Frailty and Mortality Outcomes After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Background

Frailty has been identified as a risk factor for mortality. However, whether frailty increases mortality risk in patients undergoing percutaneous coronary intervention (PCI) has been controversial. Therefore, we conducted a systematic review and meta-analysis of the frailty measures and mortality outcomes in this setting.

The potential role of nutrition on lens pathology: a systematic review and meta-analysis

Oxidative stress is one of the main mechanisms of lens opacification, and certain nutritional antioxidants are suspected to have a protective effect. To examine the role of these nutritional antioxidants on cataract prevention, we searched major databases and reviewed current evidence regarding the protective effect of nutritive antioxidants. We included observational studies that investigate the association between one or more of the following micronutrients and cataract: vitamin A, vitamin C, vitamin E, lutein, zeaxanthin, α- and β-carotene. Two independent authors extracted data and assessed their quality. We pooled results for overall cataract incidence for all types of cataract and separately for nuclear, cortical, and posterior subcapsular cataract. We did not perform sensitivity analysis. Twenty-five studies were included in the qualitative and 24 in the quantitative part of the study, with a total of 295,821 participants over 30 years old. Results from pooled analysis showed a protective effect of antioxidants on cataract, but not all of them reached statistical significance. Statistically significant results were reached for vitamin C (odds ratio [OR] = 0.88, 95% confidence interval [CI] [0.81, 0.97]), beta-carotene (OR = 0.89, 95% CI [0.83, 0.95]), and lutein and zeaxanthin (OR = 0.92, 95% CI [0.85, 0.99]). We did not find statistically significant results for vitamin E (OR = 0.84, 95% CI [0.70, 1.01]), vitamin A (OR = 0.90, 95% CI [0.80, 1.00]), or alpha-carotene (OR = 0.92, 95% CI [0.85, 1.00]). The present study shows a relation between certain antioxidants and cataract, but further studies, especially interventional, are needed to confirm this hypothesis.     

Aortic root surgery with circulatory arrest: Predictors of prolonged postoperative hospital stay

Objective

Little is known about the outcomes of aortic root operations that involve inducing hypothermic circulatory arrest for relatively extensive proximal aortic surgery. We attempted to identify predictors of postoperative hospital length of stay (LOS) and factors that affect postoperative recovery.

Beneficial effect of MPFF administration on the healing process of venous ulcer

Introduction

Venous hypertension underlies all clinical manifestations of chronic venous insufficiency (CVI). It is transmitted to the microcirculation and results in capillary changes which lead to edema, skin damage and eventually venous ulceration. The venoactive drugs are believed to have a therapeutic effect in venous disorders. This study evaluated the effect on the healing process of venous leg ulcers of systemic treatment with a semi-synthetic micronized purified flaνοnoid fraction (MPFF).

Material and Method

The study population comprised 60 patients with CVI and venous ulcer of the lower extremities, who were randomised into three groups, each of 20 patients. The patients in group Α, considered as the control group, used only elastic compression stockings. Group Β patients used elastic compression stockings and took MPFF 500mg orally, twice daily, until the complete healing of the ulcer. Group C used elastic compression stockings, and took MPFF 500mg twice daily until the complete healing of the ulcer, plus antibiotics. The ulcer healing rate was measured based on the healing index Η = (D0-Dx/D0) × 100, where D is the day from starting treatment. Venous blood samples were collected from each patient, before, and 20 and 40 days after the beginning of treatment, from the ulceration site and from an upper extremity vein (systemic circulation), for measurement of the white blood cells (WBCs).

Results

Healing time was statistically significantly shorter in groups Β and C than in the control group Α (p = 0.01 and p = 0.001, respectively). The difference between groups Β and C was not significant. Comparison between the initial blood sample and that after 20 days of treatment showed that the WBC trapping rate in the capillaries around the ulcer was reduced by half with the administration of MPFF.

Conclusion

Administration of MPFF has a beneficial effect on capillary permeability and improves the microcirculation, with particular effect on the WBCs trapped in the capillaries around the venous leg ulcer. As a consequence MPFF administration improves the healing rate of the venous ulcers.

     

Correlation of filler content and elastic properties of resin-composites.

OBJECTIVES: The aim was to determine the Young's modulus (E), bulk modulus (B), shear modulus (G) and Poisson's ratio (nu) of a series of composite restorative materials and to correlate them with their filler volume-fractions. METHODS: Twelve model resin-composite formulations, with systematically varied volume-fraction (Tokuyama), a flowable resin-composite (Point 4 flowable, Kerr) and two hybrid resin-composites (Filtek Supreme XT, 3M-Espe & X-tra Fil, Voco) were investigated. Twelve cylindrical specimens (5 mm x 6 mm) were prepared from each material. Six were free to expand radially under axial compressive loading, and were used to calculate the Young's modulus (E). The other six were radially constricted in a rigid stainless steel ring during loading, from which the bulk modulus (B) was calculated. Compression loading was performed at 1mm/min. The Young's and bulk moduli were determined using equations of elasticity. Poisson's ratio from nu=0.5-(E/6B) and shear modulus from G=E/2(1+nu). RESULTS: Young's moduli ranged from 2.19 to 7.15GPa, bulk moduli from 12.79 to 22.43GPa and shear moduli from 0.74 to 2.47GPa. Poisson's ratio ranged from 0.45 for the stiffer to 0.47 for the more compliant composites. Statistically significant differences (ANOVA and Bonferroni at p=0.05) were found depending on filler volume-fraction. SIGNIFICANCE: Elastic moduli varied significantly and a positive correlation existed between elastic moduli and filler volume-fraction (r2: 0.905-0.992 and 0.940-1.000 for Young's and bulk moduli, respectively).