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61.
Reant P Chasseriaud W Pillois X Dijos M Arsac F Roudaut R Lafitte S 《Echocardiography (Mount Kisco, N.Y.)》2012,29(8):927-932
Objectives: We evaluated the ability of two-dimensional speckle tracking strain echocardiography to detect left ventricular (LV) systolic dysfunction as compared with LV ejection fraction (EF) in healthy subjects following acute alcohol intoxication. Methods and Results: In total, 25 healthy subjects were investigated using echocardiography 4-6 hours after the onset of alcohol intoxication at a regional festive gathering, and then compared to 23 healthy control subjects without alcohol consumption. Heart rate, blood pressure, blood alcohol level, LV volumes, EF, shortening fraction, E/A ratio, as well as global longitudinal strain (LS) were recorded. Mean blood alcohol level was 1.3 ± 0.3 g.L(-1) . Mean systolic blood pressure and heart rate were slightly increased in the alcohol group compared to controls (147.5 ± 21.8 mmHg vs 127.0 ± 9.9 mmHg, P = 0.003, and 79.7 ± 10.7 bpm vs 70.6 ± 7.6 bpm, P < 0.001, respectively). While there was no significant difference in terms of LVEF (62.9 ± 4.4% vs 64.8 ± 5.9%, P = 0.18) or shortening fraction (34.7 ± 5.9% vs 36.0 ± 4.3%, P = 0.54), global LS was significantly impaired (-17.8 ± 2.0% vs -21.2 ± 1.8%, P < 0.001). In addition, subjects who consumed alcohol had increased LV end-diastolic (108.3 ± 20.1 mL vs 95.5 ± 14.6 mL, P = 0.037) and end-systolic volumes (41.6 ± 11.4 mL vs 33.7 ± 6.9 mL, P = 0.024), along with depressed aortic time-velocity integral (19.9 ± 3.2 mL vs 21.9 ± 2.5 mL, P = 0.034). According to multivariate linear regression analyses, blood alcohol level was the only factor significantly associated with global LS (β=-3.6 ± 1.0, P = 0.005). Conclusion: Alcohol intoxication around festive days induces acute LV contraction abnormalities, which may be detected using global LS by speckle tracking at an earlier stage and more accurately than LVEF decreases. 相似文献
62.
Subodh Verma MD PhD FRCSC Bobby Yanagawa Sameer KalraMarc Ruel MD PhD FRCSC Mark D. Peterson Michael H. Yamashita Andrew Fagan Maria E. Currie Christopher W. White Stephane Leung Wai Sang Cristian Rosu Steve Singh Holly Mewhort Nandini Gupta Paul W.M. Fedak 《The Journal of thoracic and cardiovascular surgery》2013
63.
Ukena C Dobre D Mahfoud F Kindermann I Lamiral Z Tala S Rossignol P Turgonyi E Pitt B Böhm M Zannad F 《Journal of cardiac failure》2012,18(6):439-445
BackgroundHyperglycemia predicts death in cardiovascular disease, but intensive glucose-lowering strategies increase mortality rates in diabetes. The present analysis investigated the prognostic value of postadmission blood glucose (BG) concentration on clinical outcomes in high-risk patients with heart failure after acute myocardial infarction.Methods and ResultsA total of 6,496 patients from the Eplerenone Post–Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) were categorized into 4 groups by plasma glucose concentration: ≤4.5 mmol/L (hypoglycemia), 4.5–5.5 mmol/L (normoglycemia), 5.5–8.3 mmol/L (elevated glucose level), and >8.3 mmol/L (severe hyperglycemia). We evaluated the time to all-cause death (primary end point) and time to cardiovascular death or hospitalization (secondary end point). Hypo- and severe hyperglycemia were prevalent in 509 (8%) and 1,588 (24%) patients, respectively. There was a U-shaped relationship between BG level and incidence of all-cause death (11.8% in patients with normoglycemia vs 15.1% and 19.9% in those with hypo- and severe hyperglycemia; P < .001). The incidence of the secondary end point was increased only in hyperglycemic patients (36% vs 23% in normoglycemic patients; P < .001). In multivariate Cox regression analysis, hypoglycemia (hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.06–1.81; P = .002) and severe hyperglycemia (HR 1.52, CI 1.27–1.83; P < .0001) proved to be strong predictors of all-cause death. There was no significant interaction between eplerenone treatment and blood glucose levels regarding clinical outcomes.ConclusionsIn heart failure after acute myocardial infarction, both hypo- and hyperglycemia at the postacute phase identify patients with increased risk of death during long-term follow-up. 相似文献
64.
Stephane Besnard Hanan Khemiri Fabienne Masse Pierre Denise Marion Verdaguer Christian Gestreau 《Sleep & breathing》2012,16(1):135-147
Background
Serotonin (5-HT) has a role in respiratory function and dysfunction. Although 5-HT affects respiratory drive to both phrenic and cranial motoneurons, relatively little is known about the role of 5-HT receptor subtypes in the control of upper airway muscle (UAM) respiratory activity. 相似文献65.
Benjamin Sohmer MD Christopher Hudson MD Juliet Atherstone MD A. Stephane Lambert MD Michel Labrosse PhD Munir Boodhwani MD 《Journal canadien d'anesthésie》2013,60(1):24-31
Background
As aortic valve (AV) repairs become more sophisticated, surgeons need increasingly detailed information about the structure and function of this valve. Unlike two-dimensional transesophageal echocardiography (2D-TEE), using three-dimensional (3D)-TEE makes it possible to image the entire AV. We hypothesized that measuring coaptation surface area (CoapSA) would be feasible and reproducible, and CoapSA would decrease in patients with aortic insufficiency.Methods
We developed a new technique to calculate the AV-CoapSA using 3D-TEE. We measured the coaptation surfaces between the right coronary cusp/left coronary cusp, right coronary cusp/non-coronary cusp, and left coronary cusp/non-coronary cusp in ten normal AVs and ten AVs with moderate-severe aortic insufficiency (AI). Since computer models have previously shown that CoapSA is trapezoidal, we used the formula: trapezoid area = length × (medial coaptation height + lateral coaptation height)/2. The total CoapSA was calculated by adding all three areas. To adjust for valve size, we indexed the value to the diameter of the ventricular aortic junction (VAJ). Measurements were performed by two observers.Results
The intra-observer correlation was 0.84 for one observer (P < 0.0001) and 0.93 for the other (P < 0.0001). The inter-observer correlation was 0.87 (P < 0.0001). In normal valves, the CoapSA [mean total (standard deviation)] was significantly greater than in the insufficient valves [1.61 (0.31) cm2 vs 1.03 (0.22) cm2, respectively; P < 0.001]. After indexing for the VAJ diameter, the total CoapSA remained significantly greater in normal valves than in insufficient valves.Conclusion
In this proof of concept study, we present a new and innovative technique to measure AV-CoapSA using 3D-TEE. It is reproducible and shows decreased CoapSA in patients with AI. Coaptation surface area may provide insight into mechanisms of AI and may have predictive value following AV repair. 相似文献66.
Benoit Mesnard Maxime Leroy James Hunter Delphine Kervella Marc-Olivier Timsit Lionel Badet Pascal Glemain Emmanuel Morelon Fanny Buron Moglie Le Quintrec-Donnette Vincent Pernin Marc Ladriere Sophie Girerd Christophe Legendre Antoine Sicard Laeticia Albano Stephane De Vergie Clarisse Kerleau Thomas Prudhomme Jérôme Rigaud Diego Cantarovich Gilles Blancho Georges Karam Magali Giral Simon Ville Julien Branchereau For the Données Informatisées et VAlidées en Transplantation/Computerized VAlidated Data in Transplantation Consortium Affiliations† 《BJU international》2022,129(2):225-233
67.
Habibi Akram A. Bi Andrew S. Owusu-Sarpong Stephane Mahure Siddharth A. Ganta Abhishek Konda Sanjit R. 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2022,32(6):1207-1213
European Journal of Orthopaedic Surgery & Traumatology - Although surgical procedures have been occurring as early at 6500 BC, the modern sense of the operating room (OR) did not exist until... 相似文献
68.
Julien Rigal Thomas Thelen Fergus Byrne Arnaud Cogniet Louis Boissière Stephane Aunoble Jean-Charles Le Huec 《European spine journal》2016,25(4):1000-1005
Introduction
The modern literature is producing a rapidly growing number of articles which highlight the relationship between infection and lumbar disc degeneration. However, the means by which samples are collected is questionable. Posterior approach surgery is not free from skin contamination. The possibility of intraoperative contamination of disc biopsies cannot be excluded.Objective
The objective of this study was to determine if an association existed between lumbar disc degeneration and chronic infection of the intervertebral disc.Materials and methods
313 patients (186/127, F/M) with chronic low back pain secondary to degenerative disc disease which was resistant to medical treatment were included in a single-centre prospective study. All underwent a lumbar anterior video-assisted minimally invasive fusion or disc prosthesis in L4–L5 and/or L5–S1 via an anterior retroperitoneal approach. The patients MRI scans demonstrated in Pfirrmann's classification grade IV or V disc degeneration; 385 disc drives were taken. In terms of Modic changes, 303 Modic 1, 58 Modic II and 24 absence of Modic change, respectively. All underwent intraoperative biopsy, performed according to a strict aseptic protocol. The biopsies were then cultured for 4 weeks with specialised enrichment cultures and subjected to histopathological analysis.Results
The mean age was 47 ± 8.6 years sterile cultures were obtained in 379 samples (98.4 %) and 6 were positive (1.6 %). The cultured bacteria were: Propionibacterium acnes (n:2), Staphylococcus epidermidis (n:2), Citrobacter freundii (n:1), and Saccharopolyspora hirsuta (n:1). Histopathological analysis did not demonstrate any evidence of a neutrophilia. There were no delayed or secondary infections.Discussion and conclusion
Unlike the posterior approach where contamination is common, the anterior video-assisted approach allows a biopsy without skin contact. This approach to the spine is the most effective way to eliminate the risk of contamination. Our results confirm the absence of any relationship between infection and disc degeneration. We suggest that the 6 positive samples in our study may be related to contamination. The absence of infection at 1-year followup is an additional argument in favour of our results. In conclusion, our study shows no association between infection and disc degeneration. The pathophysiology of disc degeneration is complex, but the current literature opens new perspectives.69.
Multicenter prospective randomized study comparing the technique of using a bovine pericardium biological prosthesis reinforcement in parietal herniorrhaphy (Tutomesh TUTOGEN) with simple parietal herniorrhaphy,in a potentially contaminated setting
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Marius Nedelcu MD Pierre Verhaeghe MD Mehdi Skalli MD Gerard Champault MD Christophe Barrat MD Hugues Sebbag MD Fabian Reche MD Laurent Passebois MD Daniel Beyrne MD Jean Gugenheim MD Stephane Berdah MD Amine Bouayed MD Jean Michel Fabre MD David Nocca MD 《Wound repair and regeneration》2016,24(2):427-433
The use of parietal synthetic prosthetic reinforcement material in potentially contaminated settings is not recommended, as there is a risk that the prosthesis may become infected. Thus, simple parietal herniorrhaphy, is the conventional treatment, even though there is a significant risk that the hernia may recur. Using new biomaterials of animal origin presently appears to offer a new therapeutic solution, but their effectiveness has yet to be demonstrated. The purpose of this multicenter prospective randomized single‐blind study was to compare the surgical treatment of inguinal hernia or abdominal incisional hernia by simple parietal herniorrhaphy without prosthetic reinforcement (Group A), with Tutomesh TUTOGEN biological prosthesis reinforcement parietal herniorrhaphy (Group B), in a potentially contaminated setting. We examined early postoperative complications in the first month after the operation, performed an assessment after one year of survival without recurrence and analyzed the quality of life and pain of the patients (using SF‐12 health status questionnaire and Visual Analog Pain Scale) at 1, 6, and 12 months, together with an economic impact study. Hundred and thirty four patients were enrolled between January 2009 and October 2010 in 20 French hospitals. The groups were comparable with respect to their enrollment characteristics, their history, types of operative indications and procedures carried out. At one month post‐op, the rate of infectious complications (n(A) = 11(18.33%) vs. n(B) = 12(19.05%), p = 0.919) was not significantly different between the two groups. The assessment after one year of survival without recurrence revealed that survival was significantly greater in Group B (Group A recurrence: 10, Group B: 3; p = 0.0475). No difference in the patients' quality of life was demonstrated at 1, 6, or 12 months. However, at the 1 month follow‐up, the “perceived health” rating seemed better in the group with Tutomesh (p = 0.022). No significant difference between the two parietal repair groups was observed during the follow‐ups with respect to the criterion of pain (using a visual analog scale). There was a significant difference between the two parietal repair groups with regard to the number of days spent in intensive care unit, in favor of the Tutomesh technique (p = 0.010). The use of a Tutomesh bioprosthesis for hernia repair or postincisional hernia in a potentially contaminated workplace reduces the risk of short‐term recurrence without increasing overall comorbidity. 相似文献
70.