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1.
IEEE Trans Haptics ; PP2024 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-39093674

RESUMEN

Wearable haptic devices provide touch feedback to users for applications including virtual reality, prosthetics, and navigation. When these devices are designed for experimental validation in research settings, they are often highly specialized and customized to the specific application being studied. As such, it can be difficult to replicate device hardware due to the associated high costs of customized components and the complexity of their design and construction. In this work, we present Snaptics, a simple and modular platform designed for rapid prototyping of fully wearable multi-sensory haptic devices using 3D-printed modules and inexpensive off-the-shelf components accessible to the average hobbyist. We demonstrate the versatility of the modular system and the salience of haptic cues produced by wearables constructed with Snaptics modules in two human subject experiments. First, we report on the identification accuracy of multi-sensory haptic cues delivered by a Snaptics device. Second, we compare the effectiveness of the Snaptics Vibrotactile Bracelet to the Syntacts Bracelet, a high-fidelity wearable vibration feedback bracelet, in assisting participants with a virtual reality sorting task. Results indicate that participant performance was comparable in perceiving cue sets and in completing tasks when interacting with low-cost Snaptics devices as compared to a similar research-grade haptic wearables.

2.
J Pers Soc Psychol ; 126(5): 895-912, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38869894

RESUMEN

Affective reactivity, defined as within-person increases in negative affect triggered by daily stressors, has well-established links to personal well-being. Prior work conceptualized affective reactivity as an intrapersonal phenomenon, reflecting reactions to one's own stressors. Here, we conceptualized reactivity interpersonally, examining one's responses to a romantic partner's daily stressors. Across four longitudinal dyadic studies, we investigated how reactivity to partner stress predicts relationship quality appraisals. In fledgling couples, reactivity to a partner's stressors, assessed via weekly (Study 1; N = 152) and daily (Study 2; N = 144) diaries, positively predicted partner relationship quality. In both studies, the associations were mediated by the partner's perceptions of responsiveness. Furthermore, reactivity to partner stress buffered against declines in partner relationship quality over 8 weeks in Study 1 and 13 months in Study 2. The relevance of reactivity to partner stress for relationship quality diminished in the later stages of relationships. Among samples of established couples (Studies 3 and 4, Ns = 164 and 208, respectively), reactivity to partner stress did not directly predict partner relationship quality or moderate its trajectory over time. Overall, the predominant pattern across four studies painted a portrait of relational well-being benefits specific to fledgling relationships. Through its novel framework of situating affective reactivity interpersonally between partners, the present research contributes to both affective science and relationship science. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Afecto , Relaciones Interpersonales , Parejas Sexuales , Estrés Psicológico , Humanos , Femenino , Masculino , Adulto , Estrés Psicológico/psicología , Parejas Sexuales/psicología , Afecto/fisiología , Adulto Joven , Estudios Longitudinales , Satisfacción Personal , Esposos/psicología , Persona de Mediana Edad
3.
Curr Opin Psychol ; 52: 101610, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37352794

RESUMEN

Theoretical and empirical research on responsiveness focused mostly on cultural ecologies of independence. Emerging studies suggest that the responsiveness process may unfold differently in cultural ecologies of interdependence. We organize these studies into a working conceptual model. The model argues that two mechanisms-expectations of culturally normative relationship behaviors and relative centrality of relationships-carry the influence of cultural ecology on responsiveness. Together, these mechanisms explain variation in (a) self-expressive behaviors thought to elicit responsiveness, (b) associations between partner behaviors and perceived responsiveness, and (c) associations between perceived responsiveness and well-being.


Asunto(s)
Relaciones Interpersonales , Modelos Psicológicos , Humanos
4.
J Pers Soc Psychol ; 124(5): 958-970, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-35901364

RESUMEN

Motivated by the Attachment Security Enhancement Model (Arriaga et al., 2018), the present research investigated the associations between positive relationship experiences and romantic attachment avoidance in three dyadic studies that combined multiple methods, including daily diaries, laboratory observations, and longitudinal follow-ups. Frequency of daily positive relationship events (but not external positive events) during a 21-day diary period predicted declines in romantic attachment avoidance (but not anxiety) from pre- to post-diary in fledgling couples (Study 1) and newlyweds (Study 2). Video-recorded discussions of fledgling couples' shared positive experiences revealed that behaviors validating the relationship (but not simply showing conversational interest) predicted lagged declines in romantic attachment avoidance (but not anxiety) over 1 month (Study 3). The associations were mediated by positive affect during the diary period in Studies 1 and 2, and by changes in positive affect from pre- to post-discussion in Study 3. Positive relationship experiences did not significantly interact with time in predicting romantic avoidance over a 1-year follow-up with quarterly assessments of attachment orientations in Study 1, over an 8-month follow-up with monthly assessments in Study 2, or over a 2-month follow-up with monthly assessments in Study 3. Altogether, these studies provide one of the most comprehensive tests of how positive relationship experiences in nondistressing contexts are linked to romantic attachment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Asunto(s)
Relaciones Interpersonales , Parejas Sexuales , Humanos , Ansiedad , Matrimonio , Trastornos de Ansiedad , Apego a Objetos
5.
Tex Heart Inst J ; 49(3)2022 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-35763034

RESUMEN

Guillain-Barré syndrome, a rare peripheral neuropathy, appears to occur more often in patients who have recently undergone surgery than in the general population. However, the pathophysiologic relationship between surgery and Guillain-Barré syndrome is elusive. Few cases of Guillain-Barré syndrome after cardiac surgery have been reported. Autonomic dysfunction, a serious complication of Guillain-Barré syndrome, has not been previously reported after cardiac surgery. We describe the case of a 71-year-old woman in whom the acute motor axonal neuropathic subtype of Guillain-Barré syndrome developed after mitral valve replacement. Despite plasmapheresis and intravenous immunoglobulin therapy, she died of complications from severe autonomic dysfunction 25 days postoperatively. Recognizing the potential cardiovascular involvement of Guillain-Barré syndrome is important, because patients who undergo cardiac surgery can be vulnerable to autonomic dysfunction in the early postoperative period.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Síndrome de Guillain-Barré , Enfermedades del Sistema Nervioso Periférico , Anciano , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Femenino , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/etiología , Síndrome de Guillain-Barré/terapia , Humanos , Inmunoglobulinas Intravenosas , Enfermedades del Sistema Nervioso Periférico/complicaciones
6.
Artículo en Inglés | MEDLINE | ID: mdl-35293569

RESUMEN

OBJECTIVES: This study presents the mid-term results of a novel tricuspid valve (TV) repair strategy defined as 'mitralization of TV' (resection and plication of the posterior leaflet, ring implantation, optional leaflet procedures) applied for the correction of tricuspid regurgitation (TR). METHODS: Between 2017 and 2020, a total of 22 patients underwent concomitant TV repair using mitralization of the TV. Fourteen of the patients had functional TR (2 of them had severe tethering), 5 patients had prolapse and 3 patients had rheumatic involvement. RESULTS: There was no in-hospital mortality. Moderate or severe TR was not observed in any patient in echocardiographic evaluations before discharge. The mean follow-up duration was 30.9 + 6.2 months. Moderate-to-severe TR-free survival was 100% in the second year and 94.7% in the third year. CONCLUSIONS: Mitralization of the TV is a safe and effective treatment modality in terms of its mid-term results. This new technique provides an innovative perspective for the treatment of TR, especially in complex TV pathologies.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Implantación de Prótesis de Válvulas Cardíacas , Insuficiencia de la Válvula Tricúspide , Ecocardiografía , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Implantación de Prótesis de Válvulas Cardíacas/métodos , Humanos , Estudios Retrospectivos , Resultado del Tratamiento , Válvula Tricúspide/diagnóstico por imagen , Válvula Tricúspide/cirugía , Insuficiencia de la Válvula Tricúspide/complicaciones , Insuficiencia de la Válvula Tricúspide/diagnóstico por imagen , Insuficiencia de la Válvula Tricúspide/cirugía
7.
Exp Clin Transplant ; 20(8): 762-767, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-30251943

RESUMEN

OBJECTIVES: Our study was conducted to determine the effects of intraoperative antithymocyte globulin administration on donor hearts procured after cardiocirculatory death. We evaluated the impact of antithymocyte globulin on graft function and related parameters during isothermic blood cardioplegia. MATERIALS AND METHODS: In this prospective and randomized single center study, 30 patients with orthotropic heart transplant were divided into 2 groups: group 1 included 15 patients who received retrograde antithymocyte globulin infusion via coronary sinus intraoperatively and immediately after organ procurement and group 2 included 15 patients who received traditional antithymocyte globulin infusion after implantation. RESULTS: Study patients had a mean age of 33.8 years (range, 15-56 y). All patients had panel reactive antibody less than 10% except for 3 patients. The cluster of differentiation 3-positive cell count decrease was more than 20%. The inotropic therapy dose required and the myocardial pressure (stiffness) were less for group 1 patients. These patients had less acute rejection episodes than group 2 (0% vs 13.3%; P < .05). CONCLUSIONS: Favorable clinical outcomes were observed in terms of less acute rejection episodes and better graft function at least during the early posttransplant period. Intraoperative antithymocyte globulin treatment may have a preventive effect for acute cellular rejection in heart transplant patients.


Asunto(s)
Trasplante de Corazón , Trasplante de Riñón , Adulto , Suero Antilinfocítico/efectos adversos , Rechazo de Injerto , Supervivencia de Injerto , Trasplante de Corazón/efectos adversos , Humanos , Terapia de Inmunosupresión , Inmunosupresores/efectos adversos , Estudios Prospectivos , Donantes de Tejidos , Resultado del Tratamiento
8.
Vasc Endovascular Surg ; 55(8): 811-816, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34121518

RESUMEN

INTRODUCTION: Intraluminal thrombolytic therapy is the first step treatment of thrombotic malfunction of tunneled hemodialysis catheters (THC). The factors that affect catheter restoration and also catheter survival following thrombolytic therapy are not well described. In this study, we aimed to reveal the predictors that affect the success of the procedure and also present post-restoration catheter patency after intraluminal thrombolytic administration. METHOD: This retrospective study included 62 patients with tunneled THC thrombosis treated with alteplase between 2017 and2020 in the study center. Age, comorbidities, the use of antiplatelet and anticoagulants, a history of catheter thrombosis, time on dialysis, the duration of the catheter were investigated as possible predictors of procedural success. The independent predictive factors for procedural success were evaluated by using backward stepwise likelihood ratio logistic regression analysis. Primaryand assisted patencieswere presented with Kaplan-Meier graphs. RESULTS: Thrombolityc was administered to 62 patients 102 times. The median primary patency from the first thrombolytic administration to a second catheter thrombosis was 9 months (range 1-20 months). The overall median patency was 12 months (range 2-23 months). The overall procedural success rate was 79.4% (81/102).Multivariate analyses revealed that a history of prior catheter thrombosis was the only risk factor for procedural success (OR: 0.49; 95% CI: 0.26-0.91; p = 0.004). The need for a second dwell time among patients with prior history of thrombolysis was significantly higher compared to patients without a history of catheter thrombosis (12/26 patients, 46.2% and 6/55 patients, 10.9%; respectively; p = 0.001). CONCLUSION: The success of thrombolysis in subsequent de novo THC thrombosis decreases in patients who previously required intraluminal thrombolytic administration. Identifying patient subgroups with a high risk for THC thrombosis may be useful to investigate effective secondary prevention strategies.


Asunto(s)
Catéteres de Permanencia , Terapia Trombolítica , Catéteres de Permanencia/efectos adversos , Humanos , Diálisis Renal/efectos adversos , Estudios Retrospectivos , Terapia Trombolítica/efectos adversos , Resultado del Tratamiento
9.
BMC Cardiovasc Disord ; 21(1): 167, 2021 04 09.
Artículo en Inglés | MEDLINE | ID: mdl-33836659

RESUMEN

BACKGROUND: New-onset postoperative atrial fibrillation (POAF) is common after cardiac surgery. Early identification of its risk factors during the preoperative period would help in reducing the associated morbidity, mortality, and healthcare costs. AIM OF THE STUDY: This study aimed to identify the predictors of POAF following open cardiac surgery, with emphasis on biochemical parameters. METHODS: A total of 1191 patients with no preoperative atrial fibrillation (AF) and undergoing open cardiac surgery for any reason were included in this retrospective study. Data on clinical and biochemical parameters, the occurrence of new-onset AF, and its clinical course were retrieved from the hospital database. RESULTS: During the early postoperative period 330 patients (27.7%) developed atrial fibrillation, at median third postoperative day (range 1-6 days) and 217 (65.8%) responded to treatment. Multivariate analysis identified the following as the significant independent predictors of any POAF: EF < 60% (Odds ratio (OR), 2.6), valvular intervention (OR, 2.4), liver failure (OR, 2.4), diabetes (OR, 1.6), low hematocrit (OR, 2.1), low thrombocyte (OR, 5.6), low LDL (OR, 1.6), high direct bilirubin (OR, 2.0), low GFR (OR, 1.6), and high CRP (OR, 2.0). Following parameters emerged as significant independent predictors of persistent AF: EF < 60% (OR, 1.9), diabetes (OR, 2.1), COPD (OR, 1.8), previous cardiac surgery (OR, 3.1), valvular intervention (OR, 2.4), low hematocrit (OR, 1.9), low LDL (OR, 2.1), high HbA1c (OR, 2.0), and high CRP (OR, 2.7). CONCLUSIONS: Certain parameters assessed during preoperative physical and laboratory examinations have the potential to be used as markers of POAF.


Asunto(s)
Fibrilación Atrial/etiología , Proteína C-Reactiva/análisis , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Hemoglobina Glucada/análisis , Lipoproteínas LDL/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Fibrilación Atrial/sangre , Fibrilación Atrial/diagnóstico , Biomarcadores/sangre , Bases de Datos Factuales , Femenino , Hematócrito , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Adulto Joven
10.
Braz J Cardiovasc Surg ; 36(1): 64-70, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33594862

RESUMEN

OBJECTIVE: We aimed to analyze the early and long-term results of open-heart surgery in Turkish patients aged 80 years or older who were operated on at our center. METHODS: All patients aged 80 years or older who underwent surgery between January 2000 and December 2013 at a high-level heart center were included in the study. The in-hospital data of study patients were obtained from the electronic database and from the hospital files. Survival data were analyzed as a long-term outcome. RESULTS: A total of 245 patients aged 80-93 years were evaluated in the study. The patients were followed up 5.4±3.7 years after open-heart surgery. In-hospital mortality rates were 10% in elective cases and 15.1% overall. Age ≥85 years, chronic kidney disease, chronic obstructive pulmonary disease, and emergency surgery were independent predictors of in-hospital mortality. The median survival time was found to be 4.4±0.3 years for all participants. The long-term survival of patients who underwent emergency cardiac surgery was significantly lower than that of elective patients (log-rank <0.001). CONCLUSION: Octogenarians have satisfactory long-term outcomes after open-heart surgery when operated electively. On the other hand, patients operated under emergency conditions have worse inhospital outcomes and long-term follow-up results.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Enfermedad Pulmonar Obstructiva Crónica , Factores de Edad , Anciano de 80 o más Años , Procedimientos Quirúrgicos Electivos , Mortalidad Hospitalaria , Hospitales , Humanos , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento
11.
Rev. bras. cir. cardiovasc ; 36(1): 64-70, Jan.-Feb. 2021. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1155785

RESUMEN

Abstract Objective: We aimed to analyze the early and long-term results of open-heart surgery in Turkish patients aged 80 years or older who were operated on at our center. Methods: All patients aged 80 years or older who underwent surgery between January 2000 and December 2013 at a high-level heart center were included in the study. The in-hospital data of study patients were obtained from the electronic database and from the hospital files. Survival data were analyzed as a long-term outcome. Results: A total of 245 patients aged 80-93 years were evaluated in the study. The patients were followed up 5.4±3.7 years after open-heart surgery. In-hospital mortality rates were 10% in elective cases and 15.1% overall. Age ≥85 years, chronic kidney disease, chronic obstructive pulmonary disease, and emergency surgery were independent predictors of in-hospital mortality. The median survival time was found to be 4.4±0.3 years for all participants. The long-term survival of patients who underwent emergency cardiac surgery was significantly lower than that of elective patients (log-rank <0.001). Conclusion: Octogenarians have satisfactory long-term outcomes after open-heart surgery when operated electively. On the other hand, patients operated under emergency conditions have worse in-hospital outcomes and long-term follow-up results.


Asunto(s)
Humanos , Anciano de 80 o más Años , Enfermedad Pulmonar Obstructiva Crónica , Procedimientos Quirúrgicos Cardíacos , Estudios Retrospectivos , Factores de Riesgo , Factores de Edad , Resultado del Tratamiento , Mortalidad Hospitalaria , Procedimientos Quirúrgicos Electivos
12.
Phlebology ; 36(1): 54-62, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32741257

RESUMEN

OBJECTIVES: To compare traditional surgery with two minimally invasive endo-venous procedures in terms of their long-term effect on the quality of life in great saphenous vein insufficiency (GSV). METHOD: This prospective observational study included 217 patients that underwent surgical stripping (n = 62), radiofrequency ablation (n = 70), or cyanoacrylate embolization (n = 85) for the treatment of GSV insufficiency. Venous Clinical Severity Score (VCSS) assessments were made, 36-item Short-Form Health Survey (SF-36) questionnaire and Chronic Venous Insufficiency quality of life Questionnaire (CIVIQ-14) were administered, before and 1 year after the treatments. RESULTS: Surgical stripping group had significantly higher closure rates than the other groups (p < 0.05). At 12 months, decrease in VCSS scores was less pronounced in the cyanoacrylate embolization group when compared to the other two groups (p < 0.05). Improvement in CIVIQ-14 scores was better in the radiofrequency ablation group when compared to the cyanoacrylate embolization group (p < 0.05). Surgical stripping or radiofrequency ablation groups performed better on several domains of SF-36, when compared to the cyanoacrylate embolization group. CONCLUSIONS: Surgical stripping and radiofrequency ablation seem to provide a better quality of life results at one year in patients undergoing treatment for GSV insufficiency.


Asunto(s)
Ablación por Radiofrecuencia , Várices , Insuficiencia Venosa , Cianoacrilatos , Humanos , Calidad de Vida , Vena Safena/cirugía , Factores de Tiempo , Resultado del Tratamiento , Insuficiencia Venosa/cirugía
13.
Heart Surg Forum ; 23(6): E883-E887, 2020 Nov 24.
Artículo en Inglés | MEDLINE | ID: mdl-33234191

RESUMEN

PURPOSE: To evaluate the clinical impact of pleurotomy during skeletonized internal thoracic artery (ITA) harvesting in patients undergoing on-pump coronary artery bypass grafting (CABG). METHODS: Consecutive patients (n = 758) who underwent CABG with skeletonized ITA were divided into 2 groups according to pleural integrity: open pleura (OP) and closed pleura (CP). Propensity score matching was performed after retrospective data extraction. The measured outcomes were postoperative pulmonary and hemorrhagic complications, 30-day mortality, and duration of hospital stay. RESULTS: Among 236 propensity score-matched pairs, there was no statistically significant difference between the 2 groups in terms of first 30-day mortality (OP, n = 7 [3%]; CP, n = 5 [2.5%]), blood product use (OP, 0.90 ± 0.71; CP, 0.74 ± 0.7), or median duration of hospital stay. The incidence of postoperative pleural effusion, thoracentesis, prolonged mechanical ventilation, respiratory failure, excessive drainage, cardiac tamponade, and reexploration and the number of patients requiring transfusion were similar in both groups. CONCLUSION: The clinical effect of pleural protection or pleurotomy on postoperative outcomes is limited in patients undergoing on-pump CABG with skeletonized ITA.


Asunto(s)
Enfermedad de la Arteria Coronaria/cirugía , Arterias Mamarias/trasplante , Pleura/cirugía , Complicaciones Posoperatorias/prevención & control , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Tasa de Supervivencia/tendencias , Resultado del Tratamiento , Turquía/epidemiología
14.
Braz J Cardiovasc Surg ; 35(5): 732-740, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-33118739

RESUMEN

OBJECTIVE: To evaluate the frequency, causes, and related predictive factors of intensive care unit (ICU) readmissions after coronary artery bypass grafting (CABG) surgery. METHODS: A total of 4112 consecutive patients who underwent on-pump CABG between January 2007 and January 2017 were retrospectively evaluated. The patients were divided into two groups as patients with and without ICU readmission. Demographic and perioperative characteristics were compared between the two groups. RESULTS: The ICU readmission rate was 3.5%. The most common reasons for ICU readmissions were respiratory (29%) and cardiac (23.4%) complications. The 90-day mortality risk was significantly higher in the readmitted patients than the non-readmitted patients (22.1% and 1.6%, respectively; P<0.001; OR=17.6; 95% CI=11.19-28.41). Severe left ventricular dysfunction, chronic obstructive pulmonary disease, end-stage renal disease, emergency CABG, EuroSCORE II > 5%, cross-clamp time > 35 minutes, postoperative respiratory complications, neurological complications, and cardiac complications showed a strong association with ICU readmissions. CONCLUSION: ICU readmission after CABG is associated with an increased mortality rate. Evaluation, not only of patients' comorbidities, but also of intraoperative conditions and postoperative complications, is important to identify patients at risk for ICU readmission.


Asunto(s)
Puente de Arteria Coronaria , Unidades de Cuidados Intensivos , Readmisión del Paciente , Femenino , Humanos , Masculino , Complicaciones Posoperatorias , Estudios Retrospectivos , Factores de Riesgo
15.
Rev. bras. cir. cardiovasc ; 35(5): 732-740, Sept.-Oct. 2020. tab, graf
Artículo en Inglés | LILACS, Sec. Est. Saúde SP | ID: biblio-1137335

RESUMEN

Abstract Objective: To evaluate the frequency, causes, and related predictive factors of intensive care unit (ICU) readmissions after coronary artery bypass grafting (CABG) surgery. Methods: A total of 4112 consecutive patients who underwent on-pump CABG between January 2007 and January 2017 were retrospectively evaluated. The patients were divided into two groups as patients with and without ICU readmission. Demographic and perioperative characteristics were compared between the two groups. Results: The ICU readmission rate was 3.5%. The most common reasons for ICU readmissions were respiratory (29%) and cardiac (23.4%) complications. The 90-day mortality risk was significantly higher in the readmitted patients than the non-readmitted patients (22.1% and 1.6%, respectively; P<0.001; OR=17.6; 95% CI=11.19-28.41). Severe left ventricular dysfunction, chronic obstructive pulmonary disease, end-stage renal disease, emergency CABG, EuroSCORE II > 5%, cross-clamp time > 35 minutes, postoperative respiratory complications, neurological complications, and cardiac complications showed a strong association with ICU readmissions. Conclusion: ICU readmission after CABG is associated with an increased mortality rate. Evaluation, not only of patients' comorbidities, but also of intraoperative conditions and postoperative complications, is important to identify patients at risk for ICU readmission.


Asunto(s)
Humanos , Masculino , Femenino , Readmisión del Paciente , Puente de Arteria Coronaria , Unidades de Cuidados Intensivos , Complicaciones Posoperatorias , Estudios Retrospectivos , Factores de Riesgo
16.
Braz J Cardiovasc Surg ; 35(4): 452-458, 2020 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-32864923

RESUMEN

OBJECTIVE: To evaluate the clinical impact of coronary dominance type in terms of early and long-term outcomes in patients undergoing elective coronary artery bypass grafting (CABG). METHODS: A total of 844 consecutive patients who underwent elective CABG were divided into two groups based on preoperative angiographic views as left dominant (LD) and right dominant or co-dominant (RD+CD). The measured outcomes were postoperative complications, 30-day mortality, long-term mortality, and major adverse cardiac and cerebrovascular events (MACCE). RESULTS: RD+CD was present in 87.9% (n=742) and LD in 12.1% (n=102) of patients. Postoperative complications, 30-day mortality, and 30-day readmissions were similar in both groups. The median duration of follow-up was 3.4 years. LD was not an independent predictor of mortality (adjusted hazard ratio [HR] 1.53, 95% confidence interval [CI] 0.89-2.45, P=0.12), but it was an independent predictor of MACCE in the long term (adjusted HR 2.18, 95% CI 1.39-3.42, P=0.001). CONCLUSION: In patients undergoing elective surgical revascularization, left coronary dominance is associated with increased MACCE risk in the long term. Therefore, the assessment of coronary dominance type should be an integral part of outpatient management after CABG.


Asunto(s)
Enfermedad de la Arteria Coronaria , Intervención Coronaria Percutánea , Puente de Arteria Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Pronóstico , Estudios Retrospectivos , Resultado del Tratamiento
17.
Rev. bras. cir. cardiovasc ; 35(4): 452-458, July-Aug. 2020. tab, graf
Artículo en Inglés | LILACS, Sec. Est. Saúde SP | ID: biblio-1137293

RESUMEN

Abstract Objective: To evaluate the clinical impact of coronary dominance type in terms of early and long-term outcomes in patients undergoing elective coronary artery bypass grafting (CABG). Methods: A total of 844 consecutive patients who underwent elective CABG were divided into two groups based on preoperative angiographic views as left dominant (LD) and right dominant or co-dominant (RD+CD). The measured outcomes were postoperative complications, 30-day mortality, long-term mortality, and major adverse cardiac and cerebrovascular events (MACCE). Results: RD+CD was present in 87.9% (n=742) and LD in 12.1% (n=102) of patients. Postoperative complications, 30-day mortality, and 30-day readmissions were similar in both groups. The median duration of follow-up was 3.4 years. LD was not an independent predictor of mortality (adjusted hazard ratio [HR] 1.53, 95% confidence interval [CI] 0.89-2.45, P=0.12), but it was an independent predictor of MACCE in the long term (adjusted HR 2.18, 95% CI 1.39-3.42, P=0.001). Conclusion: In patients undergoing elective surgical revascularization, left coronary dominance is associated with increased MACCE risk in the long term. Therefore, the assessment of coronary dominance type should be an integral part of outpatient management after CABG.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Enfermedad de la Arteria Coronaria/cirugía , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Intervención Coronaria Percutánea , Complicaciones Posoperatorias , Pronóstico , Puente de Arteria Coronaria , Estudios Retrospectivos , Resultado del Tratamiento
18.
Vasc Endovascular Surg ; 54(7): 650-655, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32666909

RESUMEN

Atherosclerotic true aneurysms of the superficial femoral artery (SFA) and profunda femoris artery (PFA) are rare and difficult to detect. The synchronous presence of SFA and PFA aneurysms is even rarer. Herein, we present a case with ipsilateral true SFA and PFA aneurysms diagnosed with rupture. A review of the international literature is made, and the diagnosis and treatment options of this rare condition are discussed. A 75-year-old male was admitted to our hospital with an aneurysm on the distal SFA and the ipsilateral PFA, as well as a hematoma around the PFA. It was difficult to determine the source of the rupture before surgery, even with proper imaging. Successful ligation of the PFA and an aneurysmectomy followed by a bypass grafting for the SFA were performed. An intraoperative examination revealed that the SFA aneurysm had ruptured. In elderly males with a history of ectasia or aneurysm on the aorta or peripheral arteries, a synchronous aneurysm on the SFA or the PFA should be suspected.


Asunto(s)
Aneurisma Roto/diagnóstico por imagen , Angiografía por Tomografía Computarizada , Arteria Femoral/diagnóstico por imagen , Anciano , Aneurisma Roto/cirugía , Arteria Femoral/cirugía , Oclusión de Injerto Vascular , Humanos , Ligadura , Masculino , Valor Predictivo de las Pruebas , Resultado del Tratamiento
19.
Braz J Cardiovasc Surg ; 35(2): 198-205, 2020 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-32369301

RESUMEN

OBJECTIVE: To compare the anatomical and physiological scoring systems and the outcomes of surgical management of penetrating cardiovascular trauma at a rural center. METHODS: Seventy-seven patients underwent emergency surgery at our center between January/2012 and October/2018 due to penetrating cardiovascular trauma. Injury Severity Score (ISS), Revised Trauma Score (RTS), New Injury Severity Score (NISS), and Trauma and Injury Severity Score (TRISS) were calculated. The validation of these risk scores to predict mortality was assessed by the area under the receiver operating characteristic curve analysis. RESULTS: All trauma scores were correlated with mortality. As ISS, NISS, and TRISS values increased and RTS values decreased, the mortality rate increased. The area under the curve (AUC) in the receiver operating characteristic curve analysis was 0.943 for TRISS, 0.915 for RTS, 0.890 for ISS, and 0.896 for NISS (P<0.001 for each). Logistic regression analysis revealed that scores were correlated with mortality (P<0.001 for each). By investigating cardiac injuries alone, only TRISS and RTS results correlated with mortality for cardiac injuries (Mann-Whitney U test, P=0.003 and P=0.01, respectively). The AUC was only statistically significant for TRISS and RTS (AUC=0.929, P<0.05 for both). For vascular injuries, all the scores were significantly correlated with in-hospital mortality (Mann-Whitney U test, P<0.001 for each). TRISS had the highest AUC (AUC=0.946, P<0.001). CONCLUSION: TRISS has the highest predictivity for in-hospital mortality in patients with penetrating cardiovascular trauma.


Asunto(s)
Heridas Penetrantes , Mortalidad Hospitalaria , Humanos , Valor Predictivo de las Pruebas , Curva ROC , Estudios Retrospectivos , Índices de Gravedad del Trauma
20.
Turk Gogus Kalp Damar Cerrahisi Derg ; 28(1): 55-62, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32175143

RESUMEN

BACKGROUND: In this study, we aimed to investigate frequency, patterns, etiologies, and costs of unplanned readmissions after left ventricular assist device implantation. METHODS: Between April 2012 and September 2016, 99 unplanned readmissions of a total of 50 consecutive bridge-to-transplant patients (45 males, 5 females; mean age 46.9±10.3 years; range, 19 to 67 years) who were successfully discharged after left ventricular assist device implantation were retrospectively analyzed. Patient demographic data, hemodynamic measurements before implantation, and readmissions after discharge were recorded. Hospitalizations due to major problems which were unable to be managed in routine outpatient clinic were accepted as unplanned readmissions. Survival analysis was performed. RESULTS: The readmission rate was 1.7 per year after discharge. Survival of patients who were readmitted within the first 90 days was found to be significantly lower than those without early readmission. The most common reasons of readmissions during follow-up were major infection (23.2%), neurological dysfunction (22.2%), cardiac causes (12.1%), bleeding (11.1%), and device malfunction (10.1%). Neurological dysfunctions (82,005 USD) and device malfunctions (73,300 USD) caused the highest economic burden. CONCLUSION: Among patients with a left ventricular assist device, hospital readmissions are common. Development of preventive strategies as well as effective treatment methods focused on longterm adverse events is critical to reduce the frequency and costs of hospital readmissions.

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