiovascular function

    NARCIS (Netherlands)

    Schinkel, L.D. van; Sleddering, M.A.; Lips, M.A.; Jonker, J.T.; Roos, A. de; Lamb, H.J.; Jazet, I.M.; Pijl, H.; Smit, J.W.A.

    2014-01-01

    OBJECTIVE: Cardiac ectopic fat depositions are thought to play a role in the pathogenesis of cardiovascular disease (CVD), the main cause of death in patients with type 2 diabetes. Diet-induced weight loss results in a decrease in cardiac ectopic fat stores, however if this is the same for surgicall

  11. Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery

    DEFF Research Database (Denmark)

    Tully, Phillip J; Winefield, Helen R; Baker, Robert A

    2015-01-01

    BACKGROUND: Although depression and anxiety have been implicated in risk for major adverse cardiovascular and cerebrovascular events (MACCE), a theoretical approach to identifying such putative links is lacking. The objective of this study was to examine the association between theoretical...... conceptualisations of depression and anxiety with MACCE at the diagnostic and symptom dimension level. METHODS: Before coronary artery bypass graft (CABG) surgery, patients (N = 158; 20.9 % female) underwent a structured clinical interview to determine caseness for depression and anxiety disorders. Depression...... and anxiety disorders were arranged into the distress cluster (major depression, dysthymia, generalized anxiety disorder, post-traumatic stress disorder) and fear cluster (panic disorder, agoraphobia, social phobia). Patients also completed the self-report Mood and Anxiety Symptom Questionnaire, measuring...

  12. Orthostatic function and the cardiovascular response to early mobilization after breast cancer surgery

    DEFF Research Database (Denmark)

    Gamborg Müller, Rasmus; Bundgaard-Nielsen, Morten; Kehlet, H

    2010-01-01

    Early postoperative mobilization is essential for an enhanced recovery, but it can be hindered by orthostatic intolerance, characterized by signs of cerebral hypoperfusion, such as dizziness, nausea, vomiting, and ultimately syncope. Orthostatic intolerance is frequent after major surgical proced...... breast cancer surgery....

  13. Study of the Dynamics of Transcephalic Cerebral Impedance Data during Cardio-Vascular Surgery

    Science.gov (United States)

    Atefi, S. R.; Seoane, F.; Lindecrantz, K.

    2013-04-01

    Postoperative neurological deficits are one of the risks associated with cardio vascular surgery, necessitating development of new techniques for cerebral monitoring. In this study an experimental observation regarding the dynamics of transcephalic Electrical Bioimpedance (EBI) in patients undergoing cardiac surgery with and without extracorporeal circulation (ECC) was conducted to investigate the potential use of electrical Bioimpedance for cerebral monitoring in cardio vascular surgery. Tetrapolar transcephalic EBI measurements at single frequency of 50 kHz were recorded prior to and during cardio vascular surgery. The obtained results show that the transcephalic impedance decreases in both groups of patients as operation starts, however slight differences in these two groups were also observed with the cerebral impedance reduction in patients having no ECC being less common and not as pronounced as in the ECC group. Changes in the cerebral impedance were in agreement with changes of haematocrit and temperature. The origin of EBI changes is still unexplained however these results encourage us to continue investigating the application of electrical bioimpedance cerebral monitoring clinically.

  14. beta-blocker Therapy is Not Associated with Reductions in Angina or Cardiovascular Events After Coronary Artery Bypass Graft Surgery : Insights from the IMAGINE Trial

    NARCIS (Netherlands)

    Booij, Harmen G.; Damman, Kevin; Warnica, J. Wayne; Rouleau, Jean L.; van Gilst, Wiek H.; Westenbrink, B. Daan

    2015-01-01

    To evaluate whether beta-blockers were associated with a reduction in cardiovascular events or angina after Coronary Artery Bypass Graft (CABG) surgery, in otherwise stable low-risk patients during a mid-term follow-up. We performed a post-hoc analysis of the IMAGINE (Ischemia Management with Accupr

  15. Association of β-blocker therapy with risks of adverse cardiovascular events and deaths in patients with ischemic heart disease undergoing noncardiac surgery

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Mérie, Charlotte; Jørgensen, Mads

    2014-01-01

    IMPORTANCE: Clinical guidelines have been criticized for encouraging the use of β-blockers in noncardiac surgery despite weak evidence. Relevant clinical trials have been small and have not convincingly demonstrated an effect of β-blockers on hard end points (ie, perioperative myocardial infarction......, ischemic stroke, cardiovascular death, and all-cause death). OBJECTIVE: To assess the association of β-blocker treatment with major cardiovascular adverse events (MACE) and all-cause mortality in patients with ischemic heart disease undergoing noncardiac surgery. DESIGN, SETTING, PARTICIPANTS, AND EXPOSURE...... to calculate the 30-day risks of MACE (ischemic stroke, myocardial infarction, or cardiovascular death) and all-cause mortality associated with β-blocker therapy. MAIN OUTCOMES AND MEASURES: Thirty-day risk of MACE and all-cause mortality. RESULTS: Of 28,263 patients with ischemic heart disease undergoing...

  16. Temporomandibular Joint Disorders Among Patients Treated in the Department of Oral and Maxillofacial Surgery at Muhimbili National Hospital

    OpenAIRE

    2010-01-01

    Temporomandibular joint disorders (TMJD) are the most common debilitating conditions of the stomatognathic system. Although they exist in the community they are not mentioned in the literature as an endemic health problem. Their prevalence does not seem to be clear enough for the health system in Tanzania to give them priority as other health problems. Study setting: The study was done in the department of Oral and Maxillofacial Surgery at Muhimbili National Hospital (MNH). To determine the o...

  17. [The pneumoperitoneum course forecasting and surgery tactic in the group of patients with acute and chronic cholecystitis and concomitant pathology of cardiovascular system].

    Science.gov (United States)

    Korotkyĭ, V M; Soliaryk, S O; Tsyganok, A M; Sysak, O M

    2012-01-01

    The share of elderly and senile patients with acute cholecystitis concomitant cardiovascular pathology whom the laparoscopic cholecystectomy has been provided is increased. The heightened intraabdominal pressure has negative influence at the cardiovascular system, so the alternative ways for treatment of this group of patients are used in clinic. We propose the pneumoperitoneum model using the pneumatic belt which is fixed at the abdomen in preoperative period in patients with an acute and chronic cholecystitis. This model is useful to forecast cardiovascular disorders during future laparoscopic cholecystectomy. The arterial pressure level, pulse score and ECG are monitored during the test (90 min). Myocardial ischemia appearance seems that the risk of laparoscopic cholecystectomy with pneumoperitoneum is high. The alternative method of surgery in such group of patients (no pneumoperitoneum is applied) is laparoscopic assisted cholecystectomya from miniaccess. This method allows to reducing frequency of intra- and postoperative complications connected with pneumoperitoneum negative influence at the patients with concomitant pathology of cardiovascular system.

  18. Estratégias para redução do uso de hemoderivados em cirurgia cardiovascular Strategies to reduce the use of blood components in cardiovascular surgery

    Directory of Open Access Journals (Sweden)

    Helmgton José Brito de Souza

    2008-03-01

    Full Text Available OBJETIVO: O objetivo deste estudo é avaliar as estratégias adotadas por nossa equipe para reduzir o uso de hemoderivados em pacientes submetidos a cirurgia cardiovascular. MÉTODOS: Entre outubro de 2005 e janeiro de 2007, foram operados 101 pacientes. Destes, 51 (50,5% eram do sexo masculino e 50 (49,5% do feminino. A idade variou de 13 a 80 anos (média de 50,76 anos. A estratégia utilizada consiste em uso de antifibrinolíticos, hemodiluição normovolêmica e reposição total do perfusato. RESULTADOS: A média de utilização de hemoderivados por paciente foi de 1,45 UI de CH; 0,75 UI de PF; 0,89 UI de crioprecipitados e 1,43 UI de plaquetas. Em 59 (58,4% pacientes, não foram usados hemoderivados e somente 12 (11,9% pacientes necessitaram mais de quatro UI de CH. Dentre os 27 (26,7% pacientes cujo tempo de circulação extracorpórea (CEC excedeu os 120 minutos, 17 (63% necessitaram de hemotransfusão. Apenas três (2,97% pacientes desenvolveram coagulopatia, sendo dois (1,98% reoperados por sangramento. Dos três pacientes que desenvolveram coagulopatia, dois pertenciam ao subgrupo de idosos. CONCLUSÃO: Na série apresentada, as medidas adotadas conseguiram reduzir a necessidade de hemotransfusão no pós-operatório de cirurgia cardíaca. Pacientes com tempo de CEC maior que 120 minutos tenderam a necessitar de hemotransfusão. A associação de cirurgia em pacientes idosos e tempo de CEC superior a 120 minutos resultou em maior utilização de sangue e hemoderivados no período pós-operatório.OBJECTIVE: The aim of this study is to evaluate the strategies adopted by our team to reduce the use of bloods components in patients undergoing cardiovascular surgical procedures. METHODS: Between October 2005 and January 2007, 101 patients were operated. Fifty-one (50.5% were male and 50 (49.5% female. Patients' age ranged from 13 to 80 years (mean of 50.76 years. The strategy consisted in using antifibrinolytics and normovolemic

  19. N-acetylcysteine instead of theophylline in patients with COPD who are candidates for elective off-pump CABG surgery: Is it possible in cardiovascular surgery unit?

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    Seyed Jalil Mirhosseini

    2013-01-01

    Full Text Available Background: Forced expiratory volume in one second (FEV1 is a good predictor of chronic obstructive pulmonary disease (COPD. COPD is characterized by a chronic limitation of airflow. This study was designed to compare the effects and complications of theophylline alone, N-acetylcysteine (NAC alone, and a combination of the two drugs on the rates of FEV1 in patients with COPD who were candidates for off-pump coronary artery bypass graft (CABG surgery. Methods: This clinical trial was performed on 100 patients who had a smoking history of 27 pack years with a range of 20 to 40 pack years but were not heavy smokers and were candidates for elective off-pump CABG surgery in Afshar Cardiovascular Hospital, Yazd, Iran. The patients with a history of asthma and bronchospasm and non-COPD respiratory disorders were excluded. There were three groups, that is, the theophylline group (n=33 that received theophylline 10 mg/kg TDS after consumption of food, NAC group (n=33 who received NAC 10-15 mg/kg BD after consumption of food, and the combined group (n=32 who received theophylline and NAC together. Data were analyzed by analysis of variance (ANOVA, Chi-square, and exact test for quantitative and qualitative variables. Results: One hundred patients with COPD enrolled in this study as possible candidates for CABG surgery. Average age of the patients was 60.36±10.21 years. Of the participants, 83 (83.3% were male and 17 (17% were female. Rate of postoperative FEV1 to basal FEV1 was 0.76±0.32, 0.66±0.22, and 0.69±0.24 in the treatments with theophylline, NAC, and the combination, respectively. Theophylline, NAC, and a combination of these drugs can decrease the rate of postoperative FEV1 compared to basal FEV1 significantly. (P=0.0001 Conclusion: Theophylline alone, NAC alone, and a combination of these drugs improve pulmonary function, and there are no significant differences between these protocols. Stomach discomfort and cardiac complications in

  20. Role of multimodality cardiac imaging in preoperative cardiovascular evaluation before noncardiac surgery

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    Fathala Ahmed

    2011-01-01

    Full Text Available The preoperative cardiac assessment of patients undergoing noncardiac surgery is common in the daily practice of medical consultants, anesthesiologists, and surgeons. The number of patients undergoing noncardiac surgery worldwide is increasing. Currently, there are several noninvasive diagnostic tests available for preoperative evaluation. Both nuclear cardiology with myocardial perfusion single photon emission computed tomography (SPECT and stress echocardiography are well-established techniques for preoperative cardiac evaluation. Recently, some studies demonstrated that both coronary angiography by gated multidetector computed tomography and stress cardiac magnetic resonance might potentially play a role in preoperative evaluation as well, but more studies are needed to assess the role of these new modalities in preoperative risk stratification. A common question that arises in preoperative evaluation is if further preoperative testing is needed, which preoperative test should be used. The preferred stress test is the exercise electrocardiogram (ECG. Stress imaging with exercise or pharmacologic stress agents is to be considered in patients with abnormal rest ECG or patients who are unable to exercise. After reviewing this article, the reader should develop an understanding of the following: (1 the magnitude of the cardiac preoperative morbidity and mortality, (2 how to select a patient for further preoperative testing, (3 currently available noninvasive cardiac testing for the detection of coronary artery disease and assessment of left ventricular function, and (4 an approach to select the most appropriate noninvasive cardiac test, if needed.

  1. The cardiovascular effects of sevoflurane and isoflurane after premedication of healthy dogs undergoing elective surgery.

    Science.gov (United States)

    Abed, Janan M; Pike, Fred S; Clare, Monica C; Brainard, Benjamin M

    2014-01-01

    Sevoflurane and isoflurane are commonly used in veterinary anesthesia. The objective of this prospective, randomized, open-label clinical study was to compare the cardiovascular effects of sevoflurane and isoflurane via direct arterial blood pressure measurements and the lithium dilution cardiac output (LDCO) on premedicated healthy dogs undergoing elective tibial plateau leveling osteotomy (TPLO). Nineteen client-owned dogs were included. All dogs were premedicated with hydromorphone (0.05 mg/kg IV and glycopyrrolate 0.01 mg/kg subcutaneously). Ten dogs were anesthetized with sevoflurane and nine dogs were anesthetized with isoflurane. Eighteen dogs were instrumented with a dorsal pedal arterial catheter, and one dog had a femoral arterial catheter. All dogs had continuous, direct systolic (SAP), diastolic (DAP), and mean arterial (MAP) blood pressure readings as well as heart rate (HR), cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI), stroke volume variation (SVV), and pulse pressure variation (PPV) recorded q 5 min during the surgical procedure. There was no significant statistical difference in all parameters between the sevoflurane and isoflurane treatment groups. Both sevoflurane and isoflurane inhalant anesthetics appear to have similar hemodynamic effects when used as part of a multimodal anesthetic protocol in premedicated healthy dogs undergoing an elective surgical procedure.

  2. A Novel Clinical Pharmacy Management System in Improving the Rational Drug Use in Department of General Surgery

    Directory of Open Access Journals (Sweden)

    L Bao

    2013-01-01

    Full Text Available Hospital information system is widely used to improve work efficiency of hospitals in China. However, it is lack of the function providing pharmaceutical information service for clinical pharmacists. A novel clinical pharmacy management system developed by our hospital was introduced to improve the work efficiency of clinical pharmacists in our hospital and to carry out large sample statistical analyzes by providing pharmacy information services and promoting rational drug use. Clinical pharmacy management system was developed according to the actual situation. Taking prescription review in the department of general surgery as the example, work efficiency of clinical pharmacists, quality and qualified rates of prescriptions before and after utilizing clinical pharmacy management system were compared. Statistics of 48,562 outpatient and 5776 inpatient prescriptions of the general surgical department were analyzed. Qualified rates of both the inpatient and outpatient prescriptions of the general surgery department increased, and the use of antibiotics decreased. This system apparently improved work efficiency, standardized the level and accuracy of drug use, which will improve the rational drug use and pharmacy information service in our hospital. Meanwhile, utilization of prophylactic antibiotics for the aseptic operations also reduced.

  3. Surveillance of antibiotic and analgesic use in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo

    Directory of Open Access Journals (Sweden)

    Haliti NR

    2015-10-01

    Full Text Available Naim R Haliti,1 Fehim R Haliti,2 Ferit K Koçani,3 Ali A Gashi,4 Shefqet I Mrasori,3 Valon I Hyseni,5 Samir I Bytyqi,5 Lumnije L Krasniqi,2 Ardiana F Murtezani,5 Shaip L Krasniqi5 1Department of Forensic Medicine, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, 2Department of Children Dentistry, University Dentistry Clinical Center of Kosovo, 3Department of Oral Disease, University Dentistry Clinical Center of Kosovo, 4Department of Oral Surgery, University Dentistry Clinical Center of Kosovo, 5Institute of Pharmacology and Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, Prishtina, Kosovo Background: Because Kosovo has no reliable information on antimicrobial and analgesic use in dental practice, the survey reported here evaluated the antibiotic and analgesic prescriptions in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo (UDCCK.Methods: The data of 2,442 registered patients for a 1-year period were screened and analyzed concerning antibiotic and analgesic use as per standards of rational prescription.Results: Dentistry doctors prescribed antibiotics significantly more often than analgesics. Antibiotics were prescribed in 8.11% of all cases, while only 1.35% of total prescriptions were for analgesics. The total consumption of antibiotic drugs in the UDCCK was 4.53 Defined Daily Doses [DDD]/1,000 inhabitants/day, compared with only 0.216 DDD/1,000 inhabitants/day for analgesics. From a total number of 117 patients, 32 patients received combinations of two antibiotics.Conclusion: Pharmacotherapy analysis showed that the prescription rates of antibiotics and analgesics in the UDCCK are not rational in terms of the qualitative aspects of treatment. For the qualitative improvement of prescription of these drug groups, we recommend the implementation of treatment guidelines following rational standards. Keywords: antibiotic, analgesics

  4. Surgery

    Science.gov (United States)

    ... the hospital, sometimes in an intensive care unit (ICU). Direct discharge home A person being sent home ... from surgery should occur gradually. Some people need rehabilitation , which involves special exercises and activities, to improve ...

  5. Oral surgical procedures and prevalence of oral diseases in Oral Surgery Department in Faculty of Dentistry Sarajevo

    Directory of Open Access Journals (Sweden)

    Sadeta Šečić

    2013-12-01

    Full Text Available Introduction: The aim of this study is to determine prevalence of oral diseases and oral surgical procedures at Department of Oral Surgery, Faculty of Dental Medicine, University in Sarajevo.Methods: The current study is retrospective analysis of oral surgical procedures performed from January 2011 to December 2012 at Department of Oral Surgery, Faculty of Dental Medicine, University in Sarajevo. The data were statistically analyzed by T-test of independent samples and using Chi-squared test. P value lower than 0,001 was considered to be statistically significant.Results: A total of 1299 patients were included in study. The age range is from 18 to 84 years, with mean age ± SD= 35±15 years. There were 42 different clinical diagnoses, and 13 diagnoses appeared in more than 1% of all patients. Impacted and semi-impacted teeth, periapical lesions and retained roots are the most frequent diagnoses and represent 68% of all diagnoses. Embedded and impacted teeth (35% and diseases of pulp and periapical tissues (31% are the most frequent diagnoses with respect of ICD-10. Impacted teeth is the most common diagnosis and removal of impacted third molars is the most common oral surgical procedure.Conclusion: Study points out variety of dentoalveolar patology and complexity of dental health care that often requires interdisciplinary approach in order to achieve optimal outcome for patient.

  6. The effects of work on the health of nurses who work in clinical surgery departments at university hospitals 1

    Science.gov (United States)

    da Silva, Rosângela Marion; Zeitoune, Regina Célia Gollner; Beck, Carmem Lúcia Colomé; de Martino, Milva Maria Figueiredo; Prestes, Francine Cassol

    2016-01-01

    ABSTRACT Objective: to analyze the effects of work on the health of nurses who work in clinical surgery departments at university hospitals in relation to physical, social and psychological suffering and pain. Methods: a quantitative transversal study was carried out between 2012 and 2013 in four institutions in a state located in the south of Brazil. We studied 65 nurses who responded to questions on their habits. We also obtained sociodemographical information on them as well as conducting an evaluation on work relational damage using an evaluation scale. Associations were checked through the use of the Chi-Sqaure and Fisher's exact test. Correlations were checked using the Spearmann test. Results: we found that physical ailments persisted and that there were connections between social and psychological pain/suffering and variable physical activities as well as connections with accidents in the work place and the option to work shifts. We noted correlations between social and psychological pain/suffering. Conclusion: nurses had their health compromised due to their work in clinical surgery departments. PMID:27508914

  7. THORACIC AND CARDIOVASCULAR SURGERY

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    5.2 Upper respiratory tract, lung960697 Analysis of surgical treatment in474 patients with small cell lung cancer. BaiLianqi (白连启), et al. Beijing Res Inst TuberThorac Tumor, Beijing 101149. Chin J ThoracCardiovasc Surg 1996; 12(4): 211-213 The author summarized the effect and indi-cation of surgical resection of small cell lungcancer in 474 patients from 1957 to the end of

  8. Tourniquet-induced cardiovascular responses in anterior cruciate ligament reconstruction surgery under general anesthesia: Effect of preoperative oral amantadine

    Directory of Open Access Journals (Sweden)

    Ashraf Abd Elmawgood

    2015-01-01

    Conclusion: Preoperative oral amantadine reduced tourniquet induced hypertension and postoperative analgesic requirements in anterior cruciate ligament reconstruction surgery under general anesthesia.

  9. Analysis of impacted and retained teeth operated at Department of Oral Surgery, School of Dental Medicine, Zagreb.

    Science.gov (United States)

    Brakus, Ivan; Filipović Zore, Irina; Borić, Ratka; Siber, Stjepan; Svegar, Domagoj; Kuna, Tihomir

    2010-03-01

    The purpose of the present study is to see whether we follow global guidelines for operative procedures and diagnoses for impacted and retained teeth, and to compare these results with older results in Croatia. Operative protocols from Department of Oral Surgery, School of Dental Medicine, Zagreb in the period from 1997 till 1999 were used in the present study. 4756 patients were operated (total of 4857 diagnosis were set). Of all diagnoses, 24.89% (N=1209) belongs to dens impactus, 5.13% (N=249) to dens semiimpactus, 6.05% (N=294) to dens retentus and 0.64% (N=31) to dentitio difficilis. These four diagnoses make 36.71% of all 4857 set diagnoses. Most commonly impacted teeth are: 8- (38.64%), -8 (35.88%), 8+ (10.9%) and +8 (9.29%). Most commonly retained teeth are: 3+ (19.1%) and +3 (18.8%), while in the remaining two diagnoses -8 and 8- are most commonly diagnosed and operated teeth. Impacted teeth are in 97.90% of the cases operated by alveolotomy procedure. With semiimpacted teeth alveolotomy was conducted in 94.12% cases, and 5.10% of such teeth were extracted. With retained teeth alveolotomy was conducted in 65.21%, corticotomy in 23.01% and extraction in 8.77% of the cases. With dentitio difficilis alveolotomy was applied in 46.88%, extraction in 37.50%, circumcision in 9.38% and corticotomy in 6.25% of the cases. Intra muscular corticosteroids (Dexamethason) were used in 2.80% of the cases, most commonly with dens impactus and dens retentus diagnosis. PHD was done in 4.21% cases. Although its use is on the increase, Dexamethason is still rarely used in everyday practice, despite global guidelines for the postoperative use of corticosteroids. PHD analysis is used most commonly with retained teeth since they usually come with follicular cysts. Anesthesia without epinephrine was used in only 1.80% of the operating procedures, because the epinephrine solution used at Oral Surgery Department is 1:160000.

  10. a Bariatric Surgery Department

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    Ramon Vilallonga

    2012-01-01

    Full Text Available Objective. Robot-assisted sleeve gastrectomy has the potential to treat patients with obesity and its comorbidities. To evaluate the learning curve for this procedure before undergoing Roux en-Y gastric bypass is the objective of this paper. Materials and Methods. Robot-assisted sleeve gastrectomy was attempted in 32 consecutive patients. A survey was performed in order to identify performance variables during completion of the learning curve. Total operative time (OT, docking time (DT, complications, and length of hospital stay were compared among patients divided into two cohorts according to the surgical experience. Scattergrams and continuous curves were plotted to develop a robotic sleeve gastrectomy learning curve. Results. Overall OT time decreased from 89.8 minutes in cohort 1 to 70.1 minutes in cohort 2, with less than 5% change in OT after case 19. Time from incision to docking decreased from 9.5 minutes in cohort 1 to 7.6 minutes in cohort 2. The time required to dock the robotic system also decreased. The complication rate was the same in the two cohorts. Conclusion. Our survey indicates that technique and outcomes for robot-assisted sleeve gastrectomy gradually improve with experience. We found that the learning curve for performing a sleeve gastrectomy using the da Vinci system is completed after about 20 cases.

  11. Topical negative pressure therapy Recent experience of the department of plastic surgery at Ibn Sina University Hospital, Rabat, Morocco

    Directory of Open Access Journals (Sweden)

    Abdelmoughit Echchaoui

    2014-12-01

    Full Text Available IntroductionThe topical negative pressure therapy (TNP is a non-invasive method to treat chronic and acute wounds locally, using a continuous or intermittent negative pressure.The objective of this study is to present the first experience of this type of treatment used in clinical cases in our department. By presenting these cases, we highlight indication and efficiency of this new technique applied in relatively complicated situations, at the same time it also allows a significant improvement in treating injuries and chronic wounds.Materials and methodsIn this study, we present the recent experience of the Department of Reconstructive and Plastic Surgery of the University Hospital Center of Avicenne in Rabat. This therapy was used for the first time this year (in 2014, in three young patients who presented with chronic wounds associated with local and general factors that are unfavorable for the healing process.ResultsIn all three of our cases we obtained highly satisfactory clinical results.TNP allows wounds to bud in a shorter time, as well as a fast healing by second intention due to controlled wound healing or split-skin graft without using flaps. This enables to decrease the margin of error, the time and the number of dressing replacements, and to reduce the length of hospital stay.ConclusionThis is an expensive and specific equipment. However, the cost-benefit ratio analysis shows that it is an essential method that should be part of our therapeutic strategies.Keywords: loss of substance, negative pressure, budding, healing.  

  12. [Dr. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery, Kyoto University, and his achievements (Part 6: Studying abroad of Dr. Matsuoka and opening to public, reputation and achievement of the department)].

    Science.gov (United States)

    Hirotani, Hayato

    2011-03-01

    Dr. Michiharu Matsuoka studied orthopaedic surgery in Germany, Austria and other countries during the period from August, 1902 to May, 1906. He visited many university pathological institutes and surgical and orthopaedic clinics to study pathology and to learn the practice of orthopaedic surgery. After that, he started his practice at the newly established Department of Orthopaedic Surgery in the Medical School of Kyoto Imperial University in June, 1906. The department was opened in 1907 and in 1911 it was opened to all citizens and practical doctors in Kyoto City and exhibited many orthopaedic specimens and instruments. In particular, the x-ray apparatus of the Department was so well equipped that a German radiologist who visited the Department admired it in his article that was published in the journal of radiology in 1911. The Department was not surpassed by others for the number of patients with the dislocation of the hip and tuberculous spondylitis as well as the advanced quality and variety of roentgenological and pathological researches on these diseases.

  13. Emprego do suporte cardiopulmonar com bomba centrífuga e oxigenador de membrana em cirurgia cardiovascular pediátrica Use of centrifugal pump and extracorporeal membrane oxygenation as cardiopulmonary support in pediatric cardiovascular surgery

    Directory of Open Access Journals (Sweden)

    Fernando A. Atik

    2008-04-01

    several aspects related to the use of extracorporeal membrane oxygenation in a pediatric heart center and determine its immediate and late outcomes. METHODS: Between October 2005 and January 2007, 10 patients who were submitted to pediatric cardiac surgery underwent extracorporeal membrane oxygenation implant. Median age was 58.5 days (40% neonates and median body weight was 3.9 kg. Circulatory assistance was initiated aiming at the recovery and the weaning protocols followed daily clinical and echocardiographic criteria. Support was discontinued when transplant was contraindicated, when the patient was unable to recover or when survival was considered to be limited by a multidisciplinary team. RESULTS: Extracorporeal membrane oxygenation was employed after corrective or palliative heart surgery in 80% and preoperatively in the remaining ones. It was most often indicated for irresponsive hemodynamic instability (40%, post-cardiotomy shock (20% and post-cardiac arrest (20%. The mean duration on support was 58 ± 37 hours. Weaning was successfully in 50% of the cases and 30% were discharged home. Actuarial survival was 40%, 30% and 20% at 30 days, 3 months and 24 months, respectively. CONCLUSION: Extracorporeal membrane oxygenation is an effective and useful tool for the resuscitation of patients presenting severe hemodynamic and/or respiratory failure in the perioperative period of pediatric cardiovascular surgery.

  14. Connotation Construction of the Department of Trauma Surgery%论创伤外科内涵建设

    Institute of Scientific and Technical Information of China (English)

    张连阳

    2011-01-01

    本文所指创伤外科是集中收治从头到脚的主要损伤的外科病房.本文论述创伤外科与急诊医学、重症医学、灾难医学和野战外科的关系,并对创伤外科的内涵,建设创伤外科的条件和面临的主要问题进行探讨.%In the article, trauma surgery refers to the surgical ward for patients with injury from head to foot. The relation of trauma surgery with emergency medicine, critical care medicine, disaster medicine, military surgery was discussed. The author also defined the connotation of trauma surgery, pointed out the main problems faced by the construction of trauma surgery.

  15. Internet Presentation of Departments of Pediatric Surgery in Germany and Their Compliance with Recommended Criteria for Promoting Services and Offering Professional Information for Patients.

    Science.gov (United States)

    Farhat, Naim; Zoeller, Christoph; Petersen, Claus; Ure, Benno

    2016-08-01

    Introduction The presentation of health institutions in the internet is highly variable concerning marketing features and medical information. We aimed to investigate the structure and the kind of information provided on the Web sites of all departments of pediatric surgery in Germany. Furthermore, we aimed to identify the degree to which these Web sites comply with internet marketing recommendations for generating business. Method The Web sites of all pediatric surgery units referred to as departments on the official Web site of the German Society of Pediatric Surgery (GSPS) were assessed. The search engine Google was used by entering the terms "pediatric surgery" and the name of the city. Besides general data eight content characteristics focusing on ranking, accessibility, use of social media, multilingual sites, navigation options, selected images, contact details, and medical information were evaluated according to published recommendations. Results A total of 85 departments of pediatric surgery were included. On Google search results 44 (52%) ranked number one and 34 (40%) of the department's homepages were accessible directly through the homepage link of the GSPS. A link to own digital and/or social media was offered on 11 (13%) homepages. Nine sites were multilingual. The most common navigation bar item was clinical services on 74 (87%) homepages. Overall, 76 (89%) departments presented their doctors and 17 (20%) presented other staff members with images of doctors on 53 (62%) and contact data access from the homepage on 68 (80%) Web sites. On 25 (29%) Web sites information on the medical conditions treated were presented, on 17 (20%) details of treating concepts, and on 4 (5%) numbers of patients with specific conditions treated in the own department per year. Conclusion We conclude that numerous of the investigated online presentations do not comply with recommended criteria for offering professional information for patients and for promoting

  16. Art to Heart: The Effects of Staff- Created Art on the Postoperative Rehabilitation of Cardiovascular Surgery Patients.

    Science.gov (United States)

    Bowen, Mary Gwyn; Wells, Nancy L; Dietrich, Mary S; Sandlin, Victoria

    2015-01-01

    Postoperative ambulation is important for reducing complications following surgery. The type of art patients view on the ambulation route may influence the distance patients walk. In this study, patients ambulated greater distances when staff-created art was placed on hallway walls.

  17. An audit of the quality of referral letters received by the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital.

    LENUS (Irish Health Repository)

    Moloney, Justin

    2010-11-01

    One hundred consecutive referral letters, sent by dental practitioners to the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital, were audited in terms of quality. The audit was based on the Scottish Intercollegiate Guidelines Network (SIGN) recommendations of 1998. The audit demonstrated that in general referral letters required modification and did not give the clinician the required information. This paper sets out the results of the audit and suggests a template that should be used for future referrals.

  18. An audit of the quality of referral letters received by the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital.

    LENUS (Irish Health Repository)

    Moloney, Justin

    2010-10-01

    One hundred consecutive referral letters, sent by dental practitioners to the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital, were audited in terms of quality. The audit was based on the Scottish Intercollegiate Guidelines Network (SIGN) recommendations of 1998. The audit demonstrated that in general referral letters required modification and did not give the clinician the required information. This paper sets out the results of the audit and suggests a template that should be used for future referrals.

  19. [Guidelines for intensive care in cardiac surgery patients: haemodynamic monitoring and cardio-circulatory treatment guidelines of the German Society for Thoracic and Cardiovascular Surgery and the German Society of Anaesthesiology and Intensive Care Medicine].

    Science.gov (United States)

    Carl, M; Alms, A; Braun, J; Dongas, A; Erb, J; Goetz, A; Göpfert, M; Gogarten, W; Grosse, J; Heller, A; Heringlake, M; Kastrup, M; Kröner, A; Loer, S; Marggraf, G; Markewitz, A; Reuter, M; Schmitt, D V; Schirmer, U; Wiesenack, C; Zwissler, B; Spies, C

    2007-03-01

    Hemodynamic monitoring and adequate volume-therapy, as well as the treatment with positive inotropic drugs and vasopressors, are the basic principles of the postoperative intensive care treatment of patient after cardiothoracic surgery. The goal of these S3 guidelines is to evaluate the recommendations in regard to evidence based medicine and to define therapy goals for monitoring and therapy. In context with the clinical situation the evaluation of the different hemodynamic parameters allows the development of a therapeutic concept and the definition of goal criteria to evaluate the effect of treatment. Up to now there are only guidelines for subareas of postoperative treatment of cardiothoracic surgical patients, like the use of a pulmonary artery catheter or the transesophageal echocardiography. The German Society for Thoracic and Cardiovascular Surgery and the German Society for Anaesthesiology and Intensive Care Medicine made an approach to ensure and improve the quality of the postoperative intensive care medicine after cardiothoracic surgery by the development of S3 consensus-based treatment guidelines. Goal of this guideline is to assess available monitoring methods and their risks as well as the differentiated therapy of volume-replacement, positive inotropic support and vasoactive drugs, the therapy with vasodilators, inodilators and calcium-sensitizers and the use of intra-aortic balloon pumps. The guideline has been developed according to the recommendations for the development of guidelines by the Association of the Scientific Medical Societies in Germany (AWMF). The presented key messages of the guidelines were approved after two consensus meetings under the moderation of the Association of the Scientific Medical Societies in Germany (AWMF).

  20. Influence of head flexion on intraocular pressure, cardiovascular, and respiratory responses in patients undergoing cataract surgery after endotracheal intubation

    Directory of Open Access Journals (Sweden)

    MR Safavi

    2007-11-01

    Full Text Available Background: In cataract surgery, the periorbital area is prepared anddraped after induction of general anesthesia and endotracheal intubation (ETI.For this purpose, the patient’s head and neck is usually flexed 30 to 45degrees. Neck flexion causes displacement of the endotracheal tube tip towardthe carina. Stimulation of the tracheal mucosa may cause bucking, increasedintraocular pressure (IOP, laryngospasm and/or bronchospasm, during lightanesthesia. Laryngeal constriction and all components of the tracheal responsemay affect end-tidal carbon dioxide pressure (PETCO2 and peripheral arterialhemoglobin oxygen saturation (SpaO2. Thus, in the current study, weinvestigated the influence of head and neck flexion on heart rate (HR, systolicand diastolic blood pressure (SAP and DAP, SpaO2, PETCO2, and IOP in patientsundergoing cataract surgery with endotracheal intubation during generalanesthesia.Patients and Methods: The present prospective study comprised patientsaged from 40 to 80 year with 106 American Society of Anesthesia (ASA physicalstatus I and II. Anesthesia was induced with thiopental sodium, lidocaine andfentanyl. Atracurium 0.5 mg/kg was administered to facilitate trachealintubation. HR, SAP, DAP, SpaO2, PETCO2, and IOP were measured at 1, 2, and 5minutes after head flexion.Results: Mean SAP, DAP, IOP, and HR was increased after ETI and headflexion compared with baseline values. PETCO2 and SpaO2 were decreased after ETIand at 1, 2 minutes after head flexion compared with baseline values.Conclusion: In patients undergoing cataract surgery during generalanesthesia, endotracheal tube movement caused changes in head and neck positionresulting in significant effects on heart rate, systolic and diastolic bloodpressures, laryngeal reflexes, SpaO2, PETCO2, and intraocular pressure.

  1. Age-specific performance of the revised cardiac risk index for predicting cardiovascular risk in elective noncardiac surgery

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Wissenberg, Mads; Jørgensen, Mads Emil;

    2015-01-01

    BACKGROUND: The revised cardiac risk index (RCRI) holds a central role in preoperative cardiac risk stratification in noncardiac surgery. Its performance in unselected populations, including different age groups, has, however, not been systematically investigated. We assessed the relationship......%, 71%, 64%, 66%, and 67% in patients aged ≤ 55, 56 to 65, 66 to 75, 76 to 85, and >85 years, respectively; the negative predictive values were >98% across all age groups. CONCLUSIONS: In a nationwide unselected cohort, the performance of the RCRI was similar to that of the original cohort. Having ≥ 1...

  2. [Systemic Antimicrobials Consumption and Expenditures in Departments of Surgery of Multi-Profile Hospitals in the Russian Federation and the Republic of Belarus: Results of Multicentre Pharmacoepidemiological Study].

    Science.gov (United States)

    Belkova, Yu A; Rachina, S A; Kozlov, R S; Mishchenko, V M; Pavlukov, R A; Abubakirova, A I; Berezhanskiy, B V; Eliseeva, E V; Zubareva, N A; Karpov, I A; Kopylova, I A; Palyutin, Sh Kh; Portnyagina, U S; Pribytkova, O V; Samuylo, E K

    2016-01-01

    The results of the systemic antimicrobials (AM) consumption and expenditures assessment in the departments of surgery of multi-profile hospitals in different regions of the Russian Federation and the Republic of Belarus in 2009-2010 based on retrospective collection and analysis of the data from the hospital expenditure notes using ATC/DDD methodology are presented. The average AM consumption and expenditure rates in the above mentioned departments varied from 24.9 DDD/100 bed-days to 61.7 DDD/100 bed-days depending on the department profile, with beta-lactams (cephalosporins and penicillins) share in the consumption being as high as 70-90%, followed by fluoroquinolones and aminoglycosides. Only 55-70% of the consumed AM belonged to the drugs of choice, whereas the improper AM consumption and expenditure rates amounted up to 10-18%. The study outputs can be used for the budget allocation and AM distribution improvement in the departments of surgery, as well as for the development and efficacy control of the local antimicrobial stewardship programs.

  3. Resultados da implementação de modelo organizacional de um serviço de cirurgia cardiovascular Results of the establishment of an organizational model in a cardiovascular surgery service

    Directory of Open Access Journals (Sweden)

    Fernando A. Atik

    2009-06-01

    Full Text Available OBJETIVO: A crescente complexidade de pacientes encaminhados a cirurgia cardíaca exige maior eficiência dos serviços que prestam assistência, no sentido de manter a mesma qualidade. O objetivo é examinar o impacto, em curto prazo, da adoção de um modelo organizacional nos resultados cirúrgicos. MÉTODOS: No período entre janeiro de 2006 a junho de 2007, 367 pacientes adultos consecutivos foram submetidos à cirurgia cardiovascular. Os dados pré, intra e pós-operatórios foram colhidos prospectivamente e armazenados em um banco de dados institucional. Modelo organizacional foi implementado em agosto de 2006 e se baseou em trabalho multiprofissional integrado centralizado no paciente, medicina baseada em evidências com condutas padronizadas e resolução de conflitos interpessoais. Os desfechos estudados foram mortalidade hospitalar e eventos combinados (óbito, acidente vascular cerebral, infarto agudo do miocárdio e insuficiência renal aguda, por meio de regressão logística multivariada. RESULTADOS: Após a adoção do modelo, houve redução da mortalidade hospitalar (de 12% para 3,6%, risco relativo= 0,3; P=0,003 e de eventos combinados (de 22% para 15%, risco relativo= 0,68; P=0,11. Operações realizadas anteriormente à implementação do modelo estiveram associadas independentemente com maior mortalidade (OR=2,5; P=0,04, ajustada para características préoperatórias e complexidade pelo EuroSCORE. Outros preditores de mortalidade foram idade > 65 anos (OR=6,36; IC95% 2,57 - 17,21; P 145 minutos (OR=8,57; IC95% 3,55 - 21,99; POBJECTIVE: Increasing complexity of patients referred to cardiac surgery demands more effective heart centers, in order to maintain the same quality. The aim of this study is to examine the short-term effect of adoption of an organizational model on surgical outcomes. METHODS: From January 2006 to June 2007, 367 consecutive adult patients underwent cardiovascular surgery. Pre-, intra- and postoperative

  4. 野战心血管介入手术方舱的护理配合模式%Nursing Cooperation Mode of Field Cardiovascular Interventional Surgery Shelter

    Institute of Scientific and Technical Information of China (English)

    李菲; 孙景阳; 姚天明; 梁明; 霍煜; 梁卓; 韩雅玲

    2011-01-01

    Objective To discuss the nursing cooperation in field cardiovascular interventional surgery shelter. Methods Under the simulate field environment and settings,cardiovascular interventional operations were performed in the shelter on the large animals (experimental pigs and dogs) combined with certain nursing procedure. Results Totally 19 cases of interventional operations,including 7 coronary angiog-raphies,4 coronary stenting,2 stent-graft occlusions, 1 left bundle branch radiofrequency ablation and 5 temporary cardiac pacing,were performed on 16 animals combined with relative nursing procedure. The total success rate was 94. 7%. Conclusion The speedy, practical and effective of nursing cooperation mode in the field cardiovascular interventional shelter play the vital roles in guaranteeing the success of field interventional operation.%目的 探讨野战条件下心血管介入手术方舱的护理配合.方法 对野战心血管介入手术方舱进行拉动展开,模拟野战条件下的环境及条件,在方舱内对大动物(实验猪或狗)进行介入手术演练,以特定的护理流程形成有效的护理配合,构建野战条件下心血管介入方舱的护理配合模式.结果 在方舱内对16只动物进行19例次介入手术,其中冠状动脉造影术7例次、心脏临时起搏术5例次、冠脉支架置入术4例次、带膜支架封堵术2例次、左束支射频消融术1例次,配合相关的护理流程,手术成功率达94.7%.结论 野战条件下,在心血管介入方舱内行介入救治手术时,快速、高效、实用的护理配合是手术成功的有效保证.

  5. 浅析临床普外危重症的治疗%Analysis of Clinical Treatment of Critically Ill Patients in General Surgery Department

    Institute of Scientific and Technical Information of China (English)

    付寒林

    2015-01-01

    目的:研究分析普外科危重患者的临床治疗方式。方法根据我院普外科危重患者186例的临床治疗资料来进行研究分析,术后为患者提供氧代谢来调整器官功能情况,对治疗效果进行总结分析。结果患者接受一系列治疗措施后,致死率比较低,治疗效果较显著。结论普外科患者接受手术治疗,清除感染病灶,遏制高分解代谢能够对患者的生命体征稳定起到帮助,降低了临床死亡率,提升手术治疗效果,改善患者的生活质量。%Objective To study the clinical treatment of critically ill patients in department of general surgery.Methods According to the clinical treatment data of 186 cases of critically ill patients in the department of general surgery in our hospital to carry on the research analysis, for patients with postoperative oxygen metabolism to adjust the organ function, to analyze the therapeutic effect.Results A series of treatment measures in this study of patients in clinic, the lethal rate was relatively low, relatively significant patients receive treatment effect.ConclusionPatients in the department of general surgery received operation treatment, clear the infection foci, curb high catabolism stable vital signs, can reduce clinical mortality, improve the effect of operation treatment, improve the quality of life of patients.

  6. Comparison of cardiovascular magnetic resonance of late gadolinium enhancement and diastolic wall thickness to predict recovery of left ventricular function after coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Udompunturak Suthipol

    2008-09-01

    Full Text Available Abstract Background The objective was to compare the value of late gadolinium enhancement (LGE and end-diastolic wall thickness (EDWT assessed by cardiovascular magnetic resonance (CMR in predicting recovery of left ventricular function after coronary artery bypass surgery (CABG. Methods We enrolled patients with coronary artery disease and left ventricular ejection fraction Results We studied 46 men and 4 women with an average age of 61 years. Baseline left ventricular ejection fraction was 37 ± 13%. A total of 2,020 myocardial segments were analyzed. Abnormal wall motion and the LGE area were detected in 1,446 segments (71.6% and 1,196 segments (59.2% respectively. Wall motion improvement was demonstrated in 481 of 1,227 segments (39.2% that initially had wall motion abnormalities at baseline. Logistic regression analysis showed that the LGE area, EDWT and resting wall motion grade predicted wall motion improvement. Comparison of Receiver-Operator-Characteristic (ROC curves demonstrated that the LGE area was the most important predictor (p Conclusion LGE and EDWT are independent predictors for functional recovery after revascularization. However, LGE appears to be a more important factor and independent of EDWT.

  7. Application of da Vinci robotic surgery system in Department of Urology%达芬奇机器人手术在泌尿外科的应用

    Institute of Scientific and Technical Information of China (English)

    孙祯; 符伟军; 祝强; 杨国强; 王忠新; 宋勇; 祖强; 王保军; 朱大庆

    2016-01-01

    目的 探索达芬奇机器人手术在泌尿外科应用的安全性和有效性.方法 回顾性分析我院2014年1月至2015年4月采用达芬奇机器人辅助腹腔镜手术治疗16例泌尿外科患者的临床资料.结果 16例手术全部成功,包括肾部分切除术3例、肾根治性切除术2例、前列腺根治性切除术6例、膀胱根治性切除及回肠膀胱术4例、膀胱根治性切除及输尿管皮肤造瘘术1例.3例肾部分切除患者、2例肾根治性切除患者、1例膀胱根治性切除及输尿管皮肤造瘘患者和6例前列腺根治性切除患者的平均手术时间及出血量相当,但4例膀胱根治性切除及回肠膀胱术患者的手术时间及出血量较多,分别为(436.3±16.8) min及(325.0±95.7) ml.所有患者的手术过程顺利,无中转开放手术、无围手术期并发症.结论 机器人手术在泌尿外科应用是安全有效的,尤其适用于狭窄盆腔手术及功能重建手术.%Objective To explore the safety and effectiveness of applying da Vinci robotic surgery system in Department of Urology. Methods The clinical data of 16 patients in the Department of Urology in our hospital from January 2014 to April 2015 using da Vinci robotic surgery system for laparoscopic surgery were retrospectively ana-lyzed. Results All of the 16 patients were operated successfully, including 3 patients of partial nephrectomy, 2 patients of radical nephrectomy, 6 patients of radical prostatectomy, 4 patients of radical cystectomy and Bricker operation, 1 pa-tient of radical cystectomy and ureterocutaneostomy. The average operation time and amount of blood loss in the 3 pa-tients with partial nephrectomy, 2 patients with radical nephrectomy, 1 patient with radical cystectomy and ureterocutane-ostomy, 6 patients with radical prostatectomy were comparable, but the operation time and amount of blood loss were more in the 4 patients of radical cystectomy and Bricker operation [(436.3 ± 16.8) min and (325

  8. Non-Opioid Analgesics Consumption At The Surgery Departments Of A Secondary Care Hospital In General Hospital In Kraljevo, Serbia

    OpenAIRE

    Aleksic Dejan; Bukonjic Andriana; Stefanovic Srdjan

    2015-01-01

    The aim of this study was to determine the amount of non-opioid analgesics consumed at the surgical departments of a secondary care hospital in Serbia, a developing country undergoing a socioeconomic transition that thus lacks sufficient funds to finance and invest in the healthcare system.

  9. Non-Opioid Analgesics Consumption At The Surgery Departments Of A Secondary Care Hospital In General Hospital In Kraljevo, Serbia

    Directory of Open Access Journals (Sweden)

    Aleksic Dejan

    2015-09-01

    Full Text Available The aim of this study was to determine the amount of non-opioid analgesics consumed at the surgical departments of a secondary care hospital in Serbia, a developing country undergoing a socioeconomic transition that thus lacks sufficient funds to finance and invest in the healthcare system.

  10. Study on Influential Factors of Prognosis Status in Intracranial Aneurysm Surgery Patients in the Department of Cerebral Surgery%神经外科颅内动脉瘤手术患者预后影响因素研究

    Institute of Scientific and Technical Information of China (English)

    毛华

    2013-01-01

    Objective:To investigate the influential factors of prognosis in the intracranial aneurysm surgery patients. Methods:The clinical data of sixty-five intracranial aneurysm surgery patients who were treated in the department of cerebral surgery in our hospital from June 2010 to June 2011 were collected by self-made questionnaire according to literature summary. Then the collected clinical data of patients with intracranial aneurysm surgery patients were analysed by the SPSS16.0 for descriptive statistics and binary classification logistic regression analysis to find out prognosis status and its influential factors of intracranial aneurysm surgery patients. Results:Thirty-eight intracranial aneurysm surgery patients were favorable prognosis,the good prognosis rate was 58.46%,the bad prognosis rate was 41.54%,binary classification logistic regression analysis showed that age, hypertension, Fisher ‘s classification and Hunt - Hess classification had risk factors,but treatment in time is a protective factor,but fully resection was a protective effect on intracranial aneurysm surgery patients. Conclusion:The prognosis status of intracranial aneurysm surgery patients was bad.it is affected by various factors.We take the targeted intervention measures to improve the prognosis of intracranial aneurysm surgery patients.%  目的:探讨神经外科颅内动脉瘤手术患者预后影响因素。方法:采用根据查阅颅内动脉瘤手术患者相关文献制定自编问卷收集2010年6月~2011年6月在我院神经外科住院治疗的65例颅内动脉瘤手术患者对临床资料,采用二分类Logistic回归分析对颅内动脉瘤手术患者预后影响因素。结果:在本研究入选的65例患者中,38例患者预后良好,预后良好率为58.46%,而预后不良率为41.54%,多因素Logistic回归分析发现年龄、高血压、Fisher’s分级和Hunt-Hess分级是影响颅内动脉瘤手术患者预后的危险因素。结论:颅内动脉瘤手

  11. 术中给予艾塞那肽对心脑血管的保护作用研究%Protective effects of Exenatide on cardiovascular function of patients underwent cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    冯丽娜

    2014-01-01

    Objective To study the protective effect of exenatide on cardiovascular function of patients underwent cardiac surgery. Methods From March 2012 to August 2013,168 patients enrolled in our hospital were randomly divided into 2 groups including 80 cases of control group and 88 cases of exenatide group. Results Compared with the control group,exenatide group has lower blood sugar after surgery (P0. 05).Conclusion For cardiac surgery patients,exenatide could reduce cardiovascular disease complications caused by surgery by protecting effect on heart and brain.%目的:探讨术中给予艾塞那肽对心脑血管的保护作用。方法收集2012年3月-2013年8月我院择期心脏外科手术患者168例,随机分为对照组80例和艾塞那肽组88例。结果2组手术后血糖比较差异有统计学意义(P0.05)。结论艾塞那肽对心脏外科手术患者具有保护心脑血管的作用,可以减少手术引起的心脑血管疾病并发症,值得推广。

  12. The Cardiovascular Research Grid (CVRG)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CardioVascular Research Grid (CVRG) project is creating an infrastructure for sharing cardiovascular data and data analysis tools. CVRG tools are developed using...

  13. Accounting and comparing of expenditure on the medical services given at neuro-surgery department of Imam Khomeyni Hospital in the year of 1994 (1373

    Directory of Open Access Journals (Sweden)

    Abasi Moghadam M

    1998-09-01

    Full Text Available This study was focused on analysis of expenditure on all the medical services given at Neuro-Surgery Department of Imam-Khomeini Hospital in the year of 1994 (1373. In this study, all the information on descriptive method and the techniques of cost analysis and cost per unit of service provided accountancy, were analysed. 573 patients were considered in this study. 522 of them underwent 13 different types of neuro-surgery operations. 92.6% of them total departmental costs were related to current expenditures and 7.4% of that was related to the capial expenditures. The personnel costs with 49% was the highest portion of the total costs. Percentage wise, the costs were as follows: Medicine, materials and equipment 22%, food 17.6%, depreciation 7.4%, fuel, water, electricity and telephone 3.5%. The mean duration of stay was 16.3 days for every in-patient. The percentage of occupied bed was 58% if the percentage of desired bed occupancy was supposed 80%, therefore, 22% of the bed, plus 3512 bed-day were gone wasted. The real cost of med-care policy need to be more rational for the operation and hospitalization. It should be mentioned that the wasted time was 886 hours and wasted cost was 71, 708, 410 Rials in operation room.

  14. Outbreak of nosocomial infections in thoracic surgery department: a survey report%胸外科手术部医院感染暴发事件调查

    Institute of Scientific and Technical Information of China (English)

    杨宇红; 刘丹

    2011-01-01

    目的 通过对某医院胸外科病房手术部铜绿假单胞菌医院感染暴发事件调查分析,明确手术部医院感染暴发调查的思路,发现手术部医院感染调查中的问题,提高医院感染暴发的识别、调查、报告和应急处理能力.方法 应用描述流行病学原理,对胸外科在2010年发现的6例铜绿假单胞菌手术部位感染患者现场调查,对手术部铜绿假单胞菌医院感染因素查阅文献,列表分析,观察表格特征,提出该次铜绿假单胞菌感染暴发危险因素,同时采取接触隔离等一系列预防控制措施;运用分析流行病学原理,对感染病例进行病例对照分析,评估假设;依照试验流行病学原理,对采取控制措施前后效果进行前瞻性队列研究,验证控制措施的有效性.结果 胸科手术部铜绿假单胞菌感染发生在感染后约两周,手术方式、吻合口瘘、手术部感染等并发症、手卫生与环境卫生不严格是感染的主要危险因素;提高手术技巧,加强手卫生、接触隔离等消毒隔离措施可使食管癌根治术后手术部感染率明显下降,但肺癌根治术后感染率变化不显著.结论 医院感染暴发事件中应用流行病学方法不仅科学可靠,增强科室医务人员消毒、隔离意识,而且能比较及时准确控制、有效预防医院感染的发生;肺癌根治术后肺炎发生的危险因素需要进一步调查,医院感染工作人员要加强医院感染病例监测制度的落实.%OBJECTIVE To make clear about the hospital infection outbreak survey way, enhance the abilities of hospital infection outbreak recognition, investigation, report and emergency handling through investigation and analysis of Pseudomonas aeruginosa hospital outbreak in the department of surgery on a thoracic ward. METHODS Applied to describe epidemiological principle of thoracic in 2010, 6 patients found P. aeruginosa patients surgical site infection of field investigation, the

  15. Evolução da cirurgia cardiovascular no Instituto do Coração: análise de 71.305 operações Evolución de la cirugía cardiovascular en el Instituto do Coração: análisis de 71.305 operaciones Evolution of cardiovascular surgery at the Instituto do Coração: analysis of 71,305 surgeries

    Directory of Open Access Journals (Sweden)

    Luiz Augusto F. Lisboa

    2010-02-01

    las técnicas percutáneas, del tratamiento clínico y de la prevención primaria. OBJETIVO: Evaluar la incidencia y la mortalidad de operaciones cardiovasculares realizadas en el Instituto do Coração (InCor-HCFMUSP. MÉTODOS: A partir del banco de datos del Instituto do Coração, se analizaron las operaciones cardiovasculares realizadas entre el 1984 y el 2007, y se consideró como la tendencia de los principales procedimientos las tasas de mortalidad. RESULTADOS: En 24 años, se llevaron a cabo 71.305 operaciones cardiovasculares, con un promedio anual de 2.971 procedimientos. El número de cirugía de revascularización miocárdica, que en la década de 1980 tenía un promedio de 856/año, actualmente está por volta de 1.106/año. Los procedimientos de las válvulas cardiacas pasaron de 400 para 597 operaciones/año, con un crecimiento de un 36,7% en relación con la década del 1990. Las correcciones de las cardiopatías congénitas también tuvieron un aumento expresivo de un 50,8% con relación a la última década. La mortalidad global promedio, que en el inicio era de un 7,5%, actualmente es del 7%, con un 4,9% entre los procedimientos electivos. En las cirugías de revascularización miocárdica, la mortalidad promedio actual es de un 4,8% y entre las operaciones valvulares es de un 8,5%. En las correcciones de las cardiopatías congénitas corresponde a un 5,3%. CONCLUSIÓN: La cirugía cardiovascular sigue en ascensión. La revascularización miocárdica todavía es la operación más realizada. Sin embargo, el perfil de los procedimientos se viene alterando con el mayor crecimiento del abordaje sobre las válvulas cardiacas y de las cardiopatías congénitas. Las tasas de mortalidad son superiores cuando comparadas a los índices internacionales, reflejando la alta complejidad presentada en un servicio terciario y de referencia nacional.BACKGROUND: Cardiovascular surgery has been undergoing transformations due to the advancement of percutaneous

  16. Exploration of postgraduate education in cardiovascular surgery%心血管病研究生培养模式探索

    Institute of Scientific and Technical Information of China (English)

    孙阳; 易蔚

    2014-01-01

    目的:探讨心血管病研究生的培养模式。方法选取第四军医大学西京医院心血管病医院全日制硕士研究生34名,随机分为双语教学组和完全中文教学组。结束一学期的专业课学习后,发放问卷匿名调查双语教学的效果。在另一学期将34名研究生随机分为实验组:采用问题导向学习( PBL)教学法;对照组:采用传统教学法。结束一学期的临床专业技能培训后,采用理论考试和操作考核结合的方法,测试学生的学习效果。结果88.2%学生认为双语教学模式对学习有帮助,仅有5.9%学生认为双语教学方法对学习无明显帮助。大部分学生认为双语教学更好地培养了自学、思维、表达能力,并充分调动了英语学习热情,达到更好的教学效果。 PBL教学法41.2%学生综合成绩优秀,47.1%良好,而传统教学法学生综合成绩优秀率仅为11.8%,良好占35.3%,5.9%学生成绩差。结论重视研究生双语教学及PBL教学法,加强培养研究生临床专业技能,并注重训练研究生科研思维,提高了研究生专业综合素质的培养和心血管病研究生培养质量。%Objective To explore how to improve postgraduate education in cardiovascular surgery. Methods 34 master grad-uate students were divided randomly into two groups receiving bilingual teaching or Chinese teaching respectively. The effect of bilingual teaching was identified through an anonymous questionnaire at the end of a term. Again the students were divided randomly into two groups receiving problem-based learning ( PBL) teaching or traditional teaching respectively, and learning effectiveness was detected through a theory test and an operation test at the end of a term. Results 88.2% of post-graduates chosed that bilingual teaching was"Helpful" to their learning, and only 5. 9% of them chose "No obvious help". The majority of post-graduates believed

  17. Testicular torsion based on material from the Department of Paediatric Surgery, Urology and Traumatology at Wladyslaw Buszkowski Children’s Hospital in Kielce during 2008–2013

    Directory of Open Access Journals (Sweden)

    Roman Sławek

    2014-06-01

    Full Text Available Introduction: Among the causes of acute scrotum syndrome, testicular torsion undoubtedly causes the most serious consequences. The remaining aetiological factors are torsion of the testicular appendages and of the epididymis, epididymo-orchitis, testicular injury, incarcerated inguinal hernia, acute testicular hydrocele and idiopathic scrotal oedema. Torsion of the testis occurs as a result of a twisting of the testis around the vertical axis. This leads to venous occlusion and subsequently to arterial occlusion with ischaemia and necrosis of the gonad. Aim of the research: Determination of the possibilities of saving the testicle after torsion of the gonad. Material and methods: S ixty-eight cases of testicular torsion were analysed in boys aged 0–18 years who were treated during the period 2008–2013 in the Department of Paediatric Surgery, Urology and Traumatology in Kielce. The evaluation determined whether or not the gonad could be saved. The degree of macroscopically evident testicular necrosis was determined and the decision made concerning the saving or resecting the gonad. Further development of the saved testicle was monitored ambulatorily. Results: In 39 patients the testicle was removed due to necrosis, while in the remaining cases the gonad was saved. Torsion of the left testicle was more frequently observed. The symptoms of the torsion were: testicle pain, nausea and vomiting and, more rarely, abdominal pain. The symptoms occurred from 2 h to several days before reporting to hospital. Emergency surgery was performed. After the surgery ultrasonographic control covered the assessment of blood flow, echostructure and dimensions of the saved gonad (due to the possibility of atrophy after torsion. Conclusions: A patient who reports pain in the scrotal region should be approached as an emergency case, requiring immediate diagnostics and, very often, emergency surgical management. USG examination with the assessment of

  18. 肝胆外科住院患者抗菌药物应用分析%Use of antibiotics among hospitalized patients of hepatobiliary surgery department

    Institute of Scientific and Technical Information of China (English)

    张洪卫; 李晓娜; 张天伟

    2015-01-01

    OBJECTIVE To investigate the rationality of use of antibiotics among the hospitalized patients of hepato‐biliary surgery department so as to provide guidance for the reasonable clinical use of antibiotics .METHODS The clinical data of 260 patients who were hospitalized the hepatobiliary surgery department from Jan 2010 to Oct 2013 were retrospectively analyzed ,and the rationality of use of antibiotics was observed .RESULTS Of the 260 pa‐tients ,242 cases used antibiotics ,with the utilization rate of antibiotics of 93 .08% .Among the 242 patients who used antibiotics ,about 8 categories ,22 types of antibiotics ,were involved ;the cephalosporins ,penicillins ,quino‐lones ,and imidazole nitrates were the most frequently used antibiotics ;the combination use of antibiotics was widespread ,there were 78 (32 .23% ) patients receiving two‐drug therapy ,67 (27 .69% ) patients receiving three‐drug therapy ,and 53 (21 .90% ) patients receiving more than three‐drug therapy ;the metronidazole plus cephalo‐sporins plus quinolones or aminoglycosides was the most frequently used three‐drug therapy .Only 43 of 260 pa‐tients underwent the detection of pathogens ,with the submission rate of 16 .54% .CONCLUSION The use of anti‐biotics among the hospitalized patients of hepatobiliary surgery department basically conforms to the principle of effectiveness and safety ,however ,unreasonable use of antibiotics remains among the minority of the patients , which should be paid high attention to .%目的:了解肝胆外科住院患者的抗菌药物应用及其合理性,为临床合理使用抗菌药物提供参考依据。方法回顾性分析医院2010年1月-2013年10月收治的260例肝胆外科住院患者临床资料,调查其抗菌药物的应用并分析其用药合理性。结果260例患者中有242例使用了抗菌药物,抗菌药物的使用率达93.08%;242例用药患者中所涉及的抗菌药物约8大类、22个品种;使用最多

  19. The Medical Records Data Focused by the Clinical Doctors of Chest Surgery Department%胸外科临床医师关注的病案数据

    Institute of Scientific and Technical Information of China (English)

    胡晓星; 王洋; 李辉

    2016-01-01

    胸外科临床疾病主要分类为良性、恶性,有其特定的临床表现及体征,且多数需要手术干预,不论是传统的手术方式或微创手术方式,都有特征性的基本规律.在依法执业中的医疗行为均会通过病案被记录下来,必然会产生大量的诊疗信息和诊疗数据.而胸外科医师最为关注的病案数据主要包括病史、病理、手术方式、治疗方案、高证据力的辅助检查、心肺功能、伴随疾病、治疗效果、综合医疗风险评估.病案书写、病案信息的质量不仅会影响临床实践、临床教学、临床科研数据的精准性、完整性,还会影响到产生课题及文章中的数据应用的科学性、逻辑性、真实性,最终影响到病例积累行成的数据库质量.做为胸外科各级医师,务必加以重视,写好每份临床病案.%The main classification of clinical diseases of chest surgery department included benign and malignant, which had their certain clinical symptoms and signs, and most of them needed operation intervention. Both the traditional or minimally invasive operation modes, both of them had their characteristic basic rules. All the medical behaviors in the lawful practice progress would be recorded by the medical records, and it would be certainly generated lots of information and data of treatment. But the medical records data mostly focused by the doctors of chest surgery department mainly included medical history, pathology, surgical procedure, treatment, high probative value of auxiliary examination, cardiopulmonary function, along with the disease, treatment effect and comprehensive health risk assessment. The quality of medical records writing and the information would not only influence the precision and completeness of clinical practice, clinical teaching and clinical research data, but also would effect the scientific, logical and authenticity of the data application of the topic and article, and finally would

  20. Characteristics of maxillofacial injuries resulting from road traffic accidents – a 5 year review of the case records from Department of Maxillofacial Surgery in Katowice, Poland

    Directory of Open Access Journals (Sweden)

    Drugacz Jan

    2006-08-01

    Full Text Available Abstract Background In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland from January 2001 to December 2005. Methods The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident. Results The traffic accidents were the cause of 19,93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22,21%, followed by tooth and alveolar process injuries (20,71% and mandibular fractures (18,69%. All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM. Conclusion Our results

  1. 心血管内科护理中不安全因素分析%Analysis on the Unsafe Factors in the Nursing of Cardiovascular Department of Internal Medicine

    Institute of Scientific and Technical Information of China (English)

    袁辉; 柯霞; 贺艳萍

    2016-01-01

    Objective To analyze and summarize the risk factors in cardiovascular nursing in department of internal medicine,and list the corresponding nursing countermeasures; Methods During the period from January 2013 to January 2015,120 patients admitted to the cardiovascular department of internal medicine in our hospital. To review and analyze the clinical nursing data of patients,and summarize the risk factors that exist in the cardiovascular department of internal medicine nursing. Results The unsafe factors of cardiovascular department of internal medicine nursing process are the main factors of nursing staff,the patient's own factors and environmental factors. Conclusion By strengthening nurse patient communication and exchange,strengthen the nursing staff of professional ethics and the level of care,improving hospital environment and other measures can effectively prevent and improve the existing in the unsafe factors of nursing in the department of cardiology.%目的:分析并总结出现在心血管内科的护理中的诸多不安全因素,并列举相应的护理对策。方法选取2013年1月~2015年1月我院心血管内科收治的120例患者,回顾分析患者的临床护理资料,总结出存在于心血管内科护理中的不安全因素。结果回顾发现不安全因素主要有医院护理人员因素、患者自身因素及环境因素等。结论通过加强护患沟通和交流,加强护理人员的职业操守和护理水平,加强医院的软硬件设施实力,改善住院环境等措施可有效预防和改善存在于心血管内科护理中的不安全因素。

  2. 浅谈肝胆外科专业进修医师带教%Experience of Teaching Advanced-study Doctors in the Department of Hepatobiliary Surgery

    Institute of Scientific and Technical Information of China (English)

    杨美华; 岳海燕; 张宝华

    2012-01-01

    To discuss the clinical teaching experience for advanced - study doctors in department of Hepatobiliary surgery as the following ; to make understand of students fully; to strengthen pre - job training; to strengthen basic skill training; to carry out problem based learning and evidence - based medicine practice, to train good medical ethics and improve doctor - patient communication ability, to strengthen the assessment and management strictly.%探讨肝胆外科专科医院进修生的临床带教经验.结合长期的进修生培养工作,就教学医院进修生培养总结归纳以下经验:充分了解进修生的特点;加强岗前培训;加强三基培养;开展问题式教学,进行循证医学实践;培养良好的医德医风,提高医患沟通能力;加强考核,严格管理.

  3. Using a relational database to improve mortality and length of stay for a department of surgery: a comparative review of 5200 patients.

    Science.gov (United States)

    Ang, Darwin N; Behrns, Kevin E

    2013-07-01

    The emphasis on high-quality care has spawned the development of quality programs, most of which focus on broad outcome measures across a diverse group of providers. Our aim was to investigate the clinical outcomes for a department of surgery with multiple service lines of patient care using a relational database. Mortality, length of stay (LOS), patient safety indicators (PSIs), and hospital-acquired conditions were examined for each service line. Expected values for mortality and LOS were derived from University HealthSystem Consortium regression models, whereas expected values for PSIs were derived from Agency for Healthcare Research and Quality regression models. Overall, 5200 patients were evaluated from the months of January through May of both 2011 (n = 2550) and 2012 (n = 2650). The overall observed-to-expected (O/E) ratio of mortality improved from 1.03 to 0.92. The overall O/E ratio for LOS improved from 0.92 to 0.89. PSIs that predicted mortality included postoperative sepsis (O/E:1.89), postoperative respiratory failure (O/E:1.83), postoperative metabolic derangement (O/E:1.81), and postoperative deep vein thrombosis or pulmonary embolus (O/E:1.8). Mortality and LOS can be improved by using a relational database with outcomes reported to specific service lines. Service line quality can be influenced by distribution of frequent reports, group meetings, and service line-directed interventions.

  4. Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: A five year longitudinal cohort study

    NARCIS (Netherlands)

    P.J. Tully (Phillip); H.R. Winefield (Helen); R.A. Baker (Robert); J. Denollet (Johan); S.S. Pedersen (Susanne); G.A. Wittert (Gary); D.A. Turnbull (Deborah)

    2015-01-01

    textabstractBackground: Although depression and anxiety have been implicated in risk for major adverse cardiovascular and cerebrovascular events (MACCE), a theoretical approach to identifying such putative links is lacking. The objective of this study was to examine the association between theoretic

  5. European Association of Cardiovascular Imaging/Cardiovascular Imaging Department of the Brazilian Society of Cardiology recommendations for the use of cardiac imaging to assess and follow patients after heart transplantation.

    Science.gov (United States)

    Badano, Luigi P; Miglioranza, Marcelo H; Edvardsen, Thor; Colafranceschi, Alexandre Siciliano; Muraru, Denisa; Bacal, Fernando; Nieman, Koen; Zoppellaro, Giacomo; Marcondes Braga, Fabiana G; Binder, Thomas; Habib, Gilbert; Lancellotti, Patrizio

    2015-09-01

    The cohort of long-term survivors of heart transplant is expanding, and the assessment of these patients requires specific knowledge of the surgical techniques employed to implant the donor heart, the physiology of the transplanted heart, complications of invasive tests routinely performed to detect graft rejection (GR), and the specific pathologies that may affect the transplanted heart. A joint EACVI/Brazilian cardiovascular imaging writing group committee has prepared these recommendations to provide a practical guide to echocardiographers involved in the follow-up of heart transplant patients and a framework for standardized and efficient use of cardiovascular imaging after heart transplant. Since the transplanted heart is smaller than the recipient's dilated heart, the former is usually located more medially in the mediastinum and tends to be rotated clockwise. Therefore, standard views with conventional two-dimensional (2D) echocardiography are often difficult to obtain generating a large variability from patient to patient. Therefore, in echocardiography laboratories equipped with three-dimensional echocardiography (3DE) scanners and specific expertise with the technique, 3DE may be a suitable alternative to conventional 2D echocardiography to assess the size and the function of cardiac chambers. 3DE measurement of left (LV) and right ventricular (RV) size and function are more accurate and reproducible than conventional 2D calculations. However, clinicians should be aware that cardiac chamber volumes obtained with 3DE cannot be compared with those obtained with 2D echocardiography. To assess cardiac chamber morphology and function during follow-up studies, it is recommended to obtain a comprehensive echocardiographic study at 6 months from the cardiac transplantation as a baseline and make a careful quantitation of cardiac chamber size, RV systolic function, both systolic and diastolic parameters of LV function, and pulmonary artery pressure. Subsequent

  6. 浅析普外科护理潜在的护理风险和对策%Analysis of Potential Nursing Risks and Countermeasures in Department of General Surgery

    Institute of Scientific and Technical Information of China (English)

    胡建芳

    2016-01-01

    目的分析普外科护理潜在的风险,提出有针对性的对策。方法选取2005年1月~2008年1月我院80例普外科患者,调查患者日常护理中潜在的风险,提出解决对策。结果护理风险主要有护理人员风险意识不足,普外科人员配置缺乏科学性,普外科护理操作不规范,与患者沟通不足,护理文书不规范等。结论针对潜在的风险,院方需定期的开展安全教育,进行专业的普外科护理知识和技巧的培训,优化人员配置,来提高普外科护理水平。%Objective To analyze the potential risk of nursing in Department of general surgery, and to propose some countermeasures. Methods From January 2005 to January 2008 in our hospital 80 cases of patients in Department of general surgery, to investigate the potential of the daily care of patients with potential risks, and put forward countermeasures. Results Nursing risk mainly nurses lack of risk awareness, general surgery staffing lack scientific, general surgery nursing operation is not standard, the lack of communication with patients, nursing documents not standard and so on. Conclusion In view of the potential risks, the hospital need to regularly carry out safety education and professional general surgery nursing knowledge and skills training, optimize the allocation of staff, to improve the level of general surgery nursing.

  7. Robotic technology in cardiovascular medicine.

    Science.gov (United States)

    Bonatti, Johannes; Vetrovec, George; Riga, Celia; Wazni, Oussama; Stadler, Petr

    2014-05-01

    Robotic technology has been used in cardiovascular medicine since the late 1990s. Interventional cardiology, electrophysiology, endovascular surgery, minimally invasive cardiac surgery, and laparoscopic vascular surgery are all fields of application. Robotic devices enable endoscopic reconstructive surgery in narrow spaces and fast, very precise placement of catheters and devices in catheter-based interventions. In all robotic systems, the operator manipulates the robotic arms from a control station or console. In the field of cardiac surgery, mitral valve repair, CABG surgery, atrial septal defect repair, and myxoma resection can be achieved using robotic technology. Furthermore, vascular surgeons can perform a variety of robotically assisted operations to treat aortic, visceral, and peripheral artery disease. In electrophysiology, ablation procedures for atrial fibrillation can be carried out with robotic support. In the past few years, robotically assisted percutaneous coronary intervention and abdominal aortic endovascular surgery techniques have been developed. The basic feasibility and safety of robotic approaches in cardiovascular medicine has been demonstrated, but learning curves and the high costs associated with this technology have limited its widespread use. Nonetheless, increased procedural speed, accuracy, and reduced exposure to radiation and contrast agent in robotically assisted catheter-based interventions, as well as reduced surgical trauma and shortened patient recovery times after robotic cardiovascular surgery are promising achievements in the field.

  8. Avaliação da adequação do controle de fatores de risco cardiovascular após cirurgia de revascularização miocárdica Evaluating the adequacy of cardiovascular risk factor control after myocardial revascularization surgery

    Directory of Open Access Journals (Sweden)

    Andrea Cristina Costa Barbosa

    2007-12-01

    Full Text Available FUNDAMENTO: Os fatores de risco cardiovascular (FR são responsáveis pela ocorrência de eventos cardiovasculares. OBJETIVO: Estimar o porcentual de pacientes submetidos a cirurgia de revascularização miocárdica (RM que conseguem controle adequado de fatores de risco (FR modificáveis, pelo menos seis meses após o procedimento. MÉTODOS: O estudo incluiu 88 pacientes, no qual se realizaram análise de prontuários e entrevista clínica, entre seis e 12 meses após a realização de cirurgia de RM em hospital de referência para doenças cardiovasculares, no período de janeiro a dezembro de 2004. RESULTADOS: A média de idade foi 63,1±9,9 anos: 51 (58% eram do sexo masculino, 86 (97,7%, hipertensos, 38 (43,2%, diabéticos, 85 (96,6%, dislipidêmicos e 10 (11,4%, tabagistas. O controle da hipertensão (PA BACKGROUND: Cardiovascular risk factors (RF for coronary artery disease (CAD are responsible for the occurrence of cardiovascular events. OBJECTIVE: To estimate the percentage of patients submitted to myocardial revascularization surgery (MRS that attains adequate control of modifiable RF at least six months after the surgery. METHODS: Data collection was based on the review of medical records and a clinical interview of 88 patients submitted to MRS between January and December of 2004 at a reference hospital for cardiovascular diseases. The patients were interviewed in the follow-up period, between six and twelve months after the surgical revascularization. RESULTS: Mean age was 63.1 ± 9.9 years; 51 patients (58% were males, 86 (97.7% were hypertensive, 38 (43.2% were diabetic, 85 (96.6% had hypercholesterolemia and 10 (11.4% were smokers. Hypertension control (PA < 140 x 90 mmHg was attained by 24.4% of the patients; cholesterol (LDL cholesterol < 100 mg/dl and diabetes control (blood glucose levels < 110 mg/dl levels were 30.6% and 31.6%, respectively. The use of antihypertensive drugs, hypoglycemic agents and statins, when indicated

  9. Point of care testing in the management of coagulation dysfunction in cardiovascular surgery%即时检验在心血管手术出凝血管理中的应用

    Institute of Scientific and Technical Information of China (English)

    周珊

    2012-01-01

    即时检验是指现场采样即刻分析、快速得到检验结果的一类新方法,主要优势在于检测方法简单易行、耗时较短,能在手术室内操作完成.心血管手术患者术后失血量大,血小板功能异常是重要原因之一.本文综述了目前常用的几种血小板功能即时检验方法在心脏手术中的应用.%Point of care testing is a new developing technology, which can reduce the turn-around time of results and provide quick information for clinicians. Platelet dysfunction is one of the major reasons of postoperative bleeding after cardiovascular surgery. In this review , we focused on the use of point of care testing in the management of coagulation dysfunction in cardiovascular surgey.

  10. 心内科护士心理压力源调查分析及对策%Aanlysis and strategies of sources of stress of nurses in cardiovascular department

    Institute of Scientific and Technical Information of China (English)

    袁素平; 张安琴; 潘彩霞

    2008-01-01

    目的 分析心内科护士心理压力源产生的主要原因.方法 选择成都市3家三甲医院护士110名,随机分为心内科护士(研究组)及内科其他专业护士(对照组)各55名,对其进行问卷调查,了解2组护士心理压力产生的原因,并将2组护士在家庭、社会、人际关系、工作性质和工作强度、继续教育和职业需求等方面比较,针对心内科护士存在较高的心理压力,采取相应的减压策略.结果 2组护士在社会、人际关系、工作性质和工作强度、继续教育和职业需求等方面比较差异有统计学意义,在家庭方面比较差异无统计学意义.结论 心内科护士在社会方面、人际关系方面、工作性质和工作强度方面、继续教育和职业需方面较其他专业护士有更强的心理压力.对心内科护士心理压力源进行分析,采取相应的减压策略,能更好地保护其身心健康,提高护理质量.%Objective To analyze the main causes of sources of stress for nurses in cardiovascular department. Methods We selected 110 nurses from three class-one hospitals in Chengdu and divided them into the nurses in cardiovascular department (the research group) and nurses in other departments (the control group). We compared the two groups in the following aspects: family, society, interpersonal relationship, work nature and work strength, continuing education and professional demand. In view of the high spirit stress existed in nurses in cardiovascular department, some corresponding stress-relief strategies were adopted. Results Two groups were statistically different in social, interpersonal relationship, work nature and work strength, continuing education and professional demand. While in the aspect of family, no difference was seen. Conclusions nurses in cardiovascular department had high spirit stress in social, interpersonal relationship, work nature and work strength, continuing education and professional demand. To analyze

  11. Experimental valuation of specific hospital waste production in sanitary departments and surgeries; Valutazione sperimenatle della produzione specifica di rifiuti sanitari a rischio infettivo da reparti e gruppi operatori di una struttura ospedaliera

    Energy Technology Data Exchange (ETDEWEB)

    Serra, R.

    1999-10-01

    Experimental measures of hospital waste production in sanitary departments and surgeries at highly specialised hospital have been carried out. The salient differences in waste specific production in several departments explain relevantly the variability of hospital waste production reported in technical literature. [Italian] Sono state effettuate rilevazioni sperimentali della produzione di rifiuti speciali sanitari a rischio infettivo dai reparti digenza, di terapia intensiva e dalle sale operatorie di una struttura opsedaliera ad alta specializzazione. Le differenze significative riscontrate tra reparti o sale operatorie afferenti a unita' funzionali diverse, rendono conto della variabilita' dei valori di produzione di rifiuti speciali sanitari a rischio infettivo da strutture ospedaliere riscontrate nella letteratura.

  12. 精神专科医院外科住院患者精神病共病现状分析%Status analysis on psychiatric comorbidity of inpatients from surgery department of psychiatric hospitals

    Institute of Scientific and Technical Information of China (English)

    沈萍; 沈仲夏; 徐美英; 陈海勤; 金莉; 陈海支

    2012-01-01

    目的 分析精神专科医院外科住院患者精神病共病的流行病学情况及特征.方法外科住院患者791例,对其中共患精神病者进行统计学分析.结果 791例患者中共患精神病59例,精神病前3位分别为精神分裂症、抑郁症、神经症;外科疾病前3位分别为骨折、脑外伤、肠梗阻.结论 精神专科医院外科住院患者精神病共病比例高,共患疾病有相关性.%Objective To study the cpidcmiological status and characteristics on psychiatric comorbidity of inpatients from surgery department of psychiatric hospitals. Method Take statistic analysis on patients with psychiatric comorbidity from 791 inpatients from surgery department. Result There arc 59 psychiatric comorbidity patients from 791 patients. The first three of psychosis arc schizophrenia, depression and neurosis and the first three surgical diseases arc fracture, brain injury and intestinal obstruction. Conclusion There is a high level of psychiatric comorbidity among inpatients from surgery department of psychiatric hospitals. There is correlation between comorbidity diseases.

  13. Virtual Surgery Contrast Development Simulation with Cardiovascular Intervention%心血管介入虚拟手术造影剂显影仿真

    Institute of Scientific and Technical Information of China (English)

    邓子龙; 谢叻; 罗买生; 蔡佳音; 顾力栩

    2015-01-01

    心血管介入手术造影剂的使用对肾功能尤其对肾功能不全患者影响较大。在使用心血管介入手术模拟器进行手术培训过程中,造影剂剂量信号的检测是造影剂模拟的关键技术之一。将光学位移传感器用于造影剂注射剂量信号检测,并成功应用于心血管介入手术模拟器。通过Windows API提取光学位移传感器位移信息,并进行实验验证基于光学位移传感器的造影剂注射剂量信号检测的可行性。%The contrast agent used in cardiovascular interventional operation has adverse effects on renal function, especially for the renal inadequacy patients. In the use of cardiovascular interventional operation simulator for operation training, detection of contrast agent signal has become one of the key techniques of contrast agent simulation. This paper presents the signal detection of contrast agent dose by using optical displacement sensor, and the successful application to cardiovascular interventional operation simulator. The installation box of sensor is manufactured by using 3D printing technology, the displacement information of optical displacement sensor is extracted by windows API, and experiments are conducted to verify the feasibility of contrast agent signal detection based on optical displacement sensor.

  14. Practice of Clinical Pharmaceutical Services for Patients with Diabetes in Cardiovascular Department%对心血管内科糖尿病患者的药学服务实践

    Institute of Scientific and Technical Information of China (English)

    黄敏燕; 谢诚

    2015-01-01

    目的:探讨临床药师对心血管内科糖尿病患者的药学服务模式和监护要点。方法:以典型病例为例,阐述临床药师直接参与心血管内科糖尿病患者的治疗,提供药学监护。结果:临床药师通过参与心血管内科糖尿病患者的药物治疗与监护,加强了与医护人员的合作,增强了患者的用药安全性。结论:临床药师可从入院沟通、药品不良反应监测、个体化用药及出院用药指导等方面入手,积极开展药学服务。%OBJECTIVE:To explore the working mode and key point of clinical pharmaceutical services for patients with diabetes by clinical pharmacists in cardiovascular department .METHODS:To take the typical cases as example , the clinical pharmacists directly participated in the medication treatment , and provided pharmaceutical services for patients with diabetes in cardiovascular department .RESULTS: By the participation of clinical pharmacists in medication treatment and care , cooperation between the medical staff and clinical pharmacists was strengthened .At the same time, the safety and rationality of patients'medication were enhanced .CONCLUSIONS: In order to provide clinical pharmaceutical services , the clinical pharmacists could focus on hospital communication , monitoring of adverse drug reactions, individualized medication and discharge medication instructions , etc.

  15. EFECTOS DE LA HEMODILUCIÓN NORMOVOLÉMICA CON AUTODONACIÓN DE BAJO VOLUMEN SOBRE ALGUNOS PARÁMETROS HEMATOLÓGICOS EN LA CIRUGÍA CARDIOVASCULAR CON CIRCULACIÓN EXTRACORPÓREA / Effects of normovolemic hemodilution with low volume autologous donations on various hematological parameters in cardiovascular surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Shemanet García Cid

    2011-09-01

    Full Text Available Introduction and Objectives: Cardiac surgery with extracorporeal circulation is characterized by large perioperative blood loss and multifactorial disorders of coagulation parameters. For these reasons, there is frequent use of allogeneic transfusions. The purpose of this study was to determine the effects of intentional normovolemic hemodilution, with low volume autologous donation, on some hematological parameters in patients undergoing cardiopulmonary bypass. Method: A longitudinal, comparative, prospective study was performed in 27 patients who underwent cardiovascular surgery with cardiopulmonary bypass, subjected to intentional low volume normovolemic hemodilution. The following parameters were studied: the patient's blood volume, bleeding count, hematocrit figures, platelet count, thromboplastin time and INR before and after hemodilution and autotransfusion. Results: A blood volume average extraction of 10.5% for men and 13,12 % for women was found, with a highly significant reduction in hematocrit, and a significant reduction in platelet, although both variables were within normal values, without involvement of the coagulation parameters with hemodilution. After autotransfusion, a highly significant increase in hematocrit and platelet count was found, with significant reduction of thromboplastin time and INR. Conclusions: The low volume normovolemic hemodilution does not produce clinically important changes in the studied hematological parameters, and autotransfusion after cardiopulmonary bypass improves these parameters.

  16. Experience of self-made interview path diagram for preoperative interview of patients with ICU surgery in department of thoracic surgery%自制访视路径图在胸外科ICU术前患者访视中的实施体会

    Institute of Scientific and Technical Information of China (English)

    刘慧; 钱静; 秦爱华; 凌红霞

    2012-01-01

    Objective To explore the effect of self-made interview path diagram on preoperative interview of patients with ICU surgery in department of thoracic surgery. Methods Self-made interview path diagram was applied for the preoperative interviews of 500 patients with ICU surgery in department of thoracic surgery. Results Through interview, the patients'emotions such as tension and fear relieved, nurse-patient relationship were improved, and it was benefit for rehabilitation of patients. Conclusion Preoperative interview before ICU surgery can make the patients adapt to environment of care unit much better after surgery, avoid the occurrence of the unexpected accident events, promote the rehabilitation of patients and deepen the connotation of high quality nursing.%目的 讨论应用自制访视路径图在胸外科ICU术前患者访视中的效果.方法 对500例胸外科ICU术前患者应用自制访视路径图进行术前访视.结果 通过访视可缓解患者紧张、恐惧心理,融洽护患关系,有利于患者术后康复.结论 ICU护士的术前访视,可使患者在术后能更好地适应监护室环境,避免各种意外事件发生,促进患者康复,深化优质护理的内涵.

  17. Genomics in cardiovascular diseases: analysis of the importance of the toll-like receptor signaling pathway

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    Bustamante J

    2012-10-01

    Full Text Available J Bustamante,1 E Tamayo,2 J Herreros3,41Department of Cardiovascular Surgery, Hospital Universitario La Princesa, Madrid, 2Department of Anesthesiology and Intensive Care, Hospital Clinico Universitario de Valladolid, Valladolid, 3Department of Cardiovascular Surgery, Hospital Universitario Valdecilla, Santander, 4Biomedical Engineering Institute of Santander, Santander, SpainAbstract: The development of techniques for genomics study makes it possible for us to further our knowledge about the physiopathology of various immunological or infectious diseases. These techniques improve our understanding of the development and evolution of such diseases, including those of cardiovascular origin, whilst they help to bring about the design of new therapeutic strategies. We are reviewing the genetic alterations of immunity in said field, and focusing on the signaling pathway of toll-like receptors because not only does this play a decisive role in response to microorganisms, it is also heavily involved in modulating the inflammatory response to tissue damage, a side effect of numerous cardiovascular diseases. These alterations in tissue homeostasis are present under a wide range of circumstances, such as reperfusion ischemia (myocardial infarction phenomena, arteriosclerosis, or valvulopathy.Keywords: genome-wide association study, single-nucleotide polymorphism, innate immune system, ischemic/reperfusion, myocardial infarction

  18. Application of single-site laparoscopic technique in Department of Hepatobiliary Surgery%单孔腹腔镜技术在肝胆外科的应用进展

    Institute of Scientific and Technical Information of China (English)

    卢攀; 张伟

    2016-01-01

    NOTES (natural orifi ce transluminal endoscopic surgery) has been developed rapidly because of its advantages such as less trauma, less pain, faster recovery and better cosmetic effect. This paper reviews the progress of single-site laparoscopic technique in Department of hepatobiliary surgery.%经自然腔道内镜手术NOTES(natural orifice transluminal endoscopic surgery),因其具有创伤小、痛苦轻、恢复快、美容效果好等优点而得以迅速发展。现就对单孔腹腔镜技术在肝胆外科中的应用进展进行综述。

  19. Cardiac Pediatric Surgery in Normothermia during Cardiopulmonary Bypass Cirugía cardiovascular pediátrica en normotermia durante la circulación extracorpórea

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    Luis Enrique Marcano Sanz

    2012-02-01

    Full Text Available

    Hypothermia during cardiopulmonary bypass is a method used in most of the protocols of pediatric cardiac surgery. There are evidences of its side effects. Normothermia in children as a novel strategy, was begun by Lecompte in 1995 and nowadays 12 000 surgical interventions have been performed in nine European centres during the last 15 years. Clinical reports show less incidence of complications and use of inotropic support, shorter cardiopulmonary bypass time, ventilator support and intensive care unit stay when normothermia was used. The aim of this review is identify the physiopathology issues of extracorporeal circulation in normothermia and hypothermia in pediatric cardiac surgery, as theoretical support to introduce normothermia as first line option. The conclusion is that normothermia is more physiological than hypothermia, able to protect organs of the human body in a safe and effective way.

    La hipotermia durante la circulación extracorpórea es un método comúnmente utilizado en cirugía cardiovascular infantil, pero existen evidencias de que induce efectos nocivos. La normotermia como alternativa novedosa en cirugía pediátrica fue introducida por Lecompte en 1995 y actualmente nueve centros europeos acumulan una experiencia de 12 000 intervenciones durante los últimos 15 años. Los reportes clínicos muestran menor  incidencia de complicaciones, disminución en el uso de inotrópicos, menores  tiempos de circulación extracorpórea, de ventilación mecánica y de estadía en terapia intensiva al compararla con la hipotermia. Se realizó una revisión bibliográfica con el objetivo de identificar elementos fisiopatológicos durante la circulación extracorpórea en normotermia e hipotermia en la cirugía cardiovascular pediátrica, como marco teórico para introducir la normotermia como modalidad de primera elección. Se concluye que la normotermia es una técnica más fisiológica, capaz de proteger los diferentes

  20. Cardiovascular Deconditioning

    Science.gov (United States)

    Charles, John B.; Fritsch-Yelle, Janice M.; Whitson, Peggy A.; Wood, Margie L.; Brown, Troy E.; Fortner, G. William

    1999-01-01

    Spaceflight causes adaptive changes in cardiovascular function that may deleteriously affect crew health and safety. Over the last three decades, symptoms of cardiovascular changes have ranged from postflight orthostatic tachycardia and decreased exercise capacity to serious cardiac rhythm disturbances during extravehicular activities (EVA). The most documented symptom of cardiovascular dysfunction, postflight orthostatic intolerance, has affected a significant percentage of U.S. Space Shuttle astronauts. Problems of cardiovascular dysfunction associated with spaceflight are a concern to NASA. This has been particularly true during Shuttle flights where the primary concern is the crew's physical health, including the pilot's ability to land the Orbiter, and the crew's ability to quickly egress and move to safety should a dangerous condition arise. The study of astronauts during Shuttle activities is inherently more difficult than most human research. Consequently, sample sizes have been small and results have lacked consistency. Before the Extended Duration Orbiter Medical Project (EDOMP), there was a lack of normative data on changes in cardiovascular parameters during and after spaceflight. The EDOMP for the first time allowed studies on a large enough number of subjects to overcome some of these problems. There were three primary goals of the Cardiovascular EDOMP studies. The first was to establish, through descriptive studies, a normative data base of cardiovascular changes attributable to spaceflight. The second goal was to determine mechanisms of cardiovascular changes resulting from spaceflight (particularly orthostatic hypotension and cardiac rhythm disturbances). The third was to evaluate possible countermeasures. The Cardiovascular EDOMP studies involved parallel descriptive, mechanistic, and countermeasure evaluations.

  1. 糖尿病患者非心脏手术围术期心血管事件的危险因素%Risk factors for perioperative cardiovascular events in patients with diabetes mellitus undergoing noncardiac surgery

    Institute of Scientific and Technical Information of China (English)

    吴国荣; 郑晋伟; 陈骏萍; 甘林光; 胡序凯; 张晓艳

    2013-01-01

    目的 筛选糖尿病患者发生围术期心血管事件(PCE)的危险因素.方法 择期行非心脏手术的糖尿病患者500例,根据围术期是否发生PCE分为PCE组和非PCE组.记录患者一般资料和麻醉方式、麻醉时间、术中血糖、血流动力学波动情况.将组间差异有统计学意义的因素进行logis-tic回归分析,筛选PCE的危险因素.结果 79例患者发生PCE,发生率为15.8%.2组患者年龄、甘油三酯水平、高敏C反应蛋白(hs-CRP)水平、血流动力学波动情况、ECG异常比率比较差异有统计学意义(P<0.05).logistic回归分析结果显示,甘油三酯≥1.7 mmol/L、年龄≥65岁、hs-CRP≥8mg/L和术中血流动力学异常波动≥基础值30%是非心脏手术糖尿病患者PCE的危险因素.结论 高甘油三酯、老龄、高hs-CRP水平和术中血流动力学异常波动(≥基础值30%)是糖尿病患者非心脏手术围术期PCE的危险因素.%Objective To determine the risk factors for perioperative cardiovascular events (PCEs) in patients with diabetes mellitus undergoing noncardiac surgery.Methods From June 2011 to October 2012 in our hospital,500 diabetic patients scheduled for elective non-cardiac surgery were divided into 2 groups according to the development of PCEs:PCE group and non-PCE group.The general data of patients,anesthetic methods,anesthesia time,blood glucose level during surgery and fluctuation of hemodynamics were recorded.The risk factors of which P values were less than 0.05 would enter the binary logistic regression analysis to stratify PCE-related risk factors.Results Seventy-nine patients developed PCEs (15.8 %) during perioperative period.There was significant difference between the two groups in age,levels of triglyceride and hs-CRP,fluctuation of hemodynamics,and abnormality in ECG (P < 0.05).Logistic regression analysis showed that the risk factors for PCEs included triglyceride level ≥ 1.7 mmol/L,age ≥ 65yr,hs-CRP level ≥ 8

  2. 心血管内科心率变异性分析174例%Analysis of heart rate variability in 174 cases of cardiovascular department of Internal Medicine

    Institute of Scientific and Technical Information of China (English)

    独孤昌军

    2015-01-01

    目的:了解心内科心率变异性与心血管疾病的变化规律,主要影响因素。方法采用Holter对174名心内科住院患者进行24小时动态心电图监测,然后分析时域法指标随不同疾病的变化规律。进行统计学分析,t检验。结论心率变异性在高血压组、冠心病组、心肌梗塞组、糖尿病组、心力衰竭组明显降低,有统计学差异。在植物神经功能紊乱组无明显降低,无统计学差异。心律失常组与无心律失常的健康对照组有部分差异。%Objective To investigate the changes of heart rate variability and cardiovascular diseases in Department of Cardiology,and to investigate the main factors affecting the changes of heart rate variability and cardiovascular diseases..Methods Holter was used to monitor 174 hours of ambulatory ECG in 24 Department of Cardiology,and then the time domain index was analyzed with different disease.T test. Results The SDNN,SDANN,PNN50%in hypertension,coronary heart disease,myocardial infarction,diabetes,heart failure and other group decreased significantly,P<0.05 were considered to be statistically significant difference;RDSSM in hypertension,coronary heart disease with diabetes mellitus group decreased significantly,P value<0.05 significant difference.Conclusion The heart rate variability in the hypertension group,coronary heart disease group,myocardial infarction group,diabetes group,heart failure group were significantly lower,there were statistically significant differences.There was no significant difference in the functional disorder of the autonomic nervous system.There were some differences in the healthy control group of arrhythmia and arrhythmia.

  3. Anticoagulación en microcirugía reconstructiva en los servicios de Cirugía Maxilofacial en España Anticoagulation in reconstructive microsurgery in maxillofacial surgery departments in Spain

    Directory of Open Access Journals (Sweden)

    Lorena Pingarrón Martín

    2012-06-01

    Full Text Available Objetivo: Conocer el protocolo de terapia anticoagulante que siguen en el perioperatorio de este tipo de intervención los principales servicios de Cirugía Oral y Maxilofacial de España que realizan microcirugía reconstructiva de cabeza y cuello. A partir de aquí, resumir la terapia anticoagulante mayoritaria e intentar unificar criterios. Material y métodos: Los autores realizan un estudio descriptivo tras contactar a través de encuesta telefónica y/o por correo electrónico con los principales servicios de Cirugía Oral y Maxilofacial de los hospitales en España en los que se realiza cirugía reconstructiva con injertos libres microvascularizados. Resultados: De los 65 servicios de Cirugía Oral y Maxilofacial de España, 29 (44% son los integrantes del estudio. El resto de servicios se excluyen por no realizar regularmente reconstrucción microquirúrgica o no notificar los resultados de la encuesta. De estos 29 servicios participantes, 22 (73% siguen un protocolo de antitrombosis en los procedimientos microquirúrgicos. Conclusión: Pese a no existir una pauta estandarizada de antitrombosis, hay datos concluyentes de que el dextrano no debe utilizarse por el alto riesgo de complicaciones sistémicas, así como de que los únicos fármacos que han conseguido una reducción de la trombosis microvascular son la heparina y el AAS con respecto a la ausencia de terapia antitrombótica.Objective: To find out the protocol for anticoagulation therapy in the perioperative period following microvascular reconstruction in major Oral and Maxillofacial Surgery Departments in Spain. From this, to summarise the majority anticoagulant therapy and attempt to unify criteria. Material and Methods: The authors conducted a descriptive study. A survey was performed contacting by telephone and/or email with the major Oral and Maxillofacial Surgery departments in Spain who perform reconstructive surgery with microvascular free flaps. Results: Of the 65

  4. 烧伤整形外科医院感染的病原菌分布及耐药性%Nosocomial infections in department of burn and plastic surgery:distribution and antimicrobiai resistance

    Institute of Scientific and Technical Information of China (English)

    彭友林

    2012-01-01

    OBJECTIVE To investigate the status of nosocomial infections and drug resistance of pathogens in department of burn and plastic surgery and provide the reference for the prevention and control of nosocomial infections in department of surgery. METHODS Retrospective review was performed for data, from medical record of patients with nosocomial infections. The primary diseases, operation category and resistance rate were analyzed statistically. RESULTS The pathogenic bacteria causing nosocomial infections in department of burn and plastic surgery mainly comprised Staphylococcus aureus (28. 1 % ), coagulase-negative Staphylococcus (18. 0%), Pseud-omonas aeruginosa (17. 2%) , and Klebsiellar pneumonia (13. 3%) , etc. The above strains all showed high drug resistance. Among 59 strains of Staphylococci, 28 strains of methicillin-resistant Staphylococcus aureus (MRS) were detected with the detection rate of 47. 5%. CONCLUSION Effective interventions should be adopted to prevent and control the nosocomial infections in department of burn and plastic surgery.%目的 探讨烧伤整形外科医院感染现状及病原菌耐药性,为预防与控制外科医院感染提供参考依据.方法 同顾性医院感染患者的病案资科,统计医院感染的原发疾病及手术种类、病原菌耐药率.结果 烧伤整形外科医院感染主要病原菌是:金黄色葡萄球菌、凝固酶阴性葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌,分别占28.1%、18.0%、17.2%、13.3%;以上病原菌均显示出较高的耐药性;59株葡萄球菌属中,检出耐甲氧西林葡萄球菌(MRS)28株,检出率为47.5%.结论 务必采取有效的干预措施,预防与控制烧伤整形外科医院感染.

  5. Comparative evaluation of atenolol and clonidine premedication on cardiovascular response to nasal speculum insertion during trans-sphenoid surgery for resection of pituitary adenoma: A prospective, randomised, double-blind, controlled study

    Directory of Open Access Journals (Sweden)

    Devendra Gupta

    2011-01-01

    Full Text Available Severe cardiovascular responses in the form of tachycardia and hypertension following nasal speculum insertion occur during sublabial rhinoseptal trans-sphenoid approach for resection of small pituitary tumours. We compare the effects of preoperative administration of clonidine (α-2 agonist and atenolol (α-blocker over haemodynamic response, caused by speculum insertion during trans-sphenoid pituitary resection. We enrolled 66 patients in age range 18-65 years, of ASA I-II, and of either sex undergoing elective sublabial rhinoseptal trans-sphenoidal hypophysectomy. Group I (control received placebo, group II (clonidine received tablet clonidine 5 μg/kg, and group III (atenolol received tablet atenolol 0.5 mg/kg. The heart rate increased on speculum insertion and 5 and 10 minutes following speculum insertion as compared to the pre-speculum values in the control group, while no change in the heart rate was observed in other groups (P<0.05. There was a rise in the mean arterial pressure during and 5, 10, and 15 minutes after nasal speculum insertion in the control group, whereas it was not seen in other groups (P<0.05. We therefore suggest that oral clonidine and oral atenolol (given 2 hours prior to surgery is an equally effective and safe method of attenuating haemodynamic response caused by nasal speculum insertion during trans-sphenoid pituitary resection.

  6. Comparative evaluation of atenolol and clonidine premedication on cardiovascular response to nasal speculum insertion during trans-sphenoid surgery for resection of pituitary adenoma: A prospective, randomised, double-blind, controlled study.

    Science.gov (United States)

    Gupta, Devendra; Srivastava, Shashi; Dubey, Rajeev K; Prakash, Prabhakar S; Singh, Prabhat K; Singh, Uttam

    2011-03-01

    Severe cardiovascular responses in the form of tachycardia and hypertension following nasal speculum insertion occur during sublabial rhinoseptal trans-sphenoid approach for resection of small pituitary tumours. We compare the effects of preoperative administration of clonidine (α-2 agonist) and atenolol (α-blocker) over haemodynamic response, caused by speculum insertion during trans-sphenoid pituitary resection. We enrolled 66 patients in age range 18-65 years, of ASA I-II, and of either sex undergoing elective sublabial rhinoseptal trans-sphenoidal hypophysectomy. Group I (control) received placebo, group II (clonidine) received tablet clonidine 5 µg/kg, and group III (atenolol) received tablet atenolol 0.5 mg/kg. The heart rate increased on speculum insertion and 5 and 10 minutes following speculum insertion as compared to the pre-speculum values in the control group, while no change in the heart rate was observed in other groups (Pclonidine and oral atenolol (given 2 hours prior to surgery) is an equally effective and safe method of attenuating haemodynamic response caused by nasal speculum insertion during trans-sphenoid pituitary resection.

  7. Causes and indications for reoperation in valve replacement and coronary artery bypass graft (CABG in 915 patients in cardiac surgery department in Imam Khomeini Hospital, 1374-77

    Directory of Open Access Journals (Sweden)

    Radmehr H

    2001-08-01

    Full Text Available Valvular and coronary artery disease are among the most important causes of disability and death in the world and Iran as well. Every year, half a million death because of these diseases is reported in United State. The incidence of degenerative and valvular diseases of heart is increasing. Considering the industrialization of our country, the incidence of these kind of problems are increasing as well. In this study, there is an attempt to recognize the causes of cardiac surgery. We conducted a retrospective study in 915 cardiac surgery patients (630 CABG and 285 valve replacement from 1374 to 1377. In CABG patients, there were 46 cases of reoperation (78.3 percent male 21.7 percent female. The most reoperations for bleeding was less than 24 hours in 90.3 percent. In valvular patients the causes of reoperation were: A Valvular complications (female/male=3/1, B Non valvular complications (female/male=1/3. The most common nonvalvular complication was bleeding (66.6 percent. The most common valvular complication was bioprosthetic valve degeneration. The meantime between two operation in valvular complications was 11.8 years. In all cases (915 the incidence of bleeding was 3.8 percent, mediastinitis 0.8 percent, cardiac tamponade 0.8 percent and GI bleeding 0.5 percent.

  8. Practice and Experience of Clinical Pharmacist Participating in Ward Round of Cardiovascular Department%临床药师参与心血管内科查房的实践和体会

    Institute of Scientific and Technical Information of China (English)

    陈秋琴; 王君萍; 杜贯涛

    2012-01-01

    OBJECTIVE: To discuss and summarize the necessary knowledge, focus and experiences when clinical pharmacists take part in the ward round in cardiovascular department of our hospital. METHODS; Several examples on important issues clinical pharmacists concerned were analyzed, such as rational drug use, drug interaction, adverse drug reactions, use of antibiotics. RE-SULTS&CONCLUSION: Clinical pharmacists participating in ward round could improve medical quality. Clinical pharmacists should hold the opportunity and greet the challenge, improve pharmaceutical and medical professional level to provide high quality and brand new pharmaceutical care for medical staffs and patients.%目的:总结我院临床药师参与心内科查房的体会,探讨临床药师查房的必要知识准备及应关注的重点.方法:对临床药师关注的重点如合理用药、药物相互作用、不良反应、抗生素使用等进行举例分析.结果与结论:临床药师参与临床查房能提高医疗质量.临床药师应抓住机遇,迎接挑战,不断提高药学和医学专业水平,为医护人员和患者提供高质量的、全新的药学服务.

  9. Indications and Outcomes of the Components Separation Technique in the Repair of Complex Abdominal Wall Hernias: Experience From the Cambridge Plastic Surgery Department

    Science.gov (United States)

    Adekunle, Shola; Pantelides, Nicholas M.; Hall, Nigel R.; Praseedom, Raaj; Malata, Charles M.

    2013-01-01

    Objectives: The components separation technique (CST) is a widely described abdominal wall reconstructive technique. There have, however, been no UK reports of its use, prompting the present review. Methods: Between 2008 and 2012, 13 patients who underwent this procedure by a single plastic surgeon (C.M.M.) were retrospectively evaluated. The indications, operative details, and clinical outcomes were recorded. Results: There were 7 women and 6 men in the series with a mean age of 53 years (range: 30-80). Patients were referred from a variety of specialties, often as a last resort. The commonest indication for CST was herniation following abdominal surgery. All operations except 1 were jointly performed with general surgeons (for bowel resection, stoma reversal, and hernia dissection). The operations lasted a mean of 5 hours (range: 3-8 hours). There were no major intra- and postoperative problems, except in 1 patient who developed intra-abdominal compartment syndrome, secondary to massive hemorrhage. All patients were satisfied with the cosmetic improvement in their abdominal contours. None of the patients have developed a clinical recurrence after a mean follow-up of 16 months (range: 3-38 months). Conclusions: The components separation technique is an effective method of treating large recalcitrant hernias but appears to be underutilized in the United Kingdom. The management of large abdominal wall defects requires a multidisciplinary approach, with input across a variety of specialities. Liaison with plastic surgery teams should be encouraged at an early stage and the CST should be more widely considered when presented with seemingly intractable abdominal wall defects. PMID:24058718

  10. Incidence and reasons of medication errors in cardiovascular department%心血管内科给药护理不良事件发生频率及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    张少华; 李晓梅; 付文波; 陈芳

    2016-01-01

    目的 观察心血管内科给药护理不良事件的发生频率,并对其相关因素进行分析.方法 采用便利抽样法选择2015年1月在广州军区武汉总医院心血管内科住院的328例患者,及执行给药护理操作的所有护理人员为研究对象.表格式记录护士进行给药操作的所有项目及不良事件发生情况.将给药不良事件分为医嘱类不良事件、抄写类不良事件和给药类不良事件3类(27项),采用相关性分析探讨不良事件发生的因素.结果 共观察给药护理1643次,发生给药不良事件246例,发生率为14.97%.研究中已发生的不良事件均为Ⅰ~Ⅱ级,未对患者造成任何伤害;其中医嘱类给药不良事件发生65例,抄写类不良事件发生76例,给药类不良事件发生105例.药品种类因素中,心血管系统中扩血管药、抗心律失常药不良事件发生与输液速度(医嘱类)呈正相关(r值分别为0.053,0.046;P<0.05);降压药、降脂药及抗血小板药不良事件发生与遗漏(抄写类)呈正相关(r值分别为0.037,0.062,0.044;P<0.05);抗凝药不良事件发生与遗漏(给药类)、给药频率失误(给药类)呈正相关(r值分别为0.075,0.034;P<0.05).给药途径因素中,口服与遗漏(抄写类)呈正相关(r=0.025,P<0.05),静脉推注与输液速度(医嘱类)呈正相关(r=0.067,P<0.05),静脉滴注与技术失误(给药类)呈正相关(r=0.036,P<0.05).护士及患者一般情况因素中,剂量错误(超量、少量)与夜班及周末班患护比例高相关(r=0.072,P<0.05),药物之间相互作用与护士工作年限低相关(r=0.045,P<0.05).结论 心血管内科护理不良事件的发生与患护比高、护士工作经验不够、心血管药物种类繁多、给药方式复杂等相关,管理者需从这些方面入手改进,提高护理质量.%Objective To investigate the incidence of medication errors ( MEs ) in Cardiovascular Department and to analyze the reasons to the adverse events. Methods

  11. 护理风险管理在心血管内科护理中的应用%Application of nursing risk management in the department of cardiovascular internal medicine

    Institute of Scientific and Technical Information of China (English)

    曾冬梅

    2015-01-01

    Objective:To explore the application effect of nursing risk management in department of cardiovascular internal medicine.Methods:200 patients hospitalized in the department of cardiovascular internal medicine were selected from January 2013 to August 2014 as the observation group.200 patients admitted to hospital were selected from March 2012 to December 2012 as the control group.Patients in the control group were given the general nursing,while in the observation group were strict implementation of nursing operation rules,formulate risk management of nursing interventions for patients.Results:In the observation group there occurred 3 cases of adverse events,and the incidence of adverse events was 1.5%.There was 1 cases of medication errors,1 cases of pipeline fall off and 1 cases of accidental injury.192 patients were satisfact,and the satisfaction rate was 96%.In the control group there were 10 cases of adverse events,the incidence of adverse events was 5%,there were 2 cases of medication errors,2 cases of lines fall,3 cases of pressure sore,3 cases accidental injury in.168 patients were satisfact,the satisfaction rate was 84%.The difference was statistically significant between the two groups(P<0.05).Conclusion:Implementation of nursing risk management in department of ardiovascular internal medicine can significantly reduce nursing events and improve the satisfaction of patients,so it is worthy of clinical promotion.%目的:探讨护理风险管理在心血管内科的应用效果。方法:2013年1月-2014年8月收治心血管内科住院患者200例作为观察组,2012年3月-2012年12月收治住院患者200例作为对照组。对照组进行一般的护理,观察组严格执行护理操作规程,制定护理风险管理干预措施,对患者进行护理干预。结果:观察组共发生不良事件3例,不良事件发生率1.5%,其中给药错误1例,管路脱落1例,意外伤害1例。患者满意192例,满意度96.0%。

  12. Current role of endovascular therapy in Marfan patients with previous aortic surgery

    Directory of Open Access Journals (Sweden)

    Ibrahim Akin

    2008-02-01

    Full Text Available Ibrahim Akin, Stephan Kische, Tim C Rehders, Tushar Chatterjee, Henrik Schneider, Thomas Körber, Christoph A Nienaber, Hüseyin InceDepartment of Medicine, Division of Cardiology at the University Hospital Rostock, Rostock School of Medicine, Ernst-Heydemann-Str. 6, 18057 Rostock, GermanyAbstract: The Marfan syndrome is a heritable disorder of the connective tissue which affects the cardiovascular, ocular, and skeletal system. The cardiovascular manifestation with aortic root dilatation, aortic valve regurgitation, and aortic dissection has a prevalence of 60% to 90% and determines the premature death of these patients. Thirty-four percent of the patients with Marfan syndrome will have serious cardiovascular complications requiring surgery in the first 10 years after diagnosis. Before aortic surgery became available, the majority of the patients died by the age of 32 years. Introduction in the aortic surgery techniques caused an increase of the 10 year survival rate up to 97%. The purpose of this article is to give an overview about the feasibility and outcome of stent-graft placement in the descending thoracic aorta in Marfan patients with previous aortic surgery.Keywords: Marfan syndrome, aortic dissection, root replacement, stent-graft, previous aortic surgery

  13. Evaluation and predictive nursing on patients with infection of prone incision in department of general surgery%普外科易发切口感染患者的评估与预见性护理

    Institute of Scientific and Technical Information of China (English)

    关艳霞

    2014-01-01

    目的:通过对易发切口感染炎患者的评估,实施预见性护理,减少切口感染的发生率。方法:普外科收治患者200例,对其进行评估,找出危险因素,进行预见性护理,与未给予预见性护理的200例患者比较,观察切口感染发生的情况。结果:实施预见性护理后患者的切口感染发生率明显低于未实施预见性护理的患者。结论:找出普外科患者切口感染的易发因素,实施预见性护理,能有效防止切口感染的发生。%Objective:According to the assessment of patients infection in prone incision,we carry out predictive nursing in order to reduce the incidence of wound infection.Methods:200 patients were selected by the department of general surgery.We evaluated them to find out the risk factors,in order to carry out predictive nursing.We compared them with 200 patients in the department of neurology,and observed the occurrence of wound infection.Results:The incidence of wound infection is lower in patients with predictive nursing than whom lack of it.Conclusion:To find out the risk factors of incision infection in patients of general surgery department,and give them implement predictive nursing,we can prevent the infection of incisional wound effectively.

  14. Plastic Surgery

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A A ... forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word "plastic" ...

  15. Nose Surgery

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Nose Surgery Nose Surgery Patient Health Information News media interested ... high a priority as appearance. Can Cosmetic Nasal Surgery Create A "Perfect" Nose? Aesthetic nasal surgery (rhinoplasty) ...

  16. Laser conization for the treatment of cervical intraepithelial neoplasia: the experience of the Colposcopy and Laser Surgery Unit, Department of Obstetrics and Gynecology, Conegliano Hospital

    Science.gov (United States)

    Fantin, Gian P.; Grasso, Alessandra; Tasinazzo, Raffaella; Bortolozzi, Giorgio

    1998-01-01

    From November 1990 to December 1995 eighty patients were treated with laser conization. They were high grade CIN extending to the endocervical canal and/or with purely ectocervical lesions and patients with low grade endocervical CIN persisting more than one year or cyto- histological discrepancy. Before surgery all the patients had colposcopy, cytology and guided cervical biopsies. Seventy-six out of eighty underwent local anaesthesia and in three cases a general anaesthetic was required although one case was treated without any anaesthesia. Complementary vaporization of the cone bed was performed in every single case. All specimens were judged fully evaluable by the pathologist. The accuracy of the preconization histology as evaluated in 79 patients. Exact agreement or a one degree discrepancy between punch biopsies and cone specimens was found in 96.25%. We did not find any unexpected invasive carcinoma. The apex of the specimen was free of disease in 93.75% of cases. A high grade lesion on the endocervical margin was found in 4 out of 5 cases with an apex involvement. Stenosis of the external cervical os occurred in 7 cases, 3 of which were symptomatic. In our experience laser conization is an effective and safe treatment of CIN with the results comparable to the literature.

  17. Surgery Risk Assessment (SRA) Database

    Data.gov (United States)

    Department of Veterans Affairs — The Surgery Risk Assessment (SRA) database is part of the VA Surgical Quality Improvement Program (VASQIP). This database contains assessments of selected surgical...

  18. 甘油灌肠剂灌肠在妇科腹部手术前肠道准备中的临床应用%Glycerine enema sausage befor gynecology department abdomen surgery in intestinal tract preparation clinical practice

    Institute of Scientific and Technical Information of China (English)

    黄娟; 杨颖; 黄瑜; 黄亚雪

    2015-01-01

    Objective The discussion of glycerine enema sausage uses in the clinical practice value which before the gy‐necology department abdomen surgery the intestinal tract prepares .Methods October ,2013- - June ,2014 ,210 example gynecology department abdomen surgery patient stochastically divides into the control group of 105 examples and the experi‐mental group of 105 examples ,The experimental group gives the glycerine enema sausage ,The control group gives the tra‐ditional soapy water sausage ,After two kind of sausage method sausage time ,the sausage number of times ,pour into the liquid volume ,the intestinal tract cleanliness ,patient's comfort level ,the complications ,the technique aspects and so on anus exhaust time carry on the observation contrast .Results Experimental group's effect surpasses the control group obvi‐ously ,Two groups of comparisons have the remarkable statistics significance (P<0 .05) .Conclusion When the glycerine enema sausage operate easily ,the patient comfort level is high ,the complication are few ,and merit quickly ,In the intestinal tract preparation has the important clinical practice value before the gynecology department abdomen surgery .%目的:探讨甘油灌肠剂灌肠用于妇科腹部手术前肠道准备的临床应用价值。方法将我科2013年10月~2014年6月210例妇科腹部手术患者,随机分为对照组和实验组,各105例。实验组予甘油灌肠剂灌肠。对照组予传统肥皂水灌肠。并对两组灌肠时间、灌肠次数、灌入液量、肠道清洁度、患者舒适度、术后肛门排气时间进行比较。结果两组灌肠时间、灌肠次数、灌入液量、肠道清洁度、患者舒适度及术后肛门排气时间比较,有显著性差异(P<0.05)。结论甘油灌肠剂灌肠具有操作简便、节时,患者舒适度高,并发症少,术后恢复快等优点,在妇科腹部手术前肠道准备中具有重要的临床应用价值。

  19. The Effect of Psychological Nursing Intervention Applied in the Department of Hepatobiliary Surgery%心理护理干预在肝胆外科中的效果应用

    Institute of Scientific and Technical Information of China (English)

    崔淑芹

    2015-01-01

    Objective To investigate the application of psychological nursing intervention in the department of hepatobiliary surgery,and to analyze the intervention on the recovery of patients with mental and physical effect. Methods 50 cases of patients accepted operation in department of hepatobiliary surgery in our hospital,who were divided into control group and experimental group randomly,the control group of 25 patients with routine nursing, test group of 25 patients with psychological nursing intervention based on routine nursing. Results In the test group,whether regulation of patients with postoperative complications of emotional or psychological anxiety,emotional control,compared with the control group had better effect(P<0.05). Conclusion Psychological nursing intervention on patients in the department of hepatobiliary surgery can effectively slow down the catheter cause discomfort and the incision pain,reduce the patient on the prognosis of the disease and drainage control situation concern.%目的:观察心理护理干预在肝胆外科中的应用,并分析干预对患者身心恢复的效果。方法选取我院50例接受肝胆外科手术的患者,随机将患者分为对照组和试验组,对照组25例患者采用常规护理方法,试验组25例患者在常规护理基础上进行心理护理干预,对两组的应用效果进行对比分析。结果试验组不论是对患者的术后并发症的情绪的调控,还是心理焦虑等情绪的调控,较之对照组都有较好的效果(P<0.05),具有统计学意义。结论心理护理干预对肝胆外科患者能有效减缓尿管导致的不适和切口疼痛,降低患者对疾病预后和引流管制情况的担心,患者接受度高,能更好地帮助患者身心康复。

  20. 整形美容科继续教育模式的探讨%The research of specialized continuous education model in the department of Plastic and Aes-thetic surgery

    Institute of Scientific and Technical Information of China (English)

    柴琳琳; 毕胜; 宋雨健; 曹川; 李世荣

    2015-01-01

    Plastic and Aesthetic surgery is a science which creates beauty by combining know-ledge and art. Combined with the professional characteristics of plastic surgery, we reformed the cur-riculum content and teaching mode of continuous education, including a established interactive theoret-ical learning model based on Journal club, the strengthening of clinical practice integrated with multiple related disciplines, the expanding the knowledge of Sociology, Psychology and Ethics, and the construc-tion of a long-term platform of network resources. Therefore, a comprehensive and specialized continu-ous education model in the department of plastic and aesthetic surgery was ultimately formed, whose preliminary assessment was favorable, and could be helpful in the cultivation of high-quality plastic and aesthetic surgeons in the future.%整形美容外科是一门知识性和艺术性相结合创造美的学科,结合整形美容科的专业特色,有必要改革继续教育课程内容和教学模式。通过建立以Journal club为基础的互动式理论学习,融合多学科交叉性临床实践活动,覆盖医学、美学、心理学、社会学等多领域知识;构建长期网络资源平台,最终形成全面并具专业特色的整形美容科继续教育模式。初步评价良好,为培养适应社会需要的高素质整形美容外科人才做了有益的探索。

  1. Clinical and statistical analysis of traumatic injuries of the maxillofacial region and its complications on materials of the Department of Maxillofacial Surgery from 2008 till 2012

    Directory of Open Access Journals (Sweden)

    Lepilin A.V. Bakhteeva G.R.

    2013-09-01

    The ratio of male and female patients during the study period did not change (men 89%, women — 11 %. Single fractures that do not require surgical treatment were dominated. Operating activities during the study period of fracture increased. For 5 years, the number of complications of traumatic injuries remained the same. Conclusion. Statistical analysis of traumatic injuries of the maxillofacial region shows that the average age of the patients decreased by almost 5 years, reduced average hospital stay. Most of the patients were admitted to the profile department in the early period (up to 3 days after preparation, but 21.6% of the patients were received only with the development of complications. The article concludes that there is a need to find new methods of diagnosis, treatment and prevention of complications of traumatic injuries.

  2. Cardiovascular pharmacogenetics.

    Science.gov (United States)

    Myburgh, Renier; Hochfeld, Warren E; Dodgen, Tyren M; Ker, James; Pepper, Michael S

    2012-03-01

    Human genetic variation in the form of single nucleotide polymorphisms as well as more complex structural variations such as insertions, deletions and copy number variants, is partially responsible for the clinical variation seen in response to pharmacotherapeutic drugs. This affects the likelihood of experiencing adverse drug reactions and also of achieving therapeutic success. In this paper, we review key studies in cardiovascular pharmacogenetics that reveal genetic variations underlying the outcomes of drug treatment in cardiovascular disease. Examples of genetic associations with drug efficacy and toxicity are described, including the roles of genetic variability in pharmacokinetics (e.g. drug metabolizing enzymes) and pharmacodynamics (e.g. drug targets). These findings have functional implications that could lead to the development of genetic tests aimed at minimizing drug toxicity and optimizing drug efficacy in cardiovascular medicine.

  3. 心血管外科术后意识障碍和急性心血管事件的病因分析及治疗体会%The Cause and Treatment in Conscious Disturbance and Acute Cardiovascular Events in Patients After Cardiovascular Surgery

    Institute of Scientific and Technical Information of China (English)

    刘平; 陈伊; 杜娟

    2012-01-01

    Objective: To investigate the cause,treatment and prognosis in patients with conscious disturbance and acute cardiovascular events after cardiovascular surgery.Methods: We retrospectively analyzed 39 patients with conscious disturbance and acute cardiovascular events at the early post operation stage from January 2010 to February 2011 in our hospital. We studied the type of disease, method of operation with the performing surgeon, and we also analyzed the length of mechanical ventilation time and the special treatment after the operation.Results: There were 11/39 patients with early post-operational deliration and agitation,2 of them accompanied by acute cardiovascular events. There were 18 surgeons involved in 39 operations, and one surgeon performed from 1 to 6 operations unevenly. Among them, for 9 surgeons conducted 9 operations, 5 patients accompanied with early post-operational deliration and agitation , 1 patient had acute cardiovascular event. While for the same surgeon performed 6 operations, only 1 patient had early post-operational deliration and agitation. With proper treatment as sedation, dehydration and the supportive therapy in central nervous system,all patients recovered.Conclusion: The post operational conscious disturbance and acute cardiovascular events incurred by air embolism should be highly recognized and clearly diagnosed. The occurrence of aeroembolism is closely related to eliminating the remaining air bubble in ventricular chamber and great vessels, monitoring and guiding equipments and the skill of operating surgeon. The degree of air embolus and the dysfunction of involved organs are directly related to patients prognosis.%目的:探讨心血管外科术后意识障碍和急性心血管事件患者的致病因素、疾病经过和相关并发症的治疗.方法:回顾性分析2010-01至2011-02间,39例心血管外科术后早期严重意识障碍的患者,观察分析本组患者的病种与手术方式,术者与手术例数分布,

  4. RESULTADOS DE LA VALVULOPLASTIA MITRAL PERCUTÁNEA. EXPERIENCIA EN EL INSTITUTO DE CARDIOLOGÍA Y CIRUGÍA CARDIOVASCULAR DE CUBA (1998-2004 / Results of percutaneous mitral valvuloplasty. Experiences at the Cardiology and Cardiovascular Surgery Institute in Cuba (1998-2004

    Directory of Open Access Journals (Sweden)

    Raymid García Fernández

    2010-03-01

    Full Text Available Antecedents and Objectives: The percutaneous mitral valvuloplasty is the procedure of choice in patients with mitral stenosis and an adequate valvular anatomy. The cases treated in Cuba were few until 1998, and the first ones were carried out by foreign medical professionals. This article aims at showing the results of the development of this technique in Cuba. Method: A total of 110 consecutive percutaneous mitral valvuloplasties were carried out in 107 patients (three of them were repeated due to restenosis at the Cuban Cardiology and Cardiovascular Surgery Institute, between June 17th 1998 and June 30th 2004 (106 using the Inoue method and 4 by Multi-track. The average evolution time was 24.6 months (72 maximum and 1,93 minimum. Results: Before the procedure, 94.54 percent of the patients were within the functional classification III and IV of the NYHA; after the procedure 96,36 percent were within functional classification I and II. Using the Wilkins score ≤ 8, average areas of 2,18 cm2 were obtained; and between 9 and 12, areas of 1,81 cm2. The initial success of the procedure was 96,36 percent, and without complications 92,72 percent. Mortality was 0,9 percent, survival 100 percent, and 91,74 percent of the patients were free from complications. As an adverse event in the follow-up it was determined a mitral reestenosis in 5 patients (4,54 %. The average stay in hospital was of 1,36 days. The savings concerning hospitalization was of $ 4136775.39. Conclusions: Percutaneous mitral valvuloplasty is a safe and effective method in patients with mitral stenosis; its results remain in the sort, medium or long run.

  5. Aplicação da ventilação não-invasiva em insuficiência respiratória aguda após cirurgia cardiovascular Application of noninvasive ventilation in acute respiratory failure after cardiovascular surgery

    Directory of Open Access Journals (Sweden)

    Vera Regina de Morais Coimbra

    2007-11-01

    response, oxygenation-related, and hemodynamics of patients with hypoxemic acute respiratory failure (ARF submitted to noninvasive mechanical ventilation (NIV during the postoperative phase of cardiovascular surgery in order to identify predictive variables of success, and to compare the different types of NIV. METHODS: Seventy patients with hypoxemic ARF were randomized to one of three modalities of NIV - continuous positive airway pressure (CPAP and ventilation with two pressure levels (PEEP + SP and BiPAP®. Ventilation, oxygenation-related, and hemodynamics variables were analyzed at pre-application, and 3, 6, and 12 hours after the protocol began. RESULTS: Thirteen patients were excluded. Thirty-one patients progressed to independence from ventilatory support and comprised the success group, and 26 required orotracheal intubation and were considered the nonsuccess group. Age, initial heart rate (HR, and respiratory rate (RR showed elevated levels in the nonsuccess group (p=0.042, 0.029, and 0.002, respectively. A greater number of intraoperative complications were seen in the nonsuccess group (p=0.025. Oxygenation variables increased only in the success group. Among the NIV types, 57.9% of patients in the ventilator group, 57.9% in the two-pressure levels group, and 47.3% in the CPAP group progressed with success. Oxygenation and RR variables showed improvement only in the groups with two pressure levels. CONCLUSION: Patients with hypoxemic ARF in the postoperative stage after cardiovascular surgery showed better oxygenation, RR, and HR during NIV application. In older patients and those with higher baseline RR and HR values, NIV was not sufficient to reverse ARF. The two-pressure level modes showed better results.

  6. 综合护理对妇产科患者术后疼痛的效果观察%The Observation of the Comprehensive Nursing for the Pain of Patients in the Department of Obstetrics and Gynecology After Surgery

    Institute of Scientific and Technical Information of China (English)

    卫艳玲

    2014-01-01

    目的:探讨综合护理对妇产科患者术后疼痛的改善效果。方法选取我院从2013年1月~2014年1月所收治的260例妇产科患者作为临床研究对象,将所有患者随机分为护理组和对照组两组,对照组患者采用常规护理措施,护理组患者采用综合护理措施。评价两组患者的术后疼痛情况,以评价护理效果。结果护理组患者0级率为36.2%,对照组为15.4%;护理组患者3级率为1.5%,对照组为18.5%。两组比较,差异有统计学意义(P <0.05)。结论综合护理干预能对妇产科手术患者的术后疼痛有较好的缓解,促进患者的快速康复。%Objective To investigate the effect of the comprehensive nursing for the pain of patients in the department of obstetrics and gynecology after surgery. Methods 260 patients who had been treated in the department of obstetrics and gynecology from January, 2013 to January, 2014 were selected as research objects. They were divided into nursing group and control group. Traditional nursing was given to control group. Comprehensive nursing was given to nursing group. The postoperative pain was observed. Results The 0 level in nursing group was 36.2% and it was 15.4% in control group. The 3 level in nursing group was 1.5% and it was 18.5% in control group. By contrast, the variation in scores had statistical significance (P<0.05) . Conclusion Comprehensive nursing for the pain of patients in the department of obstetrics and gynecology after surgery can relieve postoperative pain and promote a rapid recovery.

  7. Aortic rupture during reoperative bariatric surgery

    Directory of Open Access Journals (Sweden)

    Sorin Hostiuc

    2015-08-01

    Full Text Available Abstract Morbid obesity has become a very common problem worldwide, causing severe health-related consequences including cardiovascular or metabolic diseases, arthritis, sleep apnea, or an increased risk of cancer. Bariatric surgery was shown to be the only way to achieve sustainable weight loss and to decrease the frequency and severity of metabolic and cardiovascular comorbidities. The purpose of this article is to present a case of bariatric surgery complicated with lesion of the aorta with a lethal outcome.

  8. Cataract Surgery

    Science.gov (United States)

    ... and Videos: What Do Cataracts Look Like? Cataract Surgery Written by: Kierstan Boyd Reviewed by: Elena M ... how they work. What to expect with cataract surgery Before surgery: Your ophthalmologist will measure your eye ...

  9. 急诊医护人员行清创缝合术遭受工作场所暴力的防范与应对%The prevention and response of emergency department workplace violence while performing debridement surgery

    Institute of Scientific and Technical Information of China (English)

    黄俊; 傅保国; 贺喜元; 李艾华; 王莉; 冯烨; 胡成

    2015-01-01

    Objective: To explore the prevention and response effect of workplace violence(WPV) when emergency department medical personal performing debridement surgery. Methods: Combine with the threatened violence evaluation system (STAMP), adopt preventive measures against workplace violence in response to violence induced by patients and family members during debridement surgery, analyze the incidence rate before and after the implementation of measures. Results: Work violence rate fell to 0.40% from 1.30% before the implementation, the difference was statistically signiifcant (P<0.05). Conclusion: Targeted measures should be created to high-risk population, particularly focusing on early identiifcation, prevention, and improve service quality.%目的:评价急诊医护人员施行清创缝合术时发生工作场所暴力的防范与应对效果。方法:结合工作场所暴力先兆评价工具(STAMP)制定工作场所暴力防范措施以应对在急诊行清创缝合术患者及其家属主导的工作场所暴力,分析比较实施防范措施前、后暴力发生率。结果:急诊行清创缝合术患者及其家属暴力发生率由实施前的1.30%下降至0.40%,差异有统计学意义(P<0.05)。结论:应对急诊清创缝合术暴力的发生要针对高危人群制定针对性措施,重在早期识别、预防和提高服务质量。

  10. Study on the Effect of Medical Cooperation for Nursing in Department of General Surgery%医护合作健康应用于医院普外科护理效果研究

    Institute of Scientific and Technical Information of China (English)

    张丽琼; 龙文华

    2015-01-01

    Objective To explore the medical health cooperative mode in general surgery nursing clinical ef ect.Methods Department of general surgery in our hospital,300 cases of patients were randomly divided into the number of the two groups,respectively adopt the health care cooperation mode and regular periodic health education model.Compare two groups of patients before discharge to disease the master degree of knowledge and compliance of medical staf charged after discharge.Results Two groups of patients after health education on knowledge situation,the degree of satisfaction with education,dif erences in the two groups have statistical significance.Conclusion The medical cooperation mode is worth popularizing more widely in clinical.%目的探究医护合作健康模式在普外科护理中的临床效果。方法选择收治我院普外科的300例患者,随机分为数目对的两组,分别采用医护合作健康模式和常规阶段性健康教育模式。比较两组患者出院前对疾病知识的掌握程度和出院后对医护人员嘱咐的依从性。结果在健康教育后两组患者对知识的了解情况、对教育的满意程度等方面两组的差异具有统计学意义。结论医护合作的模式值得更广的推广于临床。

  11. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Weight Loss Surgery (Bariatric Surgery) KidsHealth > For Parents > Weight Loss Surgery (Bariatric Surgery) ... bariatric surgery might be an option. About Bariatric Surgery Bariatric surgery had its beginnings in the 1960s, ...

  12. Prophylactic application of antibiotics in general surgery department during perioperative period%普外科围手术期预防性应用抗菌药物分析

    Institute of Scientific and Technical Information of China (English)

    饶珠峰; 马忠才; 李兴艳; 朱德刚; 韦中盛

    2013-01-01

    目的 了解医院普外科围手术期抗菌药物预防性使用情况,分析存在问题,为合理使用抗菌药物提供参考依据.方法 采用回顾性调查方法,收集病例,对抗菌药物应用情况进行统计分析.结果 调查189例患者,共181例预防性应用抗菌药物,占95.8%,其中Ⅰ类手术切口24例,抗菌药物使用16例,使用率66.7%;Ⅱ、Ⅲ类切口139例和26例,使用率均为100.0%;抗菌药物联合用药中各型切口均以二联为主,Ⅰ、Ⅱ、Ⅲ型切口二联用药分别为11、120、24例,使用率分别为68.8%、86.3%、92.3%;Ⅰ类切口用药时间不规范术前4例,术后无不规范例数;Ⅱ类切口用药时间不规范术前20例、术后11例;Ⅲ类切口类切口用药时间不规范术前26例、术后20例;抗菌药物联合用药中各型切口均以二联为主;189例手术患者使用例次最多的是第三代头孢菌素,占30.5%,其次是第二代头孢占菌素22.1%;在选用抗菌药物时,经验用药占89.0%,根据病菌培养具体用药占11.0%.结论 医院普外科围手术期预防性抗菌药物应用类别的选择符合要求,在联合用药指征、给药时机和疗程方面仍存在不合理现象,需要进一步的规范抗菌药物应用.%OBJECTIVE To learn the status of prophylactic use of antimicrobial agents in general surgery department during the perioperative period and analyze the existing problems so as to provide reference for the reasonable use of antibiotics. METHODS By means of retrospective survey, the cases were collected and the statistical analysis of antibiotic application was performed. RESULTS Of 189 patients investigated, there were 181 (95. 8%) patients with the prophylactic antimicrobial agents, including 24 cases of type Ⅰ incision, 139 cases of type Ⅱ incision,and 26 cases of type Ⅲ incision. There were 16 of 24(66. 7%)patients with type Ⅰ incision who used antibiotics. The utilization rates of the patients

  13. 综合医院脊柱外科门诊患者心理状况调查研究%Survey on psychologic status in outpatients of spinal surgery department in a general hospital

    Institute of Scientific and Technical Information of China (English)

    陆刚; 李幼辉; 王利民; 郭慧荣; 李峥

    2009-01-01

    目的 探讨综合医院脊柱外科门诊患者的心理状况,并通过分组探讨患者术前心理情况,为开展心理干预提供依据.方法 采用症状自评量表(SCL-90)调查了综合医院104例脊柱外科门诊患者,并将其中确诊准备手术的患者纳入准备手术组,其余为非准备手术组.结果 被调查患者的躯体化、强迫状态、抑郁、焦虑、敌对5个因子分的得分均显著高于常模(P<0.01).而其中准备手术组的躯体化、强迫状态、抑郁、焦虑、恐怖5个因子的得分均显著高于非准备手术组(P<0.01).结论 脊柱外科患者伴发心理障碍并不少见,尤其是准备手术治疗的患者,建议在传统药物及手术治疗疾病的同时合并心理治疗.%Objective To discuss the psychological status of outpatients in spinal surgery depart-ment and to survey the influence of preoperative psychologic on the patients after divided them into two groups, and to supply data for psychological - social intervention. Methods Symptom Checklist 90 (SCL -90) were used in 104 outpatients which were divided into the ready operation group and the non -ready op-eration group. Results All the patiens gained obviously more scores in the somatization factor, obsession factor, depression factor, anxiety factor, and hostility factor than norm (P < 0.01) . The somatization factor score, obsessive factor score, depressive factor score, anxious factor score and phobic anxiety factor score of the ready operation group were significantly higher than non - ready operation group (P < 0.01). Conclu-sions Patients of spinal surgery suffer psychological disorders, especially for the ready operation patiens. We suggest that biological treatment should combine with psychological intervention.

  14. Endothelial dysfunction: cardiovascular risk factors, therapy, and outcome

    Directory of Open Access Journals (Sweden)

    Hadi AR Hadi

    2005-10-01

    Full Text Available Hadi AR Hadi, Cornelia S Carr, Jassim Al SuwaidiDepartment of Cardiology and Cardiovascular Surgery, Hamad General Hospital – Hamad Medical Corporation, Doha, State of QatarAbstract: Endothelial dysfunction is a well established response to cardiovascular risk factors and precedes the development of atherosclerosis. Endothelial dysfunction is involved in lesion formation by the promotion of both the early and late mechanisms of atherosclerosis including up-regulation of adhesion molecules, increased chemokine secretion and leukocyte adherence, increased cell permeability, enhanced low-density lipoprotein oxidation, platelet activation, cytokine elaboration, and vascular smooth muscle cell proliferation and migration. Endothelial dysfunction is a term that covers diminished production/availability of nitric oxide and/or an imbalance in the relative contribution of endothelium-derived relaxing and contracting factors. Also, when cardiovascular risk factors are treated the endothelial dysfunction is reversed and it is an independent predictor of cardiac events. We review the literature concerning endothelial dysfunction in regard to its pathogenesis, treatment, and outcome.Keywords: endothelial dysfunction, coronary atherosclerosis, coronary artery disease

  15. Lung surgery

    Science.gov (United States)

    ... are thoracotomy and video-assisted thoracoscopic surgery (VATS). Robotic surgery may also be used. Lung surgery using a ... clot from the pulmonary artery ( pulmonary embolism ) Treat complications of tuberculosis Video-assisted thoracoscopic surgery can be used to treat many of these ...

  16. Preoperative respiratory physical therapy in cardiac surgery

    NARCIS (Netherlands)

    Hulzebos, H.J.

    2006-01-01

    Cardiac surgery is one of the most common surgical procedures and accounts for more resources expended in cardiovascular medicine than any other single procedure. Because cardiac surgery involves sternal incision and cardiopulmonary bypass, patients usually have a restricted respiratory function in

  17. Application and effects of the management procedure of pressure ulcer prevention in thoracic surgery departments%胸外科预防压疮管理流程的应用及效果

    Institute of Scientific and Technical Information of China (English)

    杨丛萍; 杨晓平; 李满平; 雷冰

    2011-01-01

    Objective To explore the effects of the management procedure of pressure ulcers prevention applied in thoracic surgery departments. Methods A total of 3,456 patients were enrolled and the pressure ulcers management procedure was applied. Multiple measures for preventing pressure ulcers were adopted, and the incidence of pressure ulcers was monitored. Results A total of 3,300 cases with low risk for pressure ulcer did not occur pressure ulcer. Among 156 cases with high risk for pressure ulcer,5 cases got phase Ⅰ of pressure ulcer and 2 cases had phase Ⅱ of pressure ulcer,which were successfully cured after symptomatic treatments. Conclusion Application of the management procedure of pressure ulcer prevention can effectively reduce the incidence of pressure ulcer in thoracic surgical departments, and alleviate the level of pressure ulcer.%目的 探讨胸外科预防压疮管理流程的应用效果.方法 对3 456例胸外科患者实施预防压疮管理流程,通过采取不同的措施进行压疮防治,观察患者压疮的发生率.结果 3 300例患者未发生压疮,156例高危患者发生难免性压疮Ⅰ期5例,Ⅱ期2例,经对症处理均顺利痊愈.结论 采用预防压疮管理流程,有效地降低了胸外科患者压疮的发生率,减轻了压疮程度.

  18. Susceptible factors for nosocomial infections in patients of department of spine surgery and nursing countermeasures%脊柱外科患者医院感染因素分析及护理对策

    Institute of Scientific and Technical Information of China (English)

    闫桂虹; 张培红; 程慧玲; 郭江雪

    2012-01-01

    OBJECTIVE To explore the susceptible factors for nosocomial infections in hospitalized patients of department of spine surgery and formulate the strategies for prevention and control of nosocomial infections, METHODS The nosocomial infections in hospitalized patients admitted in department of spine surgery during Jan 2006-Dec 2010 was statistically analyzed. RESULTS Among 4057 hospitalized patients, nosocomial infections occurred in 282 cases, 314 case-times in total, the infection rate was 6.95%, and the case-time infection rate was 7.74%; among various primary diseases, the incidence of nosocomial infections was 11, 8% in fractures and dislocations and 5. 22% in degenerative changes ;the main sites with nosocomial infections were lower respiratory tract (35. 67%) , urinary tract (30, 57%) , and upper respiratory tract (14. 01%); the correlative factors for nosocomial infections included the age, length of hospital stay, the severity of paraplegia, surgery and invasive operations(P<10. 01), CONCLUSION It is necessary to formulate the corresponding strategies for prevention and control according to the susceptible factors for nosocomial infections; to strengthen the basic nursing care and strict aseptic operation and hand hygiene can decrease the incidence of nosocomial infections.%目的 探讨脊柱外科患者发生医院感染的相关因素,制定预防与控制医院感染的对策.方法 对2006年1月-2010年12月脊柱外科医院感染患者的情况进行统计分析.结果 4057例住院患者中发生医院感染282例、314例次,医院感染率6.95%、例次感染率7.74%;不同原发疾病中骨折脱位、退行性改变的感染率为11.80%、5.22%;感染部位主要为下呼吸道、泌尿道、上呼吸道,分别占35.67%、30.57%、14.01%;医院感染与患者年龄、住院时间、截瘫程度、手术及侵入性操作有关(P<0.01).结论 针对引发医院感染的相关因素采取相应的预防和控制对策,加

  19. Epidemiologic and Bacteriologic Study of the Burned Patients from the Plastic Surgery Department of the County Emergency Hospital of Ploieşti, over a 4 Years Period (2010-2013).

    Science.gov (United States)

    Zbuchea, A; Racasan, O; Falca, V; Mitache, C; Vladescu, C

    2015-01-01

    This study analyses the epidemiologic data and the bacteriologic results of a total number of 759 burned patients, which were treated and discharged from the Plastic Surgery Department of the County Emergency Hospital of Ploiesti, between 01 01 2010 and 31 12 2013. The investigated parameter shave been: age and gender distribution, rural or urban population, burn etiology, total burn surface area (TBSA),TBSA, location and depth of lesions, therapeutic management,length of hospital stay, types of bacteria isolated from the infected wounds and their sensitivity to antibiotics, patients' mortality. The statistical analysis revealed the following results: mean age 51.33 ± 18.44 years, male/female ratio 1.35/1, rural/urban ratio 1.34/1, most common etiologies were scalds (44.8%) and flames (37.6%), mean TBSA 7.7 ± 8.4%, main locations were the extremities, splitthickness skin grafting in 15% of the patients, hospital stay 15.57 ± 13.84 days, main bacteria isolated were Pseudomonas aeruginosa (26.3%) and Staphylococcus aureus (22.9%), mortality rate 0.13%. The best methods to decrease the burn morbidity are the burn and infection prevention, for which several measures are discussed.

  20. [FEMALE SURGEONS SHOULD BE AWARE OF THE IMPORTANCE OF A CLEAR VISION FOR THEIR CAREER AND LIFE PLANS TO ACHIEVE THEIR CAREER DEVELOPMENT.: A SURVEY OF 20 FEMALE SURGEONS AT THE DEPARTMENT OF SURGERY AND ONCOLOGY, KYUSHU UNIVERSITY].

    Science.gov (United States)

    Nagayoshi, Kinuko; Mori, Hitomi; Kameda, Chizu; Nakamura, Katsuya; Ueki, Takashi; Tanaka, Masao

    2015-05-01

    A shortage of surgeons has been a serious problem in recent years. There is an urgent need to utilize female surgeons who tend to resign because of bearing and raising of children. To examine possible measures to deal with the issue, we performed questionnaire survey about work-life balance and career planning on 20 female surgeons in the Department of Surgery and Oncology, Kyushu University. The response rate was 80.0%. In the 16 respondents, seven were unmarried and nine were married. A large fraction of the respondents recognized the importance of work-life-balance. Female surgeons have many difficulties to continue working with good work-life balance; therefore, understanding and cooperation of both their spouses and coworkers is considered to be necessary. Married female surgeons considered that improvement of the working environment and sufficient family support were more important for good work-life balance compared to those who were unmarried. Female surgeons should recognize the importance of improvement of their environment, including the workplace and the family to continue working with good work-life balance in youth and should have the prospects about their career plan of their own.

  1. Chair in Pediatric Surgery

    OpenAIRE

    Graña, Francisco; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    Inaugural lecture of the course of 1922, Department of Paediatric Surgery, by Dr. Francisco Grana, Professor of Pediatric Surgery and Orthopedics at the Faculty of Medicine of Lima, the National Academy of Medicine, of the Peruvian Society of Surgery. Lección inaugural del curso de 1922, Cátedra de Cirugía Infantil, por el Dr. Francisco Graña, Catedrático de Cirugía Infantil y Ortopedia en la Facultad de Medicina de Lima, de la Academia Nacional de Medicina, de la Sociedad Peruana de Cirug...

  2. Outlined history of the development of the world and Polish cardiac surgery.

    Science.gov (United States)

    Dziatkowiak, A J

    2006-04-01

    It was the dream of humanity to perform surgery on an open non-beating heart. Scientific and medical discoveries five thousand years ago in China, partially adopted by the Western civilization, laid, through ancient Egypt, Mesopotamia, Greece, Rome and, later on in the Renaissance, the foundations for the development of empirical medicine. The 19th and the 20th centuries shoved dynamic scientific and technical development in various fields including medicine and surgery whose importance grew with the necessity to help the patients wounded in the wars. A break-through event in the development of surgery was overcoming of pain and discovery of reasons of infections and the control thereof, and, in the case of cardiology and cardiac surgery, the discoveries in physiology of circulation and the diagnostics of cardiovascular system diseases. This review contains a brief description of medical science in the past centuries, emphasizing the most important discoveries. A focus has been placed on the contribution of general surgery and thoracic surgery to the development of Polish and World cardiac surgery. The I Congress of the Polish Surgeons was held in 1889 in the Austria occupied territory of Cracow, which celebrated its one hundredth anniversary. The main obstacles in the development of clinical cardiac surgery included intratracheal general anesthesia, antisepsis and aseptics, hypothermia, oxygenators, extracorporeal circulation, transfusions, blood clotting and thromboses and cardioplegia. The spectacular heart and aorta surgical operations performed for the first time in the world and in Poland as well as the names of cardiac surgeons employed by the important cardiac surgery centers in Poland have been mentioned. The Department of Heart, Vascular and Transplantology Surgery of Cracow, the role and the share of Fundacja Rozwoju Kardiochirurgii COR AEGRUM in Cracow (COR AEGRUM Foundation for the Development of Cardiac Surgery in Cracow) in the construction of the

  3. Clinical Observation of Acute Respiratory Distress Syndrome After Operation in Department of Thoracic Surgery%胸外科术后急性呼吸窘迫综合征的临床观察

    Institute of Scientific and Technical Information of China (English)

    马永峰

    2016-01-01

    目的:探讨胸外科术后急性呼吸窘迫综合征的临床防治措施及其临床效果。方法选取近期来我院行胸外科手术治疗,且术后并发急性呼吸窘迫综合征患者80例,患者一经确诊为急性呼吸窘迫综合征,转入ICU病房,给予呼吸机辅助呼吸,增强吸氧浓度;积极对症处理患者的原发疾病;严格控制患者入水量,确保胸腔引流通畅;给予敏感抗生素抗感染;加强营养支持。结果80例患者经临床治疗后,其PaO2、PaCO2、RR、HR、MAP及BH等各项临床指标均得到了显著的改善,P<0.05比较差异具有统计学意义。80例患者经临床治疗后,70例痊愈(97.5%),10例死亡(12.5%)。结论综合疗法是目前治疗胸外科术后急性呼吸窘迫综合征最为有效的方式。%Objective To investigate the clinical control measures and clinical effect of acute respiratory distress syndrome after operation in Department of thoracic surgery.Methods In recent years, our hospital thoracic surgery, and postoperative acute respiratory distress syndrome in 80 cases, patients were diagnosed as acute respiratory distress syndrome into ICU, ventilator assisted breathing, oxygen concentration enhancement, active symptomatic treatment of patients with primary disease, strictly control the patient into the water to ensure drainage unobstructed, give sensitive antibiotic resistance to infection and nutritional support.Results After clinical treatment, 80 cases of patients with PaO2, PaCO2, RR, HR, MAP and BH and other clinical indicators have been significantlyimproved,P<0.05 comparison has statistical significance. After clinical treatment, 70 cases were cured (97.5%), 10 cases died (12.5%).Conclusion Comprehensive therapy is the most effective method for the treatment of acute respiratory distress syndrome.

  4. Meta分析在胸外科研究生循证医学教学中的应用%Meta-analysis in postgraduate teaching of evidence-based medicine in department of thoracic surgery

    Institute of Scientific and Technical Information of China (English)

    杨文涛; 施立; 朱蓉英; 陈勇兵; 桑永华

    2016-01-01

    Objective To study the value of meta-analysis in postgraduate teaching of evidence-based medicine in department of thoracic surgery. Methods 21 postgraduate students from grade 2008 to 2013 in medical school of Suzhou University were selected. Awareness rate, interestingness and ability of meta-analysis were compared after teaching meta-analysis. Results After teaching meta-analysis, awareness rate, interestingness and ability of meta-analysis of the students were significantly increased. Conclusion The application of Meta teaching methods in thoracic surgery graduate student teaching can significantly improve students' awareness of evidence-based medicine, and then improve the students' learning interest and Meta-analysis using ability, which is an effective teaching method and worth promoting.%目的:探讨Meta分析在胸外科研究生循证医学教学中的应用价值。方法选择苏州大学医学部2008级至2013级硕士研究生共21名作为研究对象,给予其Meta教学方法,统计使用教学前后研究对象对循证医学的认识率、感兴趣率以及meta分析运用能力。结果在教学后研究对象对循证医学的认识率、感兴趣率以及meta分析运用能力均较教学前显著提高。结论 Meta教学方法在胸外科研究生循证医学教学中的应用可显著提高学生对循证医学的认识,继而提高学生学习兴趣和Meta分析运用能力,是一种有效的教学方法,值得推广。

  5. After Surgery

    Science.gov (United States)

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  6. Turbinate surgery

    Science.gov (United States)

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery ... There are several types of turbinate surgery: Turbinectomy: All or part of the lower turbinate is taken out. This can be done in several different ways, but sometimes a ...

  7. Analysis in application of flexible management in nursing care of general surgery department%柔性管理在普外科护理中的应用分析

    Institute of Scientific and Technical Information of China (English)

    刘燕玲; 焦伟华; 罗惠凤

    2010-01-01

    目的 探讨柔性管理在普外科护理中的应用效果.方法 以2007年1~10月普外科护理人员21人和患者836例作为研究对象,对其实施柔性管理.以实施柔性管理前2006年1~12月普外科护理人员21人和住院患者797例作为对照,比较柔性管理对护士、患者的影响及护理满意度变化.结果 实施柔性管理后,护士工作和学习热情大大提高,学历和职称层次较实施前明显提高;实施前患者平均住院28 d,人均住院费用12 131元,实施后患者平均住院日下降为20 d,人均住院费用为8764元,实施前后比较差异显著;实施前护理满意度为87.0%,实施后则为97.0%,实施后患者的满意度显著高于实施前.结论 柔性管理在普外科护理中的应用效果显著,适合在实践中更多应用.%Objective To investigate the application effect of flexible management in nursing of general surgery department. Methods 21 nursing staff and 836 patients from January to October, 2007 were selected as research object, and were given flexible management. 21 nursing staff and 797 patients from January to December were selected as the control. The influence of flexible management on nurses and patients and satisfaction degree with nursing work before and after application of flexible management were compared. Results Working and learning enthusiasm greatly improved,educational background and professional titles of nurses increased after application of flexible management. The average hospitalization time was 28 days,the per capita cost was 12 131 yuan,satisfaction degree with nursing was 87.0% before application of flexible management, but the average hospital stay of patients decreased to 20 days, the per capita cost decreased to 8764 yuan and satisfaction degree with nursing increased to 97.0% after application of flexible management. Conclusions Application of flexible management in nursing care of general surgery department showed significant effect,it is

  8. LOCAL ANESTHETICS IN PATIENTS WITH CARDIOVASCULAR DISEASES.

    Directory of Open Access Journals (Sweden)

    risto Daskalov

    2015-03-01

    Full Text Available A significant problem in the dental medicine is pain alleviation. Many studies in the dental anesthesiology result in the production of new agents for locoregional anesthesia. Objective: This article aim to present the results of the last studies on the effect of the local anesthetics used in the oral surgery on patients with cardiovascular diseases. Material: A general review of the existing literature on the effect of the adrenaline, included as vasoconstrictor in the local anesthetics, used in patients with cardiovascular diseases is made. The benefits of vasoconstrictors for the quality of the anesthetic effect are proven. Conclusion: A small amount of adrenaline in the anesthetic solution does not result in complications development in patients with controlled cardiovascular diseases. Articaine is recommended agent of first choice for local anesthesia in the oral surgery.

  9. 我院手术支持中心的药事管理模式探索%Exploration on the New Pharmaceutical Administration Pattern of Central Surgery Service Department in Our Hospital

    Institute of Scientific and Technical Information of China (English)

    戴春雷; 缪旭东; 朱元琴; 卜晓光; 陈金凤

    2012-01-01

    目的:加强手术药品的管理.方法:成立手术支持中心,从工作流程改造、运用信息技术等各环节入手,对其药事管理模式进行探索.结果:该药事管理模式大大减少了医护人员手术准备时间和患者等待时间;保证了手术期间麻醉和精神药品使用情况能及时、准确地登记,便于统一管理;能做好药品数量与金额的双重管理,做到账物相符.结论:该管理模式能保证手术药品供应质量,避免差错.%OBJECTIVE: To strengthen the management of surgical drugs. METHODS: The management of the central surgery service department was guided through drug position, workflow reform and information management to explore the pattern of pharmaceutical administration. RESULTS: The new pharmaceutical administration pattern had reduced the operator's preparing time and the patient's waiting time, ensured that the cases of using narcotic and psychotropic drugs could be booked exactly in time, and manage the amount and sum of drugs to make the account fit the contents. CONCLUSIONS: The pattern can ensure efficiency and quality of drug supply and avoid errors.

  10. 护理人员分层使用模式在普外科病区应用的效果%Clinical application of graded management of nurses in general surgery department

    Institute of Scientific and Technical Information of China (English)

    乔莉娜; 王璇; 车文芳; 马华; 赵阳

    2010-01-01

    目的 探讨护理岗位分层管理模式在临床运行的方式与优越性.方法 对普外科实施护理人员分层使用,改进护理人员配备、排班、培训考核及绩效分配的方法,并把实施前、后住院病人对护理工作满意率进行比较分析.结果 护理岗位分层管理模式运行后,护士的责任心增加,病人对护理工作满意率达到了99%,护理质量优于运行前,差异有统计学意义(P<0.05).结论 护理人员分层使用模式更加合理地运用了护理人力资源,满足临床护理实际工作的需要,是可行的运行模式.%Objective To investigate the application and advantage of graded management of nurses in clinic work. Methods This subject introduced the method of graded management of nurses in general surgery department, in order to improve methods of nursing personnel, scheduling, training and allocation. Then, the clinical basic nursing of quality and the patients' degree of satisfaction were compared and analyzed after and before application to graded management. Results Nurses' responsibility was strengthened obviously, patients' rate of satisfaction reached 99% and the quality of nursing improved, which was higher than before, and there was statistical difference (P < 0.05 ). Conclusions The mode of graded management makes nursing human resource more reasonably, and meets the need of clinical nursing work, so it is better than common management mode.

  11. 心胸外科围手术期患者中心静脉导管感染因素分析%Analysis on the factors to perioperative patients with central venous catheter in cardiothoracic surgery department

    Institute of Scientific and Technical Information of China (English)

    赵辉; 梁冰; 王豪杰; 施巩宁

    2014-01-01

    目的:分析心胸外科围手术期患者中心静脉导管感染因素并采取有效措施。方法回顾性分析320例患者的中心静脉导管留置情况并进行调查。结果留置中心静脉导管最长23 d,最短4 d,平均时间8.3 d,导管尖端进行细菌培养,20例培养出葡萄球菌,56例培养出真菌,4例培养出葡萄球菌合并真菌。结论严格无菌操作,仔细观察,合理使用抗生素,正确选择穿刺部位,定期更换敷料及接头,可以有效预防感染的发生。%ObjectiveTo investigate the infection factors of central venous catheter(CVC) and lookfor measures to deal with infection of perioperative patients with CVC.MethodsRetrospectively analyzed the clinical data of 320 patiets who were placed CVC in cardiothoracic surgery department.ResultsThe longest position time of CVC was 23 days, the shortest position time was 4 days, with an average time of 8.3 days. Bacterial culture of the catheter tip was took place when CVC was pulled out from central venous, 20 cases were found staphylococcus, 56 cases were found fungus, 4 cases were found both staphylococcus and staphylococcus. ConclusionStrict aseptic operation, careful observation, rational use of antibiotics, correct selection of puncture, periodically changed dressings and connectors, can effectively prevent the occurrence of the infection.

  12. Antimicrobial resistance of Pseudomonas aeruginosa causing nosocomial infection in department of general surgery%医院普外科感染铜绿假单胞菌的耐药性

    Institute of Scientific and Technical Information of China (English)

    王群兴; 叶湘; 何晓雯; 余良芳; 周宜兰

    2011-01-01

    OBJECTIVE To investigate antimicrobial resistance of Pseudomonas aeruginosa (PAE) causing nosocomial infection in department of general surgery in our hospital and provide the scientific evidence for clinically reasonable use of antibiotics. METHODS Referring to National Guide to Clinical Laboratory Procedures, the bacterial culture and identification were performed. The susceptibility testing was performed by K-B methods recommended by CLSI. RESULTS Among 158 isolates of PAE, resistance rates of imipenem,meropenem, amikacin piperacillin/tazobactam and cefoperazone/sulbactam were the lowest, arriving at 11.4 %-14.6%. The resistance rate of trimethoprim-sulfamethoxazole (60. 1%) was the highest. The detection rate of pan-resistant PAE was 9. 5%. CONCLUSIONS The microbiologists in department of clinical laboratory should monitor dynamically and publish regularly the bacterial drug resistance to control multiresistant strains causing nosocomial infection.%目的 探讨医院普外科感染铜绿假单胞菌(PAE)的耐药特性,为临床医师合理用药提供科学依据.方法 细菌培养和菌株鉴定严格按照进行,采用CLSI推荐的K-B法进行药敏试验和判断结果.结果 普外科158株PAE对亚胺培南、美罗培南、阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦耐药率较低,在11.4%~14.6%;耐药率最高的抗菌药物是磺胺甲嗯唑/甲氧苄啶,为60.1%;PAE泛耐药菌株检出15株,检出率为9.5%.结论 检验科临床微生物室应对细菌耐药性进行动态监测和定期公示,有效控制多药耐药细菌医院感染.

  13. Heart Surgery Terms

    Science.gov (United States)

    ... Patients Choosing Wisely® Adult Cardiac Surgery What is Pediatric Heart Disease? What is Risk Adjustment? Valve Repair/Replacement Surgery Esophageal Surgery Lung/Thoracic Surgery Aneurysm Surgery Arrhythmia Surgery Other Types of Surgery Clinical ...

  14. Laser therapy in cardiovascular disease

    Science.gov (United States)

    Rindge, David

    2009-02-01

    Cardiovascular disease is the number one cause of death worldwide. It is broadly defined to include anything which adversely affects the heart or blood vessels. One-third of Americans have one or more forms of it. By one estimate, average human life expectancy would increase by seven years if it were eliminated. The mainstream medical model seeks mostly to "manage" cardiovascular disease with pharmaceuticals or to surgically bypass or reopen blocked vessels via angioplasty. These methods have proven highly useful and saved countless lives. Yet drug therapy may be costly and ongoing, and it carries the risk of side effects while often doing little or nothing to improve underlying health concerns. Similarly, angioplasty or surgery are invasive methods which entail risk. Laser therapy1 regenerates tissue, stimulates biological function, reduces inflammation and alleviates pain. Its efficacy and safety have been increasingly well documented in cardiovascular disease of many kinds. In this article we will explore the effects of laser therapy in angina, atherosclerosis, coronary artery disease, hypertension, hyperlipidemia, myocardial infarction, stroke and other conditions. The clinical application of various methods of laser therapy, including laserpuncture and transcutaneous, supravascular and intravenous irradiation of blood will be discussed. Implementing laser therapy in the treatment of cardiovascular disease offers the possibility of increasing the health and wellbeing of patients while reducing the costs and enhancing safety of medical care.

  15. Recovery Following Orthognathic Surgery

    Science.gov (United States)

    1993-01-01

    USAF Chief Administration 13. ABSTRACT (Mlaxomum 200 words ) Acaesslon For WTTS CPA&t DTIC TAB [1 Unlnlnounced 3)¶’rt QUTALIT 32CT! By~i~’bt f Ditiu~tif...cardiovascular physiology. Int J Adult Orthod Orthognath Surg 1986;1:133-159. 3. Zimmer B, Schwestka R, Kubein-Meesenburg D: Changes in mandibu- lar...mobility after different procedures of orthoganthic surgery. Eur J Orthod 1992;14:188-197. 4. Aragon SB, Van Sickels JE: Mandibular range of motion with

  16. Thromboprophylaxis in orthopaedic surgery

    NARCIS (Netherlands)

    M.C. Struijk-Mulder

    2014-01-01

    This thesis describes the use of thromboprophylatic modalities after total hip and total knee arthroplasty by Dutch orthopedic departments over a period of ten years and several uncertainties regarding thromboprophylaxis in other areas of orthopedic surgery. In this thesis some of these uncertaintie

  17. 胸外科患者分级心理护理模式效果评价%Effect evaluation of hierarchical psychological nursing mode on patients in Thoracic Surgery Department

    Institute of Scientific and Technical Information of China (English)

    申凌慧; 胡海珍; 赵鹏伟

    2013-01-01

    目的 评价分级心理护理模式对胸外科患者的干预效果,为今后临床心理护理提供参考.方法 选取2011年2月~2012年10月至武警内蒙古总队医院外三科住院治疗行择期胸外科手术的患者116例作为研究对象,将其分为干预组(n=86)和对照组(n=30).计算患者术前SCL-90量表及匹兹堡睡眠指数量表得分,并根据评估结果将干预组患者划分心理护理等级,采取相应的分级护理策略进行干预,在术后出院前再次评估SCL-90量表及匹兹堡睡眠指数量表得分,同时比较术后恢复活动的时间、并发症发生情况.结果 出院前干预组的SCL-90平均得分为(1.79±0.48)分,匹兹堡睡眠指数得分为(2.96±0.44)分;对照组SCL-90平均得分为(2.96±0.44)分,匹兹堡睡眠指数得分为(3.21±0.48)分,干预组及对照组得分均低于术前,差异有统计学意义(P<0.05).通过分级心理护理干预,出院前干预组SCL-90平均得分及匹兹堡睡眠指数得分低于对照组,差异有统计学意义(P<0.01),但术后恢复活动时间及手术并发症发生率比较差异无统计学意义(P>0.05).结论 分级心理护理模式能够改善患者的术后负性情绪及睡眠质量,效果优于普通心理护理.%Objective To evaluate the effect of hierarchical psychological nursing mode for patients in thoracic surgery department,thus to provide reference for future clinical psychological nursing.Methods 116 cases of research objects were selected from inpatients who accepted selective thoracic surgery in the Third Department of Surgery of Inner Mongolia Armed Police Hospital from February 2011 to October 2012.They were divided into intervention group (n =86) and control group (n =30).The patients were scored with preoperative SCL-90 scale and Pittsburgh sleep quality index.And according to the evaluation results,patients in intervention group were subdivided with psychological nursing grade,and they were intervened with

  18. 糖化血红蛋白与择期非心脏手术患者心血管疾病的相关性分析%The Correlation Analysis of Glycated Hemoglobin and Choosing Time Cardiac Surgery Patients with Cardiovascular Disease

    Institute of Scientific and Technical Information of China (English)

    杨国锋; 吴娜

    2013-01-01

    目的:对糖化血红蛋白与择期非心脏手术患者心血管疾病的相关性进行分析探讨,为今后的临床诊治与预防工作提供可靠的参考依据。方法:抽取在2010年1月-2013年3月间本院收治的合并糖尿病择期非心脏手术患者218例,对其进行糖化血红蛋白水平检测,依照检测结果将其分成糖化血红蛋白<6.5%组和糖化血红蛋白≥6.5%组,而后对这两组患者展开术后24 h动态心电监护,对患者术前与术后心血管事件发生率进行对比分析。结果:糖化血红蛋白≥6.5%组心血管事件发生率较糖化血红蛋白<6.5%组显著升高(P<0.05);两组患者的空腹血糖、甘油三酯、总胆固醇以及高密度脂蛋白等生化指标的检测结果比较差异均有统计学意义(P<0.05)。结论:糖化血红蛋白与心血管事件的发生之间存在一定的相关性,特别是在合并糖尿病的择期非心脏手术患者,高糖化血红蛋白水平会增加心血管事件发生率,临床应对其给予关注。%Objective:To discuss and analysis the correlation analysis of glycated hemoglobin and choosing time cardiac surgery patients with cardiovascular disease,and provide reliable reference for clinical diagnosis and treatment prevention for future work.Method:218 cases of patients with glycated hemoglobin and choosing time cardiac surgery patients of our hospital from January 2010 to March 2013 were chosen ,their glycated hemoglobin level were detected,according to the test results they were divided into glycated hemoglobin<6.5%group and glycated hemoglobin ≥ 6.5 group,and then the two groups of patients were given postoperative 24-hour holter monitoring ,and then they were given preoperative and postoperative incidence cardiovascular events analyzation.Result:Incidence of cardiovascular events of glycated hemoglobin ≥ 6.5 group was significantly greater than that of glycated hemoglobin<6.5%group(P<0.05).The detection

  19. 延续护理在胃肠外科肠造口患者中的应用效果%Efficacy of continuing nursing in treatment of patients with colostomy in gastrointestinal surgery department

    Institute of Scientific and Technical Information of China (English)

    王爱萍; 张凌; 周志英; 黄惠珠

    2015-01-01

    目的:探讨延续护理在永久性肠造口患者中的应用效果。方法将胃肠外科出院的永久性肠造口患者87例分为延续护理组和对照组,对照组行常规出院宣教,延续护理组采取电话随访、家庭访视、网络平台随访、造口联谊会等形式进行护理干预;观察比较2组患者永久性肠造口有关知识的掌握、各种并发症发生率、满意度。结果延续护理组患者对永久性肠造口相关知识的掌握度显著高于对照组,并发症发生率显著低于对照组,满意度调查显著高于对照组,差异均有统计学意义(P <0.05)。结论延续护理可提高患者的自我护理能力,同时减少并发症的发生,提高造口患者的满意度。%ABSTRACT:Objective To investigate the efficacy of continuing nursing in treatment of pa-tients with permanent colostomy.Methods A total of 87 discharged patients with permanent colostomy in department of gastrointestinal surgery were divided into continuing nursing group and control group.The control group was treated with conventional discharge education,while contin-uing nursing group were conducted with phone follow up,home visits,network platform,follow-up colostomy sodality.Permanent colostomy related knowledge,incidence rate of complications and nursing satisfactory degree were compared between two groups.Results Permanent colostomy re-lated knowledge of the observation group was significantly better than the control group,the inci-dence rate of complications was significantly lower than the control group,and nursing satisfactory degree was significantly higher than the control group(P <0.05).Conclusion Continuing nurs-ing can improve the self-care ability of patients,reduce the incidence of complications and improve satisfactory degree of patients.

  20. Application of Risk Management in Nursing Management of General Surgery Department%普外科护理管理中风险管理的应用体会

    Institute of Scientific and Technical Information of China (English)

    袁倩倩; 谢唯双

    2013-01-01

    目的:探讨风险管理在普外科临床护理管理中的应用。方法:通过对日常护理工作中可能存在的风险进行评估,制定常见风险的应急处理程序,对其工作制度进行完善,改进工作流程,提高护士对风险意识的强化培训,加强护理风险监控等措施。结果:实施风险管理后,提高了护士的护理风险意识,使患者满意度明显高于实施管理前。结论:护理管理中应用风险管理后,有效的提高了护理人员对普外科工作中的危险因素的预见性和干预性,提高了患者对护理工作的满意度,显著降低了护理纠纷的发生。%Objective: study the application of risk management in clinical nursing management of general surgery department. Method:through evaluating the potential risk in daily nursing work, the common risk emergency treatment procedure is developed, the working system is improved and the workflow is improved, the risk awareness training of nurse is enhanced, and the measures on strengthening nursing risk monitor is developed. Result: after implementing risk management, the nursing risk awareness of nurse is improved, and the satisfaction of patients is significantly higher than before. Conclusion: after the application of risk management in nursing management, it effectively improves the foresee and intervention ability of risk elements in nursing, improves the satisfaction of patients and significantly reduces the nursing disputes.

  1. Transcatheter valve implantation for patients with aortic stenosis: A position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

    NARCIS (Netherlands)

    A. Vahanian (Alec); O. Alfieri (Ottavio); N. Al-Attar (Nawwar); M. Antunes (Manuel); J.J. Bax (Jeroen); B. Cormier (Bertrand); A. Cribier (Alain); P.P.T. de Jaegere (Peter); G. Fournial (Gerard); A.P. Kappetein (Arie Pieter); J. Kovac (Jan); S. Ludgate (Susanne); F. Maisano (Francesco); N. Moat (Neil); F.W. Mohr (Friedrich); P. Nataf (Patrick); L. Pié rard (Luc); J.L. Pomar (Jose); J. Schofer (Joachim); P. Tornos (Pilar); M. Tuzcu (Murat); B.A. van Hout (Ben); L.K. von Segesser (Ludwig); T. Walther (Thomas)

    2008-01-01

    textabstractAims: To critically review the available transcatheter aortic valve implantation techniques and their results, as well as propose recommendations for their use and development. Methods and results: A committee of experts including European Association of Cardio-Thoracic Surgery and Europ

  2. Metallurgy Department

    DEFF Research Database (Denmark)

    Risø National Laboratory, Roskilde

    The activities of the Metallurgy Department at Risø during 1981 are described. The work is presented in three chapters: General Materials Research, Technology and Materials Development, Fuel Elements. Furthermore, a survey is given of the department's participation in international collaboration...

  3. Potential Risks and Countermeasures of Nursing Management in Cardiovas-cular Department of Internal Medicine%心血管内科护理管理工作中的潜在风险及对策

    Institute of Scientific and Technical Information of China (English)

    董慧

    2016-01-01

    随着人们生活水平提高,老龄化人口的增多,心血管疾病住院的患者越来越多,如何能够提高护理质量,降低患者住院期间出现意外风险的发生率越来越受到医护人员和患者的关注。该文从护理管理、护理人员、住院患者三方面总结分析了心血管内科护理管理期间存在的潜在风险,提出在护理工作中完善的护理管理机制、增强法制观念、岗位责任明确、加强技能培训、改善服务态度、学习沟通技巧、加强安全措施管理、加强健康教育等方法,最大程度消除护理工作中的潜在风险,提高护理满意度。%Along with the improvement of people's living standard, the increase in aging population, more and more pa_tients with cardiovascular disease in hospital, how to improve the quality of nursing, the risk of accidental incidence of more and more attention by the medical staff and patients appears to reduce the patients during hospitalization. This paper from the nursing management, nursing staff, hospital patients summary analysis of the cardiovascular internal medicine nursing management during the potential risk, improve in the nursing work in nursing management mechanism put forward, strength_en the concept of law, clear post responsibility, strengthen training, improve service attitude, learning communication skills, strengthen safety management measures, to strengthen health education etc., will be in the care of the potential risks to the greatest extent destroyed, improve nursing satisfaction.

  4. 心血管外科医护一体化伤口治疗管理模式探讨%Investigation on the wound caring mode in the department of surgical cardiovascular

    Institute of Scientific and Technical Information of China (English)

    白阳静; 陈佳丽; 李梅; 陈红

    2012-01-01

    目的 探讨心血管外科医护一体化伤口治疗管理模式.方法 构建心血管外科医护一体化伤口治疗管理模式,对心血管外科伤口治疗进行规范化流程管理,实施12个月后,对比实施前246名患者和实施后271名患者的伤口愈合情况、平均住院日,同时单纯随机抽取60名患者进行模式实施前后的满意度调查,应用秩和检验、t检验进行模式实施前后效果比较.结果 应用医护一体化的伤口治疗管理模式12个月后,患者满意度及伤口愈合情况明显改善,患者平均住院日缩短,差异有统计学意义(P<0.05).结论 医护一体化伤口治疗管理模式有利于提高伤口治疗效果、促进医护合作,取得良好的社会效益.%OBJECTIVE To explore the implementation and effects of the Doctor-Nurse Integration Wound Caring Mode in the caring of surgical cardiovascular wound. METHODS We established the Doctor-Nurse Integration Wound Caring Mode in the surgical Cardiovascular wound caring for 12 months. The effects of this mode were evaluated by wound healing and patient satisfaction about wound care. Rank sura test was used to analyze data to compare the effect of the implementation of the Doctor-Nurse Integration Wound Caring Mode. 246 patients before implementation and 271 patients after implementation were compared to assess the effect of wound healing rate. Random sampling method was used to select 60 patients to assess patient satisfaction. RESULTS After implementation of the Doctor-Nurse Integration Wound Caring Mode for 12 months, the patients' satisfaction and the wound healing were statistically significantly improved (P< 0.05) , and the average inpalient day was significantly decreased (P< 0.05). CONCLUSION The Doctor-Nurse Integration Wound Caring Mode is useful to improve effectiveness of wound caring, patient satisfaction and efficiency of society.

  5. [Bariatric surgery in Denmark.

    DEFF Research Database (Denmark)

    Funch-Jensen, P.; Iversen, M.G.; Kehlet, H.

    2008-01-01

    INTRODUCTION: In 2005 the National Board of Health (NBH) published guidelines on bariatric surgery in Denmark. The aim of the present study was to shed light on the national bariatric effort in relation to these guidelines. MATERIAL AND METHODS: The analysis is based on extraction of the following......, a tendency which was attributable to the activities of one of the private clinics. CONCLUSION: The frequency with which bariatric surgery is performed follows a strongly increasing trend and the procedures are only performed at the public departments selected by the National Board of Health...

  6. Efeitos da posição sentada na força de músculos respiratórios durante o desmame de pacientes sob ventilação mecânica prolongada no pós-operatório de cirurgia cardiovascular Effects of sitting position on the strength of respiratory muscles during weaning of patients under prolonged mechanical ventilation in the postoperative period of cardiovascular surgery

    Directory of Open Access Journals (Sweden)

    Emília Nozawa

    2011-06-01

    Full Text Available O objetivo do estudo foi investigar os efeitos da posição sentada, nos parâmetros ventilatórios e hemodinâmicos, em pacientes com suporte ventilatório mecânico prolongado, estáveis hemodinamicamente. Participaram do estudo 40 pacientes que foram randomizados em grupo controle (n=17 e grupo intervenção (n=23. Foram mensurados parâmetros hemodinâmicos, gasometria arterial, força muscular respiratória e ventilometria, realizados em dois momentos: primeira e segunda avaliação, com intervalo de 30 minutos entre as medidas. No grupo controle, as duas avaliações foram realizadas no leito, com a cabeceira elevada a 30°. No grupo intervenção, a primeira avaliação foi realizada no leito (30° e a segunda, 30 minutos após transferência para a poltrona, na posição sentada (90°. A idade média da amostra foi de 64,7±11,2 anos. O resultado do estudo demonstrou que não houve diferenças em relação às variáveis, hemodinâmicas, gasométricas, capacidade vital forçada, volume minuto e volume de ar corrente. Entretanto, ocorreu aumento significativo da pressão inspiratória máxima (PImáx no grupo intervenção (pThe purpose was to study the effects of sitting position, in ventilatory and hemodynamic parameters, in patients under prolonged mechanical ventilation, in the postoperative of cardiovascular surgery. Participated 40 postoperative cardiovascular patients, intubated and mechanically ventilated, were randomized into control group (n=17 and intervention group (n=23. Hemodynamic parameters, arterial blood gases, respiratory muscle strength and ventilometry, were measured in two moments: first and second evaluation, with 30-minute interval between measurements. In the control group, both evaluations were performed at head of the bed elevated at 30°. In the sitting group, the first evaluation was developed at 30° and the second, (30 minutes after transfer to the armchair in the sitting position (90°. The mean age of

  7. Relationship between cobalamin deficiency and delirium in elderly patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Sevuk U

    2015-08-01

    Full Text Available Utkan Sevuk,1 Erkan Baysal,2 Nurettin Ay,3 Yakup Altas,2 Rojhat Altindag,2 Baris Yaylak,2 Vahhac Alp,3 Ertan Demirtas4 1Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, 2Department of Cardiology, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, 3Department of General Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, 4Department of Cardiovascular Surgery, Liv Hospital, Ankara, Turkey Background: Delirium is common after cardiac surgery and is independently associated with increased morbidity, mortality, prolonged hospital stays, and higher costs. Cobalamin (vitamin B12 deficiency is a common cause of neuropsychiatric symptoms and affects up to 40% of elderly people. The relationship between cobalamin deficiency and the occurrence of delirium after cardiac surgery has not been examined in previous studies. We examined the relationship between cobalamin deficiency and delirium in elderly patients undergoing coronary artery bypass grafting (CABG surgery.Material and methods: A total of 100 patients with cobalamin deficiency undergoing CABG were enrolled in this retrospective study. Control group comprised 100 patients without cobalamin deficiency undergoing CABG. Patients aged 65 years or over were included. Diagnosis of delirium was made using Intensive Care Delirium Screening Checklist. Delirium severity was measured using the Delirium Rating Scale-revised-98.Results: Patients with cobalamin deficiency had a significantly higher incidence of delirium (42% vs 26%; P=0.017 and higher delirium severity scores (16.5±2.9 vs 15.03±2.48; P=0.034 than patients without cobalamin deficiency. Cobalamin levels were significantly lower in patients with delirium than patients without delirium (P=0.004. Delirium severity score showed a moderate correlation with cobalamin levels (Ρ=-0.27; P=0.024. Logistic regression analysis demonstrated that

  8. Thyroid Surgery

    Science.gov (United States)

    ... etc.). Surgery is also an option for the treatment of hyperthyroidism (Grave’s disease or a “toxic nodule” (see Hyperthyroidism brochure ), for large and multinodular goiters and for any goiter that may be causing ... MEANS OF TREATMENT? Surgery is definitely indicated to remove nodules suspicious ...

  9. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard

    2009-01-01

    ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in......-depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed...... before surgery, and 11 were interviewed at least 6 months after surgery. To provide additional information, 12 patients were interviewed before randomisation. Interviews were audio-recorded, transcribed and analysed using the Framework approach. RESULTS: Strong preference for surgery was commonplace...

  10. Patch in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alireza Alizadeh Ghavidel

    2014-06-01

    Full Text Available Introduction: Excessive bleeding presents a risk for the patient in cardiovascular surgery. Local haemostatic agents are of great value to reduce bleeding and related complications. TachoSil (Nycomed, Linz, Austria is a sterile, haemostatic agent that consists of an equine collagen patchcoated with human fibrinogen and thrombin. This study evaluated the safety and efficacy of TachoSil compared to conventional technique.Methods: Forty-two patients scheduled for open heart surgeries, were entered to this study from August 2010 to May 2011. After primary haemostatic measures, patients divided in two groups based on surgeon’s judgment. Group A: 20 patients for whom TachoSil was applied and group B: 22 patients that conventional method using Surgicel (13 patients or wait and see method (9 cases, were performed in order to control the bleeding. In group A, 10 patients were male with mean age of 56.95±15.67 years and in group B, 9 cases were male with mean age of 49.95±14.41 years. In case group 70% (14/20 of the surgeries were redo surgeries versus 100% (22/22 in control group.Results: Baseline characteristics were similar in both groups. In TachoSil group 75% of patients required transfusion versus 90.90% in group B (P=0.03.Most transfusions consisted of packed red blood cell; 2±1.13 units in group A versus 3.11±1.44 in group B (P=0.01, however there were no significant differences between two groups regarding the mean total volume of intra and post-operative bleeding. Re-exploration was required in 10% in group A versus 13.63% in group B (P=0.67.Conclusion: TachoSil may act as a superior alternative in different types of cardiac surgery in order to control the bleeding and therefore reducing transfusion requirement.

  11. Pseudoexfoliation syndrome and cardiovascular diseases

    Institute of Scientific and Technical Information of China (English)

    Georgios; K; Andrikopoulos; Dimitrios; K; Alexopoulos; Sotirios; P; Gartaganis

    2014-01-01

    Pseudoexfoliation(PEX) syndrome is a well-recognized late-onset disease caused by a generalized fibrillopathy. It is linked to a broad spectrum of ocular complications including glaucoma and perioperative problems during cataract surgery. Apart from the long-known intraocular manifestations, PEX deposits have been found in a variety of extraocular locations and they appear to represent a systemic process associated with increased cardiovascular and cerebrovascular morbidity. However, as published results are inconsistent, the clinical significance of the extraocular PEX deposits remains controversial. Identification of PEX deposits in the heart and the vessel wall, epidemiologic studies, as well as, similarities in pathogenetic mechanisms have led to the hypothesis of a possible relation between fibrillar material and cardiovascular disease. Recent studies suggest that PEX syndrome is frequently linked to impaired heart and blood vessels function. Systemic and ocular blood flow changes, altered parasympathetic vascular control and baroreflex sensitivity, increased vascular resistance and decreased blood flow velocity, arterial endothelial dysfunction, high levels of plasma homocysteine and arterial hypertension have all been demonstrated in PEX subjects. Common features in the pathogenesis of both atherosclerosis and PEX, like oxidative stress and inflammation and a possible higher frequency of abdominal aorta aneurysm in PEX patients, could imply that these grey-white deposits and cardiovascular disorders are related or reflect different manifestations of the same process.

  12. Viscoless microincision cataract surgery

    Directory of Open Access Journals (Sweden)

    Guy Sallet

    2008-06-01

    Full Text Available Guy SalletDepartment of Opthamology, Aalsters Stedelijk Ziekenhuis, BelgiumAbstract: A cataract surgery technique is described in which incisions, continuous circular capsulorhexis and hydrodissection are made without the use of any viscoelastics. Two small incisions are created through which the different parts of the procedure can take place, maintaining a stable anterior chamber under continuous irrigation. Subsequent bimanual phacoemulsification can be done through these microincisions. At the end of the procedure, an intraocular lens can be inserted through the self-sealing incision under continuous irrigation. 50 consecutive cataract patients were operated on without the use of viscoelastics and then compared with a group of 50 patients who had been helped with viscoelastics. No difference in outcome, endothelial cell count or pachymetry was noted between the two groups. No intraoperative complication was encountered. Viscoless cataract surgery was a safe procedure with potential advantages.Keywords: ophthalmic visco-surgical device, viscoless cataract surgery, microincision

  13. Cardiovascular Disease and Diabetes

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Cardiovascular Disease & Diabetes Updated:Nov 4,2016 The following statistics speak ... disease. This content was last reviewed August 2015. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  14. Cardiovascular manifestations of phaeochromocytoma

    NARCIS (Netherlands)

    Prejbisz, A.; Lenders, J.W.M.; Eisenhofer, G.; Januszewicz, A.

    2011-01-01

    Clinical expression of phaeochromocytoma may involve numerous cardiovascular manifestations, but usually presents as sustained or paroxysmal hypertension associated with other signs and symptoms of catecholamine excess. Most of the life-threatening cardiovascular manifestations of phaeochromocytoma,

  15. Understanding cardiovascular disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000759.htm Understanding cardiovascular disease To use the sharing features on this page, ... lead to heart attack or stroke. Types of Cardiovascular Disease Coronary heart disease (CHD) is the most common ...

  16. APOE Genotyping, Cardiovascular Disease

    Science.gov (United States)

    ... Home Visit Global Sites Search Help? APOE Genotyping, Cardiovascular Disease Share this page: Was this page helpful? Also ... of choice to decrease the risk of developing cardiovascular disease (CVD) . However, there is a wide variability in ...

  17. 75 FR 1395 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2010-01-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Cardiovascular and Renal Drugs Advisory Committee; Notice of... to the public. ] Name of Committee: Cardiovascular and Renal Drugs Advisory Committee....

  18. [Bariatric surgery: an update].

    Science.gov (United States)

    Moreno Esteban, B; Zugasti Murillo, A

    2004-01-01

    The indication of bariatric surgery as therapeutic procedure for morbid obese patients requires the application of selection criteria which deal with the degree of obesity, associated complications and previous failure of conventional therapy. Alcohol or drug addiction and concomitant serious disease are contraindications for bariatric surgery. Before operation, a full assessment is needed to identify possible eating behaviour disturbances and associated comorbidity such as cardiovascular disease, sleep apnoea, metabolic and psychiatric alterations which might induce intra and postoperative complications. Surgical techniques can be classified as restrictive, malabsortive and mixed procedures. Gastroplasty and adjustable gastric banding are restrictive techniques, which are indicated in obese patients with body mass index less than 45 kg/m2. Mixed techniques are the most used procedures. They include gastric by-pass which causes a reduction of 60-70% of weight excess, biliopancreatic diversion and duodenal switch which can eliminate a 75% of body weight excess. Following bariatric surgery a dramatic improvement in associated comorbidity can be demonstrated, specially in what refers to diabetes, hypertension, dislipidaemia and apnoea. Postoperative mortality is around 1-2%. Peritonitis and venous thromboembolism are the most serious complications. Postoperative follow-up should be lifelong and requires a progressive nutrition planning and vitamin supplementation.

  19. Assessment of in-hospital mortality risk factors in patients with severe valvular heart disease after cardiovascular surgery%重症心脏瓣膜病患者术后住院死亡危险因素分析

    Institute of Scientific and Technical Information of China (English)

    钱军岭; 王强; 王东进

    2011-01-01

    Objectiye: To explore the risk iactors for in-hospi1almortali1y of pathents with severe valvular heart disease after surgery, and to offer the basis in Older to prevent if s occurrence. M etiiods: Clinical date of235 cases with severe valvular heart disease were analyzed retrospectively. Divided into 1wo groups accord ing to whether or not death after surgery, preoperative and postoperative date were evaluated by uni-variate analysis andmultivariate logistic regression analysis. Results; Thirty- 1wo cases died during the hos-piteland the tetelity rate wasl3.6%. Low cardiac output, multiple organ iailure and malignant arrhythnia were the most frequent cause of death. Results in logistic regression method, age 3=65 years, history of valve≥l5 years, New York HeartAssociatbi( NYHA) class IV, card fothoracic rations 0.7, left ventricular ejection fractbn( LVEF) ≤0.4, concanitent coronary artery bypass graft( CABG), and acHosis in postopeF-ative24 hours were the independent risk iactors for in-hospitelmortality after surgery. Conclusion: The mortality of severe valvular heart disease after surgery was high and the pathentsmay suffer fron many can-plications The course of disease, degree of basic pathological change of heart, and perioperative treament can affect the incidence of postoperative death; early surgery, a positive preoperative preparation, shortening cardfopumonary bypass tine, and maintaining acid-base balance may be the most effective preventive method of death occurred early after card fovascular surgery.%目的:探讨重症心脏瓣膜病患者术后住院期间死亡的危险因素,为防治术后住院死亡的发生提供依据.方法:回顾性分析235例重症心脏瓣膜病患者的临床资料.按术后死亡与否分成两组,进行单因素分析和多因素logistic回归分析.结果:术后住院期间死亡32例,病死率是13.6%,主要死亡原因分别是多器官功能衰竭,术后低心排,恶性心律失常.Logistic

  20. Cardiovascular comorbiditiy in psoriasis

    OpenAIRE

    Gurcharan Singh; Simran Pal Singh Aneja

    2011-01-01

    The chronic inflammatory nature of psoriasis is also thought to predispose patients to other diseases with an inflammatory component, the most notable being cardiovascular and metabolic (cardiometabolite) disorders. This concept is supported by studies showing that psoriasis is associated with cardiovascular risk factors like diabetes, obesity, hypertension, dyslipidemia, smoking and diseases including MI. Given the increased prevalence of cardiovascular co morbidities in patients, dermatolog...

  1. 血脂监测日记在心血管内科高血脂患者中的应用%Application of serum lipids monitoring diary in patients with hyperlipidemia in cardiovascular department

    Institute of Scientific and Technical Information of China (English)

    笃铭丽; 赵钧; 王秋莉

    2012-01-01

    Objective To explore the effects of serum lipids monitoring diary on KAP (knowledge-attitude-behavior) levels and the recurrence of cardiovascular events of patients with hyperlipidemia.Methods 156 cases of hyperlipidemia patients over the age of 40 were randomly divided into two groups:the control group (n = 76)and the experimental group (n = 80).Questionnaires were used to investigate the KAP levels on serum lipids among all the patients before health education,which were provided to both groups during hospitalization.The control group only received conventional health education and telephone follow-up once a quarter after discharged,while the experimental group used the serum lipids monitoring diary in addition.Questionnaires were used again a year later to investigate their KAP levels and the recurrence of cardiovascular events was also compared between two groups.Results After experiment,lipidemia related knowledge score and behavior score in the experiment group [(27.84 ± 5.40) and (12.33 ± 2.17)] were higher than those [(22.83 ± 5.61) and (7.76 ± 1.81)] in the control group (t =-5.68,-14.29,respectively; P < 0.05),and no difference of attitude score was found in two groups [(7.44 ± 1.23) and (7.25 ± 1.23)] (t =-0.95,P > 0.05).The incidence rate of myocardial infarction (5.0%) and angina (25.0%) in the experiment group were lower than those [(11.8%) and (43.4%)] in the control group (x2 = 14.61,5.9,respectively ; P < 0.05),and no difference of the incidence of heart failure was found in two groups (3.8% and 7.9%) (x2 = 1.23,P > 0.05).There were no incidence of cardiac sudden death,cardiac shock,malignant arrhythmia and stroke in both groups.Conclusions Serum lipids monitoring diary can play a beneficial role on improving the knowledge-attitude-behavior level and reducing recurrence of cardiac infarction and angina among patients with hyperlipidemia in the meantime.%目的 探讨血脂监测日记对改善心血管内科

  2. Outpatient Surgery

    Science.gov (United States)

    ... thirds of all operations are performed in outpatient facilities, according to the Centers for Disease Control and Prevention. Outpatient surgery provides patients with the convenience of recovering at home, and can cost less. ...

  3. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  4. Laparoscopic Surgery

    Science.gov (United States)

    ... surgeon’s perspective, laparoscopic surgery may allow for easier dissection of abdominal scar tissue (adhesions), less surgical trauma, ... on Facebook About ACG ACG Store ACG Patient Education & Resource Center Home GI Health and Disease Recursos ...

  5. [Insulin: cardiovascular effects and therapeutic applications].

    Science.gov (United States)

    Schaan, Beatriz D; Rabelo, Eneida R; Irigoyen, Maria Cláudia

    2004-12-01

    Several studies have suggested a beneficial role of insulin and glucose infusions after myocardial infarction and in critically ill diabetic and non-diabetic patients. However, the insulin-glucose infusions are not routinely given to these patients, since no large randomized control trial was carried out, mechanisms involved in the benefits obtained are poorly understood, infusion protocols are complex and finally, health professionals need to change their cultural premises to apply them in their practice. Insulin has beneficial cardiovascular effects, such as the optimization of substrate use by cardiomyocites, coronary vasodilation, anti-inflammatory action and direct anti-apoptotic effects on myocardial cells. In this context, clinical studies of glucose and insulin infusions after myocardial infarction and cardiovascular surgery are reviewed, as well as possible pathophysiologic mechanisms leading to these benefits, and finally, a practical algorithm is proposed for use in intensive care and cardiovascular postoperative care units.

  6. [Aesthetic surgery].

    Science.gov (United States)

    Bruck, Johannes C

    2006-01-01

    The WHO describes health as physical, mental and social well being. Ever since the establishment of plastic surgery aesthetic surgery has been an integral part of this medical specialty. It aims at reconstructing subjective well-being by employing plastic surgical procedures as described in the educational code and regulations for specialists of plastic surgery. This code confirms that plastic surgery comprises cosmetic procedures for the entire body that have to be applied in respect of psychological exploration and selection criteria. A wide variety of opinions resulting from very different motivations shows how difficult it is to differentiate aesthetic surgery as a therapeutic procedure from beauty surgery as a primarily economic service. Jurisdiction, guidelines for professional conduct and ethical codes have tried to solve this question. Regardless of the intention and ability of the health insurances, it has currently been established that the moral and legal evaluation of advertisements for medical procedures depends on their purpose: advertising with the intent of luring patients into cosmetic procedures that do not aim to reconstruct a subjective physical disorder does not comply with a medical indication. If, however, the initiative originates with the patient requesting the amelioration of a subjective disorder of his body, a medical indication can be assumed.

  7. [Robotic surgery].

    Science.gov (United States)

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era.

  8. Tennis elbow surgery

    Science.gov (United States)

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is usually an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

  9. Noncardiac surgery in patients with aortic stenosis

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Jørgensen, Mads Emil; Martinsson, Andreas

    2014-01-01

    BACKGROUND: Past research has identified aortic stenosis (AS) as a major risk factor for adverse outcomes in noncardiac surgery; however, more contemporary studies have questioned the grave prognosis. To further our understanding of this, the risks of a 30-day major adverse cardiovascular event...

  10. Cardiovascular behavior during rehabilitation after coronary artery bypass grafting

    OpenAIRE

    2010-01-01

    OBJECTIVE: The aim of the present study was to assess the behavior of cardiovascular variables during an in-hospital cardiovascular rehabilitation program in patients following myocardial revascularization surgery. METHODS: A total of 14 patients (mean age: 55.4 ± 6.4 years, 78.6% male) participated in the study, all of whom had a previous diagnosis of coronary insufficiency and indication for elective surgery. The protocol consisted of a group of low-impact (2-3 METs) upper/lower extremity a...

  11. The effect of establishing"Painless Ward"in colorectal surgery department%在肛肠外科建立无痛病房的效果研究

    Institute of Scientific and Technical Information of China (English)

    马玉莲; 刘凯; 吕兵

    2013-01-01

    目的:探讨在肛肠外科建立无痛病房的效果。方法:构建肛肠外科无痛病房,包括建立疼痛管理团队并确定职责,对科室人员进行培训与考核,制订镇痛方案等。建立无痛病房前后采用调查问卷对患者及护理人员进行调查。结果:无痛病房建立后,患者术后疼痛评分(2.8±0.8)、48h内疼痛频次(0.9±0.6)、需止疼药物频次(0.5±0.4)、首次排便时疼痛评分(1.8±0.7)、平均住院日(7.9±0.6),均小于建立前(P<0.01),满意度评分(4.2±0.5)高于建立前(P<0.01)。护理人员对疼痛评估(1.8±0.4)、疼痛一般知识(8.4±0.9)、药物镇痛知识(17.4±0.8)、疼痛知识的综合应用(3.8±0.5)4个指标得分均高于建立前(P<0.05)。结论:通过建立无痛病房,实施规范化的疼痛管理护理工作程序,提升了护理人员疼痛知识掌握程度及疼痛管理水平,减轻了患者术后疼痛,提高了患者对镇痛效果的满意度。%Objective:To study the effect of establishing"Painless Ward"in colorectal surgery department. Methods:The model of pain management by nurses was developed, which included setting up pain management team and clarifying their responsibilities, completing staff training and evaluation, establishing standardized pain management plan, etc. Questionnaire was used to investigate patients and nursing staff after nurses' pain management practice. Results:The indicators included patients' postoperative pain score (2.8±0.8), pain frequency within 48 hours (0.9±0.6), frequency of analgesia drugs needs (0.5±0.4), pain score during the ifrst defecation (1.8±0.7) and the average length of stay (7.9±0.6). All of them were signiifcantly better than before (P<0.01). Patient satisfaction score (4.2±0.5) was higher than before (P<0.01). Nurses' knowledge in terms of pain assessment (1.8±0.4), general knowledge about pain (8.4±0.9), knowledge about

  12. Orthognathic Surgery

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Thygesen, Torben Henrik

    2016-01-01

    The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence...... on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were...... in beauty than women (P = 0.030). Sixty-four percent replied that their attractiveness had been increased after OS. Eighty-six percent were happy with the results and 89% would recommend the surgery to others in need. No significant differences in esthetic results and satisfaction were seen with regard...

  13. HCUP State Ambulatory Surgery Databases (SASD) - Restricted Access Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — The State Ambulatory Surgery Databases (SASD) contain the universe of hospital-based ambulatory surgery encounters in participating States. Some States include...

  14. [Geriatric surgery].

    Science.gov (United States)

    Paulino-Netto, Augusto

    2005-10-01

    Modern medicine, which is evidence-based and overly scientific, has forgotten its artistic component, which is very important for surgery in general and for geriatric surgery in particular. The surgeon treating an old patient must be a politician more than a technician, more an artist than a scientist. Like Leonardo da Vinci, he or she must use scientific knowledge with intelligence and sensitivity, transforming the elderly patient's last days of life into a beautiful and harmonious painting and not into something like an atomic power station which, while no doubt useful, is deprived of beauty and sometimes very dangerous.

  15. Iron deficiency and cardiovascular disease.

    Science.gov (United States)

    von Haehling, Stephan; Jankowska, Ewa A; van Veldhuisen, Dirk J; Ponikowski, Piotr; Anker, Stefan D

    2015-11-01

    Iron deficiency affects up to one-third of the world's population, and is particularly common in elderly individuals and those with certain chronic diseases. Iron excess can be detrimental in cardiovascular illness, and research has now also brought anaemia and iron deficiency into the focus of cardiovascular medicine. Data indicate that iron deficiency has detrimental effects in patients with coronary artery disease, heart failure (HF), and pulmonary hypertension, and possibly in patients undergoing cardiac surgery. Around one-third of all patients with HF, and more than one-half of patients with pulmonary hypertension, are affected by iron deficiency. Patients with HF and iron deficiency have shown symptomatic improvements from intravenous iron administration, and some evidence suggests that these improvements occur irrespective of the presence of anaemia. Improved exercise capacity has been demonstrated after iron administration in patients with pulmonary hypertension. However, to avoid iron overload and T-cell activation, it seems that recipients of cardiac transplantations should not be treated with intravenous iron preparations.

  16. [Impact of digital technology on clinical practices: perspectives from surgery].

    Science.gov (United States)

    Zhang, Y; Liu, X J

    2016-04-09

    Digital medical technologies or computer aided medical procedures, refer to imaging, 3D reconstruction, virtual design, 3D printing, navigation guided surgery and robotic assisted surgery techniques. These techniques are integrated into conventional surgical procedures to create new clinical protocols that are known as "digital surgical techniques". Conventional health care is characterized by subjective experiences, while digital medical technologies bring quantifiable information, transferable data, repeatable methods and predictable outcomes into clinical practices. Being integrated into clinical practice, digital techniques facilitate surgical care by improving outcomes and reducing risks. Digital techniques are becoming increasingly popular in trauma surgery, orthopedics, neurosurgery, plastic and reconstructive surgery, imaging and anatomic sciences. Robotic assisted surgery is also evolving and being applied in general surgery, cardiovascular surgery and orthopedic surgery. Rapid development of digital medical technologies is changing healthcare and clinical practices. It is therefore important for all clinicians to purposefully adapt to these technologies and improve their clinical outcomes.

  17. Evaluation of Level Management of Nurses in Improving the Nursing Quali-ty in the Department of Breast Surgery%护士分层级管理提高乳腺外科护理质量效果评价

    Institute of Scientific and Technical Information of China (English)

    任静

    2016-01-01

    Objective To study the clinical application effect of level management of nurses in improving the nursing quali-ty in the department of breast surgery. Methods The united nursing management model was implemented before May 2014 in the department of breast surgery in our hospital, after May 2015, all nurses were divided into five levels from N0 to N4 according to the academic levels, working limits and professional titles, the responsibilities of various levels and the training plan were made, and the level management was implemented, and the professional overall quality and nursing quality of all nursing staff in the department of breast surgery was evaluated. Results After the implementation of level management, the professional overall quality of nursing staff in the department of breast surgery was greatly improved, and the nursing quality indexes such as the ward management, basic nursing, specificity nursing, nursing document and nursing adverse events were improved compared with those before the implementation, and the differences had statistical significance, P<0.05. Conclu-sion The implementation of level management of nurses in the department of breast surgery can refine the training content, help the overall management, adjust the nursing team structure and improve the nursing efficiency thus improving the over-all nursing quality of the department.%目的:探讨护士分层级管理对提高乳腺外科护理质量的临床应用效果。方法该院乳腺外科在2014年5月之前实施传统的统一护理管理模式,2014年5月之后将科室全体护士根据学历、工作年限、职称等条件划分为N0~N4五个层级,制定各层级职责和培训计划,实施分层级管理。对实施层级管理前后6个月,乳腺外科全体护理人员专业综合素质和护理质量进行评价。结果实施层级管理之后,乳腺外科护理人员专业综合素质大幅度提升;病房管理、基础护理、专科护理、护理文

  18. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  19. Department of Clinical Investigation Annual Research Progress Report, Fiscal Year 1985,

    Science.gov (United States)

    1985-10-01

    Nursing 106 Department of OB/GYN 113 Department of Pediatrics 136 Department of Psychiatry 148 Department of Surgery 152 Chief of Staff 176 Nutrition Care...Department of Pediatrics Department of Pathology Department of Psychiatry Department of Surgery Nuclear Medicine Service Pharmacy Service Social Work...CB, Pimentel L: Abdominal Aortic- Aneurysm with Aortocaval Fistula - An Unusual Cause of Dyspnea and Edema. Ann Emerg Med 14(9), 889-96, 1985. In

  20. Morbidity and mortality of diabetes with surgery

    Directory of Open Access Journals (Sweden)

    L. L. Chuah

    2013-01-01

    Full Text Available The prevalence of Type 2 diabetes mellitus (T2DM has increased; as a result the number of patients with T2DM undergoing surgical procedures has also increased. This population is at high risk of macrovascular (cardiovascular disease, peripheral vascular disease or microvascular (retinopathy, nephropathy or neuropathy complications, both increasing their perioperative morbidity and mortality. Diabetes patients are more at risk of poor wound healing, respiratory infection, myocardial infarction, admission to intensive care, and increased hospital length of stay. This leads to increased inpatient costs. The outcome of perioperative glycaemia management remains a significant clinical problem without a universally accepted solution. The majority of evidence on morbidity and mortality of T2DM patients undergoing surgery comes from the setting of cardiac surgery; there was less evidence on non-cardiac surgery and bariatric surgery. Bariatric surgery is increasingly performed in patients with severe obesity complicated by T2DM, but is distinguished from general surgery as it immediately improves the glucose homeostasis postoperatively. The improvements in glycaemia are thought to be independent of weight loss and this requires different postoperative management. Patients usually have to follow specific preoperative diets which lead to improvement in glycaemia immediately before surgery. Here we review the available data on the mortality and morbidity of patients with T2DM who underwent elective surgery (cardiac, non-cardiac and bariatric surgery and the current knowledge of the impact that preoperative, intraoperative and postoperative glycaemic management has on operative outcomes.

  1. Psychological factors and outcomes of coronary surgery

    Directory of Open Access Journals (Sweden)

    Bokeria,Leo A.

    2013-12-01

    Full Text Available Although heart surgery is one of the most effective methods in treating cardiovascular diseases, more than 50% of patients have problems in personal, social, professional adaptation after surgery (Pogosova, 1996. According to recent studies, psychological factors contribute significantly to negative outcomes of coronary surgery. The main factors are: depression, anxiety, personal factors and character traits, social isolation, and chronic life stress (Blumental, 2003; Connerney, 2010; Contrada, 2008; Cserep, 2010, Gallagher, 2007; Hoyer, 2008; Pigney-Demaria, 2003; Rozancki, 1999; Rymaszewska, 2003; Viars, 2009, Zaitsev, 1997. The aim of the article is to describe the association between psychological factors and the outcomes of coronary surgery. We have studied how the patient’s attitude towards forthcoming open heart surgery is associated with the outcomes. We have picked out four types of attitude towards forthcoming heart surgery: 1 pessimistic (no belief in recovery, surgery is threatening, damaging, 2 indifferent (no belief in recovery, surgery will not change anything, 3 optimistic but not realistic (exaggerated expectations, belief in full recovery, 4 optimistic and realistic (adequate expectations, belief in improvement. The study has shown that patients with optimistic-realistic attitudes towards forthcoming heart surgery have better outcomes, better emotional status, and shorter stays in hospital.

  2. ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes : A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and the Society of Thoracic Surgeons.

    Science.gov (United States)

    Patel, Manesh R; Calhoon, John H; Dehmer, Gregory J; Grantham, James Aaron; Maddox, Thomas M; Maron, David J; Smith, Peter K

    2017-03-06

    The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision of the appropriate use criteria (AUC) for coronary revascularization. In prior coronary revascularization AUC documents, indications for revascularization in acute coronary syndromes (ACS) and stable ischemic heart disease were combined into 1 document. To address the expanding clinical indications for coronary revascularization, and in an effort to align the subject matter with the most current American College of Cardiology/American Heart Association guidelines, the new AUC for coronary artery revascularization were separated into 2 documents addressing ACS and stable ischemic heart disease individually. This document presents the AUC for ACS. Clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, presence of clinical instability or ongoing ischemic symptoms, prior reperfusion therapy, risk level as assessed by noninvasive testing, fractional flow reserve testing, and coronary anatomy. This update provides a reassessment of clinical scenarios that the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document but employs the recent modifications in the methods for developing AUC, most notably, alterations in the nomenclature for appropriate use categorization. A separate, independent rating panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate for the clinical scenario presented. Scores of 1 to 3 indicate that revascularization is considered rarely appropriate for the clinical scenario, whereas scores in the mid-range (4 to 6

  3. Lifestyle in Cardiovascular Disease

    NARCIS (Netherlands)

    J.O. Younge (John)

    2015-01-01

    markdownabstract__Abstract__ Globally, the burden of cardiovascular disease (CVD) is still increasing. However, in recent decades, better treatment modalities have led to less cardiovascular related deaths. After years of research, we now generally accept that lifestyle factors are the most importa

  4. Role of diclofenac in the prevention of postpericardiotomy syndrome after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Sevuk U

    2015-06-01

    Full Text Available Utkan Sevuk,1 Erkan Baysal,2 Rojhat Altindag,2 Baris Yaylak,2 Mehmet Sahin Adiyaman,2 Nurettin Ay,3 Vahhac Alp,3 Unal Beyazit,3 1Department of Cardiovascular Surgery, 2Department of Cardiology, 3Department of General Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey Objective: Postpericardiotomy syndrome (PPS, which is thought to be related to autoimmune phenomena, represents a common postoperative complication in cardiac surgery. Late pericardial effusions after cardiac surgery are usually related to PPS and can progress to cardiac tamponade. Preventive measures can reduce postoperative morbidity and mortality related to PPS. In a previous study, diclofenac was suggested to ameliorate autoimmune diseases. The aim of this study was to determine whether postoperative use of diclofenac is effective in preventing early PPS after cardiac surgery. Methods: A total of 100 patients who were administered oral diclofenac for postoperative analgesia after cardiac surgery and until hospital discharge were included in this retrospective study. As well, 100 patients undergoing cardiac surgery who were not administered nonsteroidal anti-inflammatory drugs were included as the control group. The existence and severity of pericardial effusion were determined by echocardiography. The existence and severity of pleural effusion were determined by chest X-ray. Results: PPS incidence was significantly lower in patients who received diclofenac (20% vs 43% (P<0.001. Patients given diclofenac had a significantly lower incidence of pericardial effusion (15% vs 30% (P=0.01. Although not statistically significant, pericardial and pleural effusion was more severe in the control group than in the diclofenac group. The mean duration of diclofenac treatment was 5.11±0.47 days in patients with PPS and 5.27±0.61 days in patients who did not have PPS (P=0.07. Logistic regression analysis demonstrated that diclofenac administration (odds

  5. Lung Carcinoid Tumor: Surgery

    Science.gov (United States)

    ... Disease Lung Carcinoid Tumor Treating Lung Carcinoid Tumors Surgery to Treat Lung Carcinoid Tumors Surgery is the ... be cured by surgery alone. Types of lung surgery Different operations can be used to treat (and ...

  6. Preparing for Surgery

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  7. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... outside the heart. Some heart defects may need surgery right after the baby is born. For others, ...

  8. Scoliosis surgery - child

    Science.gov (United States)

    Spinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child ... Before surgery, your child will receive general anesthesia. This will make your child unconscious and unable to feel pain ...

  9. What Is Refractive Surgery?

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  10. LASIK - Laser Eye Surgery

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  11. Corrective Jaw Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  12. Dental Implant Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  13. Facial Cosmetic Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  14. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

    OpenAIRE

    Metin Keskin; Turgut Akgül; Adem Bayraktar; Fatih Dikici; Emre Balık

    2014-01-01

    Case Report Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery Metin Keskin,1 Turgut Akgül,2 Adem Bayraktar,1 Fatih Dikici,2 and Emre BalJk3 1 General Surgery Department, Istanbul Faculty of Medicine, Istanbul University, Capa, Millet Caddesi, 34093 Istanbul, Turkey 2Orthopedic Department, Istanbul Faculty of Medicine, Istanbul University, Capa, Millet Caddesi, 34093 Istanbul, Turkey 3 General Surgery Department, School of Medicine, Koc¸ Uni...

  15. Triglycerides and cardiovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Varbo, Anette

    2014-01-01

    cholesterol might not cause cardiovascular disease as originally thought has now generated renewed interest in raised concentrations of triglycerides. This renewed interest has also been driven by epidemiological and genetic evidence supporting raised triglycerides, remnant cholesterol, or triglyceride......-rich lipoproteins as an additional cause of cardiovascular disease and all-cause mortality. Triglycerides can be measured in the non-fasting or fasting states, with concentrations of 2-10 mmol/L conferring increased risk of cardiovascular disease, and concentrations greater than 10 mmol/L conferring increased risk...... of acute pancreatitis and possibly cardiovascular disease. Although randomised trials showing cardiovascular benefit of triglyceride reduction are scarce, new triglyceride-lowering drugs are being developed, and large-scale trials have been initiated that will hopefully provide conclusive evidence...

  16. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...... to rise as the population ages, this review summarises the evidence on which such guidance is based, and provides information about how anaesthetists might participate in audit and research aimed at improving local and national outcomes for these most vulnerable of patients....

  17. 妇科老年患者卵巢癌术后尿路感染的临床分析%Clinical analysis and nursing care of urinary tract infections in elderly patients of gynecology department after ovarian cancer surgery

    Institute of Scientific and Technical Information of China (English)

    王蕾

    2013-01-01

    OBJECTIVE To investigate the characteristics and predisposing factors of the urinary tract infections (UTI)in the elderly female patients so as to guide the clinical treatment and nursing and reduce the incidence of urinary tract infections. METHODS A total of 136 cases of patients, who underwent the ovarian cancer surgery in the hospital from Jan 2008 to Dec 2011, were enrolled in the study, and the risk factors associated with the urinary tract infections were analyzed. RESULTS Of totally 136 patients investigated, the urinary tract infections occurred in 49 cases of patients with the incidence rate of 36. 03%; the urinary tract irritation was the predominant clinical performance with the positive rate of 57. 14%. Of totally 49 strains of pathogens isolated , there were 25 (51.02%) strains of gram -positive cocci, 23(46.94%) strains of gram-negative bacilli, and 1 (2.04%) strain of fungi. The comparative study of the urinary tract infection patients and the non-urinary tract infection patients concluded that the incidence of urinary tract infections after the ovarian cancer surgery was related to the urinere-main induced by the primary disease, frequency of catheterization, long-term caththeter indwelling, and underlying diseases, the difference was statistically significantc (P<0. 05). CONCLUSION It is an effective way to reduce the incidence of the urinary tract infections after the ovarian cancer surgery to strengthen the nursing of the catheter indwelling, control the time of catheterization, strictly implement the aseptic techniques, advocate the physiological bladder irrigation , and intensify the mental nursing.%目的 了解老年女性尿路感染的特点,分析其易感因素,从而指导临床治疗和护理,降低尿路感染发生率.方法 对医院2008年1月-2011年12月行卵巢癌手术136例患者的尿路感染的发生进行分析.结果 136例患者共发生尿路感染49例,发生率36.03%;临床表现以尿路刺

  18. A STUDY OF CONVERSIONS OF LAPAROSOCOPIC SURGERIES INTO OPEN SURGERIES: A ANALYTICAL STUDY

    Directory of Open Access Journals (Sweden)

    Venkata Reddy

    2015-12-01

    Full Text Available INTRODUCTION: The aim of present study is to know the Conversions in Laparoscopic surgery to Open surgery in The patients of all the surgical units in the Department of General Surgery, Government General Hospital, Rangaraya Medical College, Kakinada over a period of 2 years from July 2013 to July 2015. The Objectives of present study is to compare the Conversion Rates of Laparoscopic Surgery to Open Surgery and the factors causing Conversion to Open Surgery in our institution. PATIENTS AND METHODS The protocol is approved by institution ethics committee and written informed consent was taken from each patient. Present clinical Study is an Analytical study conducted over period of 2 years from July 2013 to July 2015 in the Department of General Surgery, Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh. RESULTS Total number of 536 laparoscopic surgeries were attempted in elective operation theatres with 21 cases out of 536 cases were converted from laparoscopy to open surgery. Total conversion rate in present study is 4%. Most of conversions occurred in laparoscopic chelecystectomy 5.73% cases in comparison to laparoscopic appendectomy 2.26% and laparoscopic hernia repair with 0%. CONCLUSIONS Over all conversion rates of laparoscopic procedure into open surgery is low when compared to other international studies. Most common causes of conversion in present study is altered anatomy, adhesions and intra operative bleed. Conversion of laparoscopic surgery into open surgery resulted in decreased morbidity, complications and increase in duration of hospital stay

  19. Experience of Nursing Management for Perioperative Pain in Patients From Trauma Surgery Department%创伤外科患者围手术期疼痛的护理管理体会

    Institute of Scientific and Technical Information of China (English)

    顾文燕; 曾莹; 姜红

    2016-01-01

    Objective: To explore the effect of nursing management on perioperative pain management in patients with trauma surgery.Methods:179 cases of trauma patients were randomly divided into study group (n=92) and control group (n=87), the control group received routine care, the study group was given pain management system. The pain level of two groups of nursing after 3d was compared with the visual analogue scale (VAS), and the nursing satisfaction degree, the pain relief effect, the length of stay, the time of sleep and the postoperative analgesia rate were compared between the two groups.Results: Compared with the control group, the study group VAS score lower, nursing satisfaction and pain ease total efifciency higher, shorter period of hospitalization, sleep for longer time, postoperative analgesia rate is lower and the differences were signiifcant (P<0.05).Conclusion:Perioperative nursing management of patients with trauma surgery can signiifcantly improve the degree of pain, improve nursing satisfaction and reduce the length of hospital stay.%目的:探讨护理管理对创伤外科患者围手术期疼痛的控制效果。方法:179例创伤外科患者随机分为研究组(n=92)和对照组(n=87),对照组给予常规护理,研究组给予系统的疼痛管理。采用视觉模拟评分(VAS)比较两组护理3d后的疼痛程度,并比较两组的护理满意度、疼痛缓解疗效、住院时间、睡眠时间和术后需要镇痛率。结果:与对照组比较,研究组的VAS评分更低、护理满意度和疼痛缓解总有效率更高、住院时间更短、睡眠时间更长、术后需要镇痛率更低,差异均具有统计学意义(P<0.05)。结论:创伤外科患者围手术期实施疼痛护理管理,可明显改善疼痛程度、提高护理满意度、降低住院时间。

  20. Analysis of the Operation Points of Anal Abscess in Pediatric Department of Anorectal Surgery%小儿肛肠外科肛周脓肿的手术要点分析

    Institute of Scientific and Technical Information of China (English)

    孙全胜

    2016-01-01

    目的:浅析不同手术时机对小儿肛周脓肿的治疗效果。方法此次研究对象选择2013年8月~2014年8月入住我院接受治疗的86例小儿肛周脓肿患儿,根据手术时机分为观察组与对照组,观察组患儿在发病一期进行根除手术,对照组患儿在发病二期后进行根除手术,观察对比两组患儿的手术治疗效果及并发症。结果观察组患儿的治疗有效率高于对照组;观察组满意度高于对照组,差异有统计学意义(P<0.05)。结论合理选择手术时机可有效提高小儿肛周脓肿患者的治愈率及满意度。%Objective To study the effect of surgical timing on the treatment of children with anal abscess.Methods From August 2013 to August 2014 to conduct clinical research in 86 cases of infantile perianal abscess in children,according to the different timing of surgerydevided into observation group and control group. Observation group in the first phase of the disease to take surgery,control group in the two period,then to observe the surgical treatment effect and complications of two groups.Results The effective rate of the observation group was higher than that of the control group. The satisfaction of observation group was higher than that of control group,the difference was statisticaly significant(P<0.05).ConclusionThe reasonable choice of the timing of surgery can effectively improve the cure rate and satisfaction of the patients with anal abscess in children.

  1. Introduction: Cardiovascular physics.

    Science.gov (United States)

    Wessel, Niels; Kurths, Jürgen; Ditto, William; Bauernschmitt, Robert

    2007-03-01

    The number of patients suffering from cardiovascular diseases increases unproportionally high with the increase of the human population and aging, leading to very high expenses in the public health system. Therefore, the challenge of cardiovascular physics is to develop high-sophisticated methods which are able to, on the one hand, supplement and replace expensive medical devices and, on the other hand, improve the medical diagnostics with decreasing the patient's risk. Cardiovascular physics-which interconnects medicine, physics, biology, engineering, and mathematics-is based on interdisciplinary collaboration of specialists from the above scientific fields and attempts to gain deeper insights into pathophysiology and treatment options. This paper summarizes advances in cardiovascular physics with emphasis on a workshop held in Bad Honnef, Germany, in May 2005. The meeting attracted an interdisciplinary audience and led to a number of papers covering the main research fields of cardiovascular physics, including data analysis, modeling, and medical application. The variety of problems addressed by this issue underlines the complexity of the cardiovascular system. It could be demonstrated in this Focus Issue, that data analyses and modeling methods from cardiovascular physics have the ability to lead to significant improvements in different medical fields. Consequently, this Focus Issue of Chaos is a status report that may invite all interested readers to join the community and find competent discussion and cooperation partners.

  2. Computer assisted radiology and surgery. CARS 2010

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2010-06-15

    The conference proceedings include contributions to the following topics: (1) CARS Clinical Day: minimally invasive spiral surgery, interventional radiology; (2) CARS - computer assisted radiology and surgery: ophthalmology, stimulation methods, new approaches to diagnosis and therapy; (3) Computer assisted radiology 24th International congress and exhibition: computer tomography and magnetic resonance, digital angiographic imaging, digital radiography, ultrasound, computer assisted radiation therapy, medical workstations, image processing and display; (4) 14th Annual conference of the International Society for computer aided surgery; ENT-CMF head and neck surgery computer-assisted neurosurgery, cardiovascular surgery, image guided liver surgery, abdominal and laparoscopic surgery, computer-assisted orthopedic surgery, image processing and visualization, surgical robotics and instrumentation, surgical modeling, simulation and education; (5) 28th International EuroPACS meeting: image distribution and integration strategies, planning and evaluation, telemedicine and standards, workflow and data flow in radiology; (6) 11th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, management and assessment of OR systems and integration; (7) 12th International workshop on computer-aided diagnosis: special session on breast CAD, special session on thoracic CAD, special session on abdominal brain, lumbar spine CAD; (8) 16th computed Maxillofacial imaging congress: computed maxillofacial imaging in dental implantology, orthodontics and dentofacial orthopedics; approaches to 3D maxillofacial imaging; surgical navigation; (9) 2nd EuroNOTES/CARS workshop on NOTES: an interdisciplinary challenge; (10) 2nd EPMA/CARS workshop on personalized medicine and ICT.; (11)poster sessions.

  3. Virtual Surgery in Congenital Heart Disease

    DEFF Research Database (Denmark)

    Sørensen, Thomas Sangild; Mosegaard, Jesper; Kislinskiy, Stefan

    2014-01-01

     Teaching, diagnosing, and planning of therapy in patients with complex structural cardiovascular heart disease require profound understanding of the three-dimensional (3D) nature of cardiovascular structures in these patients. To obtain such understanding, modern imaging modalities provide high...... et al., Cardiol Young 13:451–460, 2003). In combination with the availability of virtual models of congenital heart disease (CHD), techniques for computer- based simulation of cardiac interventions have enabled early clinical exploration of the emerging concept of virtual surgery (Sorensen et al...

  4. A comparison of cardiovascular risk factors for ten antipsychotic drugs in clinical practice

    Directory of Open Access Journals (Sweden)

    Bodén R

    2013-03-01

    Full Text Available Robert Bodén,1,2 Gunnar Edman,3,4 Johan Reutfors,2 Claes-Göran Östenson,3 Urban Ösby3,4 1Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden; 2Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden; 3Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; 4Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden Abstract: It is well known that abdominal obesity, dyslipidemia, and insulin resistance are highly prevalent in patients receiving maintenance treatment with antipsychotics, but there is limited knowledge about the association between cardiovascular risk factors and treatment with antipsychotic drugs. In this naturalistic study we investigated a sample of 809 antipsychotic-treated patients from Swedish psychosis outpatient teams. Cardiovascular risk factors (eg, metabolic syndrome, homeostasis model assessment of insulin resistance, and low-density lipoprotein values were measured, and their associations to current antipsychotic pharmacotherapy were studied. Ten antipsychotic drugs were compared in a stepwise logistic regression model. For the patients, the presence of the components of metabolic syndrome ranged from 35% for hyperglycemia to 64% for elevated waist circumference. Hypertriglyceridemia was associated with clozapine (odds ratio [OR] = 1.81, 95% confidence interval [CI] 1.08–3.04, reduced high-density lipoprotein with both clozapine and olanzapine (OR = 1.73, 95% CI 1.01–2.97; and OR = 2.03, 95% CI 1.32–3.13, hypertension with perphenazine (OR = 2.00, 95% CI 1.21–3.59, and hyperglycemia inversely with ziprasidone (OR = 0.21, 95% CI 0.05–0.89 and positively with haloperidol (OR = 2.02, 95% CI 1.18–3.48. There were no significant relationships between any of the antipsychotic drugs and increased waist circumference, homeostasis model assessment of insulin resistance, or low-density lipoprotein levels. In

  5. Cardiovascular comorbiditiy in psoriasis

    Directory of Open Access Journals (Sweden)

    Gurcharan Singh

    2011-01-01

    Full Text Available The chronic inflammatory nature of psoriasis is also thought to predispose patients to other diseases with an inflammatory component, the most notable being cardiovascular and metabolic (cardiometabolite disorders. This concept is supported by studies showing that psoriasis is associated with cardiovascular risk factors like diabetes, obesity, hypertension, dyslipidemia, smoking and diseases including MI. Given the increased prevalence of cardiovascular co morbidities in patients, dermatologists treating psoriasis need to approach the disease as a potentially multisystem disorder and must alert these patients to the potentially negative effects of their disease.

  6. Urocortin and cardiovascular protection

    Institute of Scientific and Technical Information of China (English)

    Yu HUANG; Xiao-qiang YAO; Chi-wai LAU; Yau-chi CHAN; Suk-ying TSANG; Franky Leung CHAN

    2004-01-01

    Urocortin and other hypothalamus corticotropin-releasing factor (CRF) polypeptides play biologically diverse roles in the stress, cardiovascular and inflammatory responses by acting on central and peripheral CRF receptors.Urocortin shows a significantly high sequence homology to CRF, and the concurrent expression of type-2 CRF (CRF2) receptors with urocortin in the heart suggests that urocortin may play a physiological role in the cardiac function. Urocortin is thought to be the endogenous agonist producing the cardiovascular actions previously attributed to CRF. This review highlights the current novel findings on the molecular and cellular mechanisms by which urocortin may exert its cardiovascular protective action.

  7. Application Experience of the Department of Thoracic Surgery Operation in Patients with Pulmonary Contusion and Laceration%普胸外科手术在肺挫裂伤修补患者中的应用体会

    Institute of Scientific and Technical Information of China (English)

    孙升

    2015-01-01

    目的探讨普胸外科手术在肺挫裂伤修补患者中的临床治疗效果。方法选取2012年4月~2014年4月我院收治的80例肺挫裂伤修补患者资料进行分析,根据不同治疗方案将患者分为对照组和实验组,对照组采用乌司他丁治疗,实验组采用普胸外科手术治疗,比较两组疗效。结果实验组EICU监护时间为(6.8±2.1)d,显著短于对照组(<0.05);实验组3例发生ARDS,发生率为7.5%,死亡率为0%,显著低于对照组(7例发生ARDS,发生率为17.5%;4例死亡,死亡率为10%)(<0.05)。结论肺挫裂患者采用普通外科手术修复效果理想,能够降低手术创伤,提高临床疗效,值得推广使用。%Objective To discuss general thoracic surgeries' Clinical curative ef ect on patients with pulmonary contusion repair.Methods Select materials of 80 patients with pulmonary contusion repair our hospital patients accept Between April 2013 and April 2014, to analyze it . According to the dif erent treatment,we divided the patients into control group and experimental group.The control group treated patients with ulinastatin,and The experimental group used the general thoracic surgery to patients.To compare two groups of curative ef ect.Results The experimental group EICU monitoring time was (6.8±2.1) days,and it is significantly shorter than the control group ( <0.05).The experimental group had 3 cases of ARDS.The incidence was 7.5%, the death rate was 0%.It is Significantly lower than the control group (7 cases of ARDS,The incidence was 17.5%;4 cases of death,The mortality rate of 10%) ( < 0.05).Conclusion Patients with sharp crack to use common surgical repair,its ef ect is ideal.It can reduce surgical trauma and improve clinical curative ef ect, and it is worthy of promotion ot use.

  8. Relationship between resistance rate of pathogen and utilization strength ofβ-lactam in general surgery department%普外科病原菌耐药率与β-内酰胺类药物使用强度的关系

    Institute of Scientific and Technical Information of China (English)

    方圆; 陈涛; 李晓华; 刘平; 陈楠

    2016-01-01

    Objective To evaluate the relationship between the resistance change trend of pathogen and the dosages of β-lactam in general surgery department. Methods To make statistics and to analyze the relationship on the resistance rate of main pathogen and the utilization strength of β-lactam, which were detected from 2012 to 2014, applied the statistical software. Results There were correlation between the utilization strength of ceftizoxime and the resistance rate of escherichia coli and klebsiella pneumonia, between the utilization strength of cefepime and the resistance rate of klebsiella pneumonia, there was no correlation between the utilization strength of piperacillin-tazobactam and the resistance rate of enterobacteriaceae, there was correlation all monitoring cultivated varieties and the resistance rate of pseudomonas aeruginosa. Conclusion Enterobacteriaceae is also the key point of infection treatment in general surgery department. The third generation cephalosporin in the treatment of bacterial infection of enterobacteriaceae is chosen carefully in general surgery department. Piperacillin-tazobactam should be chosen on patients with the ESBLs risk of enterobacteriaceae.%目的:评价普外科病原菌耐药变化趋势与β-内酰胺类用量间的关系。方法统计2012~2014年检出主要病原菌耐药率及β-内酰胺类使用强度,运用统计软件分析两者的相关性。结果头孢唑肟使用强度与大肠埃希菌、肺炎克雷伯菌耐药率间均有相关性,头孢吡肟与肺炎克雷伯菌对其耐药率间有相关性,哌拉西林他唑巴坦使用强度与肠杆菌科耐药率间无相关性,所有监测品种均与铜绿假单胞菌耐药率间有相关性。结论肠杆菌科细菌仍是普外科治疗感染的重点。普外科慎重选择三代头孢治疗肠杆菌科细菌感染,对有感染产ESBLs肠杆菌科细菌风险的患者,可选择哌拉西林他唑巴坦。

  9. Cardiovascular manifestations in hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Vairamani Kandan

    2016-07-01

    Conclusions: This study shows that cardiovascular manifestations are quite common and varied in hyperthyroidism which are to be looked for in the management. [Int J Res Med Sci 2016; 4(7.000: 3032-3038

  10. Cardiovascular modeling and diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Kangas, L.J.; Keller, P.E.; Hashem, S.; Kouzes, R.T. [Pacific Northwest Lab., Richland, WA (United States)

    1995-12-31

    In this paper, a novel approach to modeling and diagnosing the cardiovascular system is introduced. A model exhibits a subset of the dynamics of the cardiovascular behavior of an individual by using a recurrent artificial neural network. Potentially, a model will be incorporated into a cardiovascular diagnostic system. This approach is unique in that each cardiovascular model is developed from physiological measurements of an individual. Any differences between the modeled variables and the variables of an individual at a given time are used for diagnosis. This approach also exploits sensor fusion to optimize the utilization of biomedical sensors. The advantage of sensor fusion has been demonstrated in applications including control and diagnostics of mechanical and chemical processes.

  11. [Registration of prehabilitation prior to surgery].

    Science.gov (United States)

    Tønnesen, Hanne; Duus, Benn R

    2008-04-21

    Four to eight week prehabilitation programs for smokers and harmful drinkers were included in the national guidelines in 2001. In October 2007 a guarantee for surgery within one month of waiting time came into effect in Denmark. The present Danish patient administration system already contains room for registration of prehabilitation prior to surgery. Using one specific code for prehabilitation at the surgical department and another for prehabilitation at other departments will enable correct registration. Thereby, it is possible to differentiate between ordinary waiting time before surgery and time for prehabilitation.

  12. No effect of melatonin to modify surgical-stress response after major vascular surgery

    DEFF Research Database (Denmark)

    Kücükakin, B.; Wilhelmsen, M.; Lykkesfeldt, Jens

    2010-01-01

    A possible mechanism underlying cardiovascular morbidity after major vascular surgery may be the perioperative ischaemia-reperfusion with excessive oxygen-derived free-radical production and increased levels of circulating inflammatory mediators. We examined the effect of melatonin infusion durin...... surgery and oral melatonin treatment for 3 days after surgery on biochemical markers of oxidative and inflammatory stress.......A possible mechanism underlying cardiovascular morbidity after major vascular surgery may be the perioperative ischaemia-reperfusion with excessive oxygen-derived free-radical production and increased levels of circulating inflammatory mediators. We examined the effect of melatonin infusion during...

  13. Fibrin sealant in general surgery. Personal experience and literary review.

    Science.gov (United States)

    Gubitosi, Adelmo; Ruggiero, Roberto; Docimo, Giovanni; Esposito, Alessandro

    2014-01-01

    In consideration of the use of fibrin glue in a general surgery department, authors analyze their last two years series. Operations on liver and biliary ducts, bowel and proctologic surgery, thyroid and breast surgery, abdominal wall hernias, fistulas and difficult wounds are considered with a literary review on fibrin sealant.

  14. Perioperative smoking cessation in vascular surgery

    DEFF Research Database (Denmark)

    Kehlet, M.; Heesemann, Sabine; Tonnesen, H.;

    2015-01-01

    Background: The effect of intensive smoking cessation programs on postoperative complications has never before been assessed in soft tissue surgery when smoking cessation is initiated on the day of surgery. Methods: A single-blinded randomized clinical trial conducted at two vascular surgery...... departments in Denmark. The intervention group was offered the Gold Standard Program (GSP) for smoking cessation intervention. The control group was offered the departments' standard care. Inclusion criteria were patients with planned open peripheral vascular surgery and who were daily smokers. According...... intervention and 21 as controls. There was no difference in 30-day complication rates or 6-week abstinence rates between the two groups. Conclusions: A trial assessing the effect of smoking cessation on postoperative complications on the day of soft tissue surgery is still needed. If another trial...

  15. Analysis of NHSLA claims in orthopedic surgery.

    Science.gov (United States)

    Khan, Irfan H; Jamil, Wiqqas; Lynn, Sam Mathew; Khan, Osman H; Markland, Kate; Giddins, Grey

    2012-05-01

    National Health Service (NHS) statistics in the United Kingdom demonstrate an increase in clinical negligence claims over the past 30 years. Reasons for this include elements of a cultural shift in attitudes toward the medical profession and the growth of the legal services industry. This issue affects medical and surgical health providers worldwide.The authors analyzed 2117 NHS Litigation Authority (NHSLA) orthopedic surgery claims between 1995 and 2001 with respect to these clinical areas: emergency department, outpatient care, surgery (elective or trauma operations), and inpatient care. The authors focused on the costs of settling and defending claims, costs attributable to clinical areas, common causes of claims, and claims relating to elective or trauma surgery. Numbers of claims and legal costs increased most notably in surgery (elective and trauma) and in the emergency department. However, claims are being defended more robustly. The annual cost for a successful defense has remained relatively stable, showing a slight decline. The common causes of claims are postoperative complication; wrong, delayed, or failure of diagnosis; inadequate consent; and wrong-site surgery. Certain surgical specialties (eg, spine and lower-limb surgery) have the most claims made during elective surgery, whereas upper-limb surgery has the most claims made during trauma surgery.The authors recommend that individual trusts liaise with orthopedic surgeons to devise strategies to address areas highlighted in our study. Despite differences in health care systems worldwide, the underlying issues are common. With improved understanding, physicians can deliver the service they promise their patients.

  16. [Vitamin D and cardiovascular risk].

    Science.gov (United States)

    Mayer, Otto

    2012-05-01

    The pathogenesis of cardiovascular disease is without any doubt multifactorial, and it is generally accepted, that conventional risk factors determined only about 80% of cardiovascular risk. There is accumulating evidence that vitamin D exerts important pathophysiological effects on cardiovascular system. Low vitamin D was associated with increased cardiovascular risk in several reports. This review summarizes recent epidemiological evidence and possible pathophysiological mechanism for a role of low vitamin D in cardiovascular diseases. Moreover, available data concerning vitamin D supplementation are depicted.

  17. ADMA, cardiovascular disease and diabetes.

    Science.gov (United States)

    Krzyzanowska, Katarzyna; Mittermayer, Friedrich; Wolzt, Michael; Schernthaner, Guntram

    2008-12-15

    The endogenous competitive nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) is an emerging risk marker for future cardiovascular events. Elevated ADMA concentrations have been described in patients with an adverse cardiovascular risk profile. Recently, various studies investigated the independent role of ADMA as a cardiovascular risk predictor in several patient cohorts. In addition, ADMA might not only be a risk marker but also a causative factor for cardiovascular disease. This review summarizes the literature on the relationship between ADMA, cardiovascular disease and diabetes.

  18. Kerala Pioneering Pediatric Surgery in India

    Directory of Open Access Journals (Sweden)

    TP Joseph

    2014-04-01

    Full Text Available Pediatric surgeons of Kerala are very proud to have led the development of superspeciality in any branch of medicine in Kerala and also superspeciality of Pediatric surgery in whole of India. Late Prof. Raman Nair returned in 1954 after training under Dr. Everett Koop in US. Same year, in his far-sighted vision for future development of the speciality, he moved to SATH, Medical College, Trivandrum and started Pediatric surgery as a speciality attached to Paediatrics department; this was the beginning of Pediatric surgery in India. He opted for Pediatric surgery as a full time job and did not do any general surgery work in adults. He was the first full time Pediatric surgeon of India; during the next few years, 2 surgeons, one in Calcutta, Prof. UC Chakraboty and Prof. D Anjaneyulu in Hyderabad started working as full time Pediatric surgeons. In Mumbai, Delhi and Chennai, Pediatric surgery developed much later and then all over the country.

  19. Bariatric surgery: a best practice article.

    Science.gov (United States)

    Neff, Karl John Hans; le Roux, Carel W

    2013-02-01

    Bariatric surgery can effectively reduce body weight and treat obesity associated metabolic diseases such as diabetes mellitus. There are also benefits for an individual's functional status and psychological health. A multi-disciplinary evaluation should be offered to the individual as the first essential step in considering bariatric surgery as a treatment. This evaluation should include a thorough medical assessment, as well as psychological and dietetic assessments. In this best practice article, we outline the current recommendations for referral for bariatric surgery. We also present the data for pre-operative assessment before bariatric surgery, with particular reference to cardiovascular disease and obstructive sleep apnoea. We describe the literature on outcomes after bariatric surgery, including the results for mortality, weight loss, remission of diabetes and associated endocrine disorders such as hypogonadism. Within this review, we will illustrate the impact of bariatric surgery on self-image, psychological health and perceived health and functional status. Finally, we briefly detail the potential complications of bariatric surgery, and offer advice on post-operative care and surveillance.

  20. 消化科及肝胆外科护士对肝硬化相关知识及患者健康教育认识的调查%Cirrhosis-related knowledge and awareness of patients' health education in nurses from departments of gastroenterology and hepatobiliary surgery

    Institute of Scientific and Technical Information of China (English)

    张婕; 黄婷婷

    2011-01-01

    Objective To investigate the cirrhosis-related knowledge and awareness of patients' health education in nurses from departments of gastroenterology and hepatobiliary surgery in order to provide a better basis for carrying out health education. Methods Cirrhosis-related knowledge and awareness of patients' health education were investigated in 60 nurses from department of gastroenterology and 24 nurses from department of hepatobiliary surgery using questionnaires. Results The nurses had a moderate level in cirrhosis-related knowledge. The scores of cirrhosis-related knowledge were different in nurses with different professional titles and working hours(P<0.05). The majority of nurses were fully aware of health education, but they were not satisfied with the conditions for implementing health education. Conclusion Nurses in departments of gastroenterology and hepatobiliary surgery should improve their cirrhosis-related knowledge. At present, they have no sufficient time as well as health education and communication skills. Patients and their relatives do not fully understand and believe nurses. The publicity materials are insufficient in departments to carry out health education of patients.%目的 调查消化科及肝胆外科护士对肝硬化相关知识的掌握程度及对健康教育的认识,为更好的开展科室健康教育提供依据.方法 采用问卷调查法调杏本院消化科60名及肝胆外科24名护士对肝硬化相关知识的掌握程度及对健康教育的认识.结果 护士对肝硬化相关知识掌握的总体情况处于中等水平:不同职称、专科工作时间及科室的护士对肝硬化相关知识得分的差异具有统计学意义(P<0.05);绝大多数护士对健康教育有充分的认识,但普遍对健康教育的实施条件不满意.结论 消化科及肝胆外科护士对肝硬化相关知识有待提高,目前临床科室护士没有充足的时间和熟练的健康教育技能及沟通技巧,患者及家属

  1. [Minimally invasive surgery and robotic surgery: surgery 4.0?].

    Science.gov (United States)

    Feußner, H; Wilhelm, D

    2016-03-01

    Surgery can only maintain its role in a highly competitive environment if results are continuously improved, accompanied by further reduction of the interventional trauma for patients and with justifiable costs. Significant impulse to achieve this goal was expected from minimally invasive surgery and, in particular, robotic surgery; however, a real breakthrough has not yet been achieved. Accordingly, the new strategic approach of cognitive surgery is required to optimize the provision of surgical treatment. A full scale integration of all modules utilized in the operating room (OR) into a comprehensive network and the development of systems with technical cognition are needed to upgrade the current technical environment passively controlled by the surgeon into an active collaborative support system (surgery 4.0). Only then can the true potential of minimally invasive surgery and robotic surgery be exploited.

  2. Using central venous catheter for suprapubic catheterization in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Bilehjani E

    2017-01-01

    Full Text Available Eissa Bilehjani,1 Solmaz Fakhari2 1Department of Cardiovascular Anesthesia, Tabriz University of Medical Sciences, Madani Heart Hospital, 2Department of Anesthesiology, Tabriz University of Medical Sciences, Madani Heart Hospital, Tabriz, Iran Abstract: Suprapubic catheterization is an alternative method for urinary drainage that is used when transurethral catheterization fails. Traditionally, inserted large-bore suprapubic catheters may cause fatal complications. During the past decade, we used a small central venous catheter (CVC suprapubicly in 16 male patients for the purpose of urinary drainage, when transurethral catheterization failed. The procedure is performed in no more than 10 minutes. Success rate was 100% and this approach did not lead to any complications. In conclusion, placing a CVC for suprapubic drainage is a safe method with a high success rate and we recommend it in patients with failed transurethral catheterization after a few attempts (2–3 attempts. Keywords: suprapubic catheterization complication, urethral catheterization, central venous catheter, Seldinger’s technique, cardiac surgery

  3. Aortic valve surgery: what is the future?

    Science.gov (United States)

    Hudorović, Narcis

    2008-04-01

    Modern surgical treatment for aortic valve disease has undergone significant improvements in all areas of this procedure. Successful treatment strategies for cardiovascular diseases have often been initiated and driven by surgeons. Radical excision of diseased tissue, repair and replacement strategies lead to long-term successful treatment of the underlying diseases and clearly improved patient outcome. In highly developed nations, valve surgery will be increasing applied in older people, with more co-morbidities and a higher incidence of concomitant coronary artery disease. Cardiovascular surgeons will be facing increased competition from the catheter-based procedures; these are already applied clinically, and their numbers will rise in near future. Right now interventional cardiologists supported by some cardiac surgeons are on their way to transform some conventional open surgical procedures into catheter-based less invasive interventions, such as valve repair and replacement. Cardiovascular surgery is undergoing a rapid transformation; socio-economic factors and recent advances in medical technology contribute to these changes. Further developments will come, and surgeons with all their expertise in the treatment of valvular heart disease need to be part of it. Cardiovascular surgeons have to adapt the exciting new approaches of transapical and transfemoral transcatheter valve implantation techniques.

  4. Who Needs Heart Surgery?

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. Who Needs Heart Surgery? Heart surgery is used to treat ... will work with you to decide whether you need heart surgery. A cardiologist specializes in diagnosing and ...

  5. Laser surgery - skin

    Science.gov (United States)

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  6. Gastric Sleeve Surgery

    Science.gov (United States)

    ... A Week of Healthy Breakfasts Shyness Gastric Sleeve Surgery KidsHealth > For Teens > Gastric Sleeve Surgery Print A ... buying healthy food ) continue Preparing for Gastric Sleeve Surgery Preparing for this major operation takes months of ...

  7. Surgery for Breast Cancer

    Science.gov (United States)

    ... Cancer During Pregnancy Breast Cancer Breast Cancer Treatment Surgery for Breast Cancer Surgery is a common treatment ... removed (breast reconstruction) Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main ...

  8. Surgery for Pancreatic Cancer

    Science.gov (United States)

    ... of the Tumor Pancreatic Cancer Treating Pancreatic Cancer Surgery for Pancreatic Cancer Two general types of surgery ... how far the cancer has spread. Potentially curative surgery Studies have shown that removing only part of ...

  9. Cavus Foot Surgery

    Science.gov (United States)

    ... All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A ... problems. What are the goals of cavus foot surgery? The main goal of surgery is to reduce ...

  10. Smoking and surgery

    Science.gov (United States)

    Surgery - quitting smoking; Surgery - quitting tobacco; Wound healing - smoking ... Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and ...

  11. Coronary Artery Bypass Surgery

    Science.gov (United States)

    ... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

  12. Tennis elbow surgery - discharge

    Science.gov (United States)

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  13. Open heart surgery

    Science.gov (United States)

    Heart surgery - open ... lung machine is used in most cases during open heart surgery. While the surgeon works on the ... with these procedures, the surgeon may have to open the chest to do the surgery.

  14. Plastic Surgery Statistics

    Science.gov (United States)

    ... PSN PSEN GRAFT Contact Us News Plastic Surgery Statistics Plastic surgery procedural statistics from the American Society of Plastic Surgeons. Statistics by Year Print 2016 Plastic Surgery Statistics 2015 ...

  15. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Soft Tissue Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures Administration of Anesthesia Administration of Anesthesia Oral ...

  16. Ear Plastic Surgery

    Science.gov (United States)

    ... receive light-weight earrings. Does Insurance Pay for Cosmetic Ear Surgery? Insurance usually does not cover surgery solely for ... republication strictly prohibited without prior written permission. Ears Cosmetic Surgery, Facelift, Rhinoplasty, Blepharoplasty ... Get Involved Professional Development Practice ...

  17. Carotid artery surgery - discharge

    Science.gov (United States)

    ... Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. J Am Coll Cardiol . 2011 Feb 22;57( ... 21288680 . Kinlay S, Bhatt DL. Treatment of noncoronary obstructive ... Textbook of Surgery . 19th ed. Elsevier Saunders; 2012:chap 63.

  18. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... Surgery Types of Surgery Gastric Bypass ... or intestines removed due to ulcers or cancer tended to lose a lot of weight after ...

  19. Diabetes Drugs and Cardiovascular Safety

    Directory of Open Access Journals (Sweden)

    Ji Cheol Bae

    2016-06-01

    Full Text Available Diabetes is a well-known risk factor of cardiovascular morbidity and mortality, and the beneficial effect of improved glycemic control on cardiovascular complications has been well established. However, the rosiglitazone experience aroused awareness of potential cardiovascular risk associated with diabetes drugs and prompted the U.S. Food and Drug Administration to issue new guidelines about cardiovascular risk. Through postmarketing cardiovascular safety trials, some drugs demonstrated cardiovascular benefits, while some antidiabetic drugs raised concern about a possible increased cardiovascular risk associated with drug use. With the development of new classes of drugs, treatment options became wider and the complexity of glycemic management in type 2 diabetes has increased. When choosing the appropriate treatment strategy for patients with type 2 diabetes at high cardiovascular risk, not only the glucose-lowering effects, but also overall benefits and risks for cardiovascular disease should be taken into consideration.

  20. Single incision laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    Arun; Prasad

    2010-01-01

    As a complement to standard laparoscopic surgery and a safe alternative to natural orifice transluminal endoscopic surgery,single incision laparoscopic surgery is gaining popularity.There are expensive ports,disposable hand instruments and flexible endoscopes that have been suggested to do this surgery and would increase the cost of operation.For a simple surgery like laparoscopic cholecystectomy,these extras are not needed and the surgery can be performed using standard ports,instruments and telescopes.Tri...

  1. Smartphone photography in oral and maxillofacial surgery.

    Science.gov (United States)

    Jamil, F

    2016-01-01

    An increasing number of staff in oral and maxillofacial surgery (OMFS) departments take clinical photographs with their personal phones. We report the results of a survey on the use of smartphone photography in OMFS departments in the United Kingdom, and highlight the guidelines that govern their use and the associated ethical and medicolegal implications.

  2. Clocks and cardiovascular function

    Science.gov (United States)

    McLoughlin, Sarah C.; Haines, Philip; FitzGerald, Garret A.

    2016-01-01

    Circadian clocks in central and peripheral tissues enable the temporal synchronization and organization of molecular and physiological processes of rhythmic animals, allowing optimum functioning of cells and organisms at the most appropriate time of day. Disruption of circadian rhythms, from external or internal forces, leads to widespread biological disruption and is postulated to underlie many human conditions, such as the incidence and timing of cardiovascular disease. Here, we describe in vivo and in vitro methodology relevant to studying the role of circadian rhythms in cardiovascular function and dysfunction PMID:25707279

  3. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    2008-01-01

    and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed....

  4. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    2008-01-01

    and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed.  ...

  5. Envejecimiento del sistema cardiovascular

    OpenAIRE

    2005-01-01

    Las principales características del envejecimiento del sistema cardiovascular reflejan cambios anatómicos y estructurales a nivel de la pared de los vasos, la relajación miocárdica, el llenado ventricular y la respuesta a las catecolaminas . Muchos de los cambios funcionales asociados con la edad están relacionados con estos fenómenos. Esta revisión describe los cambios relacionados con el envejecimiento a nivel estructural y funcional del sistema cardiovascular, sus posibles factores etiológ...

  6. Pharmacogenomics and cardiovascular disease

    DEFF Research Database (Denmark)

    Weeke, Peter; Roden, Dan M

    2013-01-01

    Variability in drug responsiveness is a sine qua non of modern therapeutics, and the contribution of genomic variation is increasingly recognized. Investigating the genomic basis for variable responses to cardiovascular therapies has been a model for pharmacogenomics in general and has established...... resulted in changes to the product labels but also have led to development of initial clinical guidelines that consider how to facilitate incorporating genetic information to the bedside. This review summarizes the state of knowledge in cardiovascular pharmacogenomics and considers how variants described...

  7. Research in cardiovascular care

    DEFF Research Database (Denmark)

    Jaarsma, Tiny; Deaton, Christi; Fitzsimmons, Donna

    2014-01-01

    To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined...... of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given....

  8. Myeloperoxidase and cardiovascular disease.

    Science.gov (United States)

    Nicholls, Stephen J; Hazen, Stanley L

    2005-06-01

    Myeloperoxidase (MPO) is a leukocyte-derived enzyme that catalyzes the formation of a number of reactive oxidant species. In addition to being an integral component of the innate immune response, evidence has emerged that MPO-derived oxidants contribute to tissue damage during inflammation. MPO-catalyzed reactions have been attributed to potentially proatherogenic biological activities throughout the evolution of cardiovascular disease, including during initiation, propagation, and acute complication phases of the atherosclerotic process. As a result, MPO and its downstream inflammatory pathways represent attractive targets for both prognostication and therapeutic intervention in the prophylaxis of atherosclerotic cardiovascular disease.

  9. Comparison of the acute-phase response after laparoscopic versus open aortobifemoral bypass surgery: a substudy of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Krog AH

    2016-09-01

    Full Text Available Anne H Krog,1,2 Mehdi Sahba,3 Erik M Pettersen,4 Irene Sandven,5 Per M Thorsby,1,6 Jørgen J Jørgensen,1,2 Jon O Sundhagen,2 Syed SS Kazmi2 1Institute of Clinical Medicine, University of Oslo, 2Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, 3Department of Vascular Surgery, Østfold Central Hospital, Fredrikstad, 4Department of Vascular Surgery, Sørlandet Hospital HF, Kristiansand, 5Oslo Center for Biostatistics and Epidemiology (OCBE, 6Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway Purpose: Minimally invasive surgical techniques have been shown to reduce the inflammatory response related to a surgical procedure. The main objective of our study was to measure the inflammatory response in patients undergoing a totally laparoscopic versus open aortobifemoral bypass surgery. This is the first randomized trial on subjects in this population.Patients and methods: This is a substudy of a larger randomized controlled multicenter trial (Norwegian Laparoscopic Aortic Surgery Trial. Thirty consecutive patients with severe aortoiliac occlusive disease eligible for aortobifemoral bypass surgery were randomized to either a totally laparoscopic (n=14 or an open surgical procedure (n=16. The inflammatory response was measured by perioperative monitoring of serum interleukin-6 (IL-6, IL-8, and C-reactive protein (CRP at six different time points.Results: The inflammatory reaction caused by the laparoscopic procedure was reduced compared with open surgery. IL-6 was significantly lower after the laparoscopic procedure, measured by comparing area under the curve (AUC, and after adjusting for the confounding effect of coronary heart disease (P=0.010. The differences in serum levels of IL-8 and CRP did not reach statistical significance.Conclusion: In this substudy of a randomized controlled trial comparing laparoscopic and open aortobifemoral bypass

  10. A review of Perindopril in the reduction of cardiovascular events

    Directory of Open Access Journals (Sweden)

    Duncan J Campbell

    2006-06-01

    Full Text Available Duncan J CampbellSt. Vincent’s Institute of Medical Research and the Department of Medicine, University of Melbourne, St. Vincent’s Hospital, Fitzroy, Victoria, AustraliaBackground: Angiotensin-converting enzyme inhibitors (ACEI have a well-established role in the prevention of cardiovascular events in hypertension, left ventricular dysfunction, and heart failure. More recently, ACEI have been shown to prevent cardiovascular events in individuals with increased cardiovascular risk, where hypertension, left ventricular dysfunction, or heart failure was not the primary indication for ACEI therapy.Objective: To review studies of the effects of the ACEI perindopril on cardiovascular events.Method: The EUROPA (European Trial on Reduction of Cardiac Events with Perindopril in Patients with Stable Coronary Artery Disease Study, PROGRESS (Perindopril Protection Against Recurrent Stroke Study, and ASCOT-BPLA (Anglo-Scandinavian Cardiac Outcomes Trial – Blood Pressure Lowering Arm trials are reviewed.Results: Perindopril alone reduced cardiovascular events in subjects with stable coronary heart disease. Perindopril in combination with indapamide reduced cardiovascular events in subjects with cerebrovascular disease. Perindopril in combination with amlodipine reduced cardiovascular events in subjects with hypertension.Conclusion: Perindopril reduced cardiovascular events. The reduction of cardiovascular events by perindopril was in large part associated with reduction of blood pressure, and greater reduction in cardiovascular events was associated with greater reduction of blood pressure. Perindopril may need to be combined with other antihypertensive agents to maximize reduction of cardiovascular events.Keywords: Angiotensin-converting enzyme inhibitor, hypertension, coronary heart disease, stroke, myocardial infarction, heart failure

  11. Two years of experience with robot-assisted anti-reflux surgery

    DEFF Research Database (Denmark)

    Jensen, Jonas Sanberg; Antonsen, Henning Kold; Durup, Jesper

    2017-01-01

    Background and aims Robot-assisted anti-reflux surgery (RAAS) is an alternative to conventional laparoscopic anti-reflux surgery (CLAS). The purpose of this study was to evaluate initial Danish experiences with robot-assisted anti-reflux surgery compared to conventional laparoscopic anti...... no particular advantages to performing antireflux surgery as robot-assisted procedures neither intra-operatively nor at follow-up.......-reflux surgery incorporating follow-up and evaluation of possible learning curve. Material and methods Patients undergoing primary RAAS or CLAS at The Department of Surgery A, Odense University Hospital and The Department of General Surgery, Kolding Hospital from April 2013 to April 2015 was included...

  12. Pharmacogenetics of cardiovascular drugs.

    Science.gov (United States)

    Johnson, Julie A; Humma, Larisa M

    2002-02-01

    Pharmacogenetics is a field aimed at understanding the genetic contribution to inter-patient variability in drug efficacy and toxicity. Treatment of cardiovascular disease is, in most cases, guided by evidence from well-controlled clinical trials. Given the solid scientific basis for the treatment of most cardiovascular diseases, it is common for patients with a given disease to be treated in essentially the same manner. Thus, the clinical trials have been very informative about treating large groups of patients with a given disease, but are slightly less informative about the treatment of individual patients. Pharmacogenetics and pharmacogenomics have the potential of taking the information derived from large clinical trials and further refining it to select the drugs with the greatest likelihood for benefit, and least likelihood for harm, in individual patients, based on their genetic make-up. In this paper, the current literature on cardiovascular pharmacogenetics is emphasised, and how the use of pharmacogenetic/pharmacogenomic information may be particularly useful in the future in the treatment of cardiovascular diseases is also highlighted.

  13. Cheese and cardiovascular health

    DEFF Research Database (Denmark)

    Hjerpsted, Julie Bousgaard

    Cardiovascular diseases (CVDs) are the number one cause of mortality worldwide. Low-density lipoprotein (LDL) cholesterol is a well-known risk factor of CVD which increases after the intake of saturated fatty acids (SFA). Cheese is a dietary product commonly consumed in Western countries and known...

  14. Cardiovascular effects of gliptins.

    Science.gov (United States)

    Scheen, André J

    2013-02-01

    Dipeptidyl peptidase 4 (DPP-4) inhibitors (commonly referred to as gliptins) are a novel class of oral antihyperglycaemic agents with demonstrated efficacy in the treatment of type 2 diabetes mellitus (T2DM). Preclinical data and mechanistic studies have indicated a possible beneficial action on blood vessels and the heart, via both glucagon-like peptide 1 (GLP-1)-dependent and GLP-1-independent effects. DPP-4 inhibition increases the concentration of many peptides with potential vasoactive and cardioprotective effects. Clinically, DPP-4 inhibitors improve several risk factors in patients with T2DM. They improve blood glucose control (mainly by reducing postprandial glycaemia), are weight neutral (or even induce modest weight loss), lower blood pressure, improve postprandial lipaemia, reduce inflammatory markers, diminish oxidative stress, and improve endothelial function. Some positive effects on the heart have also been described in patients with ischaemic heart disease or congestive heart failure, although their clinical relevance requires further investigation. Post-hoc analyses of phase II-III, controlled trials suggest a possible cardioprotective effect with a trend for a lower incidence of major cardiovascular events with gliptins than with placebo or active agents. However, the actual relationship between DPP-4 inhibition and cardiovascular outcomes remains to be proven. Major prospective clinical trials with predefined cardiovascular outcomes and involving various DPP-4 inhibitors are now underway in patients with T2DM and a high-risk cardiovascular profile.

  15. Neuropeptides in cardiovascular control.

    Science.gov (United States)

    Ganong, W F

    1984-12-01

    Neuropeptides can affect cardiovascular function in various ways. They can serve as cotransmitters in the autonomic nervous system; for example, vasoactive intestinal peptide (VIP) is released with acetylcholine and neuropeptide Y with norepinephrine from postganglionic neurons. Substance P and, presumably, other peptides can can affect cardiovascular function when released near blood vessels by antidromically conducted impulses in branches of stimulated sensory neurons. In the central nervous system, many different neuropeptides appear to function as transmitters or contransmittes in the neural pathways that regulate the cardiovascular system. In addition neuropeptides such as vasopressin and angiotensin II also circulate as hormones that are involved in cardiovascular control. Large doses of exogenous vasopressin are required to increase blood pressure in normal animals because the increase in total peripheral resistance produced by the hormones is accompanied by a decrease in cardiac output. However, studies with synthetic peptides that selectively antagonize the vasopressor action of vasopressin indicate that circulating vasopressin is important in maintaining blood pressure when animals are hypovolemic due to dehydration, haemorrhage or adrenocortical insufficiency. VIP dilates blood vessels and stimulates renin secretion by a direct action on the juxtaglomerular cells. Renin secretion is stimulated when the concentration of VIP in plasma exceeds 75 pmol/litre, and higher values are seen in a number of conditions. Neostigmine, a drug which increases the secretion of endogenous VIP, also increases renin secretion, and this increase is not blocked by renal denervation or propranolol. Thus, VIP may be a physiologically significant renin stimulating hormone.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Epigenetics and cardiovascular disease

    Science.gov (United States)

    Despite advances in the prevention and management of cardiovascular disease (CVD), this group of multifactorial disorders remains a leading cause of mortality worldwide. CVD is associated with multiple genetic and modifiable risk factors; however, known environmental and genetic influences can only...

  17. 加速康复外科理念在普外科ICU老年患者术前访视中的应用%Application of the concept of speed-up rehabilitation in preoperative interview in elderly patients in ICU of general surgery department

    Institute of Scientific and Technical Information of China (English)

    李萍

    2011-01-01

    Objective To study the effect of speed - up rehabilitation in preoperative interview in elderly patients in ICU of general surgery department. Methods 240 patients admitted to general surgery and elective surgery and postoperative eldcrly patients who stayed in ICU were randomly divided into two groups, namely observation group and the comparison group. 120 cases were in comparison group, which employed the traditional methods of nursing, and the other 120 patients were in the observation group, which implemented full- time preoperative interview. Two groups were compared in anxiety level before and after the visits, indicators related to assessment and nursing satisfaction. Results There were differences between the two groups in anxiety level before and after the visits, relevant assessment indicators and nursing satisfaction. The differences were. statistically significant (P< 0.01 ). Conclusion The concept of using the speed- up rehabilitation in the surgical ICU ward for elderly patients with preoperative visit is effective and necessary. It can ease the patient's postoperative anxiety and reduce postoperative complications. At the same time, it can improve nursing satisfaction, which will help the successful completion of rehabilitation.%目的 探讨加速康复外科理念在普外科ICU老年患者术前访视中的应用效果.方法 将240例普外科收治并择期手术且术后入住ICU的老年患者随机分为观察组和对照组各120例,其中对照组实施传统护理方法;观察组行专职术前访视.比较2组患者访视前后焦虑程度、术后两组相关评定指标和护理满意度.结果 两组患者访视前后焦虑程度、术后两组相关评定指标和护理满意度比较,差异有统计学意义(P<0.01).结论 在ICU病房运用加速康复外科理念,对老年患者进行术前访视是有效且必要的,可以减轻患者的术后焦虑和紧张情绪,减少术后并发症的发生,提高护理满意度,利于术后康复治疗的顺利完成.

  18. Application of the scored patient-generated subjective global assessment in monitoring the preoperative nutrition status of neoplasms patients in the department of thoracic surgery%患者主观全面评价法在胸外科肿瘤患者术前营养状况监测中的应用

    Institute of Scientific and Technical Information of China (English)

    江宾; 郭玲; 张丽平

    2014-01-01

    目的了解胸外科择期手术肿瘤患者术前营养状况,为临床掌握营养支持的合理时机和实施个体化的营养支持方案提供依据。方法采用患者主观营养评估问卷( PG-SGA )对2013年6—11月接受择期手术治疗的胸外科肿瘤患者88例术前营养状况进行评估。结果88例胸外科肿瘤患者PG-SGA营养状况评价总体得分P50为8分;无需营养干预者仅占14.8%,需医护人员行药物治疗指导者占12.5%,需营养支持治疗者占26.1%,而急需实施营养干预或改善症状的治疗者占46.6%。食管癌患者营养不良程度高于肺胸部肿瘤患者,差异有统计学意义(χ2=-3.62,P<0.01)。结论推广应用肿瘤患者营养评估专用工具PG-SGA对胸外科住院患者进行评价,根据营养风险情况进行营养指导,实施早期营养治疗,可取得最佳营养干预结果。%Objective To understand the preoperative nutrition status of neoplasms patients in the department of thoracic surgery, in order to provide the basis for mastering the appropriate time of nutritional support and the implementation of individualized nutritional support scheme.Methods Eighty-eight neoplasms patients in the department of thoracic surgery from June 2013 to November 2013 were chosen, and the preoperative nutrition status of patients was evaluated by the scored patient-generated subjective global assessment (PG-SGA).Results The P50 score of PG-SGA was 8.The percent of patients who don’ t need nutritional intervention was 14.8%, and the percent of patients who needed medication guide was 12.5%, and the percent of patients who need nutrition support was 26.1%, and the percent of patients who were in great demand of nutrition intervention was 46.6%.The degree of malnutrition in the esophageal cancer patients was higher than that in the lung/thoracic cancer patients, and the difference was statistically significant (χ2 =-3.62,P <0

  19. Effects of Sequencing Follow-up Education in Releasing Anxiety of Patients with Urinary Surgery Diseases in Outpatient Department%程序化随诊教育缓解门诊泌尿外科患者焦虑的效果

    Institute of Scientific and Technical Information of China (English)

    樊巧芝; 孙春艳; 任秋菊

    2011-01-01

    Objective To investigate the effect of sequencing follow-up education in releasing anxiety of patients with urinary surgery diseases in outpatient department.Methods From October to December 2009,100 patients who were newly diagnosed with urinary surgery diseases in outpatient department of People's Hospital of Langfang were randomly separated into control group and treatment group.The patients in the control group undergone relevant examinations and treatments directly after the initial diagnosis and treatment.While after the initial diagnosis and treatment, the patients in the treatment group undergoing the sequencing education, which was followed by the routine diagnosis and treatment.Comparisons were conducted in the changes of blood pressure and scores of self-rating anxiety scale(SAS).Results Significant differences were observed between the two groups before and after the treatment(P<0.05).Compared with those before the treatment, the SAS scores were decreased after the treatment with significant difference (P<0.05).After the treatment,significant difference was also observed in SAS scores between the two groups(P<0.05).Conclusion Sequencing follow-up education contributes to the rehabilitation of patients with urinary surgery diseases in outpatient department.%目的 探讨程序化随诊教育缓解门诊泌尿外科患者焦虑的效果.方法 选取2009年10-12月廊坊市人民医院泌尿外科门诊初诊的焦虑患者100例为研究对象,并按随机数字表法将其分为试验组和对照组.试验组患者在医生首次诊疗毕,立即由专科护士给予程序化教育,之后再例行诊后检查和治疗;对照组则首次诊疗后直接进行其他检查和治疗.比较两组患者的血压的变化及焦虑自评量表(self-rating anxiety scale,SAS)评分情况.结果 就诊前后,试验组患者血压的差异有统计学意义(P<0.05);就诊后,试验组患者的血压与对照组相比,差异有统计学意义(P<0.05).两组患

  20. Gastric bypass surgery

    Science.gov (United States)

    ... Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass ... bypass surgery is not a quick fix for obesity. It will greatly change your lifestyle. After this surgery, you must eat healthy foods, control portion sizes of ...

  1. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  2. Nonfasting hyperlipidemia and cardiovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, B G; Langsted, A; Freiberg, J J

    2009-01-01

    , total cholesterol/HDL cholesterol, and apolipoprotein B/apolipoprotein A1 all associate with increased risk of cardiovascular disease. These new data open the possibility that nonfasting rather than fasting lipid profiles can be used for cardiovascular risk prediction. If implemented, this would...... of cardiovascular disease and early death....

  3. 疾病知识培训对普外科手术患者家属不良情绪的影响%Influence of disease-related knowledge training on the unhealthy emotions of family members of surgical patients in the department of general surgery

    Institute of Scientific and Technical Information of China (English)

    王桂英

    2014-01-01

    Objective:To investigate the influence of disease -related knowledge training on the unhealthy emotions of family members of surgical patients in the department of general surgery .Methods:400 family members of the patients who would receive selective operation were taken as the research objects and they were randomly divided into the control group and the observation group (200 family members in each group).The members in the control group were given routine propaganda and health education ;the extra disease-related knowledge training was given to the members in the observation group .The scores of SAS and SDS of family members and their satisfaction were com-pared between the two groups before and after the intervention .Results:The positive rate of SAS and SDS scale was lower in the observation group than the control group after the intervention (P<0.05);the scores of emotional state assessment scale were superior in the observa-tion group to the control group(P<0.05);the degree of total satisfaction of family members was higher in the observation group than the control group(P<0.05).Conclusion:The disease-related knowledge training can alleviate the unhealthy emotions of family members of surgical patients in the department of general surgery .%目的:探讨疾病知识培训对普外科手术患者家属不良情绪的影响。方法:选取普外科400名择期手术患者的家属作为研究对象,随机分为对照组和观察组各200名,对照组进行常规宣教,观察组在对照组基础上进行疾病知识培训。比较两组家属干预前后SAS、SDS量表评估结果、情绪状态评估量表评分及满意度。结果:观察组干预后SAS、SDS量表阳性率低于对照组(P<0.05),情绪状态评估量表评分优于对照组(P<0.05),家属总满意度高于对照组(P<0.05)。结论:疾病知识培训可有效改善普外科手术患者家属的不良情绪。

  4. 层级管理对提高普外科护理工作质量和护士工作能力的影响%The Effect of Hierarchical Management on Nursing Ability in of Nurses in General Surgery Department

    Institute of Scientific and Technical Information of China (English)

    杨勤

    2013-01-01

      目的探讨层级管理对普外科护理工作质量的影响。方法选取我院40位普外科护士为研究对象,比较实施层级管理前后护理工作质量和护士工作能力以及患者对护理工作的满意度变化。结果实施层级管理后,护士在专业技术水平、理论知识、健康教育能力等护理能力均显著高于实施前(P <0.05)。护理质量、护士的工作满意度及患者对护理工作的满意度显著高于管理前(P <0.05)。结论层级管理更有利于合理的利用护理资源,提高护士的工作能力和护理质量以及患者对护理工作的满意度。%Objective To investigate the Effect of hierarchical management on nursing ability in of nurses in general surgery Department. Methods 40 cases of general surgery nurses in our hospital department were chosen as the research object, work ability and job satisfaction of nurses were compared before and after the hierarchical management. Results Nursing ability such as nurses in the professional and technical level, theoretical knowledge were significantly higher than before the implementation of hierarchical management(P<0.05). The nurse's job satisfaction and patients’nursing satisfaction were significantly higher than before (P<0.05). Conclusion The hierarchical management is more conducive to the reasonable utilization of resources; improve the nurses' work ability and satisfaction.

  5. Cutaneous mucormycosis postcosmetic surgery

    Science.gov (United States)

    Al-Tarrah, Khaled; Abdelaty, Mahmoud; Behbahani, Ahmad; Mokaddas, Eman; Soliman, Helmy; Albader, Ahdi

    2016-01-01

    Abstract Background: Mucormycosis is a rare, aggressive, and life-threatening infection that is caused by organisms belonging to the order Mucorales. It is usually acquired through direct means and virtually always affects immunocompromised patients with the port of entry reflecting the site of infection, in this case, cutaneous. Unlike other mucormycoses, patients affected by Apophysomyces elegans (A elegans) are known to be immunocompetent. This locally aggressive disease penetrates through different tissue plains invading adjacent muscles, fascia, and even bone causing extensive morbidity and may prove fatal if treated inadequately. Cutaneous mucormycosis is associated with disruption of cutaneous barriers such as trauma. However, rarely, it may be iatrogenic. No cases have been previously reported postcosmetic surgery, especially one that is so commonly performed, lipofilling. Case Report: The patient is a, previously healthy, 41-year-old middle-eastern female who was admitted to the plastic surgery department 17 days after undergoing cosmetic surgery. She suffered from extensive tissue inflammation and necrosis in both gluteal regions. Following admission, she was initially started on empirical antimicrobial therapy which was changed to an antifungal agent, voriconazole, when preliminary microbiological results showed filamentous fungi. This was discontinued and liposomal amphotericin B was commenced when further mycological analysis identified A elegans. Furthermore, she underwent a total of 10 sessions of extensive debridement to the extent that portions of the sacrum and left femoral head became exposed. Her clinical status and wounds improved with the appropriate management and she remained an inpatient for 62 days. Subsequently, she had defects in both gluteal regions which required reconstructive surgery. Conclusion: A elegans is an uncommon cause of iatrogenic cutaneous mucormycosis. A high index of clinical suspicion is required, especially in the

  6. Cardiovascular aspects in acromegaly: effects of treatment.

    Science.gov (United States)

    Lombardi, G; Colao, A; Ferone, D; Marzullo, P; Landi, M L; Longobardi, S; Iervolino, E; Cuocolo, A; Fazio, S; Merola, B; Sacca, L

    1996-08-01

    Patients with acromegaly have significant morbidity and mortality, associated with cardiovascular disease. Acromegaly is often complicated by other diseases such as diabetes mellitus, hypertension, and coronary artery disease, so the existence of acromegalic cardiomyopathy remains uncertain. Cardiac performance was investigated in patients with uncomplicated acromegaly. A subgroup of hypertensive acromegalics was also studied. In addition, the effects of chronic octreotide therapy or surgery on cardiac structure and function in acromegaly were studied. Twenty-six patients and 15 healthy controls underwent gated blood-pool cardiac scintigraphy and echocardiography at rest and during exercise. Echocardiography was repeated after 6 months of octreotide therapy (n = 11). Cardiac scintigraphy was repeated after 12 and 24 months of octreotide therapy (n = 10) or 12 to 24 months after surgery (n = 8). ECG, blood pressure, and heart rate were monitored during cardiac scintigraphy. Left ventricular mass (LVM) was calculated from the findings of the echocardiography. Serum growth hormone (GH) levels and plasma insulin-like growth factor-1 (IGF-1) levels were monitored. LVM index was significantly higher (P cardiac function were similar. Chronic octreotide decreased GH and IGF-1 levels and improved the structural abnormalities as measured by echocardiography. Chronic octreotide or surgery did not alter cardiac function parameters. Thus, important changes in cardiac structure and function occur in uncomplicated acromegaly, and improvements can be demonstrated after chronic octreotide therapy. Heart disease in acromegaly appears to be secondary to high circulating GH levels.

  7. Modified physiological and operative score for the enumeration of mortality and morbidity risk assessment model in general surgery

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), and to evaluate its efficacy.METHODS: Eighty-four patients with postoperative complications or death and 172 patients without postoperative complications, who underwent surgery in our department during the previous 2 years, were retrospectively analyzed by logistic regression. Fifteen indexes were investigated including age, cardiovascular function, respiratory function, blood test results,endocrine function, central nervous system function,hepatic function, renal function, nutritional status, extent of operative trauma, and course of anesthesia. Modified POSSUM (M-POSSUM) was developed using significant risk factors with its efficacy evaluated.RESULTS: The significant risk factors were found to be age, cardiovascular function, respiratory function,hepatic function, renal function, blood test results,endocrine function, nutritional status, duration of operation, intraoperative blood loss, and course of anesthesia. These factors were all included in the scoring system. There were significant differences in the scores between the patients with and without postoperative complications, between the patients died and survived with complications, and between the patients died and survived without complications. The receiver operating characteristic curves showed that the M-POSSUM could accurately predict postoperative complications and mortality.CONCLUSION: M-POSSUM correlates well with postoperative complications and mortality, and is more accurate than POSSUM.

  8. [The beginnings of orthopedic surgery in Israel].

    Science.gov (United States)

    Tauber, Chanan

    2013-08-01

    In early mandatory Israel, orthopedics was mainly conservative, The first modern orthopedic surgeon was Ernst Spira from Czechoslovakia who established an orthopedic service at the Beilinson Hospital in Petah Tikva and left in 1948 to establish the Orthopedic Department and the Rehabilitation Center in Tel Hashomer, which treated the War of Independence casualties including amputees and victims of spinal cord injuries. A second orthopedic department was opened in Tel Hashomer by Shmuel Weissman who left in 1961 to open the Orthopedic Department at the Ichilov hospital in Tel Aviv. Shmuel Weissman became the first Chairman of Orthopedic Surgery at the Tel Aviv University medical school. In 1955, Myer Makin opened a modern orthopedic department in the Hadassah Hospital in Jerusalem and the Alyn Hospital for crippled children. In 1951, Assaf Harofeh Hospital opened the Department of Orthopedic Surgery headed by Anatol Axer who specialized in the treatment and rehabilitation of polio patients. The majority of the second generation of orthopedic department directors was trained by these four surgeons. Major developments in the 1960s and 1970s were the introduction of the AO system revolutionizing fracture treatment from conservative to operative treatment, the advent of total hip and knee replacements, Harrington instrumentation in spinal surgery and arthroscopy were major advances in orthopedic patient care brought to Israel by the aforementioned second generation of orthopedic surgeons. Hand surgery became an independent subspecialty of orthopedics and was lead by the internationally renowned hand surgeon, Isidore Kessler.

  9. Pediatric Ingestions: Emergency Department Management.

    Science.gov (United States)

    Tarango Md, Stacy M; Liu Md, Deborah R

    2016-04-01

    Pediatric ingestions present a common challenge for emergency clinicians. Each year, more than 50,000 children aged less than 5 years present to emergency departments with concern for unintentional medication exposure, and nearly half of all calls to poison centers are for children aged less than 6 years. Ingestion of magnetic objects and button batteries has also become an increasing source of morbidity and mortality. Although fatal pediatric ingestions are rare, the prescription medications most responsible for injury and fatality in children include opioids, sedative/hypnotics, and cardiovascular drugs. Evidence regarding the evaluation and management of common pediatric ingestions is comprised largely of case reports and retrospective studies. This issue provides a review of these studies as well as consensus guidelines addressing the initial resuscitation, diagnosis, and treatment of common pediatric ingestions. Also discussed are current recommendations for decontamination, administration of antidotes for specific toxins, and management of ingested foreign bodies.

  10. No effect of melatonin to modify surgical-stress response after major vascular surgery: a randomised placebo-controlled trial

    DEFF Research Database (Denmark)

    Kücükakin, B; Wilhelmsen, M; Lykkesfeldt, Jens

    2010-01-01

    A possible mechanism underlying cardiovascular morbidity after major vascular surgery may be the perioperative ischaemia-reperfusion with excessive oxygen-derived free-radical production and increased levels of circulating inflammatory mediators. We examined the effect of melatonin infusion durin...... surgery and oral melatonin treatment for 3 days after surgery on biochemical markers of oxidative and inflammatory stress.......A possible mechanism underlying cardiovascular morbidity after major vascular surgery may be the perioperative ischaemia-reperfusion with excessive oxygen-derived free-radical production and increased levels of circulating inflammatory mediators. We examined the effect of melatonin infusion during...

  11. Transient cortical visual impairment after video-assisted thoracic surgery: a case report

    OpenAIRE

    Yang, Hee Kyung; Hwang, Jeong-Min

    2015-01-01

    Background Visual loss associated with thoracic surgery has been reported mostly after coronary angiography or bypass surgery. The position of video-assisted thoracic surgery (VATS) is usually lateral, thus not compressive to the globe. Visual loss after VATS has not been reported. Herein we report a patient without any cardiovascular risk factors who experienced transient cortical blindness after an uneventful VATS. Case presentation A 40-year-old man noticed a visual loss at the recovery ro...

  12. [Multiculturalism and cardiovascular diseases].

    Science.gov (United States)

    Gaudio, Carlo; Corsi, Filippo; Esposito, Cosimo; Di Michele, Sara; Nguyen, Bich Lien; Khatibi, Shahrzad; Sciarretta, Tesir; Franchitto, Silvia; Mirabelli, Francesca; Pannarale, Giuseppe

    2004-01-01

    Immigration has increased drastically to the point of becoming an ordinary structure of our society. Once in Italy, the immigrant's health is compromised rapidly due to a series of conditions and illnesses that exist in our country: lack of work, inadequate salary, inappropriate residence, lacking family support, climate changes, nutritional differences. Cardiovascular illnesses represent 7.6% of the diseases of the immigrants, and cause 36.6% of deaths. The risk factors that affect the genesis of cardiovascular diseases include: subjective factors (age, ethnic group), environmental, nutritional and pathological (arterial hypertension, AIDS, tuberculosis, alcohol). The challenge for our time is to design a new solidarity model to promote cultural and social integration in order to meet the multiethnical and multiracial needs of western society. This model should permit reconsideration of doctor-patient relationship in order to build a real intercultural society.

  13. Migraine and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Marcelo E. Bigal

    2011-02-01

    Full Text Available Migraine, especially migraine with aura is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine with and without aura to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication and cardiovascular mortality. The topic is therefore of considerable interest. Accordingly, herein we review the association between migraine and cardiovascular disease. We start by briefly presenting diagnostic criteria for migraine and revising its pathophysiology. We follow by summarizing the evidence on the topic. We then briefly present the results of a recent meta-analysis. We close by highlighting results of a large epidemiological study conducted after the publication of the meta-analysis.

  14. Prodrugs in Cardiovascular Therapy

    Directory of Open Access Journals (Sweden)

    Maryam Tabrizian

    2008-05-01

    Full Text Available Prodrugs are biologically inactive derivatives of an active drug intended to solve certain problems of the parent drug such as toxicity, instability, minimal solubility and non-targeting capabilities. The majority of drugs for cardiovascular diseases undergo firstpass metabolism, resulting in drug inactivation and generation of toxic metabolites, which makes them appealing targets for prodrug design. Since prodrugs undergo a chemical reaction to form the parent drug once inside the body, this makes them very effective in controlling the release of a variety of compounds to the targeted site. This review will provide the reader with an insight on the latest developments of prodrugs that are available for treating a variety of cardiovascular diseases. In addition, we will focus on several drug delivery methodologies that have merged with the prodrug approach to provide enhanced target specificity and controlled drug release with minimal side effects.

  15. Slow breathing and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Ashish Chaddha

    2015-01-01

    Full Text Available Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.

  16. Slow breathing and cardiovascular disease.

    Science.gov (United States)

    Chaddha, Ashish

    2015-01-01

    Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.

  17. Endoglin: a critical mediator of cardiovascular health

    Directory of Open Access Journals (Sweden)

    Kapur NK

    2013-05-01

    Full Text Available Navin K Kapur,1 Kevin J Morine,1 Michelle Letarte2,31Molecular Cardiology Research Institute, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA; 2Molecular Structure and Function Program, Hospital for Sick Children, 3The Heart and Stroke Foundation Richard Lewar Centre of Excellence, and the Department of Immunology, University of Toronto, Toronto, Ontario, CanadaAbstract: Endoglin (CD105 is a type III auxiliary receptor for the transforming growth factor beta (TGFß superfamily. Several lines of evidence suggest that endoglin plays a critical role in maintaining cardiovascular homeostasis. Seemingly disparate disease conditions, including hereditary hemorrhagic telangiectasia, pre-eclampsia, and cardiac fibrosis, have now been associated with endoglin. Given the central role of the TGFß superfamily in multiple disease conditions, this review provides a detailed update on endoglin as an evolving therapeutic target in the management of cardiovascular disease.Keywords: endoglin, transforming growth factor beta, vascular, cardiac remodeling

  18. Cardiovascular risk prediction

    DEFF Research Database (Denmark)

    Graversen, Peter; Abildstrøm, Steen Z; Jespersen, Lasse

    2016-01-01

    (ECG) abnormalities, heart rate, family history (of ischaemic heart disease), body mass index (BMI), waist-hip ratio, walking duration and pace, leisure time physical activity, forced expiratory volume (FEV)1%pred, household income, education, vital exhaustion, high-density lipoprotein (HDL......AIM: European society of cardiology (ESC) guidelines recommend that cardiovascular disease (CVD) risk stratification in asymptomatic individuals is based on the Systematic Coronary Risk Evaluation (SCORE) algorithm, which estimates individual 10-year risk of death from CVD. We assessed...

  19. Acute gastrointestinal complications after cardiac surgery.

    Science.gov (United States)

    Halm, M A

    1996-03-01

    Gastrointestinal problems, with an incidence of about 1%, may complicate the postoperative period after cardiovascular surgery, increasing morbidity, length of stay, and mortality. Several risk factors for the development of these complications, including preexisting conditions; advancing age; surgical procedure, especially valve, combined bypass/valve, emergency, reoperative, and aortic dissection repair; iatrogenic conditions; stress; ischemia; and postpump complications, have been identified in multiple research studies. Ischemia is the most significant of these risk factors after cardiovascular surgery. Mechanisms that have been implicated include longer cardiopulmonary bypass and aortic cross-clamp times and hypoperfusion states, especially if inotropic or intra-aortic balloon pump support is required. These risk factors have been linked to upper and lower gastrointestinal bleeding, paralytic ileus, intestinal ischemia, acute diverticulitis, acute cholecystitis, hepatic dysfunction, hyperamylasemia, and acute pancreatitis. Gastrointestinal bleeding accounts for almost half of all complications, followed by hepatic dysfunction, intestinal ischemia, and acute cholecystitis. Identification of these gastrointestinal complications may be difficult because manifestations may be masked by postoperative analgesia or not reported by patients because they are sedated or require prolonged mechanical ventilation. Furthermore, clinical manifestations may be nonspecific and not follow the "classic" clinical picture. Therefore, astute assessment skills are needed to recognize these problems in high-risk patients early in their clinical course. Such early recognition will prompt aggressive medical and/or surgical management and therefore improve patient outcomes for the cardiovascular surgical population.

  20. Advanced Cardiovascular Monitoring

    NARCIS (Netherlands)

    de Waal, E.E.C.

    2009-01-01

    The Frank-Starling curve (the curvilinear relation between cardiac output (CO) and preload) can be used for optimalization of the blood circulation and tissue oxygenation, in order to decrease morbidity and mortality in high risk surgery and critically ill patients. Measurement of CO and preload wit

  1. Photoacoustic monitoring of clot formation during surgery and tumor surgery

    Science.gov (United States)

    Juratli, Mazen A.; Galanzha, Ekaterina I.; Sarimollaoglu, Mustafa; Nedosekin, Dmitry A.; Suen, James Y.; Zharov, Vladimir P.

    2013-03-01

    When a blood vessel is injured, the normal physiological response of the body is to form a clot (thrombus) to prevent blood loss. Alternatively, even without injury to the blood vessel, the pathological condition called thromboembolism may lead to the formation of circulating blood clots (CBCs), also called emboli, which can clog blood vessels throughout the body. Veins of the extremities (venous thromboembolism), lungs (pulmonary embolism ), brain (embolic stroke), heart (myocardial infarction), kidneys, and gastrointestinal tract are often affected. Emboli are also common complications of infection, inflammation, cancer, surgery, radiation and coronary artery bypass grafts. Despite the clear medical significance of CBCs, however, little progress has been made in the development of methods for real-time detection and identification of CBCs. To overcome these limitations, we developed a new modification of in vivo photoacoustic (PA) flow cytometry (PAFC) for real-time detection of white, red, and mixed clots through a transient decrease, increase or fluctuation of PA signal amplitude, respectively. In this work, using PAFC and mouse models, we present for the first time direct evidence that some medical procedures, such as conventional or cancer surgery may initiate the formation of CBCs. In conclusion, the PA diagnostic platform can be used in real-time to define risk factors for cardiovascular diseases, assist in the prognosis and potential prevention of stroke by using a well-timed therapy or as a clot count as a marker of therapy efficacy.

  2. Infections in outpatient surgery.

    Science.gov (United States)

    Nazarian Mobin, Sheila S; Keyes, Geoffrey R; Singer, Robert; Yates, James; Thompson, Dennis

    2013-07-01

    In the plastic surgery patient population, outpatient surgery is cost effective and will continue to grow as the preferred arena for performing surgery in healthy patients. Although there is a widespread myth that outpatient surgery centers may suffer from increased infection rates due to lax infection control, the data presented from American Association for Accreditation of Ambulatory Surgery Facilities-accredited facilities prove the contrary. There is a lack of data investigating infection prevention in the perioperative period in plastic surgery patients. As data collection becomes more refined, tracking the postoperative care environment should offer additional opportunities to lower the incidence of postoperative infections.

  3. Outsourced cataract surgery and postoperative endophthalmitis

    DEFF Research Database (Denmark)

    Solborg Bjerrum, Søren; Kiilgaard, Jens F; Mikkelsen, Kim Lyngby;

    2013-01-01

    To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk.......To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk....

  4. Perioperative visual loss in ocular and nonocular surgery

    Directory of Open Access Journals (Sweden)

    Kathleen T Berg

    2010-06-01

    Full Text Available Kathleen T Berg, Andrew R Harrison, Michael S LeeDepartment of Ophthalmology, University of Minnesota, Minneapolis, MN, USAAbstract: Incidence estimates for perioperative vision loss (POVL after nonocular surgery range from 0.013% for all surgeries up to 0.2% following spine surgery. The most common neuro-ophthalmologic causes of POVL are the ischemic optic neuropathies (ION, either anterior (AION or posterior (PION. We identified 111 case reports of AION following nonocular surgery in the literature, with most occurring after cardiac surgery, and 165 case reports of PION following nonocular surgery, with most occurring after spine surgery or radical neck dissection. There were an additional 526 cases of ION that did not specify if the diagnosis was AION or PION. We also identified 933 case reports of central retinal artery occlusion (CRAO, 33 cases of pituitary apoplexy, and 245 cases of cortical blindness following nonocular surgery. The incidence of POVL following ocular surgery appears to be much lower than that seen following nonocular surgery. We identified five cases in the literature of direct optic nerve trauma, 47 cases of AION, and five cases of PION following ocular surgery. The specific pathogenesis and risk factors underlying these neuro-ophthalmic complications remain unknown, and physicians should be alert to the potential for loss of vision in the postoperative period.Keywords: perioperative, postoperative, vision loss, ocular surgery, nonocular surgery

  5. Computational surgery and dual training computing, robotics and imaging

    CERN Document Server

    Bass, Barbara; Berceli, Scott; Collet, Christophe; Cerveri, Pietro

    2014-01-01

    This critical volume focuses on the use of medical imaging, medical robotics, simulation, and information technology in surgery. It offers a road map for computational surgery success,  discusses the computer-assisted management of disease and surgery, and provides a rational for image processing and diagnostic. This book also presents some advances on image-driven intervention and robotics, as well as evaluates models and simulations for a broad spectrum of cancers as well as cardiovascular, neurological, and bone diseases. Training and performance analysis in surgery assisted by robotic systems is also covered. This book also: ·         Provides a comprehensive overview of the use of computational surgery and disease management ·         Discusses the design and use of medical robotic tools for orthopedic surgery, endoscopic surgery, and prostate surgery ·         Provides practical examples and case studies in the areas of image processing, virtual surgery, and simulation traini...

  6. Heart bypass surgery - discharge

    Science.gov (United States)

    ... Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. Philadelphia, PA: Elsevier ... Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 20th ed. Philadelphia, PA: Elsevier; ...

  7. LASIK Eye Surgery

    Science.gov (United States)

    ... are nearsighted. You may need another refractive surgery (enhancement surgery) within a year to remove more tissue. ... may happen due to certain conditions, such as abnormal wound healing, hormonal imbalances or pregnancy. Visual loss ...

  8. Heart valve surgery

    Science.gov (United States)

    ... techniques are used: Percutaneous surgery (through the skin) Robot-assisted surgery If your surgeon can repair your ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  9. Otoplasty (Cosmetic Ear Surgery)

    Science.gov (United States)

    ... By Mayo Clinic Staff Otoplasty — also known as cosmetic ear surgery — is a procedure to change the shape, position ... age 5 — through adulthood. In some cases, the surgery is done as early as age 3. If ...

  10. Cosmetic breast surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000273.htm Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  11. Cosmetic ear surgery

    Science.gov (United States)

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  12. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight ... obesity. There are different types of weight loss surgery. They often limit the amount of food you ...

  13. Hip fracture surgery

    Science.gov (United States)

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis-hip ... You may receive general anesthesia before this surgery. This means ... spinal anesthesia. With this kind of anesthesia, medicine is ...

  14. Laparoscopic Spine Surgery

    Science.gov (United States)

    ... Exhibit Opportunities Sponsorship Opportunities Log In Laparoscopic Spine Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Laparoscopic Spine Surgery Your spine surgeon has determined that you need ...

  15. Types of Heart Surgery

    Science.gov (United States)

    ... from the NHLBI on Twitter. Types of Heart Surgery Coronary Artery Bypass Grafting Coronary artery bypass grafting ( ... TAHs) might be used to treat these patients. Surgery To Place Ventricular Assist Devices or Total Artificial ...

  16. Breast Reduction Surgery

    Science.gov (United States)

    ... breastfeeding: A systematic review. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2010;63:1688. Kerrigan CL, et al. Evidence-based medicine: Reduction mammoplasty. Plastic and Reconstructive Surgery. 2013;132: ...

  17. General Dermatologic Surgery Information

    Science.gov (United States)

    ... all dermatologic surgeons perform both medically necessary and cosmetic surgery procedures to maintain the health, function and appearance ... and refinement of many of today’s therapeutic and cosmetic surgery procedures. Great strides in minimally invasive techniques and ...

  18. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by ... Bariatric procedures also often cause hormonal changes. Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic ...

  19. Bariatric Surgery Misconceptions

    Science.gov (United States)

    ... from depression or anxiety and to have lower self-esteem and overall quality of life than someone who ... is a Candidate for Bariatric Surgery? Childhood and Adolescent Obesity Find a Provider Benefits of Bariatric Surgery ...

  20. Surgery for Testicular Cancer

    Science.gov (United States)

    ... Stage Testicular Cancer Treating Testicular Cancer Surgery for Testicular Cancer Surgery is typically the first treatment for all ... Testicular Cancer, by Type and Stage More In Testicular Cancer About Testicular Cancer Causes, Risk Factors, and Prevention ...

  1. Cardiovascular physiology and sleep.

    Science.gov (United States)

    Murali, Narayana S; Svatikova, Anna; Somers, Virend K

    2003-05-01

    Sleep is a natural periodic suspension of consciousness during which processes of rest and restoration occur. The cognitive, reparative and regenerative accompaniments of sleep appear to be essential for maintenance of health and homeostasis. This brief overview will examine the cardiovascular responses to normal and disordered sleep, and their physiologic and pathologic implications. In the past, sleep was believed to be a passive state. The tableau of sleep as it unfolds is anything but a passive process. The brain's activity is as complex as wakefulness, never "resting" during sleep. Following the demise of the 'passive theory of sleep' (the reticular activating system is fatigued during the waking day and hence becomes inactive), there arose the 'active theory of sleep' (sleep is due to an active general inhibition of the brain) (1). Hess demonstrated the active nature of sleep in cats, inducing "physiological sleep" with electrical stimulation of the diencephalon (2). Classical experiments of transection of the cat brainstem (3) at midpontine level inhibited sleep completely, implying that centers below this level were involved in the induction of sleep (1, 4). For the first time, measurement of sleep depth without awakening the sleeper using the electroencephalogram (EEG) was demonstrated in animals by Caton and in humans, by Berger (1). This was soon followed by discovery of the rapid eye movement sleep periods (REM) by Aserinski and Kleitman (5), demonstration of periodical sleep cycles and their association with REM sleep (6, 7). Multiple studies and steady discoveries (4) made polysomnography, with its ability to perform simultaneous whole night recordings of EEG, electromyogram (EMG), and electrooculogram (EOC), a major diagnostic tool in study of sleep disorders. This facility has been of further critical importance in allowing evaluation of the interaction between sleep and changes in hemodynamics and autonomic cardiovascular control. Consequently the

  2. Influence of podiatry on orthopedic surgery at a level I trauma center.

    Science.gov (United States)

    Jakoi, Andre M; Old, Andrew B; O'Neill, Craig A; Stein, Benjamin E; Stander, Eric P; Rosenblatt, Joseph; Herman, Martin J

    2014-06-01

    Level I trauma centers frequently see trauma at or below the ankle, which requires consultation with the orthopedic surgery department. However, as podiatry programs begin to firmly establish themselves in more Level I trauma centers, their consultations increase, ultimately taking those once seen by orthopedic surgery. A review of the literature demonstrates that this paradigm shift has yet to be discussed. The purpose of this study was to determine how many, if any, lower extremity fracture consultations a newly developed podiatry program would take from the orthopedic surgery department. A retrospective review was performed of emergency department records from January 2007 to December 2011. Seventeen different emergency department diagnoses were used to search the database. Ultimately, each patient's emergency department course was researched. Several trends were noted. First, if trauma surgery was involved, only the orthopedic surgery department was consulted for any injuries at or below the ankle. Second, the emergency department tended to consult the podiatry program only between the hours of 8 am and 6 pm. Third, as the podiatry program became more established, their number of consultations increased yearly, and, coincidentally, the orthopedic surgery department's consultations decreased. Finally, high-energy traumas involved only the orthopedic surgery department. Whether the orthopedic surgery department or podiatry program is consulted regarding trauma surgery is likely hospital dependent.

  3. [Laser therapy in orthognatic surgery].

    Science.gov (United States)

    Kimura-Fujikami, Takao; Cabrera-Muñóz, Maria Lourdes; Del Valle-Espinoza, Alejandro

    2005-01-01

    This study describes the prevalence of patients with dentofacial deformities attended in the Maxillofacial Surgery Department of Hospital de Especialidades del Centro Medico Nacional Siglo XXI of the IMSS, during January to December 2002. Twenty-six patients received postoperative laser therapy in the right area of the mandible ramus, after bilateral sagittal modified osteotomy (BSMKSO). The results with laser therapy showed less pain and edema in comparison other patients without this therapy. The results were carried out after 24 hours, 3 days, 8 days and 15 days, and after 10 treatments of laser therapy. The X-Ray and biopsy showed bone healing 30 days, six and eight weeks after orthognatic surgery procedures.

  4. Intaoperative neuromonitoring in thyroid surgery

    Directory of Open Access Journals (Sweden)

    P O Rumyantsev

    2013-09-01

    Full Text Available Thyroid surgery is most frequent interventions on endocrine organs. Whereas laryngeal nerves which inner vate the muscles of larynx are passing nearby the thyroid and central compartment therefore the risk of their injury and functional integrity is extremely important. First of all it is recurrent laryngeal nerve which in 0.5–2.7% has not “recurrent” path and depart vagus at cricoid cartilage level. Secondary it is external branch of superior laryngeal nerve with innervates cricothyroid muscle. Routine use of intraoperative neuromonitoring significantly decrease laryngeal nerves temporary palsy (paresis rate however significant reduction of perma nent palsy frequency was not demonstrated in most published papers. At the same time all authors accept that intraoperative neuromonitoring undoubtedly facilitate detection of laryngeal nerves and allow to convince their functional capacity. Taking into account that safety is a paradigm of contemporary endocrine surgery the intra operative neuromonitoring going towards further investigation and improvement.

  5. Osteoporosis y enfermedad cardiovascular

    OpenAIRE

    Sarahí Mendoza; Miriam Noa; Rosa Más

    2007-01-01

    Las enfermedades cardiovasculares (ECV) y la osteoporosis son causas frecuentes de morbilidad en la población adulta, cuya frecuencia aumenta con la edad, por lo que al aumentar la expectativa de vida, constituyen importantes problemas de salud. El riesgo a padecer ambas patologías depende de factores de riesgo, y la prevención consiste en controlar los modificables. Las ECV y la osteoporosis presentan factores etiológicos comunes que involucran la biosíntesis del colesterol y la oxidación li...

  6. Postnatal Cardiovascular Adaptation

    Directory of Open Access Journals (Sweden)

    Ferda Ozlu

    2016-06-01

    Full Text Available Fetus depends on placental circulation in utero. A successful transition from intrauterin to extrauterine life depends on succesful physiological changes during labor. During delivery, fetus transfers from a liquid environment where oxygen comes via umbilical vein to air environement where oxygenation is supported via air breathing. Endocrinological changes are important for fetus to adapt to extrauterine life. In addition to these, cord clemping plays a crucial role in postnatal adaptation. Establishment of neonatal postnatal life and succesful overcome, the fetal cardiovascular transition period are important to stay on. [Archives Medical Review Journal 2016; 25(2.000: 181-190

  7. Cardiovascular hypertensive emergencies.

    Science.gov (United States)

    Papadopoulos, D P; Sanidas, E A; Viniou, N A; Gennimata, V; Chantziara, V; Barbetseas, I; Makris, T K

    2015-02-01

    Inevitably, a small proportion of patients with systematic hypertension will develop hypertensive crisis at some point. Hypertensive crises can be divided into hypertensive emergency or hypertensive urgency according to the presence or lack of acute target organ damage. In this review, we discuss cardiovascular hypertensive emergencies, including acute coronary syndrome, aortic dissection, congestive heart failure, and sympathomimetic hypertensive crises, including those caused by cocaine use. Each presents in a unique fashion, although some hypertensive emergency patients report nonspecific symptoms. Treatment includes several effective and rapid-acting medications to safely reduce the blood pressure, protect remaining end-organ function, relieve symptoms, minimize the risk of complications, and thereby improve patient outcomes.

  8. Fetal cardiovascular physiology.

    Science.gov (United States)

    Rychik, J

    2004-01-01

    The cardiovascular system of the fetus is physiologically different than the adult, mature system. Unique characteristics of the myocardium and specific channels of blood flow differentitate the physiology of the fetus from the newborn. Conditions of increased preload and afterload in the fetus, such as sacrococcygeal teratoma and twin-twin transfusion syndrome, result in unique and complex pathophysiological states. Echocardiography has improved our understanding of human fetal cadiovasvular physiology in the normal and diseased states, and has expanded our capability to more effectively treat these disease processes.

  9. Antioxidantes y enfermedad cardiovascular

    OpenAIRE

    Vázquez, Clotilde

    2004-01-01

    La enfermedad cardiovascular se mantiene como la más importante causa de morbi y mortalidad en la mayoría de los países desarrollados, siendo cada vez más frecuente en los países en vías de desarrollo. La orteroesclerosis es un enfermedad crónica de las arterias de mediano y gran calibre, caracterizadas por el endurecimiento y pérdida de elasticidad de su pared, que se acompaña de estrechamiento de su luz. En general, la lesión arteriosclerótica se desarrolla en tres fases: a) inici...

  10. Pharmacogenetics of cardiovascular drug therapy

    OpenAIRE

    Peters, Bas J.M.; Olaf H Klungel; de Boer, Anthonius; Ch Stricker, Bruno H; Maitland-van der Zee, Anke-Hilse

    2009-01-01

    In developed countries cardiovascular disease is one of the leading causes of death. Cardiovascular drugs such as platelet aggregation inhibitors, oral anticoagulants, antihypertensives and cholesterol lowering drugs are abundantly prescribed to reduce risk of cardiovascular disease. Notable interindividual variation exists in the response to these pharmacotherapeutic interventions, which can be partially explained by factors such as gender, age, diet, concomitant drug use and environmental f...

  11. International Conference on Pathophysiology and Drug Therapy of Cardiovascular Disorders

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@2001 Jan 22-26 Patiala, INDIA Info: Dr Manjeet Singh Professor of Cardiovascular Pharmacology Head, Department of Pharmaceutical Sciences and Drug Research Punjabi University Patiala-147002 Punjab (INDIA) Phn: 91-175-282461/63, ext 6184. Fax: 91-175-283073/282881 E-mail: rnanjeet@pbi. emet. in

  12. Oxidative Stress in Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Gábor Csányi

    2014-04-01

    Full Text Available In the special issue “Oxidative Stress in Cardiovascular Disease” authors were invited to submit papers that investigate key questions in the field of cardiovascular free radical biology. The original research articles included in this issue provide important information regarding novel aspects of reactive oxygen species (ROS-mediated signaling, which have important implications in physiological and pathophysiological cardiovascular processes. The issue also included a number of review articles that highlight areas of intense research in the fields of free radical biology and cardiovascular medicine.

  13. Hurricane Katrina: Impact on Cardiac Surgery Case Volume and Outcomes

    OpenAIRE

    Bakaeen, Faisal G.; Huh, Joseph; Chu, Danny; Coselli, Joseph S.; LeMaire, Scott A.; Mattox, Kenneth L.; Wall, Matthew J.; Wang, Xing Li; Shenaq, Salwa A.; Atluri, Prasad V.; Awad, Samir S.; Berger, David H.

    2008-01-01

    Hurricane Katrina produced a surge of patient referrals to our facility for cardiac surgery. We sought to determine the impact of this abrupt volume change on operative outcomes. Using our cardiac surgery database, which is part of the Department of Veterans Affairs' Continuous Improvement in Cardiac Surgery Program, we compared procedural outcomes for all cardiac operations that were performed in the year before the hurricane (Year A, 29 August 2004–28 August 2005) and the year after (Year B...

  14. Hand-assisted laparoscopic surgery using Gelport

    Directory of Open Access Journals (Sweden)

    Gupta Puneet

    2005-01-01

    Full Text Available Introduction: Minimally invasive surgery has revolutionized general surgery during the past 10 years. However, for more advanced surgical procedures, the acceptance of the minimally invasive approach has been slower than expected. Advanced laparoscopic surgery is complex and time-consuming. The major drawbacks of laparoscopic surgery are two-dimensional view, lack of depth perception and loss of tactile sensation. This has led to the innovation of hand-assisted laparoscopic surgery (HALS. The objective of the present study was to determine that safety of HALS. Materials and Methods: We preformed 18 HALS procedures in our department between July 2003 and January 2005 on patients who had given their informed consent for the use of Gelport. Out of these, 15 were colectomy, 2 nephrectomy and 1 splenectomy. Out of the 18 patients, 13 were males and 5 were females with the age group ranging from 44 to 72 years. Results: Hand-assisted laparoscopic surgery could be completed in 17 patients maintaining all the oncological principals of surgery. The mean operating times were 120 min for right haemicolectomy, 135 min for left colectomy, 150 min for splenectomy, and 150 min for nephrectomy. The patient undergoing radical nephrectomy by HALS had to be converted to open surgery. As the tumour was large and adherent to the spleen and posterior peritoneal wall. Postoperative recovery was excellent with an average hospital stay of 5 days. Histopathology report showed wide clearance and till date we have a good follow up of 30-380 days. Conclusion: Hand-assisted laparoscopic surgery allows tactile sensation and depth perception thereby may simplify the complex procedures. This may result in reduction of operating time and conversion rates at the same time maintaining all the oncological principles. Hand-assisted laparoscopic surgery strikes a perfect balance between an extended open laparotomy incision and an excessively tedious laparoscopic exercise. Hand

  15. Surgery Videos: MedlinePlus

    Science.gov (United States)

    ... Winston-Salem, NC, 1/15/2009) Weight Loss Surgery Laparoscopic Gastric Bypass Surgery (University of Miami Hospital ... Boston, Boston, MA, 6/08/2010) Weight Loss Surgery Laparoscopic Gastric Bypass Surgery (University of Miami Hospital ...

  16. Low Cost Simulator for Heart Surgery Training

    Directory of Open Access Journals (Sweden)

    Roberto Rocha e Silva

    Full Text Available Abstract Objective: Introduce the low-cost and easy to purchase simulator without biological material so that any institution may promote extensive cardiovascular surgery training both in a hospital setting and at home without large budgets. Methods: A transparent plastic box is placed in a wooden frame, which is held by the edges using elastic bands, with the bottom turned upwards, where an oval opening is made, "simulating" a thoracotomy. For basic exercises in the aorta, the model presented by our service in the 2015 Brazilian Congress of Cardiovascular Surgery: a silicone ice tray, where one can train to make aortic purse-string suture, aortotomy, aortorrhaphy and proximal and distal anastomoses. Simulators for the training of valve replacement and valvoplasty, atrial septal defect repair and aortic diseases were added. These simulators are based on sewage pipes obtained in construction material stores and the silicone trays and ethyl vinyl acetate tissue were obtained in utility stores, all of them at a very low cost. Results: The models were manufactured using inert materials easily found in regular stores and do not present contamination risk. They may be used in any environment and maybe stored without any difficulties. This training enabled young surgeons to familiarize and train different surgical techniques, including procedures for aortic diseases. In a subjective assessment, these surgeons reported that the training period led to improved surgical techniques in the surgical field. Conclusion: The model described in this protocol is effective and low-cost when compared to existing simulators, enabling a large array of cardiovascular surgery training.

  17. Cocaine, Marijuana, Hypertension and Cardiovascular Effects

    Directory of Open Access Journals (Sweden)

    Mohammad Hassan Ghadiani

    2015-07-01

    Full Text Available Cocaine is used by more than 14 million people worldwide, about 0.3 percent of the global population age is 15 to 64 years. After alcohol, cocaine is the most common cause of acute drug-related emergency department visits in the United States. Cocaine consumption is more frequently associated with acute cardiovascular illness.  Cocaine stimulates α1, α2, β1 and β2 adrenergic receptors through increased levels of norepinephrine and a lesser extent epinephrine. The cardiovascular effects of cocaine are thought to be similar and regardless to the route of consumption. An acute coronary syndrome is the most common cardiac problem including myocardial ischemia and infarction even in young persons without atherosclerosis, aortic dissection and rupture, arrhythmias, ventricular tachycardia and fibrillation, asystole and finally sudden death. Other cardiovascular effects that caused by cocaine include coronary artery aneurysm, palpitation, sinus tachycardia, increased systemic vascular resistance and hypertension crisis, left ventricular hypertrophy, myocarditis, cardiomyopathy, myocardial fibrosis, bundle branch block, heart block, supraventricular arrhythmia, accelerated atherosclerosis, hypotension, bradycardia and infective endocarditis  among intravenous users.Cocaine by three mechanisms cause ischemia: 1. increased myocardial oxygen demand, 2. decreased coronary blood flow due to coronary artery vasoconstriction and spasm and 3. Coronary artery thrombosis via activation of platelets, stimulation of platelet aggregation and potentiation of thromboxane production.

  18. Incidencia de desnutrición en pacientes quirúrgicos diabéticos y no diabéticos en el servicio de cirugía general Malnutrition incidence in surgical diabetic and non diabetic patients in general surgery department

    Directory of Open Access Journals (Sweden)

    O. M. Solórzano-Pineda

    2012-10-01

    Full Text Available Objetivos: La desnutrición en los pacientes hospitalizados tiene una prevalencia del 30% al 50%. Incrementando la tasa de morbilidad y mortalidad. El objetivo de este estudio es determinar la incidencia de desnutrición en pacientes diabéticos y no diabéticos en el servicio de cirugía general. Métodos: Estudio observacional prospectivo, longitudinal mediante evaluación del estado nutricional por medio de VGS, CONUT, MNA. Resultados: 384 pacientes: 97 quirúrgicos diabéticos, incidencia de desnutrición evaluada por VGS 28,8%, con MNA para pacientes mayores de 65 años incidencia de desnutrición 54,28%. 287 pacientes quirúrgicos no Diabéticos con incidencia de desnutrición por VGS de 12,9%. y con MNA de 52,94%. Conclusiones: La incidencia de desnutrición en pacientes Diabéticos quirúrgicos es el doble que los pacientes no diabéticos. Los pacientes quirúrgicos ancianos diabéticos y no diabéticos tienen la misma incidencia de desnutrición. Por la alta incidencia de desnutrición en los pacientes quirúrgicos que ingresan al servicio de cirugía general se debe valorar el estado nutricional con un método protocolizado, al ingreso con VGS o MNA si tienen más de 65 años y los pacientes internados se deberán seguir evaluando con CONUT.Objectives: The prevalence of hyponutrition among hospitalized patients varies between 30 to 50%, increasing both the morbidity and mortality rates. The aim of this study is to assess the incidence of hyponutrition in diabetic and non-diabetic patients at the General Surgery Department. Methods: Prospective, observation, and longitudinal study assessing the nutritional status by means of VGS, CONUT, and MNA. Results: 384 patients: 97 surgical diabetic patients, incidence of hyponutrition assessed by VGS 28.8%, by MNA among patients older than 65 years 54.28%. Two hundred and eighty seven non-diabetic surgical patients were assessed with an incidence of hyponutrition of 12.9%, and of 52.94% by MNA

  19. Cardiovascular benefits of exercise

    Directory of Open Access Journals (Sweden)

    Agarwal SK

    2012-06-01

    Full Text Available Shashi K AgarwalMedical Director, Agarwal Health Center, NJ, USAAbstract: Regular physical activity during leisure time has been shown to be associated with better health outcomes. The American Heart Association, the Centers for Disease Control and Prevention and the American College of Sports Medicine all recommend regular physical activity of moderate intensity for the prevention and complementary treatment of several diseases. The therapeutic role of exercise in maintaining good health and treating diseases is not new. The benefits of physical activity date back to Susruta, a 600 BC physician in India, who prescribed exercise to patients. Hippocrates (460–377 BC wrote “in order to remain healthy, the entire day should be devoted exclusively to ways and means of increasing one's strength and staying healthy, and the best way to do so is through physical exercise.” Plato (427–347 BC referred to medicine as a sister art to physical exercise while the noted ancient Greek physician Galen (129–217 AD penned several essays on aerobic fitness and strengthening muscles. This article briefly reviews the beneficial effects of physical activity on cardiovascular diseases.Keywords: exercise, cardiovascular disease, lifestyle changes, physical activity, good health

  20. Resveratrol and Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Dominique Bonnefont-Rousselot

    2016-05-01

    Full Text Available The increased incidence of cardiovascular diseases (CVDs has stimulated research for substances that could improve cardiovascular health. Among them, resveratrol (RES, a polyphenolic compound notably present in grapes and red wine, has been involved in the “French paradox”. RES is known for its antioxidant and anti-inflammatory properties and for its ability to upregulate endothelial NO synthase (eNOS. RES was able to scavenge •OH/O2•− and peroxyl radicals, which can limit the lipid peroxidation processes. Moreover, in bovine aortic endothelial cells (BAEC under glucose-induced oxidative stress, RES restored the activity of dimethylargininedimethylaminohydrolase (DDAH, an enzyme that degrades an endogenous inhibitor of eNOS named asymmetric dimethylarginine (ADMA. Thus, RES could improve •NO availability and decrease the endothelial dysfunction observed in diabetes. Preclinical studies have made it possible to identify molecular targets (SIRT-1, AMPK, Nrf2, NFκB…; however, there are limited human clinical trials, and difficulties in the interpretation of results arise from the use of high-dose RES supplements in research studies, whereas low RES concentrations are present in red wine. The discussions on potential beneficial effects of RES in CVDs (atherosclerosis, hypertension, stroke, myocardial infarction, heart failure should compare the results of preclinical studies with those of clinical trials.

  1. Cardiovascular Complications of Pregnancy

    Directory of Open Access Journals (Sweden)

    Maria Carolina Gongora

    2015-10-01

    Full Text Available Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia, gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.

  2. Cardiovascular Complications of Pregnancy.

    Science.gov (United States)

    Gongora, Maria Carolina; Wenger, Nanette K

    2015-10-09

    Pregnancy causes significant metabolic and hemodynamic changes in a woman's physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.

  3. [Intravenous monoanesthesia and antianesthetics in emergency surgery].

    Science.gov (United States)

    D'iachenko, P K; Kostiuchenko, A L

    1984-04-01

    Profiles of using the intravenous mononarcosis (sodium hydroxybutyrate, viadryl , ketamin , sombrevin, seduxen) in urgent surgery and traumatology are analyzed. Choice of certain narcotics is motivated for patients with blood loss and shock, intoxication, insufficiency of kidneys, adrenals and liver, cardio-vascular and respiratory disorders. The problem of antinarcotics is considered with reference to the efficiency of specific (bemegride, gutimine , amtizol , cytochrome "C") and nonspecific ( osmodiuretics , infusion media containing thawing water) antinarcotics . A preliminary assessment of the efficiency of different drugs of antinarcotic action is given.

  4. Cardiac Rehabilitation After Heart Valve Surgery

    DEFF Research Database (Denmark)

    Pollmann, Agathe Gerwina Elena; Frederiksen, Marianne; Prescott, Eva

    2016-01-01

    PURPOSE: Evidence of the effect of cardiac rehabilitation (CR) after heart valve surgery is scarce, but nevertheless CR is recommended for this group of patients. Therefore, this study assessed the effect of CR on exercise capacity, cardiovascular risk factors, and long-term mortality and morbidity......·O2peak) or 6-minute walk test (6MWT). A composite endpoint of all-cause mortality and hospital admission due to myocardial infarction, stroke, heart failure, endocarditis, revascularization, or reoperation was used to assess the hazard ratio between CR attenders and nonattenders. Multivariable...

  5. Sleep duration, cardiovascular disease, and proinflammatory biomarkers

    Directory of Open Access Journals (Sweden)

    Grandner MA

    2013-07-01

    Full Text Available Michael A Grandner,1,2 Megan R Sands-Lincoln,3 Victoria M Pak,2,4 Sheila N Garland1,5 1Behavioral Sleep Medicine Program, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, PA, USA; 2Center for Sleep and Circadian Neurobiology, University of Pennsylvania, PA, USA; 3Center for Evidence Based Medicine, Elsevier Inc, Philadelphia, PA, USA; 4Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, PA, USA; 5Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, PA, USA Abstract: Habitual sleep duration has been associated with cardiometabolic disease, via several mechanistic pathways, but few have been thoroughly explored. One hypothesis is that short and/or long sleep duration is associated with a proinflammatory state, which could increase risk for cardiovascular and metabolic diseases. This hypothesis has been largely explored in the context of experimental sleep deprivation studies which have attempted to demonstrate changes in proinflammatory markers following acute sleep loss in the laboratory. Despite the controlled environment available in these studies, samples tend to lack generalization to the population at large and acute sleep deprivation may not be a perfect analog for short sleep. To address these limitations, population based studies have explored associations between proinflammatory markers and habitual sleep duration. This review summarizes what is known from experimental and cross-sectional studies about the association between sleep duration, cardiovascular disease, and proinflammatory biomarkers. First, the association between sleep duration with both morbidity and mortality, with a focus on cardiovascular disease, is reviewed. Then, a brief review of the potential role of proinflammatory markers in cardiovascular disease is presented. The majority of this review details specific findings related to specific

  6. Correlation research on life style, work pressure, quality of life of nurse in department of thoracic surgery%胸外科护士生活方式及其与工作压力、生活质量的相关性研究

    Institute of Scientific and Technical Information of China (English)

    张艳燕; 陈宁

    2013-01-01

    Objective To investigate correlation of life style,work pressure,quality of life of nurse in department of thoracic surgery.Methods 61 nurses in Department of Thoracic Surgery of General Hospital of PLA from January 2009 to December 2010 were selected and divided according to age,night shift,technical post.All the nurses were investigated by general questionnaire,lifestyle questionnaire,job stressors scale,living quality measuring scale.Data was analyzed by software SPSS 16.0; correlation of life style,work pressure,quality of life was analyzed by Pearson correlation analysis.Results According to sequence in ≤ 30 years,>30-40 years,>40 years,life style score and quality of life score increased significantly,while work pressure score decreased significantly; according to sequence without night work,with night work,life style score and quality of life score decreased significantly,while work pressure score increased significantly; according to sequence in deputy director nurse,charge nurse,nurse,life style score and quality of life score decreased significantly,while work pressure score increased significantly; the differences with each other were statistically significant (P < 0.05).Negative correlation was found between life style and work pressure in each index (P < 0.05).Positive correlation was found between life style and quality of life in each index (P < 0.05).Conclusion Life style of nurses in department of thoracic surgery is better,quality of life is higher,working pressure is lower.Life style and work pressure have negative relation.Life style and quality of life have positive relation.%目的 探讨胸外科护士生活方式及其与工作压力、生活质量的相关性.方法 选取2009年1月~2010年12月在解放军总医院胸外科护士61名,按年龄、夜班情况、职称分类,分别行一般情况调查表、生活方式调查表、工作压力源量表、生活质量评定量表调查,数据资料运用SPSS 16.0软件进行

  7. A clinical approach to obstructive sleep apnea as a risk factor for cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Maeder MT

    2016-03-01

    Full Text Available Micha T Maeder,1 Otto D Schoch,2 Hans Rickli1 1Department of Cardiology, 2Department of Respiratory Medicine, Kantonsspital St Gallen, St Gallen, Switzerland Abstract: Obstructive sleep apnea (OSA is associated with cardiovascular risk factors, cardiovascular diseases, and increased mortality. Epidemiological studies have established these associations, and there are now numerous experimental and clinical studies which have provided information on the possible underlying mechanisms. Mechanistic proof-of-concept studies with surrogate endpoints have been performed to demonstrate that treatment of OSA by continuous positive airway pressure (CPAP has the potential to reverse or at least to attenuate not only OSA but also the adverse cardiovascular effects associated with OSA. However, no randomized studies have been performed to demonstrate that treatment of OSA by CPAP improves clinical outcomes in patients with cardiovascular risk factors and/or established cardiovascular disease and concomitant OSA. In the present review, we summarize the current knowledge on the role of OSA as a potential cardiovascular risk factor, the impact of OSA on cardiac function, the role of OSA as a modifier of the course of cardiovascular diseases such as coronary artery disease, atrial fibrillation, and heart failure, and the insights from studies evaluating the impact of CPAP therapy on the cardiovascular features associated with OSA. Keywords: obstructive sleep apnea, cardiovascular, risk, heart failure, atrial fibrillation, hypertension

  8. Performance, pain, and quality of life on use of central venous catheter for management of pericardial effusions in patients undergoing coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Ghods K

    2016-10-01

    Full Text Available Kamran Ghods,1 Mohammad Reza Razavi,2 Mohammad Forozeshfard3 1Clinical Research Development Unit (CRDU, Department of Cardiovascular Surgery, Kowsar Hospital, 2Nursing Care Research Center, 3Cancer Research Center, Department of Anesthesiology, Semnan University of Medical Sciences, Semnan, Iran Abstract: Different pericardial catheters have been suggested as an effective alternative method for drainage of pericardial effusion. The aim of this study was to determine the performance, pain, and quality of life on use of central venous catheter (CVC for drainage of pericardial effusion in patients undergoing open heart surgery. Fifty-five patients who had developed pericardial effusion after an open heart surgery (2012–2015 were prospectively assessed. Triple-lumen central catheters were inserted under echocardiographic guidance. Clinical, procedural, complication, and outcome details were analyzed. Intensity of pain and quality of life of patients were assessed using the numerical rating scale and Short-Form Health Survey. CVC was inserted for 36 males and 19 females, all of whom had a mean age of 58.5±15 years, and the mean duration of the open heart surgery was 8±3.5 hours. The mean central venous pressure catheter life span was 14.6 days. No cases of recurrent effusion and complication were reported. The technical success rate of procedure was 100%. Intensity of pain and quality of life of patients had improved during follow-up. CVC insertion is a safe and effective technique for the management of pericardial effusion in patients after open heart surgery. Keywords: coronary artery bypass graft, pericardial effusion, central venous catheter

  9. Cheese and cardiovascular disease risk

    DEFF Research Database (Denmark)

    Hjerpsted, Julie Bousgaard; Tholstrup, Tine

    2016-01-01

    Abstract Currently, the effect of dairy products on cardiovascular risk is a topic with much debate and conflicting results. The purpose of this review is to give an overview of the existing literature regarding the effect of cheese intake and risk of cardiovascular disease (CVD). Studies included...

  10. CARS 2008: Computer Assisted Radiology and Surgery. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-06-15

    The proceedings contain contributions to the following topics: digital imaging, computed tomography, magnetic resonance, cardiac and vascular imaging, computer assisted radiation therapy, image processing and display, minimal invasive spinal surgery, computer assisted treatment of the prostate, the interventional radiology suite of the future, interventional oncology, computer assisted neurosurgery, computer assisted head and neck and ENT surgery, cardiovascular surgery, computer assisted orthopedic surgery, image processing and visualization, surgical robotics, instrumentation and navigation, surgical modelling, simulation and education, endoscopy and related techniques, workflow and new concepts in surgery, research training group 1126: intelligent surgery, digital operating room, image distribution and integration strategies, regional PACS and telemedicine, PACS - beyond radiology and E-learning, workflow and standardization, breast CAD, thoracic CAD, abdominal CAD, brain CAD, orthodontics, dentofacial orthopedics and airways, imaging and treating temporomandibular joint conditions, maxillofacial cone beam CT, craniomaxillofacial image fusion and CBCT incidental findings, image guided craniomaxillofacial procedures, imaging as a biomarker for therapy response, computer aided diagnosis. The Poster sessions cover the topics computer aided surgery, Euro PACS meeting, computer assisted radiology, computer aided diagnosis and computer assisted radiology and surgery.

  11. Postoperative mortality after inpatient surgery: Incidence and risk factors

    Directory of Open Access Journals (Sweden)

    Karamarie Fecho

    2008-09-01

    Full Text Available Karamarie Fecho1, Anne T Lunney1, Philip G Boysen1, Peter Rock2, Edward A Norfleet11Department of Anesthesiology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; 2Department of Anesthesiology, University of Maryland, Baltimore, MD, USAPurpose: This study determined the incidence of and identified risk factors for 48 hour (h and 30 day (d postoperative mortality after inpatient operations.Methods: A retrospective cohort study was conducted using Anesthesiology’s Quality Indicator database as the main data source. The database was queried for data related to the surgical procedure, anesthetic care, perioperative adverse events, and birth/death/operation dates. The 48 h and 30 d cumulative incidence of postoperative mortality was calculated and data were analyzed using Chi-square or Fisher’s exact test and generalized estimating equations.Results: The 48 h and 30 d incidence of postoperative mortality was 0.57% and 2.1%, respectively. Higher American Society of Anesthesiologists physical status scores, extremes of age, emergencies, perioperative adverse events and postoperative Intensive Care Unit admission were identified as risk factors. The use of monitored anesthesia care or general anesthesia versus regional or combined anesthesia was a risk factor for 30 d postoperative mortality only. Time under anesthesia care, perioperative hypothermia, trauma, deliberate hypotension and invasive monitoring via arterial, pulmonary artery or cardiovascular catheters were not identified as risk factors.Conclusions: Our findings can be used to track postoperative mortality rates and to test preventative interventions at our institution and elsewhere.Keywords: postoperative mortality, risk factors, operations, anesthesia, inpatient surgery

  12. Indian poverty and cardiovascular disease.

    Science.gov (United States)

    Ramaraj, Radhakrishnan; Alpert, Joseph Stephen

    2008-07-01

    Cardiovascular disease is among the world's leading causes of death, and nearly 80% of deaths occur in developing countries. Cardiovascular disease is becoming a major health problem in India, where life expectancy has increased with decreases in infectious disease and childhood mortality. It is well established that this population experiences coronary artery disease at a younger age than other populations. With infectious diseases still endemic, noncommunicable diseases are a lower priority for the governments of developing countries. There is a clear progression to degenerative and lifestyle-related diseases such as cardiovascular disease as a result of current social and economic change. The lack of a public response to the increasing risk for cardiovascular disease thus far is due mostly to a perception among policy makers and the public that cardiovascular disease is largely a problem of the urban rich. In conclusion, this review addresses the imminent threats and ways to tackle the epidemic in India.

  13. Assessment of cardiovascular risk.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2010-10-01

    Atherosclerotic cardiovascular disease (CVD) is the most common cause of death worldwide. Usually atherosclerosis is caused by the combined effects of multiple risk factors. For this reason, most guidelines on the prevention of CVD stress the assessment of total CVD risk. The most intensive risk factor modification can then be directed towards the individuals who will derive the greatest benefit. To assist the clinician in calculating the effects of these multiple interacting risk factors, a number of risk estimation systems have been developed. This review address several issues regarding total CVD risk assessment: Why should total CVD risk be assessed? What risk estimation systems are available? How well do these systems estimate risk? What are the advantages and disadvantages of the current systems? What are the current limitations of risk estimation systems and how can they be resolved? What new developments have occurred in CVD risk estimation?

  14. Cardiovascular complications in acromegaly.

    Science.gov (United States)

    Vitale, G; Pivonello, R; Lombardi, G; Colao, A

    2004-09-01

    Cardiovascular morbidity and mortality are increased in acromegaly. In fact, GH and IGF-I excess induces a specific cardiomyopathy. The early stage of acromegaly is characterized by the hyperkinetic syndrome (high heart rate and increased systolic output). Frequently, concentric biventricular hypertrophy and diastolic dysfunction occur in acromegaly, leading to an impaired systolic function ending in heart failure if the disease is untreated or unsuccessfully untreated. Besides, abnormalities of cardiac rhythm and of valves have been also described in acromegaly. The coexistence of other complications, such as arterial hypertension and diabetes, aggravates the acromegalic cardiomyopathy. The suppression of GH/IGF-I following an efficacious therapy could decrease left ventricular mass and improve cardiac function. In conclusion, a careful evaluation of cardiac function, morphology and activity seems to be mandatory in acromegaly.

  15. Cardiovascular diseases and diabetes

    DEFF Research Database (Denmark)

    Green, A.; Sortso, C.; Jensen, Peter Bjødstrup

    2016-01-01

    We present an investigation of the occurrence of cardiovascular disease in patients with diabetes in Denmark 2000 through 2011. The Diabetes Impact Study 2013 is based on all registrants in the Danish National Diabetes Register as of July 3rd 2013 (n=497,232). Record linkage with the Danish...... of diabetes has been rather constant at higher level in males (around 16-18%) than in females (around 12-14%) during 2000-2011 (incl.). In contrast, the incidence rate of CVD after having diabetes diagnosis has declined from about 4.5 to less than 3 during the same period, with higher declining level...... for males than for females. Efforts to detect diabetes at an earlier stage have not resulted in a reduced occurrence of CVD at the diagnosis of diabetes in Denmark. However, the risk of developing CVD after the diagnosis of diabetes has been declining, possibly reflecting benefits of intensified treatment...

  16. South American Guidelines for Cardiovascular Disease Prevention and Rehabilitation

    Directory of Open Access Journals (Sweden)

    AH Herdy

    2014-08-01

    Full Text Available In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention and rehabilitation (CVDPR. In the context of the implementation of a regional and national health policy in Latin American countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline and adapt it to the national reality. The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World Health Organization (WHO, which is the reduction of worldwide cardiovascular mortality by 25% until 2025. The study group's priorities are the following: • Emphasize the important role of CVDPR as an instrument of secondary prevention with significant impact on cardiovascular morbidity and mortality; • Join efforts for the knowledge on CVDPR, its dissemination, and adoption in most cardiovascular centers and institutes in South America, prioritizing the adoption of cardiovascular prevention methods that are comprehensive, practical, simple and which have a good cost/benefit ratio; • Improve the education of health professionals and patients with education programs on the importance of CVDPR services, which are directly targeted at the health system, clinical staff, patients, and community leaders, with the aim of decreasing the barriers to CVDPR implementation.

  17. Development of plastic surgery

    Directory of Open Access Journals (Sweden)

    Pećanac Marija Đ.

    2015-01-01

    Full Text Available Introduction. Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient Times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern Era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

  18. Cardiovascular Magnetic Resonance Imaging

    Science.gov (United States)

    Pelc, Norbert

    2000-03-01

    Cardiovascular diseases are a major source of morbidity and mortality in the United States. Early detection of disease can often be used to improved outcomes, either through direct interventions (e.g. surgical corrections) or by causing the patient to modify his or her behavior (e.g. smoking cessation or dietary changes). Ideally, the detection process should be noninvasive (i.e. it should not be associated with significant risk). Magnetic Resonance Imaging (MRI) refers to the formation of images by localizing NMR signals, typically from protons in the body. As in other applications of NMR, a homogeneous static magnetic field ( ~0.5 to 4 T) is used to create ``longitudinal" magnetization. A magnetic field rotating at the Larmor frequency (proportional to the static field) excites spins, converting longitudinal magnetization to ``transverse" magnetization and generating a signal. Localization is performed using pulsed gradients in the static field. MRI can produce images of 2-D slices, 3-D volumes, time-resolved images of pseudo-periodic phenomena such as heart function, and even real-time imaging. It is also possible to acquire spatially localized NMR spectra. MRI has a number of advantages, but perhaps the most fundamental is the richness of the contrast mechanisms. Tissues can be differentiated by differences in proton density, NMR properties, and even flow or motion. We also have the ability to introduce substances that alter NMR signals. These contrast agents can be used to enhance vascular structures and measure perfusion. Cardiovascular MRI allows the reliable diagnosis of important conditions. It is possible to image the blood vessel tree, quantitate flow and perfusion, and image cardiac contraction. Fundamentally, the power of MRI as a diagnostic tool stems from the richness of the contrast mechanisms and the flexibility in control of imaging parameters.

  19. [Bariatric surgery in extremely obese children and adolescents].

    Science.gov (United States)

    Blüher, S; Till, H; Kiess, W

    2011-05-01

    The management of childhood obesity is a clinical dilemma. Validated and evidence-based intervention programs are still missing for this age group, and pediatricians increasingly see children with morbid obesity and with obesity-related comorbidities. For those extremely obese patients who failed to respond to the classical therapeutic approaches, bariatric surgery is a therapeutic option. Although available data for bariatric surgery in childhood and adolescence is limited to date, significant postoperative reduction in BMI and an evident improvement of preoperatively existing metabolic and cardiovascular comorbidities and psychosocial well-being have been reported. The indication for bariatric surgery in adolescents follows strict criteria and should be proposed within an interdisciplinary team in specialized centers, including a clinical ethics committee. This review discusses the present guidelines for bariatric surgery in childhood and adolescence as well as available follow-up data for both adults and pediatric patients.

  20. A four-year cardiovascular risk score for type 2 diabetic inpatients

    Directory of Open Access Journals (Sweden)

    Dolores Ramírez-Prado

    2015-06-01

    Full Text Available As cardiovascular risk tables currently in use were constructed using data from the general population, the cardiovascular risk of patients admitted via the hospital emergency department may be underestimated. Accordingly, we constructed a predictive model for the appearance of cardiovascular diseases in patients with type 2 diabetes admitted via the emergency department. We undertook a four-year follow-up of a cohort of 112 adult patients with type 2 diabetes admitted via the emergency department for any cause except patients admitted with acute myocardial infarction, stroke, cancer, or a palliative status. The sample was selected randomly between 2010 and 2012. The primary outcome was time to cardiovascular disease. Other variables (at baseline were gender, age, heart failure, renal failure, depression, asthma/chronic obstructive pulmonary disease, hypertension, dyslipidaemia, insulin, smoking, admission for cardiovascular causes, pills per day, walking habit, fasting blood glucose and creatinine. A cardiovascular risk table was constructed based on the score to estimate the likelihood of cardiovascular disease. Risk groups were established and the c-statistic was calculated. Over a mean follow-up of 2.31 years, 39 patients had cardiovascular disease (34.8%, 95% CI [26.0–43.6%]. Predictive factors were gender, age, hypertension, renal failure, insulin, admission due to cardiovascular reasons and walking habit. The c-statistic was 0.734 (standard error: 0.049. After validation, this study will provide a tool for the primary health care services to enable the short-term prediction of cardiovascular disease after hospital discharge in patients with type 2 diabetes admitted via the emergency department.

  1. Eye surgery in the elderly

    Directory of Open Access Journals (Sweden)

    Raczyńska D

    2016-04-01

    Full Text Available Dorota Raczyńska, Leopold Glasner, Ewelina Serkies-Minuth, Magdalena A Wujtewicz, Kamila Mitrosz Department of Ophthalmology, Medical University of Gdansk, Gdansk, Poland Abstract: Extending life expectancy is a human achievement. It does however entail problems. Ophthalmic treatments are widely recognized as having a low risk of general complications. A classic example is cataract surgery, considered to be one of the safest and most frequently performed surgical procedures in the world. However, advanced age brings with it risks that should be considered before surgery. Eye operations, as with procedures on other organs, are largely dependent on the quality of surgical tissues. Therefore, the elderly are at increased risk of complications. Improved general health and postoperative follow-up with the use of noninvasive technologies such as optical coherence tomography translate into lower intraoperative risk and better postoperative prognosis. In this review, we discuss the impact of general health on operational prognosis, therapeutic problems, and technical difficulties which a surgeon and anesthesiologist may encounter in the process. We also consider new technology and strategies specifically aimed at treating eye conditions in the elderly. Keywords: eye surgery, eye aging, anesthesiology in ophthalmology, cataract, glaucoma, vitrectomy, age-related macular degeneration

  2. COMPLICATIONS IN LAPAROSCOPIC GYNECOLOGIC SURGERY

    Institute of Scientific and Technical Information of China (English)

    冷金花; 朗景和; 黄荣丽; 刘珠凤; 孙大为

    2000-01-01

    Objective. To investigate retrospectively the complications and associated factors of gynecological laparescopies.Methods. 1769 laparoscopic surgeries were carried out from January 1994 to October 1999 at our department. The procedures included 1421 surgeries of ovary and tube, 52 myomectomies and 296 cases of laproscopic-assisted vaginal hysterectomy (LAVH). A total of 312 patients had a history of prior laparotomy (17.6%). Results. Complications occured in 34 cases, the overall complication rate was 1.92%. Unintended laparotomies occured in 6 cases(0.34% ). 12 complications were associated with insertion of Veress needle or trocar and creation of pneumoperitoneum, including 5 severe emphysema and 7 vascular injuries, this figure represents 35.3% of all complications of this series. Five intraopemtive complications (14.7 % ) occured during the laparescopic surgery (3 severe bleedings, one bladder injury and one skin bum of leg caused by damaged electrode plate), laparotomy was re-quired in four of these cases. Seventeen complications occured during postoperative stage: 2 intraperitoneal hemor-rhages needing laparotomy, 2 bowel injuries, 4 nerve paresis and 9 febrile morbidities. Cordusions. Operative gynecologic laparoscopy is associated with acceptable morbidity rate, but can not be over-looked. Complication rate seems to be higher in advanced procedures such as LAVH.

  3. Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review

    Directory of Open Access Journals (Sweden)

    Michael Mazzeffi

    2015-01-01

    Full Text Available Ketamine is a unique anesthetic drug that provides analgesia, hypnosis, and amnesia with minimal respiratory and cardiovascular depression. Because of its sympathomimetic properties it would seem to be an excellent choice for patients with depressed ventricular function in cardiac surgery. However, its use has not gained widespread acceptance in adult cardiac surgery patients, perhaps due to its perceived negative psychotropic effects. Despite this limitation, it is receiving renewed interest in the United States as a sedative and analgesic drug for critically ill-patients. In this manuscript, the authors provide an evidence-based clinical review of ketamine use in cardiac surgery patients for intensive care physicians, cardio-thoracic anesthesiologists, and cardio-thoracic surgeons. All MEDLINE indexed clinical trials performed during the last 20 years in adult cardiac surgery patients were included in the review.

  4. RECURRENCE PATTERN FOLLOWING BREAST - CONSERVING SURGERY FOR EARLY BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Govindaraj

    2015-08-01

    Full Text Available OBJECTIVE: To study the Local Recurrence and metastasis pattern after Breast - Conserving Surgery for early breast cancer. MATERIALS AND METHODS: From 2010 to 2014 in department of surgery in VIMS Bellary, 70 patients with stage I or II invasive breast carcinoma were treated with breast - conserving surgery, radiation and chemotherapy. In this study we investigated the prognostic value of clinical and pathological factors in early breast cancer patients treated with BCS. All of the surgeries were performed by a single surgical team. Recurrence and its risk factors were evaluated.

  5. Serotype distribution of Streptococcus mutans a pathogen of dental caries in cardiovascular specimens from Japanese patients.

    Science.gov (United States)

    Nakano, Kazuhiko; Nemoto, Hirotoshi; Nomura, Ryota; Homma, Hiromi; Yoshioka, Hideo; Shudo, Yasuhiro; Hata, Hiroki; Toda, Koichi; Taniguchi, Kazuhiro; Amano, Atsuo; Ooshima, Takashi

    2007-04-01

    The involvement of oral bacteria in the pathogenesis of cardiovascular disease has been studied, with Streptococcus mutans, a pathogen of dental caries, detected in cardiovascular lesions at a high frequency. However, no information is available regarding the properties of S. mutans detected in those lesions. Heart valve specimens were collected from 52 patients and atheromatous plaque specimens from 50 patients, all of whom underwent cardiovascular operations, and dental plaque specimens were taken from 41 of those subjects prior to surgery. Furthermore, saliva samples were taken from 73 sets of healthy mothers (n=73) and their healthy children (n=78). Bacterial DNA was extracted from all specimens, then analysed by PCR with S. mutans-specific and serotype-specific primer sets. The detection rates of S. mutans in the heart valve and atheromatous plaque specimens were 63 and 64 %, respectively. Non-c serotypes were identified with a significantly higher frequency in both cardiovascular and dental plaque samples from the subjects who underwent surgery as compared to serotype c, which was detected in 70-75 % of the samples from the healthy subjects. The serotype distribution in cardiovascular patients was significantly different from that in healthy subjects, suggesting that S. mutans serotype may be related to cardiovascular disease.

  6. Evaluation of the cardiovascular effects of varenicline in rats

    Directory of Open Access Journals (Sweden)

    Selçuk EB

    2015-10-01

    Full Text Available Engin Burak Selçuk,1 Meltem Sungu,2 Hakan Parlakpinar,3 Necip Ermiş,4 Elif Taslıdere,5 Nigar Vardı,5 Murat Yalçinsoy,6 Mustafa Sagır,3 Alaaddin Polat,7 Mehmet Karatas,8 Burcu Kayhan-Tetik11Department of Family Medicine, 2Inonu University Medical Faculty, Malatya, Turkey; 3Department of Pharmacology, 4Department of Cardiology, 5Department of Histology and Embryology, 6Department of Pulmonary Medicine, 7Department of Physiology, 8Department of Medical Ethics, Inonu University Medical Faculty, Malatya, TurkeyBackground: Cardiovascular disease is an important cause of morbidity and mortality among tobacco users. Varenicline is widely used worldwide to help smoking cessation, but some published studies have reported associated cardiovascular events.Objective: To determine the cardiovascular toxicity induced by varenicline in rats.Materials and methods: We randomly separated 34 rats into two groups: 1 the control group (given only distilled water orally, n=10 and the varenicline group (given 9 µg/kg/day varenicline on days 1–3, 9 µg/kg twice daily on days 4–7, and 18 µg/kg twice daily on days 8–90 [total 83 days], n=24. Each group was then subdivided equally into acute and chronic subgroups, and all rats in these groups were euthanized with anesthesia overdose on days 45 and 90, respectively. Body and heart weights, hemodynamic (mean oxygen saturation, mean blood pressure, and heart rate, electrocardiographic (PR, QRS, and QT intervals biochemical (oxidants and antioxidants, and histopathological analyses (including immunostaining were performed.Results: Acute varenicline exposure resulted in loss of body weight, while chronic varenicline exposure caused heart weight loss and decreased mean blood pressure, induced lipid peroxidation, and reduced antioxidant activity. Both acute and chronic varenicline exposure caused impairment of mean oxygen saturation. QT interval was prolonged in the chronic varenicline group, while PR interval

  7. Ergonomics in laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Supe Avinash

    2010-01-01

    Full Text Available Laparoscopic surgery provides patients with less painful surgery but is more demanding for the surgeon. The increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. Ergonomic integration and suitable laparoscopic operating room environment are essential to improve efficiency, safety, and comfort for the operating team. Understanding ergonomics can not only make life of surgeon comfortable in the operating room but also reduce physical strains on surgeon.

  8. Ergonomics in Laparoscopic Surgery

    OpenAIRE

    Supe Avinash; Kulkarni Gaurav; Supe Pradnya

    2016-01-01

    Laparoscopic surgery provides patients with less painful surgery but is more demanding for the surgeon. The increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. Ergonomic integration and suitable laparoscopic operating room environment are essential to improve efficiency, safety, and comfort for the operating team. Understanding ergonomics can not only make life of surgeon comf...

  9. 三级甲等医院普外科临床路径病种筛选及实施对策研究%Disease Selection for Clinical Path Application in General Surgery Department of Third-level Grade-A Hospital and the Countermeasures

    Institute of Scientific and Technical Information of China (English)

    刘振红; 王班; 潘艳; 陈荔枝; 曹志辉

    2012-01-01

    目的 确定医院普外科适合开展临床路径的病种,探讨医院在实施临床路径过程中可能遇到的问题,并提出相应的解决对策.方法 在文献复习的基础上,利用临床路径筛选原则和指标对唐山市某三级甲等医院普外科住院患者的病案资料进行描述和分析,确定最适合开发的临床路径病种.随机抽取医院的患者及家属、医护人员和管理人员进行个人访谈,了解临床路径的知晓情况和推行中可能遇到的问题.结果 大隐静脉曲张的病例数、治愈率、出入院诊断符合率、住院时间、住院总费用、住院时间变异系数分别为53例、96.22%、100.00%、(11.16±2.62)d、(8 062.45±2 376.18)元、23.48%;腹股沟斜疝的病例数、治愈率、出入院诊断符合率、住院时间、住院总费用、住院时间变异系数分别为98例、100.00%、100.00%、(8.95±2.30)d、(5 924.35±2 402.15)元、25.70%;急性阑尾炎的病例数、治愈率、出入院诊断符合率、住院时间、住院总费用、住院时间变异系数分别为180例、100.00%、97.22%、(8.82±2.45)d、(5 263.52±2 856.92)元、26.83%.领导是否重视、组织是否健全等是医院开展临床路径过程中可能遇到的问题.结论 普外科的临床路径开发应首选大隐静脉曲张、腹股沟斜疝、急性阑尾炎.医院在临床路径的实施过程中需要注意充分发挥领导的作用,加强宣传,健全组织建设.%Objective To determine some diseases suitable to apply clinical paths in general surgery department, and investigate the possible difficulties in the application of clinical paths and put forth the relevant countermeasures. Methods On the basis of literature review, the basic data of medical records of the inpatients in the general department of a third - level grade - A hospital were described and analyzed by using the selection principle and indexes of clinical paths so as to determine the diseases most suitable for

  10. Nrf2 and cardiovascular defense.

    Science.gov (United States)

    Howden, Reuben

    2013-01-01

    The cardiovascular system is susceptible to a group of diseases that are responsible for a larger proportion of morbidity and mortality than any other disease. Many cardiovascular diseases are associated with a failure of defenses against oxidative stress-induced cellular damage and/or death, leading to organ dysfunction. The pleiotropic transcription factor, nuclear factor-erythroid (NF-E) 2-related factor 2 (Nrf2), regulates the expression of antioxidant enzymes and proteins through the antioxidant response element. Nrf2 is an important component in antioxidant defenses in cardiovascular diseases such as atherosclerosis, hypertension, and heart failure. Nrf2 is also involved in protection against oxidant stress during the processes of ischemia-reperfusion injury and aging. However, evidence suggests that Nrf2 activity does not always lead to a positive outcome and may accelerate the pathogenesis of some cardiovascular diseases (e.g., atherosclerosis). The precise conditions under which Nrf2 acts to attenuate or stimulate cardiovascular disease processes are unclear. Further studies on the cellular environments related to cardiovascular diseases that influence Nrf2 pathways are required before Nrf2 can be considered a therapeutic target for the treatment of cardiovascular diseases.

  11. Nrf2 and Cardiovascular Defense

    Directory of Open Access Journals (Sweden)

    Reuben Howden

    2013-01-01

    Full Text Available The cardiovascular system is susceptible to a group of diseases that are responsible for a larger proportion of morbidity and mortality than any other disease. Many cardiovascular diseases are associated with a failure of defenses against oxidative stress-induced cellular damage and/or death, leading to organ dysfunction. The pleiotropic transcription factor, nuclear factor-erythroid (NF-E 2-related factor 2 (Nrf2, regulates the expression of antioxidant enzymes and proteins through the antioxidant response element. Nrf2 is an important component in antioxidant defenses in cardiovascular diseases such as atherosclerosis, hypertension, and heart failure. Nrf2 is also involved in protection against oxidant stress during the processes of ischemia-reperfusion injury and aging. However, evidence suggests that Nrf2 activity does not always lead to a positive outcome and may accelerate the pathogenesis of some cardiovascular diseases (e.g., atherosclerosis. The precise conditions under which Nrf2 acts to attenuate or stimulate cardiovascular disease processes are unclear. Further studies on the cellular environments related to cardiovascular diseases that influence Nrf2 pathways are required before Nrf2 can be considered a therapeutic target for the treatment of cardiovascular diseases.

  12. Urotensin II in cardiovascular regulation

    Directory of Open Access Journals (Sweden)

    Fraser D Russell

    2008-08-01

    Full Text Available Fraser D RussellSchool of Health and Sport Sciences, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs, Queensland, AustraliaAbstract: Cardiovascular function is modulated by neuronal transmitters, circulating hormones, and factors that are released locally from tissues. Urotensin II (UII is an 11 amino acid peptide that stimulates its’ obligatory G protein coupled urotensin II receptors (UT to modulate cardiovascular function in humans and in other animal species, and has been implicated in both vasculoprotective and vasculopathic effects. For example, tissue and circulating concentrations of UII have been reported to increase in some studies involving patients with atherosclerosis, heart failure, hypertension, preeclampsia, diabetes, renal disease and liver disease, raising the possibility that the UT receptor system is involved in the development and/or progression of these conditions. Consistent with this hypothesis, administration of UT receptor antagonists to animal models of cardiovascular disease have revealed improvements in cardiovascular remodelling and hemodynamics. However, recent studies have questioned this contributory role of UII in disease, and have instead postulated a protective effect on the cardiovascular system. For example, high concentrations of circulating UII correlated with improved clinical outcomes in patients with renal disease or myocardial infarction. The purpose of this review is to consider the regulation of the cardiovascular system by UII, giving consideration to methodologies for measurement of plasma concentrations, sites of synthesis and triggers for release.Keywords: urotensin II, cardiovascular disease, heart failure, hypertension

  13. Surgery center joint ventures.

    Science.gov (United States)

    Zasa, R J

    1999-01-01

    Surgery centers have been accepted as a cost effective, patient friendly vehicle for delivery of quality ambulatory care. Hospitals and physician groups also have made them the vehicles for coming together. Surgery centers allow hospitals and physicians to align incentives and share benefits. It is one of the few types of health care businesses physicians can own without anti-fraud and abuse violation. As a result, many surgery center ventures are now jointly owned by hospitals and physician groups. This article outlines common structures that have been used successfully to allow both to own and govern surgery centers.

  14. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems....

  15. Complications of strabismus surgery

    Directory of Open Access Journals (Sweden)

    Scott E Olitsky

    2015-01-01

    Full Text Available All surgeries carry risks of complications, and there is no way to avoid ever having a complication. Strabismus surgery is no different in this regard. There are methods to reduce the risk of a complication during or after surgery, and these steps should always be taken. When a complication occurs, it is important to first recognize it and then manage it appropriately to allow for the best outcome possible. This article will discuss some of the more common and/or most devastating complications that can occur during or after strabismus surgery as well as thoughts on how to avoid them and manage them should they happen.

  16. Integrated bariatric surgery residency

    Directory of Open Access Journals (Sweden)

    Eltorai AE

    2014-11-01

    Full Text Available Adam EM Eltorai Warren Alpert Medical School of Brown University, RI, USA Abstract: Obesity is a major public health concern. Given its lasting efficacy for improving obesity and obesity-related diseases, bariatric surgery is an increasingly common treatment option. As the implementation of the Affordable Care Act progresses, the impending physician shortage will become more severe. Thus there will be an even greater need for doctors specialized in the management and treatment of obese patients. The development of integrated bariatric surgery residency programs could be considered and is discussed herein. Keywords: obesity, bariatric surgery, integrated residency, surgery education

  17. Hyperoxaluria and Bariatric Surgery

    Science.gov (United States)

    Asplin, John R.

    2007-04-01

    Bariatric surgery as a means to treat obesity is becoming increasingly common in the United States. An early form of bariatric surgery, the jejunoileal bypass, had to be abandoned in 1980 due to numerous complications, including hyperoxaluria and kidney stones. Current bariatric procedures have not been systematically evaluated to determine if they cause hyperoxaluria. Presented here are data showing that hyperoxaluria is the major metabolic abnormality in patients with bariatric surgery who form kidney stones. Further studies are needed to assess the prevalence of hyperoxaluria in all patients with bariatric surgery.

  18. 78 FR 62506 - TRICARE; Coverage of Care Related to Non-Covered Initial Surgery or Treatment

    Science.gov (United States)

    2013-10-22

    ... a non-covered incident of treatment (such as nonadjunctive dental care or cosmetic surgery) but only... Initial Surgery or Treatment AGENCY: Office of the Secretary, Department of Defense. ACTION: Proposed rule... on a determination that a waiver authorizing the original non-covered surgery or treatment...

  19. 21 CFR 874.3540 - Prosthesis modification instrument for ossicular replacement surgery.

    Science.gov (United States)

    2010-04-01

    ... replacement surgery. 874.3540 Section 874.3540 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... § 874.3540 Prosthesis modification instrument for ossicular replacement surgery. (a) Identification. A prosthesis modification instrument for ossicular replacement surgery is a device intended for use by...

  20. Developing criteria for pediatric/adolescent bariatric surgery programs.

    Science.gov (United States)

    Michalsky, Marc; Kramer, Robert E; Fullmer, Michelle A; Polfuss, Michele; Porter, Renee; Ward-Begnoche, Wendy; Getzoff, Elizabeth A; Dreyer, Meredith; Stolzman, Stacy; Reichard, Kirk W

    2011-09-01

    The prevalence of morbid obesity in adolescents is rising at an alarming rate. Comorbidities known to predispose to cardiovascular disease are increasingly being diagnosed in these children. Bariatric surgery has become an acceptable treatment alternative for morbidly obese adults, and criteria have been developed to establish center-of-excellence designation for adult bariatric surgery programs. Evidence suggests that bariatric surgical procedures are being performed with increasing numbers in adolescents. We have examined and compiled the current expert recommendations for guidelines and criteria that are needed to deliver safe and effective bariatric surgical care to adolescents.

  1. Challenges of valve surgeries in post-renal transplant patients.

    Science.gov (United States)

    Ahmad, Tanveer; Kishore, Kolkebaile Sadanand; Maheshwarappa, Nandakumar Neralakere; Pasarad, Ashwini Kumar

    2015-01-01

    Renal transplantation remains a mainstay of therapy for the end-stage renal disease. Cardiac disease has a high prevalence in this patient population. Cardiovascular disease remains the leading cause of death among kidney transplantation patients. The cardiac disease accounts for 43% of all-cause mortality among dialysis patients and for ≈38% of all-cause mortality after transplantation. In this article, we review the factors and outcomes associated with valve surgeries in renal transplant recipients and evaluate the strategy for open heart surgery after renal transplantation performed.

  2. Allopurinol as a therapeutic option in cardiovascular disease.

    Science.gov (United States)

    Okafor, Osita N; Farrington, K; Gorog, Diana A

    2017-04-01

    Epidemiological studies indicate that hyperuricaemia is an independent risk factor for cardiovascular disease. Alongside uric acid formation, increased xanthine oxidase activity also results in the formation of oxidative free radicals and superoxide particles. Oxidative stress significantly contributes to the development of cardiovascular disease, including endothelial cell dysfunction, atherosclerosis, vascular calcification and impaired myocardial energetics. Allopurinol, a competitive xanthine oxidase inhibitor, in addition to reducing serum uric acid levels, can act as a free radical scavenger. Although traditionally used for the management of gout, there has been renewed interest in the role of allopurinol in the management of cardiovascular disease. In this review, we summarise the role of the xanthine oxidase pathway in the generation of oxidative stress and evaluate the current body of evidence assessing the clinical effects of allopurinol in patients with cardiovascular disease. A number of small clinical studies have shown a beneficial effect of allopurinol in reducing ischemia-reperfusion injury in the setting of bypass surgery and coronary angioplasty. Additionally, studies in heart failure indicate a potential favourable effect of allopurinol on endothelial dysfunction, LV function and haemodynamic indices, particularly in those with raised serum uric acid levels. Whilst this cheap and readily available pharmacological option may offer a very cost effective therapeutic option, large-scale prospective studies are required to better delineate its role in reducing hard clinical end-points.

  3. Analysis of preoperative nutritional risk of patients with malignant tumor in the department of general surgery and nursing countermeasures%普外科恶性肿瘤患者术前营养风险分析及护理对策

    Institute of Scientific and Technical Information of China (English)

    孙明侠; 张秀娟

    2012-01-01

    To analyze the factors of preoperative nutritional risk of patients with malignant tumor in the department of general surgery and explore nursing countermeasurcs. Methods:The questionnaire survey was conducted to investigate the nutritional status of 282 patients and analyzed the risk factors to affect nutritional status of the patients. Results:The malnutrition risk existed in 44.1% of the patients. The risk factors included clinical staging, chemotherapy,the taste; of food,digestive tract reaction,anxiety and depression; the availability of objective support,subjective support and social support was the factors to protect preoperative nutritional status of the patients. Conclusion:It is necessary to make a comprehensive analysis of the factors to affect the preoperative nutritional status so as to adopt corresponding nursing measures to reduce the risk and incidence of malnutrition of patients with malignant tumor.%目的:探讨普外科恶性肿瘤患者术前营养风险因素及护理对策.方法:采用问卷调查法对282例患者的营养状况进行调查,分析影响其营养状况的危险因素.结果:44.7%的患者存在营养不良风险.癌症临床分期、化疗、饭菜不合口味、消化道反应、焦虑、抑郁是影响患者术前营养状况的危险因素;客观支持、主观支持、社会支持利用度是患者术前营养状况的保护因素.结论:全面分析影响恶性肿瘤患者术前营养状况的因素,以便采取相应的护理措施降低其术前营养摄入不足的发生率.

  4. Pautas para el uso de terapia de vacío en el Servicio de Cirugía Plástica del Hospital La Fe en Valencia (España Use of vacuum therapy in the Plastic Surgery Department Hospital La Fe, Valencia (Spain

    Directory of Open Access Journals (Sweden)

    A. Hortelano Otero

    2011-12-01

    Full Text Available El tratamiento de heridas complejas, con pérdida de sustancia importante o exposición de estructuras nobles, constituye una práctica diaria en la mayoría de los Servicios de Cirugía Plástica de referencia. A pesar de que el desbridamiento quirúrgico continúa siendo la terapia de elección para el tratamiento de heridas infectadas o con abundantes restos necróticos, el advenimiento de la terapia de vacío y las mejoras tecnológicas experimentadas por dicha terapia en la última década, hacen de su utilización una herramienta coadyuvante para el control del lecho quirúrgico, de los exudados de la herida y de la colonización bacteriana. Presentamos 9 casos clínicos de uso de terapia VAC® en el tratamiento de diversas patologías, tales como: dehiscencia esternal, grandes quemados, traumatismos de extremidades, etc. En todos ellos, esta terapia constituyó un pilar fundamental en el tratamiento de los pacientes facilitando el control del exudado de las heridas, la protección de estructuras nobles y mejorando la calidad de vida y el confort de los pacientes durante su estancia hospitalaria.Treatment of complex wounds that imply loss of substance or important anatomic structures exposure has a great relevance in Plastic Surgery Departments nowadays. Even though surgical debridement keeps on being the principal choice treatment in infected or necrotic wounds, VAC® therapy use and its new technology advances in the last decade, has allowed an option to control bacterial colonization, exudates and surgical wounds. We present 9 cases of vacuum therapy use for treatment of different pathologies such as sternum dehiscence, burned patients, extremities trauma, etc. In all these cases vacuum therapy has been essential in the management of exudates, protection of anatomic vital structures as well as to improve patient's quality of life during hospital stay.

  5. Pautas para el uso de terapia de vacío en el Servicio de Cirugía Plástica del Hospital La Fe en Valencia (España Use of vacuum therapy in the Plastic Surgery Department Hospital La Fe, Valencia (Spain

    Directory of Open Access Journals (Sweden)

    A. Hortelano Otero

    2010-06-01

    Full Text Available El tratamiento de heridas complejas, con pérdida de sustancia importante o exposición de estructuras nobles, constituye una práctica diaria en la mayoría de los Servicios de Cirugía Plástica de referencia. A pesar de que el desbridamiento quirúrgico continúa siendo la terapia de elección para el tratamiento de heridas infectadas o con abundantes restos necróticos, el advenimiento de la terapia de vacío y las mejoras tecnológicas experimentadas por dicha terapia en la última década, hacen de su utilización una herramienta coadyuvante para el control del lecho quirúrgico, de los exudados de la herida y de la colonización bacteriana. Presentamos 9 casos clínicos de uso de terapia VAC® en el tratamiento de diversas patologías, tales como: dehiscencia esternal, grandes quemados, traumatismos de extremidades, etc. En todos ellos, esta terapia constituyó un pilar fundamental en el tratamiento de los pacientes facilitando el control del exudado de las heridas, la protección de estructuras nobles y mejorando la calidad de vida y el confort de los pacientes durante su estancia hospitalaria.Treatment of complex wounds that imply loss of substance or important anatomic structures exposure has a great relevance in Plastic Surgery Departments nowadays. Even though surgical debridement keeps on being the principal choice treatment in infected or necrotic wounds, VAC® therapy use and its new technology advances in the last decade, has allowed an option to control bacterial colonization, exudates and surgical wounds. We present 9 cases of vacuum therapy use for treatment of different pathologies such as sternum dehiscence, burned patients, extremities trauma, etc. In all these cases vacuum therapy has been essential in the management of exudates, protection of anatomic vital structures as well as to improve patient's quality of life during hospital stay.

  6. 术中腿部按摩对预防血管外科患者下肢深静脉血栓形成的作用%Effect of intraoperative leg massage on deep venous thrombosis of lower extremity in patients of vascular surgery department

    Institute of Scientific and Technical Information of China (English)

    宋玲; 董瑶; 罗琦; 侯琳; 刘芬; 陈哲; 陈忠

    2014-01-01

    Objective To explore the effect of leg massage during operation on deep venous thrombosis(DVT)in patients of vascular surgery department.Methods Ninety-four DVT patients were randomized into experiment group and control group according to the computer-generated numbers ,46 cases in the latter and 48 in the former.The routine care measures were applied in the control group, while intraoperative leg massage was used in the observation group.The two groups were compared in terms of curative effect and the incidence of DVT.Result The incidences of DVT in the experiment group and the control one were 2.08%(1/48)and 15.22%(7/46)respectively, showing significant difference between them(P<0.05).Conclusion The intraoperative lag massage are significant in the reduction of DVT incidences after operation.%目的:探讨术中腿部按摩对预防血管外科患者下肢深静脉血栓(deep venous thrombosis,DVT)形成的作用效果。方法根据计算机产生随机数将94例患者分为对照组46例,实验组48例。对照组手术前后实施常规护理,实验组在对照组基础上,术中实施腿部按摩,观察和比较两组患者DVT发生情况。结果实验组患者DVT发生率为2.08%(1/48),对照组为15.22%(7/46),两组比较,χ2=3.654,差异有统计学意义(P<0.05)。结论通过预防前移,在术中对患者实施腿部按摩,能有效地降低血管外科患者DVT的发生。

  7. Undergraduates' understanding of cardiovascular phenomena.

    Science.gov (United States)

    Michael, Joel A; Wenderoth, Mary Pat; Modell, Harold I; Cliff, William; Horwitz, Barbara; McHale, Philip; Richardson, Daniel; Silverthorn, Dee; Williams, Stephen; Whitescarver, Shirley

    2002-12-01

    Undergraduates students in 12 courses at 8 different institutions were surveyed to determine the prevalence of 13 different misconceptions (conceptual difficulties) about cardiovascular function. The prevalence of these misconceptions ranged from 20 to 81% and, for each misconception, was consistent across the different student populations. We also obtained explanations for the students' answers either as free responses or with follow-up multiple-choice questions. These results suggest that students have a number of underlying conceptual difficulties about cardiovascular phenomena. One possible source of some misconceptions is the students' inability to apply simple general models to specific cardiovascular phenomena. Some implications of these results for teachers of physiology are discussed.

  8. Fish cardiovascular physiology and disease.

    Science.gov (United States)

    Sherrill, Johanna; Weber, E Scott; Marty, Gary D; Hernandez-Divers, Stephen

    2009-01-01

    Fish patients with cardiovascular disorders present a challenge in terms of diagnostic evaluation and therapeutic options. Veterinarians can approach these cases in fish using methods similar to those employed for other companion animals. Clinicians who evaluate and treat fish in private, aquarium, zoologic, or aquaculture settings need to rely on sound clinical judgment after thorough historical and physical evaluation. Pharmacokinetic data and treatments specific to cardiovascular disease in fish are limited; thus, drug types and dosages used in fish are largely empiric. Fish cardiovascular anatomy, physiology, diagnostic evaluation, monitoring, common diseases, cardiac pathologic conditions, formulary options, and comprehensive references are presented with the goal of providing fish veterinarians with clinically relevant tools.

  9. Less extensive surgery compared to extensive surgery

    DEFF Research Database (Denmark)

    Lauszus, Finn F; Petersen, Astrid Christine; Neumann, Gudrun

    2014-01-01

    OBJECTIVE: To describe the outcome of adult granulosa cell tumor (AGCT) with respect to initial clinical findings, methods of surgery, and perioperative treatment. STUDY DESIGN: Retrospective follow-up study. Setting: All hospitals in Jutland. Sample: 163 women diagnosed with AGCT. Methods: Follow......-up by hospital data files, general practitioner, death certificate, and autopsy report. Revision of histopathology by a single pathologist. Main outcome measures: Survival and relapse by clinical data, stage, and type of surgery. RESULTS: The incidence of AGCT was 1.37 per year per 100,000 women (95% CI: 1.08, 1...... in postmenopausal women was associated with surgery including hysterectomy and bilateral oophorectomy (psurgery. Endometrial carcinoma was found 138 times (95% CI: 48, 275) more prevalent than the expected rate. CONCLUSION...

  10. Metabolic surgery: who and when?: Is there a good answer?

    Directory of Open Access Journals (Sweden)

    R. Cohen

    Full Text Available Currently there is little doubt that the body mass index (BMI is not an appropriate tool to grant access to metabolic surgery, especially in type 2 diabetics (T2D. Several studies are pointing towards other parameters that should go along with BMI in the treatment decision tree in non morbidly obese diabetics. Insulin resistance, fat distribution among others are considered good tools to predict favorable outcomes in medically non controlled diabetics if sent to surgery. The bottom line in good T2D control is to decrease cardiovascular mortality. Using adequate tools to screen patients to the appropriate surgical treatment may favor patients that are not under control after lifestyle changes and best medical treatment, thus decreasing longterm cardiovascular mortality secondary to type 2 diabetes.

  11. Carotenoids and cardiovascular health.

    Science.gov (United States)

    Voutilainen, Sari; Nurmi, Tarja; Mursu, Jaakko; Rissanen, Tiina H

    2006-06-01

    Cardiovascular disease (CVD) is the main cause of death in Western countries. Nutrition has a significant role in the prevention of many chronic diseases such as CVD, cancers, and degenerative brain diseases. The major risk and protective factors in the diet are well recognized, but interesting new candidates continue to appear. It is well known that a greater intake of fruit and vegetables can help prevent heart diseases and mortality. Because fruit, berries, and vegetables are chemically complex foods, it is difficult to pinpoint any single nutrient that contributes the most to the cardioprotective effects. Several potential components that are found in fruit, berries, and vegetables are probably involved in the protective effects against CVD. Potential beneficial substances include antioxidant vitamins, folate, fiber, and potassium. Antioxidant compounds found in fruit and vegetables, such as vitamin C, carotenoids, and flavonoids, may influence the risk of CVD by preventing the oxidation of cholesterol in arteries. In this review, the role of main dietary carotenoids, ie, lycopene, beta-carotene, alpha-carotene, beta-cryptoxanthin, lutein, and zeaxanthin, in the prevention of heart diseases is discussed. Although it is clear that a higher intake of fruit and vegetables can help prevent the morbidity and mortality associated with heart diseases, more information is needed to ascertain the association between the intake of single nutrients, such as carotenoids, and the risk of CVD. Currently, the consumption of carotenoids in pharmaceutical forms for the treatment or prevention of heart diseases cannot be recommended.

  12. 层级护理联合弹性排班对外科护士工作压力及幸福感的影响%Effect of Stratified Nursing Combined with Flexible Shift Arrangement on Work Stress and Subjective Well-being among Nurses in Surgery Department

    Institute of Scientific and Technical Information of China (English)

    金艳

    2015-01-01

    Objective To explore the application effect of stratified nursing combined with flexible shift arrangement among nurses in surgery department.Methods We carried out nursing model reform in nursing department to improve nursing efficacy and reduce work stress of nurses. Stratified management combined with flexible shift arrangement were implemented. Nurses' work stress, working enthusiasm, subjective well-being and life quality before and after the nursing model reform were compared. Results After the implementation of stratified management combined with flexible shift arrangement, nurses' working enthusiasm was better than before, and their work stress and professional burnout were less than before. The differences were statistically significant (P<0.05). In the aspect of life quality, the scores of nurses' mental status, appetite and sleep quality were significantly higher than before, and nurses' situation in the aspect of happiness index was also better than before with significant difference (P<0.05). Conclusion Stratified management combined with flexible shift arrangement can take full advantage of nurses at various levels and their talents while lessening their work pressure and raising subjective well-being.%目的探讨层级护理联合弹性排班在外科护士护理中的应用效果。方法为提高外科护士的护理效能,降低护士工作压力,我院护理部改革护理模式,对护士实施层级管理并进行弹性排班,比较护理管理模式改革前后护士工作压力、工作积极性、幸福感和生活质量的变化。结果层级管理联合弹性排班后,护士的工作积极性高于管理前,工作压力和倦怠感低于管理前,均有统计学意义(P<0.05)。护士在精神状态、食欲、睡眠等生活质量方面的评分均高于管理前,幸福指数方面好于管理前,有统计学意义(P<0.05)。结论层级管理联合弹性排班能够充分发挥各层级护士的优势,人尽其才

  13. Superior oblique surgery: when and how?

    Directory of Open Access Journals (Sweden)

    Taylan Şekeroğlu H

    2013-08-01

    Full Text Available Hande Taylan Şekeroğlu,1 Ali Sefik Sanac,1 Umut Arslan,2 Emin Cumhur Sener11Department of Ophthalmology, 2Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, TurkeyBackground: The purpose of this paper is to review different types of superior oblique muscle surgeries, to describe the main areas in clinical practice where superior oblique surgery is required or preferred, and to discuss the preferred types of superior oblique surgery with respect to their clinical outcomes.Methods: A consecutive nonrandomized retrospective series of patients who had undergone superior oblique muscle surgery as a single procedure were enrolled in the study. The diagnosis, clinical features, preoperative and postoperative vertical deviations in primary position, type of surgery, complications, and clinical outcomes were reviewed. The primary outcome measures were the type of strabismus and the type of superior oblique muscle surgery. The secondary outcome measure was the results of the surgeries.Results: The review identified 40 (20 male, 20 female patients with a median age of 6 (2–45 years. Nineteen patients (47.5% had Brown syndrome, eleven (27.5% had fourth nerve palsy, and ten (25.0% had horizontal deviations with A pattern. The most commonly performed surgery was superior oblique tenotomy in 29 (72.5% patients followed by superior oblique tuck in eleven (27.5% patients. The amount of vertical deviation in the fourth nerve palsy and Brown syndrome groups (P = 0.01 for both and the amount of A pattern in the A pattern group were significantly reduced postoperatively (P = 0.02.Conclusion: Surgery for the superior oblique muscle requires experience and appropriate preoperative evaluation in view of its challenging nature. The main indications are Brown syndrome, fourth nerve palsy, and A pattern deviations. Superior oblique surgery may be effective in terms of pattern collapse and correction of vertical deviations in primary

  14. Effect of surgery on cardiac structure and function in mild primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Persson, Anita; Bollerslev, Jens; Rosen, Thord

    2011-01-01

    The cardiovascular (CV) risk profile is worsened in primary hyperparathyroidism (PHPT), and CV mortality is related to serum calcium levels. It is unknown whether CV mortality is increased in the most common form of PHPT and whether the increased CV risk is reversible after surgery.......The cardiovascular (CV) risk profile is worsened in primary hyperparathyroidism (PHPT), and CV mortality is related to serum calcium levels. It is unknown whether CV mortality is increased in the most common form of PHPT and whether the increased CV risk is reversible after surgery....

  15. High quality nursing effect on research and improve the quality of clinical nursing of cardiovascular department of Internal Medicine%优质护理对提高心血管内科临床护理质量的影响研究

    Institute of Scientific and Technical Information of China (English)

    骆梅

    2014-01-01

    Objective To discuss the study and analysis of the impact of quality care to improve the quality of clinical care in cardiovascular medicine. Methods 200 cases of cardiovascular medicine-related information in patients from June 2013 to February 2014 between. Randomization. A group of ordinary care, that is, in the control group. Another group of high quality care group, namely the experimental group. Clinical outcomes and nursing satisfaction with the two groups of patients care. Results By comparison, high-quality patient care and clinical treatment group was better than in the control group patients, and signiifcantly higher satisfaction with care. Conclusions In clinical quality care available for the promotion and use.%目的:讨论及分析优质护理对提高心血管内科临床护理质量的影响研究。方法收集心血管内科2013年6月~2014年2月之间的200例患者的相关资料。随机分组。一组采用普通护理,即为对照组。另一组采用优质护理组,即为实验组。观察两组患者护理后临床治疗效果和护理满意度。结果通过比较发现,优质护理组患者临床疗效优于对照组患者,且护理满意度明显高于对照组。结论优质护理在临床上可进行推广和使用。

  16. Cardiovascular autonomic neuropathy in diabetes

    DEFF Research Database (Denmark)

    Spallone, Vincenza; Ziegler, Dan; Freeman, Roy

    2011-01-01

    in type 2 diabetes. CAN is a risk marker of mortality and cardiovascular morbidity, and possibly a progression promoter of diabetic nephropathy. Criteria for CAN diagnosis and staging are: 1. one abnormal cardio-vagal test identifies possible or early CAN; 2. at least two abnormal cardio-vagal tests....... diagnosis of CAN clinical forms, 2. detection and tailored treatment of CAN clinical correlates (e.g. tachycardia, OH, nondipping, QT interval prolongation), 3. risk stratification for diabetic complications and cardiovascular morbidity and mortality, and 4. modulation of targets of diabetes therapy......Cardiovascular Autonomic Neuropathy (CAN) Subcommittee of Toronto Consensus Panel on Diabetic Neuropathy worked to update CAN guidelines, with regard to epidemiology, clinical impact, diagnosis, usefulness of CAN testing, and management. CAN is the impairment of cardiovascular autonomic control...

  17. Cardiac Procedures and Surgeries

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Cardiac Procedures and Surgeries Updated:Sep 16,2016 If you've had ... degree of coronary artery disease (CAD) you have. Cardiac Procedures and Surgeries Angioplasty Also known as Percutaneous Coronary Interventions [PCI], ...

  18. [Robotic surgery in gynecology].

    Science.gov (United States)

    Csorba, Roland

    2012-06-24

    Minimally invasive surgery has revolutionized gynecological interventions over the past 30 years. The introduction of the da Vinci robotic surgery in 2005 has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. It can be utilized mainly in general gynecology and reproductive gynecology. The robot is being increasingly used for procedures such as hysterectomy, myomectomy, adnexal surgery, and tubal anastomosis. In urogynecology, the robot is being utilized for sacrocolopexy as well. In the field of gynecologic oncology, the robot is being increasingly used for hysterectomy and lymphadenectomy in oncologic diseases. Despite the rapid and widespread adaption of robotic surgery in gynecology, there are no randomized trials comparing its efficacy and safety to other traditional surgical approaches. This article presents the development, technical aspects and indications of robotic surgery in gynecology, based on the previously published reviews. Robotic surgery can be highly advantageous with the right amount of training, along with appropriate patient selection. Patients will have less blood loss, less post-operative pain, faster recovery, and fewer complications compared to open surgery and laparoscopy. However, until larger randomized control trials are completed which report long-term outcomes, robotic surgery cannot be stated to have priority over other surgical methods.

  19. [Cognitive deterioration after surgery

    DEFF Research Database (Denmark)

    Steinmetz, J.; Rasmussen, L.S.

    2008-01-01

    Delirium and postoperative cognitive dysfunction are important and common complications after surgery. Risk factors are first of all increasing age and type of surgery, whereas the type of anaesthesia does not seem to play an important role. Mortality is higher among patients with cognitive...

  20. [Bariatric surgery in the treatment of severe obesity].

    Science.gov (United States)

    Dhahri, Abdennaceur; Qassemyar, Quentin; Verhaeghe, Pierre; Desailloud-Godard, Rachel; Badaoui, Rachid; Regimbeau, Jean-Marc

    2009-11-20

    Over the past ten years, the treatment of severe obesity has radically changed through the benefits of bariatric surgery not only on weight loss significant and lasting, but also on reducing mortality, correction of metabolic disorders, reduction of cardiovascular risk and improving the quality of life. Its indication should be multidisciplinary. Laparoscopy has become the rule, reducing the postoperative morbimortality. Four types of intervention are regularly performed in France. We report their principle, their results and major complications.

  1. [Subclinical hypothyroidism and cardiovascular risk].

    Science.gov (United States)

    López Rubio, María Antonia; Tárraga López, Pedro Juan; Rodríguez Montes, José Antonio; Frías López, María del Carmen; Solera Albero, Juan; Bermejo López, Pablo

    2015-05-01

    Objetivos: Valorar si el hipotiroidismo subclínico puede comportarse como un factor de riesgo cardiovascular o un modificador del mismo, identificando variables epidemiológicas y riesgo cardiovascular estimado en una muestra de sujetos diagnosticados en la provincia de Albacete. Método: Estudio observacional, descriptivo y transversal realizado en Albacete durante la primera quincena de enero de 2012 en pacientes de ambos géneros con hipotiroidismo subclínico. Se analizaron las siguientes variables: glucemia basal, colesterol total, colesterol HDL, colesterol LDL, triglicéridos, TSH, T4, peso, talla, I.M.C., tensión arterial, antecedentes de patología cardiovascular, factores de riesgo cardiovascular y riesgo cardiovascular estimado. Resultados: Se obtuvieron 326 pacientes, con predominio femenino (79,2 %), menores de 65 años en el 78% y sin factores de riesgo cardiovascular en el 48,61%. La prevalencia de los factores de riesgo cardiovascular identificados fué: tabaquismo (33,2%), diabetes mellitus (24,9%), hipertensión arterial (23,4%), alteraciones lipídicas (28,9%) y fibrilación auricular (4,9 %). No se encontró asociación entre hipotiroidismo subclínico y la mayoría de los parámetros del perfil lipídico que condicionan un perfil pro-aterogénico, salvo con la hipertrigliceridemia. Asimismo, tampoco se constató asociación con riesgo cardiovascular aumentado. Conclusiones: El perfil del paciente con hipotiroidismo subclínico es una mujer de mediana edad sin factores de riesgo cardiovascular en la mitad de casos. Se ha encontrado relación entre hipotiroidismo subclínico e hipertrigliceridemia, pero no con el resto de parámetros del perfil lipídico, otros factores de riesgo cardiovascular o con aumento de dicho riesgo. Sin embargo, un 25% de diabéticos y un 22% de no diabéticos están en situación de riesgo cardiovascular moderado-alto.

  2. 预防肝胆外科手术患者尿路感染目标管理的应用研究%Application of target safety management for prevention of urinary tract infections in surgical patients of department of hepatobiliary surgery

    Institute of Scientific and Technical Information of China (English)

    朱俊青; 郭芳; 孙会凤; 陈虎; 赵冀安; 郑素芬

    2015-01-01

    OBJECTIVE To explore the effect of target safety management on prevention of urinary catheter-associ-ated urinary tract infections in the surgical patients of department of hepatobiliary surgery so as to provide data support for taking effective prevention measures .METHODS A total of 200 patients who were treated in the hospi-tal from Jan 2011 to Dec 2013 were enrolled in the study and randomly divided into the observation group and con-trol group ,with 100 cases in each group .The control group was treated with conventional intervention ,while the observation group was given the target safety management intervention ;the incidence of the catheter-associated u-rinary tract infections ,catheter indwelling time ,incidence of bacteriuria ,isolation rate of pathogenic bacteria , qualified rate of samples collection ,and rate of repeated intubation were observed and compared between the two groups .RESULTS The incidence of the infections was 2 .0% in the observation group ,lower than that of the con-trol group ;the incidence of bacteriuria was 3 .0% in the observation group ,lower than that of the control group , there was significant difference between the two groups (P< 0 .05) .The qualified rates of spot check of hand hy-giene ,air in the ward ,and object surfaces of the observation group were respectively 97 .0% ,94 .0% ,and 95 .0% ,higher than those of the control group ,there was significant difference between the two groups (P <0 .05) .The rate of repeated intubation of the observation group was 7 .0% ,lower than 18 .0% of the control group ;the catheter indwelling time of the observation group was (2 .11 ± 0 .47)days ,shorter than (2 .31 ± 0 .63) days of the control group ,and there was significant difference between the two groups (P< 0 .05) .CONCLUSION The implementation of the target safety management can remarkably reduce the incidence of the catheter -associated urinary tract infections in the surgical patients of department of hepatobiliary surgery

  3. 心胸外科术后患者肺部感染改良体位引流效果的临床分析%Clinical effect of modified postural drainage on treatment of postoperative pulmonary infections in patients of department of cardiothoracic surgery

    Institute of Scientific and Technical Information of China (English)

    钮林霞; 余雪; 杨峰

    2014-01-01

    OBJECTIVE To explore the effect of modified postural drainage sputum on treatment of the patients with postoperative refractory pulmonary infections in the department of cardiothoracic surgery and put forward inter-vention measures .METHODS From Jun 2011 to Jul 2013 ,a total of 67 patients who underwent the cardiothoracic surgery and were complicated with postoperative refractory pulmonary infections were enrolled in the study and randomly divided into two groups .On the basis of the conventional therapy ,the control group with 34 patients was treated with Trendelenburg sputum drainage ,the observation group with 33 patients was given the sputum drain-age by using Trendelenburg ,45 ° semi-recumbent position ,and high head low foot prone position ,and the major observation indicators and therapeutic effects were observed and compared between the two groups after two weeks .RESULTS After the postural sputum drainage ,the PaO2 was (96 .32 ± 6 .26) mm Hg in the observation group ,(72 .32 ± 5 .98)mm Hg in the control group ;the PaCO2 was (34 .63 ± 4 .38)mm Hg was in the observation group ,(40 .56 ± 5 .66)mm Hg in the control group ;the white blood cells counts were (10 .15 ± 2 .71) × 109/L in the observation group ,(13 .78 ± 3 .15) × 109/L in the control group ;the body temperature was (36 .46 ± 0 .53)℃in the observation group ,(37 .15 ± 0 .93)℃ in the control group ;the daily sputum volume was (451 .24 ± 36 .18) ml in the observation group ,(324 .86 ± 24 .36)ml in the control group ;the daily deoxygenation time was (14 .98 ± 1 .23)hours in the observation group ,(7 .84 ± 0 .95)hours in the control group ;the sputum was cultured nega-tive in 28 cases in the observation group ,22 cases in the control group ;the time of use of antibiotics was (13 .53 ± 1 .68)days in the observation group ,(24 .35 ± 1 .26)days in the control group ;there were 29 cases of shrink of pulmonary infection lesions in the observation group and 23 cases in the control group

  4. Exercise and the Cardiovascular System

    OpenAIRE

    Saeid Golbidi; Ismail Laher

    2012-01-01

    There are alarming increases in the incidence of obesity, insulin resistance, type II diabetes, and cardiovascular disease. The risk of these diseases is significantly reduced by appropriate lifestyle modifications such as increased physical activity. However, the exact mechanisms by which exercise influences the development and progression of cardiovascular disease are unclear. In this paper we review some important exercise-induced changes in cardiac, vascular, and blood tissues and discuss...

  5. Stress and atherosclerotic cardiovascular disease.

    Science.gov (United States)

    Inoue, Nobutaka

    2014-01-01

    Recent major advances in medical science have introduced a wide variety of treatments against atherosclerosis-based cardiovascular diseases, which has led to a significant reduction in mortality associated with these diseases. However, atherosclerosis-based cardiovascular disease remains a leading cause of death. Furthermore, progress in medical science has demonstrated the pathogenesis of cardiovascular disease to be complicated, with a wide variety of underlying factors. Among these factors, stress is thought to be pivotal. Several types of stress are involved in the development of cardiovascular disease, including oxidative stress, mental stress, hemodynamic stress and social stress. Accumulating evidence indicates that traditional risk factors for atherosclerosis, including diabetes, hyperlipidemia, hypertension and smoking, induce oxidative stress in the vasculature. Oxidative stress is implicated in the pathogenesis of endothelial dysfunction, atherogenesis, hypertension and remodeling of blood vessels. Meanwhile, mental stress is a well-known major contributor to the development of cardiovascular disease. The cardiovascular system is constantly exposed to hemodynamic stress by the blood flow and/or pulsation, and hemodynamic stress exerts profound effects on the biology of vascular cells and cardiomyocytes. In addition, social stress, such as that due to a lack of social support, poverty or living alone, has a negative impact on the incidence of cardiovascular disease. Furthermore, there are interactions between mental, oxidative and hemodynamic stress. The production of reactive oxygen species is increased under high levels of mental stress in close association with oxidative stress. These stress responses and their interactions play central roles in the pathogenesis of atherosclerosis-based cardiovascular disease. Accordingly, the pathophysiological and clinical implications of stress are discussed in this article.

  6. Vitamin D and Cardiovascular Disease

    OpenAIRE

    Vivian Cristina Garcia; Lígia Araújo Martini

    2010-01-01

    Vitamin D insufficiency/deficiency has been observed worldwide at all stages of life. It has been characterized as a public health problem, since low concentrations of this vitamin have been linked to the pathogenesis of several chronic diseases. Several studies have suggested that vitamin D is involved in cardiovascular diseases and have provided evidence that it has a role in reducing cardiovascular disease risk. It may be involved in regulation of gene expression through the presence of vi...

  7. Vitamin D and Cardiovascular Disease

    OpenAIRE

    Grübler, Martin R.; Martin Gaksch; Thomas Pieber; Katharina Kienreich; Nicolas Verheyen; Andreas Tomaschitz; Stefan Pilz

    2013-01-01

    Vitamin D deficiency, as well as cardiovascular diseases (CVD) and related risk factors are highly prevalent worldwide and frequently co-occur. Vitamin D has long been known to be an essential part of bone metabolism, although recent evidence suggests that vitamin D plays a key role in the pathophysiology of other diseases, including CVD, as well. In this review, we aim to summarize the most recent data on the involvement of vitamin D deficiency in the development of major cardiovascular risk...

  8. Gender effect on vascular inflammation following bariatric surgery.

    Science.gov (United States)

    Blum, Arnon; Tamir, Snait; Hazzan, David; Podvitzky, Oxana; Sirchan, Rizak; Keinan-Boker, Lital; Ben-Shushan, Rotem Shelly; Blum, Nava; Suliman, Laylee Shaich; Geron, Nissim

    2012-01-01

    Studies have shown that mortality was reduced by 31.6% in patients that underwent bariatric surgery compared with the non-operative control group. However, in most surgical series the majority of patients were women, and men had higher post-operative mortality rates and a higher postoperative morbidity, regardless of weight. Our primary end point was to study gender effects on vascular inflammation following bariatric surgery for weight loss. Methods. A prospective study evaluated vascular inflammation in obese patients before and three months after bariatric surgery. Markers of vascular inflammation were measured - before surgery and three months afterwards. Results. One hundred and two patients (73 women and 29 men, 40.5 ± 12.3 years old) underwent bariatric surgery. Correlation was found between BMI change and waist circumference change (r = 0.658, P women; P = 0.05) and hypertension (men > women; P = 0.06). In women, following bariatric surgery, BMI was decreased (pbariatric surgery, BMI was decreased (p = 0.001) (a decrease of 8.1), waist circumference was reduced (pbariatric surgery on vascular inflammation. Bariatric surgery had no significant effect on biochemical inflammatory markers in male patients, while females undergoing the same kind of bariatric surgery for weight loss showed a significant decrease in these markers of inflammation. These results may explain the epidemiological data that described higher morbidity and mortality among obese men undergoing bariatric operation for weight loss. This is the first study that has demonstrated a gender difference in the inflammatory responses that may affect clinical outcome, and cardiovascular morbidity and mortality.

  9. Fire Department Emergency Response

    Energy Technology Data Exchange (ETDEWEB)

    Blanchard, A. [Westinghouse Savannah River Company, AIKEN, SC (United States); Bell, K.; Kelly, J.; Hudson, J.

    1997-09-01

    In 1995 the SRS Fire Department published the initial Operations Basis Document (OBD). This document was one of the first of its kind in the DOE complex and was widely distributed and reviewed. This plan described a multi-mission Fire Department which provided fire, emergency medical, hazardous material spill, and technical rescue services.

  10. Chairing a Small Department.

    Science.gov (United States)

    Bowker, Lee H.; Lynch, David M.

    Ten management problems for chairs of small departments in small colleges are discussed, along with problem-solving strategies for these administrators. Serious disagreements within a small and intimate department may create a country club culture in which differences are smoothed over and the personal idiosyncrasies of individual members are…

  11. ROBOTIC SURGERY: BIOETHICAL ASPECTS

    Science.gov (United States)

    SIQUEIRA-BATISTA, Rodrigo; SOUZA, Camila Ribeiro; MAIA, Polyana Mendes; SIQUEIRA, Sávio Lana

    2016-01-01

    ABSTRACT Introduction: The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. Objective: To present review of the ethical aspects of robot use in surgery. Method: Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Results: Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Conclusion: Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. PMID:28076489

  12. Vitamin D and cardiovascular disease.

    Science.gov (United States)

    Norman, P E; Powell, J T

    2014-01-17

    Vitamin D plays a classical hormonal role in skeletal health by regulating calcium and phosphorus metabolism. Vitamin D metabolites also have physiological functions in nonskeletal tissues, where local synthesis influences regulatory pathways via paracrine and autocrine mechanisms. The active metabolite of vitamin D, 1α,25-dihydroxyvitamin D, binds to the vitamin D receptor that regulates numerous genes involved in fundamental processes of potential relevance to cardiovascular disease, including cell proliferation and differentiation, apoptosis, oxidative stress, membrane transport, matrix homeostasis, and cell adhesion. Vitamin D receptors have been found in all the major cardiovascular cell types including cardiomyocytes, arterial wall cells, and immune cells. Experimental studies have established a role for vitamin D metabolites in pathways that are integral to cardiovascular function and disease, including inflammation, thrombosis, and the renin-angiotensin system. Clinical studies have generally demonstrated an independent association between vitamin D deficiency and various manifestations of degenerative cardiovascular disease including vascular calcification. However, the role of vitamin D supplementation in the management of cardiovascular disease remains to be established. This review summarizes the clinical studies showing associations between vitamin D status and cardiovascular disease and the experimental studies that explore the mechanistic basis for these associations.

  13. [Air pollution and cardiovascular disease].

    Science.gov (United States)

    Haber, Guy; Witberg, Guy; Danenberg, Haim

    2007-10-01

    Cardiovascular atherothrombosis is the most common cause of death globally, with several well-known risk factors. Air pollution is a byproduct of fuel combustion by motor vehicles, power plants and industrial factories. It is composed of gases, fluids and particulate matter (PM) of different sizes, which include basic carbon, organic carbonic molecules and metals such as vanadium, nickel, zinc and iron. These particles are subdivided by their median size, a major contributing factor for their capability to enter the human body through the respiratory system. Most of the epidemiological studies have shown correlation between acute and long-term exposure to air pollution elements and cardiovascular morbidity in general, and angina pectoris and acute myocardial infarction specifically. Physiological studies have found different arrhythmias as the etiologic cause of cardiovascular morbidity and mortality following exposure to air pollution. A major finding was a decline in heart rate variability, a phenomenon known as endangering for cardiovascular morbidity and mortality, especially in patients after acute myocardial infarction. To date, several pathways have been proposed, including a hypercoagulable state following an inflammatory response, cardiac nervous autonomic disequilibrium, endothelial dysfunction with blood vessel contraction and direct toxic impact on cardiac muscle. Additional research is needed for clarifying the pathophysiological pathways by which air pollution affects the cardiovascular system. That might allow forthcoming with preventive measures and correct treatment, and hence a decrease in cardiovascular morbidity and mortality. Another important target is dose-outcome correlation curves for safety threshold calculation as a basis for air pollution regulations.

  14. Osteoporosis and ischemic cardiovascular disease.

    Science.gov (United States)

    Laroche, Michel; Pécourneau, Virginie; Blain, Hubert; Breuil, Véronique; Chapurlat, Roland; Cortet, Bernard; Sutter, Bruno; Degboe, Yannick

    2016-11-09

    Osteoporosis and cardiovascular disease were long viewed as independent of each other. However, numerous epidemiological studies, which are discussed in the first part of this review, have provided incontrovertible evidence of a link. Thus, the risk of coronary artery disease and stroke is higher in patients with a history of osteoporotic fracture or low bone mineral density than in non-osteoporotic patients. In the other direction, patients with cardiovascular disease are at higher risk for bone loss and osteoporotic fracture. The link between osteoporosis and cardiovascular disease is due in part to shared conventional risk factors such as estrogen deprivation in women, smoking, low physical activity, and diabetes. In addition, atheroma plaque calcification involves cytokines and growth factors that also play a role in bone turnover, including proinflammatory cytokines (IL-6 and TNFα), osteoprotegerin, sclerostin, matrix GLA protein, and FGF-23. Several recent studies have provided support for these pathophysiological hypotheses. Thus, elevation of osteoprotegerin, sclerostin, or FGF-23 levels may explain and predict the occurrence of both osteoporotic fractures and cardiovascular events. The association between osteoporosis and cardiovascular disease found in most epidemiological and pathophysiological studies suggests a need for evaluating potential benefits from routine bone absorptiometry and osteoporotic fracture detection in patients with cardiovascular disease and from exercise testing and arterial Doppler imaging in patients with osteoporosis.

  15. Comparative cardiovascular physiology: future trends, opportunities and challenges.

    Science.gov (United States)

    Burggren, W W; Christoffels, V M; Crossley, D A; Enok, S; Farrell, A P; Hedrick, M S; Hicks, J W; Jensen, B; Moorman, A F M; Mueller, C A; Skovgaard, N; Taylor, E W; Wang, T

    2014-02-01

    The inaugural Kjell Johansen Lecture in the Zoophysiology Department of Aarhus University (Aarhus, Denmark) afforded the opportunity for a focused workshop comprising comparative cardiovascular physiologists to ponder some of the key unanswered questions in the field. Discussions were centred around three themes. The first considered function of the vertebrate heart in its various forms in extant vertebrates, with particular focus on the role of intracardiac shunts, the trabecular ('spongy') nature of the ventricle in many vertebrates, coronary blood supply and the building plan of the heart as revealed by molecular approaches. The second theme involved the key unanswered questions in the control of the cardiovascular system, emphasizing autonomic control, hypoxic vasoconstriction and developmental plasticity in cardiovascular control. The final theme involved poorly understood aspects of the interaction of the cardiovascular system with the lymphatic, renal and digestive systems. Having posed key questions around these three themes, it is increasingly clear that an abundance of new analytical tools and approaches will allow us to learn much about vertebrate cardiovascular systems in the coming years.

  16. Collaborating to increase access to clinical and educational resources for surgery: a case study.

    Science.gov (United States)

    Tomasko, Jonathan M; Adams, Nancy E; Garritano, Frank G; Santos, Mary C; Dillon, Peter W

    2014-01-01

    A case study is described in which collaborations between a Department of Surgery, a Department of Information Technology, and an academic health sciences library resulted in the development of an electronic surgical library available at the bedside, the deployment of tablet devices for surgery residents, and implementation of a tablet-friendly user interface for the institution's electronic medical record.

  17. Gamma knife surgery for craniopharyngioma.

    Science.gov (United States)

    Prasad, D; Steiner, M; Steiner, L

    1995-01-01

    We present our results of Gamma Knife surgery for craniopharyngioma in nine patients. The current status of surgery, radiation therapy, intracavitary instillation of radionucleides and Gamma Knife surgery in the management of craniopharyngiomas is discussed.

  18. Preparing for Breast Reconstruction Surgery

    Science.gov (United States)

    ... Cancer Breast Reconstruction Surgery Preparing for Breast Reconstruction Surgery Your surgeon can help you know what to ... The plan for follow-up Costs Understanding your surgery costs Health insurance policies often cover most or ...

  19. Tests and visits before surgery

    Science.gov (United States)

    Before surgery - tests; Before surgery - doctor visits ... Pre-op is the time before your surgery. It means "before operation." During this time, you will meet with one of your doctors. This may be your surgeon or primary care ...

  20. Cancer Surgery: Physically Removing Cancer

    Science.gov (United States)

    ... in cancer diagnosis, staging, treatment and symptom relief. Robotic surgery. In robotic surgery, the surgeon sits away from the operating table ... to maneuver surgical tools to perform the operation. Robotic surgery helps the surgeon operate in hard-to-reach ...

  1. Intracranial Hypertension: Medication and Surgery

    Science.gov (United States)

    ... Intracraneal en Espanol. STORE Shop the IHRF Store Medication and Surgery Medication and Surgery Both drugs and surgery are used ... to treat the headache that accompanies chronic IH. Medications for chronic headache like tricyclic anti-depressants, beta- ...

  2. Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to ­­image-guided video-assisted thoracoscopic surgery

    Science.gov (United States)

    Terra, Ricardo Mingarini; Andrade, Juliano Ribeiro; Mariani, Alessandro Wasum; Garcia, Rodrigo Gobbo; Succi, Jose Ernesto; Soares, Andrey; Zimmer, Paulo Marcelo

    2016-01-01

    ABSTRACT The concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases. PMID:27812640

  3. Efficacy comparison between direct stent implantation surgery and deferred stent implantation surgery for patients with ST-segment elevation myocardial infarction after PCT thrombus aspiration surgery

    Institute of Scientific and Technical Information of China (English)

    Xiao-Xia Han; Xiu-Hong Liu; Ping Zhou; Guo-Mei Dan

    2016-01-01

    adverse cardiovascular events and comprehensive efficacy of which is superior to the direct stent implantation surgery.

  4. Cardiovascular Risk Factors in Severely Obese Adolescents

    Science.gov (United States)

    Michalsky, Marc P.; Inge, Thomas H.; Simmons, Mark; Jenkins, Todd M.; Buncher, Ralph; Helmrath, Michael; Brandt, Mary L.; Harmon, Carroll M.; Courcoulas, Anita; Chen, Michael; Horlick, Mary; Daniels, Stephen R.; Urbina, Elaine M.

    2015-01-01

    IMPORTANCE Severe obesity is increasingly common in the adolescent population but, as of yet, very little information exists regarding cardiovascular disease (CVD) risks in this group. OBJECTIVE To assess the baseline prevalence and predictors of CVD risks among severely obese adolescents undergoing weight-loss surgery. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study was conducted from February 28, 2007, to December 30, 2011, at the following 5 adolescent weight-loss surgery centers in the United States: Nationwide Children’s Hospital in Columbus, Ohio; Cincinnati Children’s Hospital Medical Center in Cincinnati, Ohio; Texas Children’s Hospital in Houston; University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania; and Children’s Hospital of Alabama in Birmingham. Consecutive patients aged 19 years or younger were offered enrollment in a long-term outcome study; the final analysis cohort consisted of 242 participants. MAIN OUTCOMES AND MEASURES This report examined the preoperative prevalence of CVD risk factors (ie, fasting hyperinsulinemia, elevated high-sensitivity C-reactive protein levels, impaired fasting glucose levels, dyslipidemia, elevated blood pressure, and diabetes mellitus) and associations between risk factors and body mass index (calculated as weight in kilograms divided by height in meters squared), age, sex, and race/ethnicity. Preoperative data were collected within 30 days preceding bariatric surgery. RESULTS The mean (SD) age was 17 (1.6) years and median body mass index was 50.5. Cardiovascular disease risk factor prevalence was fasting hyperinsulinemia (74%), elevated high-sensitivity C-reactive protein levels (75%), dyslipidemia (50%), elevated blood pressure (49%), impaired fasting glucose levels (26%), and diabetes mellitus (14%). The risk of impaired fasting glucose levels, elevated blood pressure, and elevated high-sensitivity C-reactive protein levels increased by 15%, 10%, and 6%, respectively, per 5-unit

  5. Cardiovascular Risk Factors and Cardiovascular Hyperreactivity in Young Venezuelans

    Directory of Open Access Journals (Sweden)

    Sady Montes Amador

    2015-07-01

    Full Text Available Background: cardiovascular hyperreactivity in young people has been associated with different risk factors and a family history of hypertension. Objective: to determine the association between a family history of hypertension and cardiovascular risk factors with cardiovascular hyperreactivity. Method: a correlational, cross-sectional study was conducted in a universe of 77 young individuals aged 18 to 40 years from the Churuguara parish of the Falcon State in Venezuela. The variables were: age, sex, skin color, family history of hypertension, medical history of hypertension, diabetes mellitus, alcohol consumption, salt intake, physical activity and body mass index. The diastolic and systolic blood pressure before and after the pressor response elicited by an isometric exercise were determined as hemodynamic variables. Results: thirteen percent of the participants developed vascular reactivity after the hand-held weight test. Cardiovascular hyperreactivity is three times higher in individuals with a family history of hypertension. Sixty percent of those with a body mass index greater than or equal to 27 kg/m2 are hyperreactive. There is a higher cardiovascular response to the hand-held weight test as the consumption of alcohol increases. Thirty three point three percent of the participants who smoke are hyperreactive. Conclusions: there is a significant association between a family history of hypertension, obesity, salt intake, alcohol consumption and vascular hyperreactivity.

  6. Comparative study on individual aromatase inhibitors on cardiovascular safety profile: a network meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhao XH

    2015-09-01

    Full Text Available Xihe Zhao,1 Lei Liu,2 Kai Li,1 Wusheng Li,1 Li Zhao,1 Huawei Zou1 1Department of Oncology, 2Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China Abstract: The third-generation aromatase inhibitors (AIs: anastrozole, letrozole, and exemestane have now become standard adjuvant endocrine treatment for postmenopausal estrogen receptor-positive breast cancer complementing chemotherapy and surgery. Because of the absence of direct head-to-head comparisons of these AIs, an indirect comparison is needed for individual treatment choice. In this network systemic assessment, the cardiovascular (CV side effects in using anastrozole, letrozole, and exemestane based on original studies on AIs vs placebo or tamoxifen were compared. We integrated all available direct and indirect evidences. The odds ratio (OR of severe CV events for indirect comparisons between exemestane and anastrozole was 1.41 (95% confidence interval [CI] =0.49–2.78, letrozole and anastrozole was 1.80 (95% CI =0.40–3.92, and letrozole and exemestane was 1.46 (95% CI =0.34–3.4. OR of subgroup risk for AIs and tamoxifen were all >1 except for thrombolism risk subgroup. The results showed that the total and severe CV risk ranking is letrozole, exemestane, and anastrozole in descending order. None of the AIs showed advantages in CV events than tamoxifen except for thromboembolism event incidence. Keywords: CV risk, breast cancer, AI, network meta-analysis

  7. A clinical perspective of obesity, metabolic syndrome and cardiovascular disease.

    Science.gov (United States)

    Han, Thang S; Lean, Mike Ej

    2016-01-01

    The metabolic syndrome is a condition characterized by a special constellation of reversible major risk factors for cardiovascular disease and type 2 diabetes. The main, diagnostic, components are reduced HDL-cholesterol, raised triglycerides, blood pressure and fasting plasma glucose, all of which are related to weight gain, specifically intra-abdominal/ectopic fat accumulation and a large waist circumference. Using internationally adopted arbitrary cut-off values for waist circumference, having metabolic syndrome doubles the risk of cardiovascular disease, but offers an effective treatment approach through weight management. Metabolic syndrome now affects 30-40% of people by age 65, driven mainly by adult weight gain, and by a genetic or epigenetic predisposition to intra-abdominal/ectopic fat accumulation related to poor intra-uterine growth. Metabolic syndrome is also promoted by a lack of subcutaneous adipose tissue, low skeletal muscle mass and anti-retroviral drugs. Reducing weight by 5-10%, by diet and exercise, with or without, anti-obesity drugs, substantially lowers all metabolic syndrome components, and risk of type 2 diabetes and cardiovascular disease. Other cardiovascular disease risk factors such as smoking should be corrected as a priority. Anti-diabetic agents which improve insulin resistance and reduce blood pressure, lipids and weight should be preferred for diabetic patients with metabolic syndrome. Bariatric surgery offers an alternative treatment for those with BMI ≥ 40 or 35-40 kg/m(2) with other significant co-morbidity. The prevalence of the metabolic syndrome and cardiovascular disease is expected to rise along with the global obesity epidemic: greater emphasis should be given to effective early weight-management to reduce risk in pre-symptomatic individuals with large waists.

  8. A clinical perspective of obesity, metabolic syndrome and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Thang S Han

    2016-02-01

    Full Text Available The metabolic syndrome is a condition characterized by a special constellation of reversible major risk factors for cardiovascular disease and type 2 diabetes. The main, diagnostic, components are reduced HDL-cholesterol, raised triglycerides, blood pressure and fasting plasma glucose, all of which are related to weight gain, specifically intra-abdominal/ectopic fat accumulation and a large waist circumference. Using internationally adopted arbitrary cut-off values for waist circumference, having metabolic syndrome doubles the risk of cardiovascular disease, but offers an effective treatment approach through weight management. Metabolic syndrome now affects 30–40% of people by age 65, driven mainly by adult weight gain, and by a genetic or epigenetic predisposition to intra-abdominal/ectopic fat accumulation related to poor intra-uterine growth. Metabolic syndrome is also promoted by a lack of subcutaneous adipose tissue, low skeletal muscle mass and anti-retroviral drugs. Reducing weight by 5–10%, by diet and exercise, with or without, anti-obesity drugs, substantially lowers all metabolic syndrome components, and risk of type 2 diabetes and cardiovascular disease. Other cardiovascular disease risk factors such as smoking should be corrected as a priority. Anti-diabetic agents which improve insulin resistance and reduce blood pressure, lipids and weight should be preferred for diabetic patients with metabolic syndrome. Bariatric surgery offers an alternative treatment for those with BMI ≥ 40 or 35–40 kg/m2 with other significant co-morbidity. The prevalence of the metabolic syndrome and cardiovascular disease is expected to rise along with the global obesity epidemic: greater emphasis should be given to effective early weight-management to reduce risk in pre-symptomatic individuals with large waists.

  9. Developments in flexible endoscopic surgery: a review

    Directory of Open Access Journals (Sweden)

    Feussner H

    2014-12-01

    Full Text Available Hubertus Feussner,1 Valentin Becker,2 Margit Bauer,1 Michael Kranzfelder,1 Rebekka Schirren,1 Tim Lüth,3 Alexander Meining,2 Dirk Wilhelm1 1Department of Surgery, 22nd Medical Department, 3Institute of Microtechnology and Medical Device Technology, Klinikum rechts der Isar, Technische Universität München, Germany Abstract: Flexible endoscopy is increasingly developing into a therapeutic instead of a purely diagnostic discipline. Improved visualization makes early lesions easily detectable and allows us to decide ad hoc on the required treatment. Deep enteroscopy allows the exploration of even the small bowel – for long a "white spot" for gastrointestinal endoscopy – and to perform direct treatment. Endoscopic submucosal dissection is a considerable step forward in oncologically correct endoscopic treatment of (early malignant lesions. Though still technically challenging, it is increasingly facilitated by new manipulation techniques and tools that are being steadily optimized. Closure of wall defects and hemostasis could be improved significantly. Even the anatomy beyond the gastrointestinal wall is being explored by the therapeutic use of endoluminal ultrasound. Endosonographic-guided surgery is not only a suitable fallback solution if conventional endoscopic retrograde cholangiopancreatography fails, but even makes necrosectomy procedures, abscess drainage, and neurolysis feasible for the endoscopist. Newly developed endoscopic approaches aim at formerly distinctive surgical domains like gastroesophageal reflux disease, appendicitis, and cholecystitis. Combined endoscopic/laparoscopic interventional techniques could become the harbingers of natural orifice transluminal endoscopic surgery, whereas pure natural orifice transluminal endoscopic surgery is currently still in its beginnings. Keywords: flexible endoscopic surgery, endoscopic ultrasound, advanced techniques, natural orifice transluminal endoscopic surgery

  10. Cardiovascular devices; reclassification of intra-aortic balloon and control systems for acute coronary syndrome, cardiac and non-cardiac surgery, or complications of heart failure; effective date of requirement for premarket approval for intra-aortic balloon and control systems for septic shock or pulsatile flow generation. Final order.

    Science.gov (United States)

    2013-12-30

    The Food and Drug Administration (FDA) is issuing a final order to reclassify intra-aortic balloon and control system (IABP) devices when indicated for acute coronary syndrome, cardiac and non-cardiac surgery, or complications of heart failure, a preamendments class III device, into class II (special controls), and to require the filing of a premarket approval application (PMA) or a notice of completion of a product development protocol (PDP) for IABPs when indicated for septic shock or pulsatile flow generation.

  11. Single port laparoscopic surgery

    DEFF Research Database (Denmark)

    Springborg, Henrik; Istre, Olav

    2012-01-01

    LESS, or laparo-endoscopic single site surgery, is a promising new method in minimally invasive surgery. An increasing number of surgical procedures are being performed using this technique, however, its large-scale adoption awaits results of prospective randomized controlled studies confirming...... potential benefits. Theoretically, cosmetic outcomes, postoperative pain and complication rates could be improved with use of single site surgery. This study describes introduction of the method in a private hospital in Denmark, in which 40 patients have been treated for benign gynecologic conditions...

  12. Surveys on surgery theory

    CERN Document Server

    Cappell, Sylvain; Rosenberg, Jonathan

    2014-01-01

    Surgery theory, the basis for the classification theory of manifolds, is now about forty years old. There have been some extraordinary accomplishments in that time, which have led to enormously varied interactions with algebra, analysis, and geometry. Workers in many of these areas have often lamented the lack of a single source that surveys surgery theory and its applications. Indeed, no one person could write such a survey. The sixtieth birthday of C. T. C. Wall, one of the leaders of the founding generation of surgery theory, provided an opportunity to rectify the situation and produce a

  13. Surveys on surgery theory

    CERN Document Server

    Cappell, Sylvain; Rosenberg, Jonathan

    2014-01-01

    Surgery theory, the basis for the classification theory of manifolds, is now about forty years old. The sixtieth birthday (on December 14, 1996) of C.T.C. Wall, a leading member of the subject''s founding generation, led the editors of this volume to reflect on the extraordinary accomplishments of surgery theory as well as its current enormously varied interactions with algebra, analysis, and geometry. Workers in many of these areas have often lamented the lack of a single source surveying surgery theory and its applications. Because no one person could write such a survey, the editors ask

  14. Department of Education (DOE)

    Data.gov (United States)

    Social Security Administration — The purpose of this agreement is to assist the U.S. Department of Education in its obligation to ensure that applicants for student financial assistance under Title...

  15. Department of Homeland Security

    Science.gov (United States)

    ... Content Official website of the Department of Homeland Security Contact Us Quick Links Site Map A-Z ... HP - 2016 CISRM HP - 2016 CISRM Critical Infrastructure Security HP - Surge Capacity Force HP - Surge Capacity Force ...

  16. Osteoporosis y enfermedad cardiovascular

    Directory of Open Access Journals (Sweden)

    Sarahí Mendoza

    2007-01-01

    Full Text Available Las enfermedades cardiovasculares (ECV y la osteoporosis son causas frecuentes de morbilidad en la población adulta, cuya frecuencia aumenta con la edad, por lo que al aumentar la expectativa de vida, constituyen importantes problemas de salud. El riesgo a padecer ambas patologías depende de factores de riesgo, y la prevención consiste en controlar los modificables. Las ECV y la osteoporosis presentan factores etiológicos comunes que involucran la biosíntesis del colesterol y la oxidación lipídica, cuya dilucidación representa una línea priorizada de investigación. El crecimiento y mantenimiento del esqueleto depende del equilibrio entre la formación y la resorción ósea a través de los procesos de modelado y remodelado óseo, controlados por células óseas (osteoblastos -OB-, osteoclastos -OC- y osteocitos, los OB son responsables de la formación ósea, los OC de la resorción ósea y los osteocitos de la red mecano sensorial. Entre los nexos de las ECV y la osteoporosis se encuentra el papel de la vía del mevalonato en la síntesis de colesterol y en la activación de OC, y el papel de los lípidos oxidados en el desarrollo de la aterosclerosis y en la transformación de las células precursoras de OB en adipocitos, disminuyendo la formación de OB activos y favoreciendo la osteoporosis. Ello justifica que sustancias hipolipemiantes y antioxidantes puedan ejercer efectos protectores sobre el hueso, y que la búsqueda de sustancias que actúen sobre ambos blancos sea un aspecto de interés en la prevención o el manejo de estas enfermedades.

  17. Department of Reactor Technology

    DEFF Research Database (Denmark)

    Risø National Laboratory, Roskilde

    The general development of the Department of Reactor Technology at Risø during 1981 is presented, and the activities within the major subject fields are described in some detail. Lists of staff, publications, and computer programs are included.......The general development of the Department of Reactor Technology at Risø during 1981 is presented, and the activities within the major subject fields are described in some detail. Lists of staff, publications, and computer programs are included....

  18. Clinical Pharmacist Intervention Effect of Prophylactic Use of Antibiotics for Type I Incision Operation in Department of General Surgery%临床药师干预对普外科I类切口手术预防性使用抗生素的影响

    Institute of Scientific and Technical Information of China (English)

    张毅丰

    2015-01-01

    Objective To evaluate and analysis the effect of the intervention of clinical pharmacists on prophylactic uses of antibacterial drugs in I type incision operation. Methods 142 cases patients with I type Incision operation in department of general surgery from January 2011 to January 2013 were regarded as control group(before the intervention). 165 cases patients with I type incision operation from February 2013 to February 2015 were regarded as observation group(after the intervention). To situation of using antibacterial drugs were compared between two groups. Results The usage rates of antibacterial drugs of observation group was lower than that of control group,there was significant difference between two groups(P<0.01). The time for the first time to use the drugs of observation group was more reasonable than that of control group,the difference was significant(P<0.05). The choice of antibacterial drugs in observation group was more reasonable than that of control group,the difference was significant(P<0.05). Conclusion The intervention of clinical pharmacists on prophylactic uses of antibacterial drugs in type incision operation can make a reasonable choice of the time to use and varieties of antibacterial drugs. The intervention of clinical pharmacists can reduce the usage rate of antibacterial drug and help the clinician to know how to reasonable preventive use of antibiotics. The method is conductive to use the antibiotics more standardized.%目的:评价分析临床药师干预对普外科I类切口手术预防性使用抗生素的影响。方法将我院普外科2011年1月~2013年1月I类切口手术患者142例作为对照组(干预前),将2013年2月~2015年2月I类切口手术患者165例作为观察组(干预后),对两组患者抗生素的应用合理情况进行比较。结果观察组抗生素的使用率低于对照组抗生素的使用率,两组比较具有显著统计学差异(P<0.01);观察组首次用药时间合理

  19. Can a Plastic Surgeon be a Department Chairman?….Really?

    Science.gov (United States)

    Neumeister, M W

    2016-04-01

    There is significant responsibility in being a Department of Surgery Chairman within a medical school. The Chairman is appointed by the Dean of Medicine to lead surgery in a path that serves the mission of the school. The Department of Surgery Chairman is charged with facilitating the academic, operational, and programmatic surgical initiatives of the School of Medicine. Traditionally the Chairman of Surgery has been a general surgeon but now our educational and clinical experiences have changed making traditional leadership less intuitive. Plastic surgeons appointed as current Chairman of the Department of Surgery are rare in the United States. Whereas, general surgeons may have less interaction with other surgical sub-specialties today, Plastic surgeons have more interaction crossing all disciplines of surgery. Innovation and creativity that defines our discipline, seems to fit well with Department leadership where strategic planning, vision and curriculum development, and the pursuit of academic and clinical quality remain core essentials to plastic surgery. This article is an editorial of my philosophy as a plastic surgeon leading a Department of Surgery.

  20. Role of green tea in reduction of cardiovascular risk factors

    OpenAIRE

    Vlachopoulos, Charalambos; Alexopoulos, Nikolaos; Stefanadis, C.

    2010-01-01

    Nikolaos Alexopoulos, Charalambos Vlachopoulos, Christodoulos Stefanadis1st Cardiology Department, Athens Medical School, Hippokration Hospital, Athens, GreeceAbstract: Tea is widely consumed worldwide. There is accumulating evidence that tea ­consumption may be associated with reduced cardiovascular risk, an association that could be attributed to its flavonoid content. Green tea, the most common type of tea consumed in Asia, contains a large amount of nonoxidized flavonoids, named c...

  1. Clinical utility of ivabradine in cardiovascular disease management: current status

    OpenAIRE

    Rosano GMC; Vitale C; Spoletini I; Volterrani M.

    2014-01-01

    Giuseppe MC Rosano,1,2 Cristiana Vitale,1,2 Ilaria Spoletini,1 Maurizio Volterrani11Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy; 2Cardiovascular and Cell Sciences Research Institute, St George's University of London, London, UK Abstract: Ivabradine is a selective antagonist of the funny channels with anti-anginal and anti-ischemic properties, approved for the treatment of coronary artery disease (CAD) and heart failure (HF). It provides pure heart rate redu...

  2. Candidates for Bariatric Surgery: Morbidly Obese Patients with Pulmonary Dysfunction

    Directory of Open Access Journals (Sweden)

    Yu-Feng Wei

    2012-01-01

    Full Text Available Obesity is a well-known major risk factor of cardiovascular disease and is associated with various comorbidities. The impact of obesity on pulmonary function remains unclear. Reductions in chest wall compliance and respiratory muscle strength due to a high percent body fat and localized fat distribution contributes to impaired pulmonary function and the occurrence of adverse respiratory symptoms. Dietary modifications and pharmaceutical agents are not effective in the long-term treatment of obesity. Treatment of morbidly obese patients using bariatric surgery has increased each year, especially after the introduction of video laparoscopic techniques. Effective weight loss after bariatric surgery may improve cardiovascular disease risk factors, including diabetes, hypertension, dyslipidemia, atherosclerosis, inflammation, chronic kidney disease, obstructive sleep apnea, and obesity hypoventilation syndrome. Bariatric surgery has also been associated with significantly improved respiratory symptoms and pulmonary function. We currently present a review of principal studies that evaluated the effects of obesity on pulmonary function and the identification of anthropometric factors of obesity that correspond to the reversal of respiratory symptoms and impaired pulmonary function after bariatric surgery.

  3. Vitamin D and Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Martin R. Grübler

    2013-07-01

    Full Text Available Vitamin D deficiency, as well as cardiovascular diseases (CVD and related risk factors are highly prevalent worldwide and frequently co-occur. Vitamin D has long been known to be an essential part of bone metabolism, although recent evidence suggests that vitamin D plays a key role in the pathophysiology of other diseases, including CVD, as well. In this review, we aim to summarize the most recent data on the involvement of vitamin D deficiency in the development of major cardiovascular risk factors: hypertension, obesity and dyslipidemia, type 2 diabetes, chronic kidney disease and endothelial dysfunction. In addition, we outline the most recent observational, as well as interventional data on the influence of vitamin D on CVD. Since it is still an unresolved issue whether vitamin D deficiency is causally involved in the pathogenesis of CVD, data from randomized controlled trials (RCTs designed to assess the impact of vitamin D supplementation on cardiovascular outcomes are awaited with anticipation. At present, we can only conclude that vitamin D deficiency is an independent cardiovascular risk factor, but whether vitamin D supplementation can significantly improve cardiovascular outcomes is still largely unknown.

  4. [Iodine deficiency in cardiovascular diseases].

    Science.gov (United States)

    Molnár, I; Magyari, M; Stief, L

    1998-08-30

    The thyroid hormone deficiency on cardiovascular function can be characterized with decreased myocardial contractility and increased peripheral vascular resistance as well as with the changes in lipid metabolism. 42 patients with cardiovascular disease (mean age 65 +/- 13 yr, 16 males) were investigated if iodine insufficiency can play a role as a risk factor for the cardiovascular diseases. The patients were divided in 5 subgroups on the ground of the presence of hypertension, congestive heart failure, cardiomyopathy, coronary disfunction and arrhythmia. Urine iodine concentration (5.29 +/- 4.52 micrograms/dl) was detected with Sandell-Kolthoff colorimetric reaction. The most decreased urine iodine concentration was detected in the subgroups with arrhythmia and congestive heart failure (4.7 +/- 4.94 micrograms/dl and 4.9 +/- 4.81 micrograms/dl, respectively). An elevated TSH level was found by 3 patients (5.3 +/- 1.4 mlU/l). An elevation in lipid metabolism (cholesterol, triglyceride) associated with all subgroups without arrhythmia. In conclusion, the occurrence of iodine deficiency in cardiovascular disease is frequent. Iodine supplementation might prevent the worsing effect of iodine deficiency on cardiovascular disease.

  5. FACTORS ASSOCIATED WITH INFECTIONS IN SPINAL SURGERY

    Directory of Open Access Journals (Sweden)

    ANA MARÍA MORALES LÓPEZ

    Full Text Available ABSTRACT Objective: To identify the factors associated with postoperative infections in spinal surgery. Methods: Descriptive, retrospective, cross-sectional study conducted in the spine surgery department of the Medical Unit of High Specialty (UMAE at the Hospital of Traumatology and Orthopedics Lomas Verdes, Mexican Institute of Social Security (IMSS between January 01, 2013 and June 30, 2014 through medical records of the service and the records of clinical care. Data were gathered in accordance with the records of patients with infection after spinal surgery. The factors considered were age group, etiologic agent, surgical site, type of treatment, bleeding volume and pharmacotherapy. Frequency and descriptive statistic was conducted. The rank sum test with the Wilcoxon test for a single sample was performed in different measurements; Pearson's correlation was calculated and all p<0.05 values were considered significant. Results: The sample was composed of 14 patients of which 11 were female (78.6% and 3 male (21.4% with predominance of surgical area in the lumbar and dorsolumbar region. There was a significant correlation between the surgical time and the amount of bleeding with p<0.001. Conclusions: It was clear that the infections present in patients after spinal surgery are multifactorial. However, in this study the correlation between time of surgery and bleeding amount had the highest importance and relevance.

  6. The first American textbook of surgery.

    Science.gov (United States)

    Smythe, W Roy

    2003-04-01

    The first systematic textbook of surgery written in the United States, The Elements of Surgery, was completed in 1813 by John Syng Dorsey, a University of Pennsylvania surgeon. The work thoroughly covered all major clinical areas of surgery of that time in a two-volume, 797-page text. Subsequent editions were published in 1818, 1823, and 1831. It became the standard surgical textbook in this country during that era and was the first American medical text exported abroad for use at the more established European centers of medical education. The reasons for writing the text included a desire to put into print the teachings of Philip Syng Physick (first Chair of the Department of Surgery at the University of Pennsylvania, and Dorsey's uncle), the new American nationalism, and socioeconomic pressures forced on the American publishing industry by the War of 1812 and preceding trade embargoes. In addition to extensive exposure to Physick, Dorsey was also uniquely qualified to write and illustrate this text, as he exhibited an unusually succinct style and was a remarkable medical artist. The book was the forerunner to William Gibson's The Institutes and Practice of Surgery and all American surgical textbooks to follow.

  7. Minimally invasive surgery for Achilles tendon pathologies

    Directory of Open Access Journals (Sweden)

    Nicola Maffulli

    2010-07-01

    Full Text Available Nicola Maffulli1, Umile Giuseppe Longo2, Filippo Spiezia2, Vincenzo Denaro21Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, London, England; 2Department of Orthopedic and Trauma Surgery, Campus Bio-Medico University, Rome, ItalyAbstract: Minimally invasive trauma and orthopedic surgery is increasingly common, though technically demanding. Its use for pathologies of the Achilles tendon (AT hold the promise to allow faster recovery times, shorter hospital stays, and improved functional outcomes when compared to traditional open procedures, which can lead to difficulty with wound healing because of the tenuous blood supply and increased chance of wound breakdown and infection. We present the recent advances in the field of minimally invasive AT surgery for tendinopathy, acute ruptures, chronic tears, and chronic avulsions of the AT. In our hands, minimally invasive surgery has provided similar results to those obtained with open surgery, with decreased perioperative morbidity, decreased duration of hospital stay, and reduced costs. So far, the studies on minimally invasive orthopedic techniques are of moderate scientific quality with short follow-up periods. Multicenter studies with longer follow-up are needed to justify the long-term advantages of these techniques over traditional ones.Keywords: tendinopathy, rupture, percutanous repair, less invasive

  8. Atypical complications of gastric bypass surgery

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Myrosia T. [University of Chicago, Department of Radiology, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637 (United States)]. E-mail: mmitchell@radiology.bsd.uchicago.edu; Pizzitola, Victor J. [University of Chicago, Department of Radiology, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637 (United States); Knuttinen, M-Grace [University of Chicago, Department of Radiology, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637 (United States); Robinson, Tiffany [University of Chicago, Department of Internal Medicine, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637 (United States); Gasparaitis, Arunas E. [University of Chicago, Department of Radiology, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637 (United States)

    2005-03-01

    Although gastric bypass surgery continues to grow in popularity for weight loss and weight maintenance in the morbidly obese, there has been little attention given to the imaging of complications associated with these surgeries. The purpose of our study is to demonstrate the variety of gastric bypass surgery complications that can be identified radiographically, with attention to the more unusual complications. This study was performed with institutional Internal Review Board approval. We performed a 5-year retrospective review of all patients who had undergone gastric bypass surgery, had complications of the surgery, and had studies performed in our department to image these complications. These studies consisted of contrast fluoroscopy and CT. We identified the more common complications of anastomotic stenoses and anastomotic leaks. We also identified six unusual complications as follow: (1) internal herniation through the small bowel mesentery, (2) internal herniation through the transverse mesocolon, (3) external herniation through the abdominal wall incision, (4) enterocutaneous fistulas, (5) antiperistaltic construction of the Roux-en-Y, and (6) incorrect anstomoses of the Roux limbs resulting in a Roux-en-O configuration. Our findings show that a thorough understanding of expected postoperative bowel configuration is essential in the evaluation of these patients. In addition, fluoroscopic evaluation should assess not only anatomy, but also motility.

  9. Pain Medications After Surgery

    Science.gov (United States)

    ... aspx?id=23897. Accessed Dec. 16, 2013. Winn HR. Youmans Neurological Surgery. 6th ed. Philadelphia, Pa.: Saunders ... Terms and Conditions Privacy Policy Notice of Privacy Practices Notice of Nondiscrimination Advertising Mayo Clinic is a ...

  10. Surgery for pancreatic cancer

    Science.gov (United States)

    ... using a tiny video camera) or using a robot depends on: The extent of the surgery The ... Procedure Meet with your doctor to make sure medical problems, such as diabetes, high blood pressure, and ...

  11. Retrosternal thyroid surgery

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007558.htm Retrosternal thyroid surgery To use the sharing features on this page, please enable JavaScript. The thyroid gland is normally located at the front of ...

  12. Septoplasty and Turbinate Surgery

    Science.gov (United States)

    ... nose. Surgery on the septum can lead to stretching or injury to these nerves. This can lead ... a painless procedure that is performed in our office. A small endoscope is used to visualize the ...

  13. Abdominal wall surgery

    Science.gov (United States)

    ... pregnancy. Skin and muscle cannot regain its normal tone. This can be a problem for very overweight people who lost a lot of weight. Tummy tuck is major surgery. It is important to read about the procedure before having it. ...

  14. Blood donation before surgery

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000367.htm Blood donation before surgery To use the sharing features on ... described here. Blood From the Public (Volunteer Blood Donation) The most common source of blood given during ...

  15. INDIRECT MICROLARYNGOSTROBOSCOPIC SURGERY

    NARCIS (Netherlands)

    MAHIEU, HF; DIKKERS, FG

    1992-01-01

    Detailed preoperative laryngostroboscopic examination is a prerequisite for phonosurgical correction of organic dysphonia. Although suspension microlaryngoscopic surgery has proved its value in the past, it excludes functional control during the removal of vocal fold swellings. Using an indirect mic

  16. Robotics in Colorectal Surgery

    Science.gov (United States)

    Weaver, Allison; Steele, Scott

    2016-01-01

    Over the past few decades, robotic surgery has developed from a futuristic dream to a real, widely used technology. Today, robotic platforms are used for a range of procedures and have added a new facet to the development and implementation of minimally invasive surgeries. The potential advantages are enormous, but the current progress is impeded by high costs and limited technology. However, recent advances in haptic feedback systems and single-port surgical techniques demonstrate a clear role for robotics and are likely to improve surgical outcomes. Although robotic surgeries have become the gold standard for a number of procedures, the research in colorectal surgery is not definitive and more work needs to be done to prove its safety and efficacy to both surgeons and patients. PMID:27746895

  17. Knee microfracture surgery

    Science.gov (United States)

    Cartilage regeneration - knee ... Three types of anesthesia may be used for knee arthroscopy surgery: Medicine to relax you, and shots of painkillers to numb the knee Spinal (regional) anesthesia General anesthesia (you will be ...

  18. Is day surgery safe?

    DEFF Research Database (Denmark)

    Majholm, Birgitte; Engbæk, J; Bartholdy, Jens

    2012-01-01

    Day surgery is expanding in several countries, and it is important to collect information about quality. The aim of this study was to assess morbidity and unanticipated hospital visits 0-30 days post-operatively in a large cohort.......Day surgery is expanding in several countries, and it is important to collect information about quality. The aim of this study was to assess morbidity and unanticipated hospital visits 0-30 days post-operatively in a large cohort....

  19. Complications of pancreatic surgery

    Directory of Open Access Journals (Sweden)

    Åke Andrén-Sandberg

    2011-01-01

    Full Text Available Many diseases, including pancreatitis benign tumors and cancer, may require pancreas surgery. Pancreatic resection can lead to a prolonged survival in pancreatic cancer and even a potential chance for cure. However, the pancreatic surgery can result in complications, and high postoperative morbidity rates are still presence. This article reviews the pancreatic abstracts of American Pancreas Club 2011, which involves the more common complications, their prevention and treatment.

  20. Future of cosmetic surgery.

    Science.gov (United States)

    Goldberg, Robert Alan

    2014-04-01

    Changes in cosmetic surgery will be driven by several key forces. The patient's self-image, and perceived place in society, will continue to drive patients to the cosmetic surgeon as well as to demand newer and better treatments. Technological advances, especially those based on an enhanced understanding of cellular and tissue physiology, promise enhanced tools other than the scalpel for the surgeon. Conceptual advances in our understanding of beauty and patient psychology will lead to a more integrative approach to cosmetic surgery.

  1. Practical implementation of the guidelines for unstable angina/non-ST-segment elevation myocardial infarction in the emergency department: a scientific statement from the American Heart Association Council on Clinical Cardiology (Subcommittee on Acute Cardiac Care), Council on Cardiovascular Nursing, and Quality of Care and Outcomes Research Interdisciplinary Working Group, in Collaboration With the Society of Chest Pain Centers.

    Science.gov (United States)

    Gibler, W Brian; Cannon, Christopher P; Blomkalns, Andra L; Char, Douglas M; Drew, Barbara J; Hollander, Judd E; Jaffe, Allan S; Jesse, Robert L; Newby, L Kristin; Ohman, E Magnus; Peterson, Eric D; Pollack, Charles V

    2005-05-24

    In the United States each year, >5.3 million patients present to emergency departments with chest discomfort and related symptoms. Ultimately, >1.4 million individuals are hospitalized for unstable angina and non-ST-segment elevation myocardial infarction. For emergency physicians and cardiologists alike, these patients represent an enormous challenge to accurately diagnose and appropriately treat. This update of the 2002 American College of Cardiology/American Heart Association Guidelines for the Management of Patients with Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction (UA/NSTEMI) provides an evidence-based approach to the diagnosis and treatment of these patients in the emergency department, in-hospital, and after hospital discharge. Despite publication of the guidelines several years ago, many patients with UA/NSTEMI still do not receive guidelines-indicated therapy.

  2. Photobiomodulation in laser surgery

    Science.gov (United States)

    Liu, Timon Cheng-Yi; Rong, Dong-Liang; Huang, Jin; Deng, Xiao-Yuan; Liu, Song-Hao

    2006-01-01

    Laser surgery provides good exposure with clear operating fields and satisfactory preliminary functional results. In contrast to conventional excision, it was found that matrix metalloproteinases and the tissue inhibitors of metalloproteinases -1 mRNA expression is higher, myofibroblasts appeared and disappeared slower in laser excision wounds. It has been suggested that the better anatomical and functional results achieved following laser cordectomy may be explained by the fact that such procedures result in better, more rapid healing processes to recover vocal cord for early glottic tumors and better. In this paper, the role of photobiomodulation in laser surgery will be discussed by the cultured monolayer normal human skin fibroblast model of the photobiomodulation of marginal irradiation of high intensity laser beam, the photobiomodulation related to the irradiated tissue, the biological information model of photobiomodulation and the animal models of laser surgery. Although high intensity laser beam is so intense that it destroys the irradiated cells or tissue, its marginal irradiation intensity is so low that there is photobiomodulation on non-damage cells to modulate the regeneration of partly damaged tissue so that the surgery of laser of different parameters results in different post-surgical recovery. It was concluded that photobiomodulation might play an important role in the long-term effects of laser surgery, which might be used to design laser surgery.

  3. Robotic surgery in gynecology

    Directory of Open Access Journals (Sweden)

    Rooma Sinha

    2015-01-01

    Full Text Available FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon′s console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over.

  4. The cardiovascular action of hexarelin

    Institute of Scientific and Technical Information of China (English)

    wYuanjie MAO; Takeshi Tokudome; Ichiro Kishimoto

    2014-01-01

    Hexarelin, a synthetic growth hormone-releasing peptide, can bind to and activate the growth hormone secretagogue receptor (GHSR) in the brain similar to its natural analog ghrelin. However, the peripheral distribution of GHSR in the heart and blood vessels suggests that hexarelin might have direct cardiovascular actions beyond growth hormone release and neuroendocrine effects. Furthermore, the non-GHSR CD36 had been demonstrated to be a specific cardiac receptor for hexarelin and to mediate its cardioprotective effects. When compared with ghrelin, hexarelin is chemically more stable and functionally more potent. Therefore, it may be a promising therapeutic agent for some car-diovascular conditions. In this concise review, we discuss the current evidence for the cardiovascular action of hexarelin.

  5. Mitochondrial cytopathies and cardiovascular disease.

    Science.gov (United States)

    Dominic, Elizabeth A; Ramezani, Ali; Anker, Stefan D; Verma, Mukesh; Mehta, Nehal; Rao, Madhumathi

    2014-04-01

    The global epidemic of cardiovascular disease remains the leading cause of death in the USA and across the world. Functional and structural integrity of mitochondria are essential for the physiological function of the cardiovascular system. The metabolic adaptation observed in normal heart is lost in the failing myocardium, which becomes progressively energy depleted leading to impaired myocardial contraction and relaxation. Uncoupling of electron transfer from ATP synthesis leads to excess generation of reactive species, leading to widespread cellular injury and cardiovascular disease. Accumulation of mitochondrial DNA mutation has been linked to ischaemic heart disease, cardiomyopathy and atherosclerotic vascular disease. Mitochondria are known to regulate apoptotic and autophagic pathways that have been shown to play an important role in the development of cardiomyopathy and atherosclerosis. A number of pharmacological and non-pharmacological treatment options have been explored in the management of mitochondrial diseases with variable success.

  6. Electrocardiographic Predictors of Cardiovascular Mortality

    Directory of Open Access Journals (Sweden)

    Ioana Mozos

    2015-01-01

    Full Text Available Cardiovascular diseases are the main causes of mortality. Sudden cardiac death may also appear in athletes, due to underlying congenital or inherited cardiac abnormalities. The electrocardiogram is used in clinical practice and clinical trials, as a valid, reliable, accessible, inexpensive method. The aim of the present paper was to review electrocardiographic (ECG signs associated with cardiovascular mortality and the mechanisms underlying those associations, providing a brief description of the main studies in this area, and consider their implication for clinical practice in the general population and athletes. The main ECG parameters associated with cardiovascular mortality in the present paper are the P wave (duration, interatrial block, and deep terminal negativity of the P wave in V1, prolonged QT and Tpeak-Tend intervals, QRS duration and fragmentation, bundle branch block, ST segment depression and elevation, T waves (inverted, T wave axes, spatial angles between QRS and T vectors, premature ventricular contractions, and ECG hypertrophy criteria.

  7. Cardiovascular risks of antiretroviral therapies.

    Science.gov (United States)

    Mondy, Kristin; Tebas, Pablo

    2007-01-01

    The use of highly active antiretroviral therapy (HAART) has resulted in sustained reductions in mortality from HIV infection. In recent years, HAART has also been associated with metabolic complications that may increase patients' cardiovascular disease risk. Recent studies have begun to support a more complex interaction between HAART, HIV infection itself, and other traditional social and immunologic factors that may predispose patients to premature cardiovascular disease. Substantial progress has been made in the development of newer antiretroviral therapies that have a better metabolic profile with respect to dyslipidemia, hyperglycemia, and lipodystrophy. Optimal selection of metabolically neutral antiretroviral therapies, together with aggressive management of other modifiable coronary risk factors, may improve cardiovascular disease risk in the long term.

  8. Social factors and cardiovascular morbidity.

    Science.gov (United States)

    Brunner, Eric John

    2017-03-01

    Recent progress in population health at aggregate level, measured by life expectancy, has been accompanied by lack of progress in reducing the difference in health prospects between groups defined by social status. Cardiovascular disease is an important contributor to this undesirable situation. The stepwise gradient of higher risk with lower status is accounted for partly by social gradients in health behaviors. The psychosocial hypothesis provides a stronger explanation, based on social patterning of living and working environments and psychological assets that individuals develop during childhood. Three decades of research based on Whitehall II and other cohort studies provide evidence for psychosocial pathways leading to cardiovascular morbidity and mortality. Job stress is a useful paradigm because exposure is long term and depends on occupational status. Studies of social-biological translation implicate autonomic and neuroendocrine function among the biological systems that mediate between chronic adverse psychosocial exposures and increased cardiometabolic risk and cardiovascular disease incidence.

  9. [Cardiovascular manifestations of human toxocariasis].

    Science.gov (United States)

    Bolívar-Mejía, Adrián; Rodríguez-Morales, Alfonso J; Paniz-Mondolfi, Alberto E; Delgado, Olinda

    2013-01-01

    Toxocariasis is a parasitic infection produced by helminths that cannot reach their adult stage in humans. For their etiological species (Toxocara canis and Toxocara cati), man is a paratenic host. Infection by such helminths can produce a variety of clinical manifestations, such as: visceral larvae migrans syndrome, ocular larvae migrans syndrome and covert toxocariasis. In the visceral larvae migrans syndrome, the organs that are mainly involved include liver, lungs, skin, nervous system, muscles, kidneys and the heart. Regarding the latter, the importance of cardiovascular manifestations in toxocariasis, as well as its clinical relevance, has increasingly begun to be recognized. The current article is based on a systematic information search, focused mainly on the clinical and pathological aspects of cardiovascular manifestations in toxocariasis, including its pathophysiology, laboratory findings, diagnosis and therapeutical options, with the objective of highlighting its importance as a zoonosis and its relevance to the fields of cardiovascular medicine in adults and children.

  10. Cardiovascular anatomy and physiology in the female.

    Science.gov (United States)

    Wingate, S

    1997-12-01

    Important differences in male and female cardiovascular anatomy and physiology may account for many of the gender differences seen in various cardiac disease states. Predominant influences on female disease manifestations include (1) women's smaller body size, hence smaller hearts and smaller coronary vessels and (2) women's fluctuating levels of estrogen throughout their lifespan. Understanding these critical anatomic and physiologic differences allows the clinician to better predict and plan care for women. For example, knowing that women generally have a smaller body surface area than men allows one to better understand why men have higher creatine kinase (CK) values than do women--an important distinction when interpreting these values in the acute care setting. The fact that women's hearts and coronary vessels are generally smaller than men's also helps one understand why women have a higher in-hospital mortality than men post-coronary artery bypass graft surgery (see article by Allen in this issue for more detailed information on revascularization). These are only a few examples of the many opportunities that acute care nurses have to integrate their knowledge of anatomy and physiology into proactive planning for their female cardiac patients.

  11. Ostomy Surgery of the Bowel

    Science.gov (United States)

    ... How it Works Digestive Diseases A-Z Ostomy Surgery of the Bowel What is ostomy surgery of the bowel? Ostomy surgery of the bowel, ... It Works . Why does a person need ostomy surgery of the bowel? A person may need ostomy ...

  12. Laparoscopic Surgery - What Is It?

    Science.gov (United States)

    ... Surgery - What is it? Laparoscopic Surgery - What is it? Laparoscopic Surgery - What is it? | ASCRS WHAT IS LAPAROSCOPIC SURGERY? Laparoscopic or “minimally ... information about the management of the conditions addressed. It should be recognized that these brochures should not ...

  13. Understanding Antegrade Colonic Enema (ACE) Surgery

    Science.gov (United States)

    ... Enema (ACE) Surgery Understanding Antegrade Colonic Enema (ACE) Surgery Antegrade colonic enema surgery (ACE) or Malone antegrade ... Email Print What is antegrade colonic enema (ACE) surgery? Antegrade colonic enema surgery (ACE) or Malone antegrade ...

  14. Cardiovascular morbidity and the use of inhaled bronchodilators

    Directory of Open Access Journals (Sweden)

    Christine Macie

    2008-03-01

    Full Text Available Christine Macie, Kate Wooldrage, Jure Manfreda, Nicholas AnthonisenDepartment of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaAbstract: We used the Manitoba Health database to examine the relationship between use of inhaled respiratory drugs in people with chronic obstructive respiratory diseases and cardiovascular hospitalizations from 1996 through 2000. The drugs examined were beta agonists [BA], ipratropium bromide IB, and inhaled steroids (ICS. End points were first hospitalizations for supraventricular tachycardia, myocardial infarction, heart failure or stroke. A nested case control analysis was employed comparing people with and without cardiovascular events. Cases and controls were matched for gender and age, and conditional logistic regression was used in multivariate analysis considering other respiratory drugs, respiratory diagnosis and visit frequency, non-respiratory, non-cardiac comorbidities, and receipt of drugs for cardiovascular disease. In univariate analyses, BA, IB and ICS were all associated with hospitalizations for cardiovascular disease, but in multivariate analyses ICS did not increase risk while both BA and IB did. There were interactions between respiratory and cardiac drugs receipt in that bronchodilator associated risks were higher in people not taking cardiac drugs; this was especially true for stroke. There were strong interactions with specific cardiac drugs; for example, both BA and IB substantially increased the risk of supraventricular tachycardia in patients not anti-arryhthmic agents, but not in the presence of such agents. We conclude that bronchodilator therapy for chronic obstructive diseases is associated with increased cardiovascular risk, especially in patients without previous cardiovascular diagnoses, and that this is unlikely due to the severity of the respiratory disease, since risk was not increased with ICS.Keywords: bronchodilator therapy, inhaled corticosteroids, nested case

  15. Nitric oxide and cardiovascular system.

    Science.gov (United States)

    Cengel, Atiye; Sahinarslan, Asife

    2006-12-01

    Endothelium has many important functions including the control of blood-tissue permeability and vascular tonus, regulation of vascular surface properties for homeostasis and inflammation. Nitric oxide is the chief molecule in regulation of endothelial functions. Nitric oxide deficiency, which is also known as endothelial dysfunction, is the first step for the occurrence of many disease states in cardiovascular system including heart failure, hypertension, dyslipidemia, insulin resistance, diabetes mellitus, hyperhomocysteinemia and smoking. This review deals with the importance of nitric oxide for cardiovascular system. It also includes the latest improvements in the diagnosis and treatment of endothelial dysfunction.

  16. Nonfasting hyperlipidemia and cardiovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, B G; Langsted, A; Freiberg, J J

    2009-01-01

    lipoproteins into the arterial intima with subsequent retention leading to atherogenesis, while low HDL cholesterol levels may be an innocent bystander. Finally, nonfasting levels of total cholesterol, non-HDL cholesterol, LDL cholesterol, apolipoprotein B, triglycerides, HDL cholesterol, apolipoprotein A1......, total cholesterol/HDL cholesterol, and apolipoprotein B/apolipoprotein A1 all associate with increased risk of cardiovascular disease. These new data open the possibility that nonfasting rather than fasting lipid profiles can be used for cardiovascular risk prediction. If implemented, this would...

  17. Glucocorticoids and the cardiovascular system: state of the art.

    Science.gov (United States)

    Nussinovitch, Udi; de Carvalho, Jozélio Freire; Pereira, Rosa Maria R; Shoenfeld, Yehuda

    2010-01-01

    Glucocorticoids (GC) are drugs commonly used, by approximately 1% of the total adult population as anti-inflammatory and immunosuppressive therapies for asthma, inflammatory bowel disease, dermatological, ophthalmic, neurological, and rheumatic autoimmune diseases. Supporting evidence exists of GC use in both immune mediated and non-immune mediated heart disease. The molecular mechanisms by which GC induces immune-modulation and direct cardioprotection, are complex and not fully understood. We review herein, the current knowledge of GC use in various immune-mediated or non-immune mediated cardiovascular conditions. GC have been investigated in autoimmune, inflammatory and idiopathic heart diseases such as atrio-ventricular conduction abnormalities, rheumatic fever, myocarditis, dilated cardiomyopathy, Churg-Strauss syndrome, Kawasaki disease and sarcoidosis. GC therapy has been studied in non-autoimmune and non-inflammatory indications such as acute myocardial infarction, angina, postpericardiotomy syndrome and other pericardial diseases, endocarditis and cardiac amyloidosis, as well as in invasive cardiology, coronary interventions, and cardiopulmonary-bypass surgery. Despite GC's role as natural, physiologic regulators of the immune system, cardiovascular adverse outcomes may occur. Some of the well-known side effects of GC therapy involve bone, metabolic, and cardiovascular systems and include osteoporosis, fractures, dyslipidemia, diabetes, obesity, and hypertension.

  18. Clonidine as a First-Line Sedative Agent After Neonatal Cardiac Surgery: Retrospective Cohort Study

    NARCIS (Netherlands)

    Kleiber, N.; Wildt, S.N. de; Cortina, G.; Clifford, M.; Ducruet, T.; Tibboel, D.; Millar, J.

    2016-01-01

    OBJECTIVES: To determine the cardiovascular tolerance of clonidine used as a first-line sedative after cardiac surgery in small infants. DESIGN: Retrospective chart review. SETTING: A tertiary and quaternary referral cardiac PICU. PATIENTS: All infants younger than 2 months who received a clonidine

  19. Strengthening Science Departments

    Science.gov (United States)

    Campbell, Todd; Melville, Wayne; Bartley, Anthony

    2012-01-01

    Teachers do not work in a vacuum. They are, in most cases, part of a science department in which teachers and the chairperson have important roles in science education reform. Current reform is shaped by national standards documents that emphasize the pedagogical and conceptual importance of best practices framed by constructivism and focused on…

  20. 小组式健康教育对改善心血管内科患者血脂相关知识-态度-行为水平的影响%Effect of group health education on the patients' knowledge-attitude-practice levels of serum lipids in cardiovascular department

    Institute of Scientific and Technical Information of China (English)

    笃铭丽

    2010-01-01

    Objective To explore the effect of group health education on the patients' knowledgeattitude-practice(KAP) levels of serum lipids. Methods Choose 213 cases admitted in our hospital over the age of 40 with cardiovascular disease from September to November 2009, who were divided into two groups:control group (n = 91 ), for routine health education; experimental group( n = 122 ), received the group health education of knowledge-attitude-behavior interventions on serum lipids. A telephone follow-up questionnaire was used to investigate the KAP levels on serum lipids of the patients after 3 months discharged from hospital.Results There's statistically significant between the control group and the experimental group on the knowledge (K), attitude ( A), practice (P), and the total KAP of serum lipids ( P < 0. 05 ), the latter scores were higher than the former. Conclusions With the intervention of systematic knowledge 、attitude and behavior education,the patients' knowledge can be improved and healthy attitude can be corrected , so the health behavior also can be promoted wellness.%目的 探讨小组式健康教育对改善心血管内科患者血脂相关知识-态度-行为(KAP)水平的影响.方法 选择2009年9-11月在我院心血管内科住院的40岁以上心血管疾病患者213例,分为两组.对照组91例,采取常规健康宣教;研究组122例,通过小组式健康教育对患者实施系统的知识、态度、行为干预.患者出院后3个月电话随访,采取问卷调查的方式收集患者的血脂KAP水平资料.结果 对照组与研究组在血脂知识(K)、态度(A)、行为(P)及总KAP上差异均有统计学意义(P<0.05),研究组各项得分均高于对照组.结论 通过小组式健康教育对患者进行系统的知识-态度-行为干预,能够提高患者的血脂知识,端正其健康态度,从而更好地履行健康行为,促进健康.